Interpretation of Results of Studies Evaluating an Intervention Highlighted in Google Health News: A Cross-Sectional Study of News

Background Mass media through the Internet is a powerful means of disseminating medical research. We aimed to determine whether and how the interpretation of research results is misrepresented by the use of “spin” in the health section of Google News. Spin was defined as specific way of reporting, from whatever motive (intentional or unintentional), to emphasize that the beneficial effect of the intervention is greater than that shown by the results. Methods We conducted a cross-sectional study of news highlighted in the health section of US, UK and Canada editions of Google News between July 2013 and January 2014. We searched for news items for 3 days a week (i.e., Monday, Wednesday, and Friday) during 6 months and selected a sample of 130 news items reporting a scientific article evaluating the effect of an intervention on human health. Results In total, 78% of the news did not provide a full reference or electronic link to the scientific article. We found at least one spin in 114 (88%) news items and 18 different types of spin in news. These spin were mainly related to misleading reporting (59%) such as not reporting adverse events that were reported in the scientific article (25%), misleading interpretation (69%) such as claiming a causal effect despite non-randomized study design (49%) and overgeneralization/misleading extrapolation (41%) of the results such as extrapolating a beneficial effect from an animal study to humans (21%). We also identified some new types of spin such as highlighting a single patient experience for the success of a new treatment instead of focusing on the group results. Conclusions Interpretation of research results was frequently misrepresented in the health section of Google News. However, we do not know whether these spin were from the scientific articles themselves or added in the news

Timing and Completeness of Trial Results Posted at ClinicalTrials.gov and Published in Journals

Background: The US Food and Drug Administration Amendments Act requires results from clinical trials of Food and Drug Administration–approved drugs to be posted at ClinicalTrials.gov within 1 y after trial completion. We compared the timing and completeness of results of drug trials posted at ClinicalTrials.gov and published in journals. Methods and Findings: We searched ClinicalTrials.gov on March 27, 2012, for randomized controlled trials of drugs with posted results. For a random sample of these trials, we searched PubMed for corresponding publications. Data were extracted independently from ClinicalTrials.gov and from the published articles for trials with results both posted and published. We assessed the time to first public posting or publishing of results and compared the completeness of results posted at ClinicalTrials.gov versus published in journal articles. Completeness was defined as the reporting of all key elements, according to three experts, for the flow of participants, efficacy results, adverse events, and serious adverse events (e.g., for adverse events, reporting of the number of adverse events per arm, without restriction to statistically significant differences between arms for all randomized patients or for those who received at least one treatment dose). From the 600 trials with results posted at ClinicalTrials.gov, we randomly sampled 50% (n = 297) had no corresponding published article. For trials with both posted and published results (n = 202), the median time between primary completion date and first results publicly posted was 19 mo (first quartile = 14, third quartile = 30 mo), and the median time between primary completion date and journal publication was 21 mo (first quartile = 14, third quartile = 28 mo). Reporting was significantly more complete at ClinicalTrials.gov than in the published article for the flow of participants (64% versus 48% of trials, p<0.001), efficacy results (79% versus 69%, p = 0.02), adverse events (73% versus 45%, p<0.001), and serious adverse events (99% versus 63%, p<0.001). The main study limitation was that we considered only the publication describing the results for the primary outcomes. Conclusions: Our results highlight the need to search ClinicalTrials.gov for both unpublished and published trials. Trial results, especially serious adverse events, are more completely reported at ClinicalTrials.gov than in the published article

Three randomized controlled trials evaluating the impact of “spin” in health news stories reporting studies of pharmacologic treatments on patients’/caregivers’ interpretation of treatment benefit

Background News stories represent an important source of information. We aimed to evaluate the impact of “spin” (i.e., misrepresentation of study results) in health news stories reporting studies of pharmacologic treatments on patients’/caregivers’ interpretation of treatment benefit. Methods We conducted three two-arm, parallel-group, Internet-based randomized trials (RCTs) comparing the interpretation of news stories reported with or without spin. Each RCT considered news stories reporting a different type of study: (1) pre-clinical study, (2) phase I/II non-RCT, and (3) phase III/IV RCT. For each type of study, we identified news stories reported with spin that had earned mention in the press. Two versions of the news stories were used: the version with spin and a version rewritten without spin. Participants were patients/caregivers involved in Inspire, a large online community of more than one million patients/caregivers. The primary outcome was participants’ interpretation assessed by one specific question “What do you think is the probability that ‘treatment X’ would be beneficial to patients?” (scale, 0 [very unlikely] to 10 [very likely]). Results For each RCT, 300 participants were randomly assigned to assess a news story with spin (n = 150) or without spin (n = 150), and 900 participants assessed a news story. Participants were more likely to consider that the treatment would be beneficial to patients when the news story was reported with spin. The mean (SD) score for the primary outcome for abstracts reported with and without spin for pre-clinical studies was 7.5 (2.2) versus 5.8 (2.8) (mean difference [95% CI] 1.7 [1.0–2.3], p < 0.001); for phase I/II non-randomized trials, 7.6 (2.2) versus 5.8 (2.7) (mean difference 1.8 [1.0–2.5], p < 0.001); and for phase III/IV RCTs, 7.2 (2.3) versus 4.9 (2.8) (mean difference 2.3 [1.4–3.2], p < 0.001). Conclusions Spin in health news stories reporting studies of pharmacologic treatments affects patients’/caregivers’ interpretation. Trial registration ClinicalTrials.gov, NCT03094078 , NCT03094104 , NCT0309558

Correction to: Three randomized controlled trials evaluating the impact of “spin” in health news stories reporting studies of pharmacologic treatments on patients’/caregivers’ interpretation of treatment benefit

Figure 3 in the original article [1] is incorrect; labels for secondary outcomes have been shifted and do not correspond to the numbers reported in the table (Additional file 8). The corrected version can be seen ahead. This figure should be used over the figure 3 seen in the original article. This error does not affect the results, interpretation, or conclusion

Direct impact of COVID-19 by estimating disability-adjusted life years at national level in France in 2020

Background: The World Health Organization declared a pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), on March 11, 2020. The standardized approach of disability-adjusted life years (DALYs) allows for quantifying the combined impact of morbidity and mortality of diseases and injuries. The main objective of this study was to estimate the direct impact of COVID-19 in France in 2020, using DALYs to combine the population health impact of infection fatalities, acute symptomatic infections and their post-acute consequences, in 28 days (baseline) up to 140 days, following the initial infection. Methods: National mortality, COVID-19 screening, and hospital admission data were used to calculate DALYs based on the European Burden of Disease Network consensus disease model. Scenario analyses were performed by varying the number of symptomatic cases and duration of symptoms up to a maximum of 140 days, defining COVID-19 deaths using the underlying, and associated, cause of death. Results: In 2020, the estimated DALYs due to COVID-19 in France were 990 710 (1472 per 100 000), with 99% of burden due to mortality (982 531 years of life lost, YLL) and 1% due to morbidity (8179 years lived with disability, YLD), following the initial infection. The contribution of YLD reached 375%, assuming the duration of 140 days of post-acute consequences of COVID-19. Post-acute consequences contributed to 49% of the total morbidity burden. The contribution of YLD due to acute symptomatic infections among people younger than 70 years was higher (67%) than among people aged 70 years and above (33%). YLL among people aged 70 years and above, contributed to 74% of the total YLL. Conclusions: COVID-19 had a substantial impact on population health in France in 2020. The majority of population health loss was due to mortality. Men had higher population health loss due to COVID-19 than women. Post-acute consequences of COVID-19 had a large contribution to the YLD component of the disease burden, even when we assume the shortest duration of 28 days, long COVID burden is large. Further research is recommended to assess the impact of health inequalities associated with these estimates

Subnational inequalities in years of life lost and associations with socioeconomic factors in pre-pandemic Europe, 2009–19: an ecological study

Background: Health inequalities have been associated with shorter lifespans. We aimed to investigate subnational geographical inequalities in all-cause years of life lost (YLLs) and the association between YLLs and socioeconomic factors, such as household income, risk of poverty, and educational attainment, in countries within the European Economic Area (EEA) before the COVID-19 pandemic. Methods: In this ecological study, we extracted demographic and socioeconomic data from Eurostat for 1390 small regions and 285 basic regions for 32 countries in the EEA, which was complemented by a time-trend analysis of subnational regions within the EEA. Age-standardised YLL rates per 100 000 population were estimated from 2009 to 2019 based on methods from the Global Burden of Disease study. Geographical inequalities were assessed using the Gini coefficient and slope index of inequality. Socioeconomic inequalities were assessed by investigating the association between socioeconomic factors (educational attainment, household income, and risk of poverty) and YLLs in 2019 using negative binomial mixed models. Findings: Between Jan 1, 2009, and Dec 31, 2019, YLLs lowered in almost all subnational regions. The Gini coefficient of YLLs across all EEA regions was 14·2% (95% CI 13·6–14·8) for females and 17·0% (16·3 to 17·7) for males. Relative geographical inequalities in YLLs among women were highest in the UK (Gini coefficient 11·2% [95% CI 10·1–12·3]) and among men were highest in Belgium (10·8% [9·3–12·2]). The highest YLLs were observed in subnational regions with the lowest levels of educational attainment (incident rate ratio [IRR] 1·19 [1·13–1·26] for females; 1·22 [1·16–1·28] for males), household income (1·35 [95% CI 1·19–1·53]), and the highest poverty risk (1·25 [1·18–1·34]). Interpretation: Differences in YLLs remain within, and between, EEA countries and are associated with socioeconomic factors. This evidence can assist stakeholders in addressing health inequities to improve overall disease burden within the EEA. Funding: Research Council of Norway; Development, and Innovation Fund of Hungary; Norwegian Institute of Public Medicine; and COST Action 18218 European Burden of Disease Network

a review of methodological design choices

Publisher Copyright: © 2023 Cambridge University Press. All rights reserved.This systematic literature review aimed to provide an overview of the characteristics and methods used in studies applying the Disability-Adjusted Life Years (DALY) concept for infectious diseases within European Union (EU)/European Economic Area (EEA)/European Free Trade Association (EFTA) countries and the United Kingdom. Electronic databases and grey literature were searched for articles reporting the assessment of DALY and its components. We considered studies in which researchers performed DALY calculations using primary epidemiological data input sources. We screened 3,053 studies of which 2,948 were excluded and 105 studies met our inclusion criteria. Of these studies, 22 were multi-country and 83 were single-country studies, of which 46 were from the Netherlands. Food- and water-borne diseases were the most frequently studied infectious diseases. Between 2015 and 2022, the number of burden of infectious disease studies was 1.6 times higher compared to that published between 2000 and 2014. Almost all studies (97%) estimated DALYs based on the incidence- and pathogen-based approach and without social weighting functions; however, there was less methodological consensus with regards to the disability weights and life tables that were applied. The number of burden of infectious disease studies undertaken across Europe has increased over time. Development and use of guidelines will promote performing burden of infectious disease studies and facilitate comparability of the results.publishersversionepub_ahead_of_prin

Burden of infectious disease studies in Europe and the United Kingdom: a review of methodological design choices.

This systematic literature review aimed to provide an overview of the characteristics and methods used in studies applying the disability-adjusted life years (DALY) concept for infectious diseases within European Union (EU)/European Economic Area (EEA)/European Free Trade Association (EFTA) countries and the United Kingdom. Electronic databases and grey literature were searched for articles reporting the assessment of DALY and its components. We considered studies in which researchers performed DALY calculations using primary epidemiological data input sources. We screened 3053 studies of which 2948 were excluded and 105 studies met our inclusion criteria. Of these studies, 22 were multi-country and 83 were single-country studies, of which 46 were from the Netherlands. Food- and water-borne diseases were the most frequently studied infectious diseases. Between 2015 and 2022, the number of burden of infectious disease studies was 1.6 times higher compared to that published between 2000 and 2014. Almost all studies (97%) estimated DALYs based on the incidence- and pathogen-based approach and without social weighting functions; however, there was less methodological consensus with regards to the disability weights and life tables that were applied. The number of burden of infectious disease studies undertaken across Europe has increased over time. Development and use of guidelines will promote performing burden of infectious disease studies and facilitate comparability of the results

Dissemination and communication of clinical research in mass media

Les médias et les réseaux sociaux constituent une source importante de diffusion et de communication des résultats de la recherche clinique. Le terme « spin » est utilisé lorsque la présentation et l’interprétation des résultats d’une étude sont déformées par les auteurs que ce soit intentionnellement ou involontairement. Les spins exagèrent les effets bénéfiques des interventions et sous-estiment les effets indésirables. Les principaux objectifs de ce travail étaient :1) d’évaluer la prévalence des « spins » dans les articles de presse, d’identifier les différentes stratégies de spin et de développer une classification de spin ; 2) d’identifier les facteurs associés à une diffusion des résultats via les réseaux sociaux et 3) d’étudier comment les articles scientifiques rapportés avec des spins diffusent via les réseaux sociaux, à partir de l’exemple de l’essai DAPT 2014. Dans un premier temps, nous avons réalisé une revue systématique des articles de presse décrivant les résultats d’études évaluant une intervention et indexés dans la rubrique santé de Google. Nous avons développé une classification des stratégies de spin pour les articles de presse et montré que la prévalence des spins est élevée. Dans un deuxième temps, nous avons réalisé une étude de cohorte d’articles évaluant les traitements contre le cancer pour identifier les facteurs associés à une attention médiatique élevée. Le critère de jugement principal était l’attention portée par les médias et les réseaux sociaux mesuré par le « score Altmetric ». Nos résultats ont montré l’importance de l’accès libre et des communiqués de presse. Enfin, nous avons effectué une analyse systématique de l’attention portée par les médias et les réseaux sociaux autour de l'étude DAPT qui était rapporté avec des spins sous estimant les effets indésirable de l’intervention. Nous avons montré que l’interprétation des résultats par les auteurs sont rarement contredits. Ces travaux ont permis de mettre en évidence l’importance des spins dans les médias et de développer des outils (classification de spin) pour améliorer la diffusion des résultats de la recherche.Mass media and social networks are important sources of disseminating and communicating clinical research. The term “spin” is used when the presentation and interpretation of the results of a study is distorted by the authors intentionally or unintentionally. Spins exaggerate the beneficial effects of interventions and underestimate adverse effects. The main objectives of this PhD were (I) to assess the prevalence of spin in health news, as well as identify and classify different strategies of spin; (II) to identify factors associated with dissemination of research results through online media, and (III) to explore how results of a trial reported with spin were disseminated to the scientific community and online media, using the 2014 DAPT trial as a case study. For the first aim, we performed a cross-sectional study of health news and described the distortion of research results of studies evaluating an intervention in Google health news. We developed a classification of spin for health news and showed a high prevalence of spin. For the second aim, we performed a cohort study of articles evaluating cancer treatments and identify factors associated with high online media attention. The primary outcome was the attention received by media and social networks measured by Altmetric score. Our results highlighted the importance of open access and press releases. Finally, we performed a systematic review of attention received by media and social networks surrounding the DAPT study which were reported with spin and undermine the adverse effects of the treatment. We showed that the interpretation of results by authors was rarely criticized. These results highlighted the importance of spin in mass media and provided a tool (classification of spin) to improve the dissemination of research results

Dissémination et communication des résultats de la recherche clinique dans les médias

Mass media and social networks are important sources of disseminating and communicating clinical research. The term “spin” is used when the presentation and interpretation of the results of a study is distorted by the authors intentionally or unintentionally. Spins exaggerate the beneficial effects of interventions and underestimate adverse effects. The main objectives of this PhD were (I) to assess the prevalence of spin in health news, as well as identify and classify different strategies of spin; (II) to identify factors associated with dissemination of research results through online media, and (III) to explore how results of a trial reported with spin were disseminated to the scientific community and online media, using the 2014 DAPT trial as a case study. For the first aim, we performed a cross-sectional study of health news and described the distortion of research results of studies evaluating an intervention in Google health news. We developed a classification of spin for health news and showed a high prevalence of spin. For the second aim, we performed a cohort study of articles evaluating cancer treatments and identify factors associated with high online media attention. The primary outcome was the attention received by media and social networks measured by Altmetric score. Our results highlighted the importance of open access and press releases. Finally, we performed a systematic review of attention received by media and social networks surrounding the DAPT study which were reported with spin and undermine the adverse effects of the treatment. We showed that the interpretation of results by authors was rarely criticized. These results highlighted the importance of spin in mass media and provided a tool (classification of spin) to improve the dissemination of research results.Les médias et les réseaux sociaux constituent une source importante de diffusion et de communication des résultats de la recherche clinique. Le terme « spin » est utilisé lorsque la présentation et l’interprétation des résultats d’une étude sont déformées par les auteurs que ce soit intentionnellement ou involontairement. Les spins exagèrent les effets bénéfiques des interventions et sous-estiment les effets indésirables. Les principaux objectifs de ce travail étaient :1) d’évaluer la prévalence des « spins » dans les articles de presse, d’identifier les différentes stratégies de spin et de développer une classification de spin ; 2) d’identifier les facteurs associés à une diffusion des résultats via les réseaux sociaux et 3) d’étudier comment les articles scientifiques rapportés avec des spins diffusent via les réseaux sociaux, à partir de l’exemple de l’essai DAPT 2014. Dans un premier temps, nous avons réalisé une revue systématique des articles de presse décrivant les résultats d’études évaluant une intervention et indexés dans la rubrique santé de Google. Nous avons développé une classification des stratégies de spin pour les articles de presse et montré que la prévalence des spins est élevée. Dans un deuxième temps, nous avons réalisé une étude de cohorte d’articles évaluant les traitements contre le cancer pour identifier les facteurs associés à une attention médiatique élevée. Le critère de jugement principal était l’attention portée par les médias et les réseaux sociaux mesuré par le « score Altmetric ». Nos résultats ont montré l’importance de l’accès libre et des communiqués de presse. Enfin, nous avons effectué une analyse systématique de l’attention portée par les médias et les réseaux sociaux autour de l'étude DAPT qui était rapporté avec des spins sous estimant les effets indésirable de l’intervention. Nous avons montré que l’interprétation des résultats par les auteurs sont rarement contredits. Ces travaux ont permis de mettre en évidence l’importance des spins dans les médias et de développer des outils (classification de spin) pour améliorer la diffusion des résultats de la recherche