A field ripe for a "Breakthrough?"

Evan Cornog

Covering scientific issues for the general public is one of the biggest challenges journalism faces today. The first difficulty is for the reporter to understand the science behind a story -- say, how a new drug affects a certain ailment, or what side effects it may produce. It is important to grasp the methodology of clinical trials, including some essential concepts of statistics. Even when a reporter is completely in command of the material, the limited "news hole" in a newspaper or on a television broadcast often means that the complex science must be boiled down to, say, 900 words or 90 seconds of air time. The reporter must also consider the desires of editors or producers, some of whom will want to present the story more sensationally so as to attract readers or viewers.

Along the way, a promising treatment for a disease can become a "cure," and a statistically insignificant side effect may be portrayed as a major health risk. Through a complex process riddled with institutional imperatives and cross-purposes, medical journalism can on occasion fall short of its objective -- sometimes propagating misinformation, even public panic. For an institution concerned with teaching and upholding the professional standards of journalism, this field offers ample opportunities for analysis and improvement.

Success has many fathers, the saying goes, but failure is an orphan. The conference "Breakthrough? The Science and Politics of Medical Journalism"1 -- held at the Columbia Graduate School of Journalism last March and jointly sponsored by 21stC, The Lancet, and the Horace W. Goldsmith Foundation -- had many fathers (and mothers). Within a few weeks in the summer of 1998, journalism dean Tom Goldstein received letters from 21stC's co-publisher William Polf, medical journalist Lynn Payer, and Dr. David Frankel, North American editor of The Lancet, each proposing a conference designed to help reporters read articles in medical journals with the same well-informed skepticism that a city hall reporter brings to a mayoral press release. Discussions by the various participants led to a full-day meeting that delved into the technical knowledge reporters need to assess such articles and provided broader perspectives on the associated business pressures and journalistic challenges.

"Breakthrough?" attempted to make medical journalists writing for mainstream news outlets more aware of some of the pitfalls endemic to the field and to provide background information that would help them cover medical journal reports with greater confidence and accuracy. The day began with a pair of cautionary tales about what happens when medical stories are misreported in the general press: David Frankel told how inaccurate reports about a new oral contraceptive in Britain resulted in a sharp rise in abortions and unwanted births, and Dr. Martin Schechter, director of the Canadian HIV Trials Networks, spoke about misleading coverage of a needle-exchange program in Canada, which was then cited by conservatives in the U.S. Congress as an argument against such programs.

The most challenging presentation was a crash course in biostatistics by Dr. Alan D. Weinberg, assistant clinical professor at Columbia's Mailman School of Public Health, who defined and explored confidence intervals, standard distributions, populations and samples, P values, relative and absolute risk, and other central concepts of statistics. In spite of the difficulty of the topic, the audience -- about 220 medical journalists, journalism students, and others -- followed attentively, aware that these concepts are essential to medical reporting. Dr. Bruce Dan of Medcast Networks critiqued the design and reporting of clinical studies, with cautionary tales about gaping mistakes that made it into print in prestigious journals. Boston University's Ellen Ruppel Shell, whose New York Times Magazine article on the rivalry between the New England Journal of Medicine and the Journal of the American Medical Association helped inspire the original idea for the conference, sparked some lively debate with her interpretation of certain controversial editorial decisions.

The day concluded with a Socratic dialogue conducted by the Fred Friendly Seminars on Media and Society, headquartered at the Journalism School. A panel of experts (see sidebar) put the issues in motion by examining a hypothetical discovery of a treatment for breast cancer -- associated with health risks of its own -- and the interwoven responses by researchers, journal editors, mass-circulation reporters, physicians, patient advocates, and the business world. The discussion brought to light the risks of sensationalism, the desire to be first with a story, the role of public relations experts, and the way news coverage affects the dialogue between doctors and patients.

Although the day's program was long and complex, it was favorably received by the audience, and discussions are under way toward another similar event in the spring of 2000. The authors in this special section of 21stC have taken up where the "Breakthrough?" participants left off. Columbia Journalism School's Kenneth Goldstein looks at the history of medical journalism as a distinct profession, with commentary on how it can best fulfill its complicated mission. Janice Hopkins Tanne provides a working science journalist's perspective on the conference; another experienced medical writer, Andrew Skolnick, analyzes controversies in the selection of research reports. A leading science reporter from the broadcast media, Robert Bazell, provides a few tips for working researchers on ways to make the most of their often troubled relationship with the media.

In an increasingly technological society, the importance of good medical and science coverage in mainstream journalism can hardly be overstated. The "Breakthrough?" conference provided a useful model for how to address the problems involved, and we at the Journalism School hope to organize additional conferences along the same lines to help make both journalists and their sources more aware of the difficulties involved in getting the story right.

1. The entire proceedings of the conference can he heard in RealAudio format at the Columbia Graduate School of Journalism's "Breakthrough?" page.

Related links...

  • EurekAlert! research media service, American Association for the Advancement of Science

  • SciTech Daily Review

  • What's Hot in Research, Institute for Scientific Information

  • UniSci, daily university science news service

  • Science Daily

  • NewsWise online database for reporters

  • Public Understanding of Science, a peer-reviewed journal

  • Michael Crichton, "Ritual Abuse, Hot Air, and Missed Opportunities," Science 283 (March 5, 1999): 1461 - 1463. (On the public image of scientists. Requires subscription.)

  • Dawn MacKeen, "Journal Wars," Salon, April 20, 1999

  • Steven E. Landsburg, "Too True to Be Good: The Real Reason You Can't Believe Everything You Read," Slate, September 15, 1999

  • Julie Bruneau and Martin T. Schechter, "The Politics of Needles and AIDS," op-ed in New York Times, April 9, 1998, reprinted by Lindesmith Center

  • CJR guide to covering managed care for reporters and editors, March/April 1999

  • National Center for Health Statistics, Centers for Disease Control and Prevention

  • Bad Science (on assorted scientific fallacies circulating in the media), Alistair B. Fraser, Dept. of Meteorology, Penn State

  • Lynn Payer's Medicine and Culture Update

  • 21stC's Metanews research media analysis department

  • EVAN CORNOG, Ph.D., associate dean for policy and development at Columbia's Graduate School of Journalism, served as ad hoc chairman of the group organizing the "Breakthrough?" conference.

    Photo Credits Simmering: Photo Jonathan Smith / Computer Illo Howard R. Roberts