Health News Review

This is not a lesson about the limitations of 140-character messages on Twitter.

Rather, it is a warning about careless Tweets that mischaracterize the real meat of the message in longer stories linked to in the Twitter message. As I wrote on Twitter in response to these two episodes, “Better not to Tweet on complex health care topics than to mischaracterize your own story with a misleading 140 characters.”

First, my friend Andrew Holtz caught the fact earlier this week that Men’s Health Magazine tweeted:

If you’re a smoker, you NEED to get a CT scan. Here’s why: http://ow.ly/5x34y

That “here’s why” link took you to a Men’s Health Magazine story, that despite being headlined “The Medical Test Every Smoker Needs,” went on to explain:

Don’t run out and ask for a CT scan, though. More than 96 percent of the positive screens in the study were false positives, which could subject you to unnecessary surgery, cancer treatments, and the complications that come with them. They’re also expensive: A chest CT scan can cost up to several thousands of dollars.

So look at how silly Men’s Health looked on this confusing back-and-forth message:

1. You NEED to get a CT scan.
2. It’s a test “every smoker needs”
3. But don’t run out and ask for one.

Then this morning I caught AARP doing the same thing. They tweeted:

Are you a smoker? CT scan those lungs – they’re proven to cut risk of lung cancer death for 55-plus: http://aarp.us/rdleHu

That links takes you to a story that includes caveats such as the following:

But even some experts who hailed the study’s results question whether the research will lead to costly, unnecessary screening and procedures on men and women who are not really at high risk. Biopsies and lung surgery on older people can be dangerous, even deadly.

The researchers, he points out, also saw a large number of spots on the scans that weren’t dangerous, leading to more scans, and even biopsies and surgery. About a quarter of all the scans found some abnormality but nearly all of them turned out to be benign. The scans also found cancers that surgeons then removed that might not have been harmful.

“If everybody who has a little finding on the scan starts to have a biopsy, then we may do a lot of harm,” Dedderbeck says.

And as government seeks to reign in rising health cost, even one of the experts who helped design the study says there are hard decisions to be made before the country commits to a new screening that could cost billions of dollars.

“There are not unlimited health care dollars,” says Edward Patz Jr., M.D., a professor of radiology at Duke University Medical Center and an investigator who helped design the study. “We have to make some decisions once we have the data whether this is really worth it or not.”

Some also worry that medical professionals more interested in profits than evidence could frighten younger people or those who aren’t heavy smokers into believing they should get a CT scan as well. Although most insurance programs and Medicare wouldn’t cover an initial screening, once a scan finds something suspicious, insurance and Medicare will pay for further tests, biopsies and even surgery. Since a large percentage of scans will show something suspicious, hospitals or radiology centers stand to make money from the procedures.

“It’s a gateway to having new patients,” says Peter B. Bach, M.D., a lung specialist and epidemiologist at Memorial Sloan-Kettering Cancer Center in New York City, who warns of “the hucksterism that will surround” the findings. “The concern is that people will use this study and overblow the benefits, seriously soft-pedal the risk and start pushing this on people who are not at high risk,” he says.

All of that is very important perspective – perspective that may be drowned out by that silly, misleading, admonition in the Twitter headline: “Are you a smoker? CT scan those lungs.”

We’re still finding our way around a lot of this social media stuff. But on health care topics, where misleading people can cause harm, it’s better to go slow and be certain than to speed ahead with cutesy Tweets that don’t even reflect the underlying hard work you’re linking to.

Comments

Gladys L. posted on July 11, 2011 at 11:40 am

Hi Gary. So I guess I have found a companion with me who notices the senseless points of other individuals such as in twitter. Sometimes people tend to share ideas as if they are an expert of it but is actually the opposite. For those who are making fun of them, they suck. They are just wasting my precious time which should be intended for worth-reading articles. They are just after the number of their followers.

Paul Dorio posted on July 13, 2011 at 6:26 am

I agree and thanks for the admonishment to all.
As regards your examples, which have to do with lung cancer screening, you recently blogged on the same subject. I think you may have reversed a sentiment, though: “All screening tests do harm; some may also do good.” In fact, screening tests certainly can do harm, by identifying non-cancerous abnormalities that don’t need further intervention. But they also importantly identify cancers. The point of screening is to identify enough cancers that make the identification of those other benign abnormalities acceptable. That’s where screening saves lives, as has been shown for mammography in numerous studies and as is being shown for lung cancer screening.
I think people who read these blogs, tweets, facebook comments etc should understand, and we/you should convey, that screening can be useful. You just need to ask your doctor whether you are an appropriate candidate. (And also ask him/her if he/she has a financial interest in the scan being discussed!)

Gary Schwitzer posted on July 13, 2011 at 6:42 am

Paul,
The reversal of the message was intentional. News stories often discuss only benefits and ignore harms.
I don’t agree that it’s simply a matter of “asking your doctor if you’re an appropriate candidate.” Decisions about screening ideally should involve a deeper level of informed, shared decision making.

Tom McCormally posted on July 13, 2011 at 9:18 am

This really isn’t about Twitter or Social Media. This is about being responsible in sharing information. Newspaper (print) headline writers are guilty of the same thing: tease, mislead, manipulate … the goal is to get people to read. Many Tweet-ers have no journalistic ethics … they don’t even know what that means. And the same, we know, of many TV reporters, tabloid reporters, etc.