1 November 2002
THE LANCET Neurology Vol 1
It is well known in media circles that including the word “sex” in a headline is a sure-fire way of attracting the attention of potential readers (see above). It is understandable, therefore, why a paper published in the Journal of Neurology, Neurosurgery, and Psychiatry (JNNP) entitled “Is multiple sclerosis a sexually transmitted infection?” was well covered in the UK media on Sept 19. The fact that a press release on the article was circulated to over 800 journalists worldwide certainly helped too. When a healthy dose of controversy was added—patient groups were outraged and at least two multiple sclerosis experts went on record as saying that the paper was “pure speculation”—the story was made.
The day after the news broke, around 400 delegates attended the Mayo Clinic National Conference on Medicine and the Media. At the end of the 3 day meeting a series of “preliminary key observations” were produced, one of which was: “Journalists’ primary concern is accurate, clear reporting, with secondary concern for a story’s consequences.” The news stories that were published on Sept 19 certainly, and understandably, upset many patients with multiple sclerosis. Are journalists right to abrogate responsibility for their actions? Nigel Hawkes, the health editor of The Times, wrote a story for the front page of his newspaper on the JNNP article. His story was accurate, balanced, and the headline was not sensationalist (though it did include a variant of the “s” word). Of course, there were other medical stories that he could have chosen, but this one had all the elements that he was looking for. “The skill with which that selection [ie, which story to cover] is made determines how successful the newspaper is”, Hawkes wrote in an article for The Times on July 12. “Until the circulation of Clinical Evidence or Bandolier matches that of The Times, I don’t believe we are getting it wrong.”
Is the journal to blame for press releasing what was bound to be a controversial paper? Although some journalists may claim otherwise, there is good evidence to suggest that press releases influence which stories are covered in the media. Of course, a good press officer, whether from a journal or from a research institution, has an eye for a story and will press release articles, within the guidelines produced by his or her institution, that are likely to appeal to journalists. News deadlines are often tight and with an increasing number of research articles to choose from journalists are bound to be guided in their choice of story by press releases. But press releases can also provide context. The JNNP release, for example, mentioned an accompanying editorial which stated that the data cited in support of the hypothesis are open to different interpretations.
The final question is whether the journal should have published the paper at all. The author of the article was heavily criticised by other neurologists in the UK press. Despite the public criticism, however, it is important to remember that his paper was refereed by three peer reviewers who presumably were broadly supportive of it. The paper contained no primary research, but rather reanalysed published data and put forward a hypothesis. The majority of good science is hypothesis driven and the publication of ideas should be actively encouraged, even if the hypothesis is controversial. In the past, medical journals have given clinicians a forum to air their views out of the media glare. Interestingly, the author of the JNNP article, in a letter to the UK MS Society explaining why he wrote his paper, said: “It must be emphasised that this was a scientific paper written for a medical journal and not for the general public. The language used assumed that the person reading it was a neuroscientist familiar with principles of epidemiology and statistics and it was never my expectation or wish that the article would be transmitted to the media.”
This view is perhaps naive, for in our mediaobsessed world it is virtually
impossible to keep scientific debate out of the public domain. Indeed,
the paternalistic attitude that pervaded medicine in the past has been
rightly criticised; the public has a right to know what their taxes are
being spent on and to be able to read about the latest thinking in medicine.
But a little knowledge can be a dangerous thing. As a result, the media
has a moral obligation to report a story fairly; journals should do their
best to ensure that what they publish has been adequately peer reviewed;
authors need to be aware that their research may end up on the front page
of a national newspaper; but perhaps most importantly, and as harsh as
it may seem in this particular case, the public needs to exert a healthy
degree of scepticism when reading the daily newspapers, especially when
the headline includes the “s”word.
© Copyright 2002, The Lancet Neurology