August 28, 2018

Observations about today’s observational studies in the news

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We want to be very clear about this

Please note: Observational studies (as with the research that linked smoking to cancer and other problems) can indeed pile up such overwhelming evidence that it would be prudent to make public health recommendations on that basis. In fact, in some cases, observational data from large numbers of people that show associations previously found in other large studies may be stronger than some data from some randomized clinical trials. Not all studies are equal. There can be strengths or biases in any study. However, an observational study cannot prove cause and effect. Statistical association is not proof of cause-and-effect. It is not unimportant. But no one should make it more than what it is. (For more on the limitations of observational studies, see the three links at the end of this article.) For years we have offered guidance to writers about the language that should be avoided when discussing observational data – and language that is better.

So when you analyze news coverage every day as we have done for more than 12 years, you can’t help but be blown away by the amount of news attention that is given to observational studies, often without discussion of limitations.

A day in the life of our daily news searches

Our first early sweep of national health care news this morning came up with all of the following – the first three of which come from the European Society of Cardiology meeting:

Eating this much chocolate could cut heart disease risk by 13 percent. – Newsweek (which borrowed from The Telegraph and The Daily Mail – a troubling practice that suggests very little independent vetting is being done by a news organization that was once a leader.)

New Wrinkle in Heart Health: Furrowed Brows May Bode Ill – HealthDay. The story did include this line, “But the study did not prove that forehead wrinkles cause heart risks to rise, and other heart experts remained skeptical.” Given that, why was the story worth publishing?

Deep forehead wrinkles may signal heart disease risk – USA Today. And yes, past observational studies have shown statistical associations between ear lobe creases and heart attack or stroke. Does that mean people who spot wrinkles/creases should run in for full body or full head wrinkle scans? Hardly. So how is this news important in readers’ lives?

(See other news on observational data from the European Society of Cardiology meeting in another post on our site today – What you need to know when it comes to bad news about “good” cholesterol.)

Can an Anti-Inflammatory Diet Improve Your Mental Health? – US News & World Report. The long piece is centered around one woman whose doctor ordered “30-some blood tests” before diagnosing her with this: “Your body is a forest fire,” and then prescribing a strict anti-inflammatory diet. So add tyranny of the anecdote as one more flaw in this story.

Not ready for prime time

You could argue that none of these news items was worth publishing. None provided evidence for news you can use.

Instead of reporting on these studies, I would urge journalists to report more on articles like these that are also in the medical literature:

Media Coverage of Medical Journals: Do the Best Articles Make the News? – Excerpt: “We present evidence that newspapers preferentially cover medical research with weaker methodology.”
Reporting of Limitations of Observational Research– Excerpt: “Observational research is abundant and influences clinical practice, in part via publication in high-impact journals and dissemination by news media. However, it frequently generates unreliable findings.¹ Inherent methodologic limitations that generate bias and confounding mean that causal inferences cannot reliably be drawn.”
When research evidence is misleading – Excerpt: “Bias in observational analyses currently presents challenges in reliably basing medical practices on this type of work alone.”

Comments (1)

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Mimi Griffith

September 4, 2018 at 8:36 am

Can you please write about the weaknesses and strengths of meta-analysis studies? I don’t think most news outlets have a clue.

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