Dire Consequences from Health Reporting: Portlandia-Style

I love when humor draws attention to much deeper issues, especially those I'm personally invested in like societal understanding of science. While catching up on past episodes of Portlandia, my stupor from automatic sequential episodes of Netflix'ing  was broken by this brilliant little diddy (by the way, who in the hell at Netflix decided this was a "good" feature. CURSE THEM. I hope Portlandia makes fun of binge watching soon. Oh wait. I think they already did):

Portlandia, Season 4, Episode 1 - Death By Confusion sketch

Working in Portland, Oregon as a biology instructor gives me ample anecdotal evidence that Portland is a health-crazed hotbed of all things "woo" and lifestyle choices based on partial scientific evidence. Then again, maybe this isn't just a "Portland" thing. Many of us in the global food allergy community are continually frustrated hearing the media reports of scientific findings that seemingly contradict each other. Seriously - Is Vitamin D "good" or "bad?" Should children consume or avoid nuts to prevent food allergies?

The deeper issue here is that the scientific process and how scientific findings typically get reported in the media are generally at odds with one another. What the Portlandia sketch highlights is that most people interact with scientific findings through a prettily packaged, media filter based on some personal emotion attached to the topic. "I read it in the New York Times..." or "I heard it on NPR..."  Science is fact-based, but the media is typically emotion-laced facts. Emotion-laced facts are not in and of itself "wrong," but it sets up an inherent bias in that we tend to consume the information that supports our preconceived notions (as if I need an excuse to eat more chocolate, right? More on chocolate science at the end of the post). Well-designed scientific studies aim to take bias out of the equation as much as possible.Where we get into trouble is when media reports on the same topic of research disagree. How many times have media reports presented conflicting science on whether red wine/chocolate/coffee/beer/eggs/etc is "good" or "bad" for you?

And this gets to another point where science and media reports of science differ. Science is a slow and steady process with a whole lot of nuance, whereas media reports of science, rapidly distill partial understanding of natural phenomena as if it were ultimate, irrefutable proof. Any one scientific study is not enough evidence to change behavior/medical advice/etc. Only when a topic has been researched through many different studies through several different approaches do scientists feel comfortable saying, "yes, this is how we believe x, y, or z is happening, and people should do a, b, or c as a result." This is scientific consensus. In the media, however, scientific findings often focus on one novel study at a time instead of the slow steady zigzagging path toward consensus. Nuance and consensus often get lost in translation, and they don't make "exciting" headlines. Consensus may have been a novel report ten years ago along with the three other competing ideas of the day that were subsequently shown to be false. I'm tired of the media making scientists look bad and unreliable.

The great irony of "death by confusion" is that overstating any individual scientific finding in the media as if it were ultimate truth backfires when the next overblown claim gets reported six months down the road. While the skit itself overblows the end result (I hope?) of this back and forth reporting, I do think that the real world effect on people is more stress and anxiety rather than less. I want real hope, not false hope.

Some basic strategies to be a good consumer of science in the media:
1. If you read articles from mainstream media channels, look for the primary source (most likely a scientific journal article). If the article fails to link to the primary source, be very skeptical.
Example media report: People Magazine
Primary source: New England Journal of Medicine

2. Read AT LEAST the abstract (research summary) if not the whole primary source if it is freely available. Do the results/conclusions seem in line with the media report?

3. Do any credible educational, research, and professional organizations with a medical board comment on the topic? In the food allergy world, this means FARE, AAFA and KFA, FAACT, AAAAI, and ACAAI. The magazine, Allergic Living, also provides great coverage of scientific findings!

Post script:
A must read published two days ago at io9 showing science reporting without due diligence:
I Fooled Millions Into Thinking Chocolate Helps Weight Loss. Here's How. By John Bohannon

Good coverage by NPR that also highlights the controversy of the "fake" chocolate study.

Love it or hate it, I have a feeling this will be a case-study for science journalism in the years to come.

Headline hyperbole - probiotics cure peanut allergy?

Note about study discussed below – please do not try oral immunotherapy (OIT) or OIT with probiotic supplements on your own! This is an experimental food allergy treatment to be performed under strict medical supervision.

In the latest edition of medical headline hyperbole, many of us learned last week that “Fatal peanut allergies could be cured by probiotic bacteria, say Australian doctors” and “This Breakthrough Treatment Helped Over 80 Percent of Allergic Kids Tolerate Peanuts.”

Sigh… We all want a cure, and many scientists/clinicians are working tirelessly toward that goal (including the research group that performed the original peer-reviewed study(1)), but please, oh please media, stop overselling the scientific findings! I’m quite literally tired of having to explain the same thing over and over again! Unfortunately, there is a reason why one of my blog labels is now “Misleading Science Headlines.” I don’t necessarily want to go into the details of why this is so detrimental to both the science and food allergy communities, but rather I’d like to take the rest of this two part post to explain why the headlines got it wrong, what can actually be concluded from the study, and where the science may go from here. Lianne Mandelbaum, who founded No Nut Traveler, authored an excellent piece at the Huff Post Blog explaining why misleading headlines are such a problem when it comes to food allergies. I encourage you to take a read.

Brief summary of the study:

Mimi Tang, et al., from the Royal Children’s Hospital in Melbourne, Australia tested if the combination of oral immunotherapy (OIT) and a probiotic supplement could lead to “sustained unresponsiveness” in peanut allergic children compared to a placebo group  (peanut allergic children who did not receive peanut OIT or probiotic). They found that after stopping treatment (ranging from 2-5 weeks) over 80% of children who received OIT + probiotic maintained a “sustained unresponsiveness” to peanut compared to only 3.6% of the placebo group (1).

Study design: Randomized, double-blind, placebo-controlled

1 reason I despise science headlines

For a week now, I've been pondering an article I came across in ScienceDaily - Dying from Food Allergy Less Likely Than Being Murdered.  As all good headlines should do, they grab the reader's attention and make you want to read more... MORE!  As a parent of a severely food allergic child, this headline certainly grabbed my attention and elicited a most visceral response - how dare they minimize our daily struggle and fear to prevent a life-threatening reaction (anaphylaxis) by comparing it to something completely unrelated (like murder?!)!  After an eye roll so large that I thought my eyeballs would permanently cramp at the top of their sockets, I opted to let the emotion settle a bit and break this down further.  Clearly, I'm biased, but I needed time to analyze this while recognizing my own biases to see if there is indeed merit to the article and the original peer-reviewed article it is based upon.