Guest writer: Dr. William-Diehl Jones
Edited by: Dr. Shreyas Kumbhare and Sharvari Narendra
A few years ago, my then teenaged son briefly took up vaping. At the time, he confidently asserted that he had done ‘extensive research’ on the safety of this activity, and that it was ‘totally safe.’ So, I responded with two questions. First, ‘You DO realize what I do for a living, right?’ The second question was, ‘Was your source Dr. Google?’ The former was rhetorical, and the latter an educated guess. I have a PhD in cell biology, and I have been a biomedical researcher for the last 30+ years; it will therefore come as no surprise that I have developed some strong opinions about what constitutes reliable research. I refrained from asking my son other questions, such as what was his search strategy, which other databases did he check, were there any meta-analyses and what were the impact factors of any peer-reviewed journal articles he might have discovered from his literature review?
It has been my experience that teenagers have a keen ability to detect sarcasm, despite their penchant for depending heavily on Google, TikTok, Instagram, Tencent, Facebook, YouTube, Twitter and Wikipedia for health-related information. Of course, research has now shown the health risks inherent in vaping, and my son has since repeatedly suggested that I would love to say, ‘I told you so’. I have resisted.
Original image source: Doctor with Patient Cartoon.svg from Wikimedia Commons by Videoplasty.com, CC-BY-SA 4.0
Herein lies one part of what I consider to be a fundamental problem facing society in general: what constitutes reliable scientific and/or medical information? With so much ‘information’ readily available on the internet, how does the lay public even begin to discern fact (as in independently verifiable data) from fallacy? To be sure, we scientists do not have a corner on truth, and we sometimes get it wrong. Another reality is that our information changes, and an integral part of the scientific process is to be able to modify our hypotheses, if necessary, based on the best, most current data. As scientists we also have evaluative tools at our disposal and a reasonable expectation that we can depend on certain resources for their veracity and reliability.
Another part of this conundrum is that scientists and health care authorities sometimes disagree. Most recently I have been struck by the public disagreements between health officials during the current Covid-19 pandemic. Sadly, much of this is fueled by politics and spin, despite the supposed objectivity of clinical science. Other times, we see discrepancies in the level of rigor practiced by researchers who are, after all, subject to the same human foibles as everyone else. So often we have all heard someone say, ‘There is a study that says …’ As an educator, I’ve had graduate students start out with this statement, and then regret it when I begin to challenge them. What journal was it in? What type of study was it? How well was it powered? Are there any meta-analyses? And just imagine the moral/intellectual distress when they first discover discrepancies between research findings from different laboratories! At least these are opportunities for critical reflection and training when this occurs. At the undergraduate level, the issues become even more fundamental. In a medical microbiology course I teach, almost every year when we come to the topic of vaccines, one or two students in my course will point to a YouTube video from some Harvard-trained immunologist who debunks the safety and efficacy of vaccines. Here is where I have to suppress my own eye rolling, and I usually begin with another question: does anyone know somebody with polio? At least there is a forum for discussing the merits of different sources of information. As scientists we also have evaluative tools at our disposal and a reasonable expectation that we can depend on certain resources for their veracity and reliability.
A third component of this issue is that we are all slowly drowning in what some have called an ‘infodemic’. The current global pandemic (there will no doubt be others) highlights both the glut of information and the difficulty in discerning good from bad research. Writer John Zarocostas, in his excellent article entitled ‘How to Fight an Infodemic’ (The Lancet, WORLD REPORT, VOLUME 395, ISSUE 10225, P676, February 29, 2020), nicely sums up the problem. In this piece, he quotes Sylvie Briand, director of Infectious Hazards Management at WHO's Health Emergencies Programme:
“We know that every outbreak will be accompanied by a kind of tsunami of information, but also within this information you always have misinformation, rumours, etc. We know that even in the Middle Ages there was this phenomenon. But the difference now with social media is that this phenomenon is amplified, it goes faster and further, like the viruses that travel with people and go faster and further. So it is a new challenge, and the challenge is the [timing] because you need to be faster if you want to fill the void…What is at stake during an outbreak is making sure people will do the right thing to control the disease or to mitigate its impact. So, it is not only information to make sure people are informed; it is also making sure people are informed to act appropriately.”
Conventional mass media also complicates the quest for dependable information, especially by choosing pictures or examples that are extreme. So, given the scope of the problem, how do we as scientists and health care professionals help patients/family/friends separate the ‘wheat from chaff’, and slow the torrent of information – not just about Covid-19, but about research in general – to a flow that becomes more manageable? There is no single answer, of course. But I suggest that the solutions come at multiple levels. At meta-level, groups such as the World Health Organization (WHO) are putting efforts into working with social media platforms to generate links to professional public heath institutes when search terms such as COVID-19 are entered. Taking this several steps further, the same approach could be beneficial with other common search terms.
Finally, every scientist and health care provider (HCP) can make two commitments. The first is to ensure our own research literacy and competence. This is of course incumbent upon any professional. The other commitment is to become better communicators. This can include taking the time to translate our respective expertise to written blog posts, social or mass media venues. Some of the challenges inherent in translating anything technical for a broader audience are to make it interesting and meaningful. To be effective in this role, it helps to ask yourself, ‘who is the audience?’ and, ‘What essential pieces of information do they want to know?’ This challenges our own biases about what we feel is important, versus what the reader will feel is important – the two are not always congruent. Additionally, while trying to find a ‘hook’, or analogy that may help render information more translatable, therein lurks the danger of over-simplifying the message to the point of inaccuracy.
People will always look for their own information resources on whatever platforms they feel comfortable. I started this blog with the title ‘On the Dangers of Dr. Google’. As the world’s most popular search platform, it is a natural inclination to check this ubiquitous search engine first, and is not necessarily an ‘evil’. I tell my students that it is perhaps best appreciated as a starting point for doing a deeper dive. At the same time, I encourage them to ask whether the information can be verified by other sources, and are those reputable. Some basic questions anyone can ask include:
Who wrote the information? What are his/her qualifications?
Was the information reviewed by a professional?
Is it opinion or is it based on statistics? What was the source of those statistics?
If a website, is it a government organization (.gov), educational institution (.edu), or a nonprofit (.org). These tend to be more reliable
Can the information be verified elsewhere?
How current is the information? Science marches on, and newer and better information can emerge
In a 'good and perfect' world, we can hope to achieve is to empower the public to become better, more critical consumers.
Dr. William-Diehl Jones is a Professor in the Faculty of Health Disciplines, Athabasca University and an Adjunct Professor in Biological Sciences, University of Manitoba. He has more than 30 years of experience in biomedical research with a focus on understanding the oxidative stress in newborn infants and has been also actively involved in teaching in Pathophysiology, Pharmacology, Microbiology and Advanced Health Assessment.