Often on Fridays, we present a Five Star Friday feature in which we profile outstanding health care journalism.
This is NOT one of those features. We’re going to the other end of the spectrum with these items in the news this week.
(We assigned our own Kat – associate editor Kathlyn Stone – to dig into this one. She does not own a cat.)
“Headline grabbing stories are almost always wrong.” says psychiatrist Allen Frances, MD, professor emeritus at Duke University. This week’s attention-seeking headlines on a new study looking at cats, parasites, poop and rage seem to be a prime example. A sample of the headlines:
First, despite the causal statements or causal inferences made in many stories, the journal manuscript itself states:
“no causal, or directional, conclusions can be made from these analyses. Second, ascertainment of subjects may limit the generalizability of these findings in that these involved subjects who volunteered for a research study, rather than for clinical treatment.”
Even the university news release on the study stated:
However, the authors caution that the study results do not address whether toxoplasmosis infection may cause increased aggression or IED.
“Correlation is not causation, and this is definitely not a sign that people should get rid of their cats,” said (a) study co-author.
But in the HealthDay story, the lead author was quoted encouraging people with anger problems to go see a doctor and be tested for toxoplasmosis:
“If you’ve got someone with aggression problems, you might check them for toxoplasmosis.”
The link between toxoplasmosis (caused by the parasite Toxoplasma gondii sometimes found in cat feces and undercooked meat) and angry outbursts is unproven. There could be hundreds of reasons why people fly into a rage, says Allen Frances, and there’s no good reason to pop a label like Intermittent Explosive Disorder (IED) on the temper outburst.
Linking IED to cat litter as this study did is a stretch, he says, for two reasons. For one thing, it’s difficult to distinguish IED from anger in every day life. IED is a quasi-diagnosis that was included in the Diagnostic and Statistical Manual DSM-V (the “psychiatrist’s bible”) under a residual category for a condition they didn’t know how to categorize. Conditions in this category – Disruptive, Impulse-Control, and Conduct Disorders – also include Oppositional Defiance Disorder and pyromania (fire setting). So IED is not a clear-cut disease but rather an observed condition that the observers hope will stimulate new research.
The research study didn’t include any controls. It’s based on seeking and finding an association between people who own cats and who also fly into a rage. “If you have a hammer, then you’re going to find a nail,” says Frances. (He chaired the task force that developed the DSM-lV and has been critical of the DSM-V.) Any conclusions drawn about IED, he says, have to be “taken with a grain of salt.” On Twitter, he concluded:
Hint to news consumers: whenever you see a health news story that says “may” or “could” – a la “Your cat could be causing your road rage” or “Your cat may have given you a dangerous brain-infecting anger parasite,” feel free to substitute “may not” or “could not.” Scientifically, you’re probably standing on equally firm (or shaky) ground with either wording. The qualifying words are forms of cowardly writing. Avoid them and those who use them.
As long as we’ve started this Frustrating Friday feature, here’s another, from the Fox TV station in San Francisco:
We’re accustomed to 72-second TV health news stories that deliver news about what will either kill or cure you. But just 72 words on your website, where you have all the room in the world? This is all they gave:
Do you have any tattoos? Turns out, they are good for your health!
A study at the University of Alabama found that getting tattoos may boost your immune system.
Because getting a tattoo is painful and stressful, your body reacts by boosting your immune system.
If you keep getting tattoos, your body builds up its defenses even more.
So ultimately, the more you get, the better.
It’s almost like health care news haiku. Once again, I feel like my brain has been tattooed by local TV news.
Even the limitations section of the journal manuscript upon which the story is loosely based was 60% longer (179 words), beginning with this:
There are several limitations of this study, leading us to be cautious lest we over-interpret these findings.
Imagine someone sitting down to plan a half hour newscast of the day’s most important news…and deciding that this belonged in that category.
KTVU’s effort was matched by more than 100 other news stories across the US that said, basically, “to hell with caution, we’re going for over-interpretation!”
I hope that in the future we are able to present far more Five Star Friday features than these Frustrating Friday flops.