HITTING THE HEADLINES Centre for Reviews and Dissemination University of York Alison Booth ab42@york.ac.uk Vickie Orton

1. HITTING THE HEADLINES Centre for Reviews and Dissemination University of York Alison Booth ab42@york.ac.uk Vickie Orton vo2@york.ac.uk

2. A digital library, designed to provide health care professionals with knowledge and know-how to support health care related decisions Access to the best current knowledge on healthcare for the NHS, patients, carers and the public National electronic Library for Health

3. Hitting the Headlines • Aimed at busy health professionals • Selected news reports • Unbiased, brief and readable summaries • appraising the research evidence • comment on accuracy of news report • ‘Live’ within 48 hours of newspaper story

4. Selecting a Headline to Hit • News story in national weekly newspaper(s) • Reference to research • Priority given to ‘big’ stories • Effects of a health care or health related intervention that is or could be provided or recommended by the NHS • Drug treatment • Surgical intervention • Diagnostic procedure or tool • Health promotion or prevention programme

5. What we don’t do…. Surgeons rebuilt my tongue – from my arm Music helped me forget Tourette’s Risk of brain damage from mobile phone use 21 days to get a beautiful back Countdown for a rear view to rival Geri’s

6. PRESSWATCHHEALTH & PHARMACEUTICAL NEWS VITAMINS CAN DAMAGE YOUR HEALTH, WARNS WATCHDOG The Food Standards Agency has said that taking large doses of vitamins and minerals over long periods of time can cause cancer, liver damage, depression and stomach upsets. Health store chiefs have automatically denounced the claim, saying that it was 'a reaction of the nanny state.' THE TIMES PAGE: 1 (101189) DAILY EXPRESS PAGE: 14 (101827) FINANCIAL TIMES PAGE: 3 (101492) THE GUARDIAN PAGE: 8 (101727) THE INDEPENDENT PAGE: 5 (101655) DAILY MIRROR PAGE: 27 (101978) THE SUN PAGE: 55 (101524) DAILY TELEGRAPH PAGE: 1 (101509) DAILY TELEGRAPH PAGE: 6 (101639) THE TIMES PAGE: 4 (101363)

7. Women on the Pill ‘still fall pregnant’ Daily Telegraph, 30/04/03 • ‘Dr Bajos, who outlined the findings in Human Reproduction, said it was….’ Daily Express, 30/04/03 • ‘The study, which appeared in the journal Human Reproduction, revealed that….’ Human Reproduction Vol.18, No5 pp.994-999, 2003 Contraception: from accessibility to efficiency Nathalie Bajos, Henri Leridon, Helene Goulard, Pascale Oustry, Nadine Job-Spira and The COCON Group

8. Critical Appraisal • Where does the evidence come from? • What were the authors' objectives? • What was the nature of the evidence? • What were the factors of interest? • What were the findings? • What were the authors’ conclusions? • How reliable are the authors’ conclusions?

9. Commentary on the newspaper article • Does the newspaper article accurately summarise the findings of the original research? • Does it accurately reflect the possibility of patients having access to the treatment? • Is the article likely to give rise to unfounded levels of anxiety or expectation? • ‘Could Ginseng replace insulin?’ • ‘Drug from a tree bark is shown to help beat cancer’ • ‘Don’t vinda lose your mind’

10. Format of Hitting the Headlines story • Headline – quote or neutral • First paragraph – subject, accuracy of newspaper story and quality of research

11. Format of Hitting the Headlines story • Bullet Points • Newspaper • Research • Relation between the two • Evaluation of the Evidence Base • Systematic Reviews • References and Resources • Consumer links

12. What makes a news story?

13. The nature of news “Newspapers are not mere repositories of information. They are organs grappling for readers attention against burning toast, mewling infants, windy station platforms and crowded bars.” "News value is equivalent to surprise. It's not a comparative exercise in the value of human life.“

14. What is published must be read • Bad news • Unusual news • Conflict / disputes • Miracles • Relevance to readers • Human interest

15. Journalistic constraints • time to select • time to write • brevity • simplicity • editorial policy • external influences

16. What is news worthy - 4 days of mail • Three books • Three feature articles • 30 invites to press conferences • 14 newsletters / bulletins • 56 scientific / medical press releases • 47 press releases from the computer industry • One directory of contacts from a university • 24 journals magazines

17. Trusted sources Journalists rely heavily on journal peer review processes to guide them in the selection and development of stories • Lancet • BMJ • JAMA • New England Journal of Medicine

18. Journalistic constraints • time to select • time to write • brevity • simplicity • editorial policy • external influences

19. External influences on newspaper reporting • Researchers • Funders • Academic publishers • Interest groups

20. External influences in action Next day hip replacement could save NHS millions • Press release issued by a hospital • PR company • Interview with patient Shirley Mattin • Patient info website • Contact details for hospitals / surgeons Only one newspaper questioned evidence base

21. Anatomy of a Newspaper ArticleThe headline Drug that may halve the chance of breast cancer The cancer ‘frisker’ Wand waved over the body finds tumours Claim of MMR dangers dismissed as ‘flawed’ MMR study finds links to brain illnesses Vaccine for skin cancer

22. James Chapman Dr Jane Collins Nigel Hawkes Sarah Boseley Steve Connor Roland Watson David Derbyshire Michael Cross Jeremy Lawrence Science Correspondent The Times children’s doctor Health Editor Health Editor Science Editor Chief Political Correspondent Medical Correspondent Freelance Health Editor Anatomy of a newspaper articleThe Journalist

23. HRT risks outweigh benefits, says study By David Derbyshire, Science Correspondent The dangers of hormone replacement therapy outweigh any of its bone strengthening health benefits, says a study. Anatomy of a Newspaper Article1. Opening paragraph – key information 1

24. Women should be given only the combined oestrogen-progestin treatment for “short-term relief” during the menopause, according to American researchers. Cancer Research UK said some forms of HRT doubled the risk of breast cancer and warned women taking it for more than a year to seek advice from their doctors. Other American studies have found an increased risk of heart disease. Anatomy of a Newspaper Article2. Information is given in decreasing order of importance 2

25. Around 1.5 million women take HRT in Britain – half take a combined version and the rest the oestrogen-only pill or patch. The New study from the University of Pittsburgh published in the Journal of the American Medical Association, looked at 16,608 women aged 50 to 79. Half took oestrogen and progestin, while the others took a placebo. The Daily Telegraph, Wed., October 1, 2003 Anatomy of a Newspaper Article3. The perspective 3

26. What are the implications? • How might this affect patients? • How might this affect practice? • How might this affect policy? • How does this relate to the existing body of evidence?

27. The cancer ‘frisker’Wand waved over the body finds tumours “A HAND-HELD scanner that ‘frisks’ patients for cancer is being hailed by doctors as a major breakthrough. The Star Trek-style wand, which is simply swiped over a patient’s body, has produced remarkable results in two trials.”

28. The cancer ‘frisker’Wand waved over the body finds tumours • Details of the studies • Quotes from researchers • Historical background to the idea • How the device actually works • Comparison with existing technology • The future development

29. The cancer ‘frisker’Wand waved over the body finds tumours “However, the results of the early trials have yet to appear in a major medical journal, and should be regarded with caution until then, according to a report published today in New Scientist magazine.” Daily Mail, Thursday, June 12, 2003 Page 41

30. How to read a newspaper article • Don’t let the headline distract you • Read the whole of the article • Ask yourself: • What is being reported? • Why is it being reported? • What the the implications for: • Practice? • Patients? in the context of existing evidence • Policy?

31. Finding the research behind the story Vickie Orton Centre for Reviews and Dissemination University of York vo2@york.ac.uk

32. Suntan lotion “raises risk of cancer”Daily Mail 29/9/03 Sun cream cancer alert Daily Express 29/9/03 Cancer Shock over suncreams Daily Star 29/09/03 Where do you go from here ?

33. Take a closer look….. • Has Hitting the Headlines already covered the story Check at http://www.nelh.nhs.uk/ • Find the research: • Journals http://www.ingenta.com http://www.medwebplus.com • Conference papers http://zetoc.mimas.ac.uk/zetoc/ http://www.medicalconferences.com/ • Research organisations • Charitable trusts • BBC http://news.bbc.co.uk/1/hi/health/default.stm • Public Health Genetics Unit http://www.phgu.org.uk/rapid_response/about_rapid_response.shtml • Obtain full copies of references • Useful meta search engines include www.alltheweb.com or www.dogpile.com and www.metor.com

34. Found it! • DARE http://nhscrd.york.ac.uk/welcome.htm • Cochrane Library http://www.nelh.nhs.uk/cochrane.asp • TRIP http://www.update-software.com/scripts/clibng/usauth.exe?Server=TRIPUSER&Product=TRIP&Guest=YES • NRR http://www.update-software.com/National/ • ReFeR http://www.info.doh.gov.uk/doh/refr_web.nsf/Home?OpenForm • CRD publications http://www.york.ac.uk/inst/crd/dissem.htm • Consumer links http://www.omni.ac.uk or http://www.nhsdirect.nhs.uk/ • Appraisal…..

35. Can’t find it….. • Sometimes a reference cannot be traced • either because insufficient detail has been given in the newspaper article http://www.wrx.zen.co.uk/britnews.htm • it is prepublication of the research http://www.biomedcentral.com • Check Hitting the Headlines archive at http://www.nelh.nhs.uk/hth/archive.asp • the article is not based on published research

36. Where to next? • Try contacting the author http://expertise.cos.com/ • Try contacting the university/research centre • Universities of the World http://geowww.uibk.ac.at/univ/ • University of Wolverhampton UK Sensitive maps http://www.scit.wlv.ac.uk/ukinfo/uk.map.html • Press releases or abstracts of conference proceedings can be useful if the full research is not available http://www.alphagalileo.org/ • CRD Information Service Email crd-info@york.ac.uk, tel 01904 321 0846 • Gather best evidence on the topic if you think it may be of interest to clinicians and patients

37. Suntan lotion “raises risk of cancer”Daily Mail 29/9/03 Sun cream cancer alert Daily Express 29/9/03 Cancer Shock over suncreams Daily Star 29/09/03 Where do you go from here ?

38. “The failure has been revealed by a new method of measuring protection – or lack of it- offered by sunscreens, that has been developed by medical research trust Raft. Dr Claire Linge, head of cell biology at Raft,…..” Daily Express Monday 29th September 2003 “The findings of the 13 year old study led by Professor Sanders, who is based at Mount Vernon Hospital in Northwood, North-West London, will be revealed today”. Daily Mail Monday September 29th 2003

39. The CRD Way • Search for Mount Vernon Hospital using Google

41. The CRD Way • Search for Mount Vernon Hospital • Search for RAFT (using Google)

43. The CRD Way • Search for Mount Vernon Hospital • Search for RAFT (using Google) • RAFT press release provided information on the journal in which the research is published • Obtain journal article

46. The CRD Way • Search for Mount Vernon Hospital • Search for RAFT • RAFT press release provided information on the journal in which the research is published • Obtain journal article • Search for related systematic reviews and CRD publications • Add relevant consumer links • Pass to reviewers and dissemination team • Back to the Information Team to convert to HTML • Sent to NeLH to appear on website http://www.nelh.nhs.uk/hth/sunscreen_cancer.asp

50. Recognising good evidence: appraising studies that are ‘Hitting The Headlines’