Three common mistakes in medical journalism

I love Gary Schwitzer, a former journalism professor at the University of Minnesota and a key advocate for better health and medical reporting at HealthNewsReview.org. Schwitzer has a quick list of the most common mistakes reporters make when writing about medical science, and I think it's something that everybody should take a look at.

Why does this bit of journalism inside-baseball matter to you? Simple. If you know how journalists are most likely to screw up, you'll be less likely to be led astray by those mistakes. And that matters a lot, especially when it comes to health science, where people are likely to make important decisions based partly on what they read in the media.

The three mistakes:

Absolute versus relative risk/benefit data

Many stories use relative risk reduction or benefit estimates without providing the absolute data. So, in other words, a drug is said to reduce the risk of hip fracture by 50% (relative risk reduction), without ever explaining that it’s a reduction from 2 fractures in 100 untreated women down to 1 fracture in 100 treated women. Yes, that’s 50%, but in order to understand the true scope of the potential benefit, people need to know that it’s only a 1% absolute risk reduction (and that all the other 99 who didn’t benefit still had to pay and still ran the risk of side effects).

Association does not equal causation

A second key observation is that journalists often fail to explain the inherent limitations in observational studies – especially that they can not establish cause and effect.

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How do we know that the moon isn't cheese?

Sean Carrol explains why there are some ideas science doesn't have to test in order to know that they're ridiculous. (Via Bora Zivkovic.) Read the rest

No, you're not in love with your iPhone

The New York Times has an op-ed out today, which claims that fMRI studies show that, when people are exposed to a pretty, shiny, ringing iPhone, the experience lights up the part of their brains that signifies a deep, compassionate love for something. iPhones trigger the same brain activity that your parents and loved ones trigger, writes branding strategist Martin Lindstrom.

Clearly, this was going to turn out to wildly misleading. You love your iPhone like you love your mother is just not the kind of statement that passes a cursory bullshit inspection. And lots of people have handily debunked it, including a couple of actual nueroimaging specialists, Russ Poldrack and Tal Yarkoni.

So, how wrong was the NYT op-ed? Pretty damn wrong. Turns out, the part of the brain Martin Lindstrom identifies with lovey-dovey emotions is a lot more complicated than that. Here's Russ Poldrack:

Insular cortex may well be associated with feelings of love and compassion, but this hardly proves that we are in love with our iPhones. In Tal Yarkoni's recent paper in Nature Methods, we found that the anterior insula was one of the most highly activated part of the brain, showing activation in nearly 1/3 of all imaging studies! Further, the well-known studies of love by Helen Fisher and colleagues don't even show activation in the insula related to love, but instead in classic reward system areas.

And Tal Yarkoni adds a lot more to this:

... the insula (or at least the anterior part of the insula) plays a very broad role in goal-directed cognition.

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The science of near-death experiences

Some recent research is confirming what a lot of us have probably long suspected—there's a pretty reasonable scientific explanation for near-death experiences.

Recently, a host of studies has revealed potential underpinnings for all the elements of such experiences.

For instance, the feeling of being dead is not limited to near-death experiences—patients with Cotard or "walking corpse" syndrome hold the delusional belief that they are deceased. This disorder has occurred following trauma, such as during advanced stages of typhoid and multiple sclerosis, and has been linked with brain regions such as the parietal cortex and the prefrontal cortex—"the parietal cortex is typically involved in attentional processes, and the prefrontal cortex is involved in delusions observed in psychiatric conditions such as schizophrenia," Mobbs explains. Although the mechanism behind the syndrome remains unknown, one possible explanation is that patients are trying to make sense of the strange experiences they are having.

This story, by Charles Q. Choi, breaks down several common elements of near-death experiences the same way. But the fact that I found most interesting relates to who has "near-death" experiences. Turns out, it's not limited to people who are actually near death. Choi reports that a study of 58 patients who had had near-death experiences found that 30 of them weren't actually in danger of dying. They just thought they were. Read the rest