This news release touting the health benefits of golf overreaches and employs unjustified language in summarizing the consensus statement of 25 experts who used questionnaires to agree upon “how best to maximize [golf’s] health benefits, promote [its] sustainability, and widen participation.”
There is no original research here. The methodology used to reach a subjective consensus is fraught with major limitations which preclude making health recommendations.
The news release fails to mention the entire process was funded by the World Golf Foundation, and some of the authors have other notable financial conflicts of interest within the golf industry.
If a news release is going to make claims of evidence showing wide-ranging health benefits related to both physical and mental health — as well as longevity — it had best back that up with real evidence.
Furthermore, when there is no original research involved, and the conflicts of interest are substantial, use of the term “evidence” is grossly misleading.
This is promotional pablum, not science.
The news release states that golfers tend to be “relatively well off” and:
“… the sport is often perceived as expensive … and not a game for the young or those on the lower rungs of the social ladder”
The cost to play 18 holes at the course closest to where this review is being written is $27. The fee at St. Andrews Royal and Ancient Golf Club in Scotland — where one of the authors is director of Golf Development — is roughly 10 times that amount.
The subtitle of this release claims golf “may not only be good for mind and body, but also for a long life.”
More specifically we’re told evidence for this comes from the “systematic review of the available evidence (342 eligible studies)” — and — “the evidence shows that playing golf regularly is associated with longevity and reducing the risk factors for heart disease/stroke. And it can boost older peoples strength and balance.”
Unfortunately, absolutely no data are offered to support these sweeping health claims.
The only potential harm from golf mentioned is an increased risk for skin cancer. It’s an important inclusion that prompts us to give a barely passing grade.
This nebulous statement is also included: “Compared with other sports, the risk of injury is moderate.” (Rugby and mixed martial arts come to mind).
What’s not mentioned is a host of musculoskeletal injuries related to the repetitive and asymmetric nature of swinging a golf club.
This study is based on a “modified Delphi method” involving 25 experts “in public health and health policy, and industry leaders.” Their qualifications are not included.
The Delphi Method has experts complete several rounds of anonymous questionnaires with the goal of reaching a consensus.
This methodology has several limitations including: it’s subjective, not objective. There are no established guidelines for implementing the surveys. The goal is to reach a convergence of opinion, and — most importantly — the resulting consensus does not equate with causation.
Not mentioning the study method and its limitations is a major weakness of this news release.
This is the second major weakness of this news release.
It’s not mentioned that this “2018 Consensus Statement on Golf and Health” was funded by an unrestricted grant from the World Golf Foundation.
Two of the authors receive fees from the European Golf tour and one is the director of Golf Development at the Royal and Ancient Golf Club in St. Andrews, Scotland.
Golf is often referred to as “a good walk spoiled.”
Common sense would suggest many of the benefits touted in this news release might also hold for a good walk or hike; unfortunately, no alternatives are mentioned.
Golf is widely available worldwide. But as suggested in the release it may be prove unaffordable for many.
This news release does not present golf as a novel form of exercise. But we think it clearly overreaches in suggesting a host of health benefits through a news release — without any supporting evidence. There is no news here, just promotion.
Given there is no study here, and the basis of the health claims is nothing more than a subjective consensus statement of experts (some with major conflicts of interest), we find the headline and health recommendations of this news release to be unjustified and overreaching.
Systematic, Criteria-Driven
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Comments (4)
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Emma Dickinson, BMJ Media Relations
October 2, 2018 at 2:17 pmIn response to your review: Firstly, this press release did not cover content from The BMJ as is implied, but a Consensus Statement published in the British Journal of Sports Medicine, an entirely different publication.
Secondly, you refer to the fact that ‘there is no original research here,’ but at no point does the release say that it is. It clearly states throughout that it refers to a Consensus Statement, which doesn’t purport to publish original research, but to produce agreed statements based on the available published research to date. These studies are clearly referenced in the text.
The fact that the release refers to a Consensus Statement is also made clear in the Academy of Medical Sciences labelling system that we use to tag all our press releases.
Thirdly, at various points you suggest that information/caveats, which don’t appear in text of the Consensus Statement, should be included in the release: the range of injuries associated with golf, alternative exercise to golf, or the limitations of the Delphi method, for example.
Our releases stick strictly to the content of the article (s) in question, and always have done, however limited you might think this content to be.
And you criticise sentences that have been lifted directly from the text. “The nebulous statement is also included ‘Compared with other sports, the risk of injury is moderate’,” is one such example. And you might find the health recommendations ‘unjustified and overreaching’ but these are drawn directly from the Consensus Statement, so hardly a fault of the press release itself.
The entire process was not funded by the World Golf Foundation, as you assert. We don’t include funding sources in the text, because our research is often funded by multiple organisations. And all these details, along with conflicts of interest, are stated at the end of every article, an embedded link to which is included in every release we issue. The release also explicitly states that those drawing up the Consensus Statement included industry leaders.
It’s not clear what point you are trying to make about the costs of golf when you compare the differences between the costs of playing at a local US club and St Andrews in Scotland: one of the key messages of the Consensus Statement is that golf is not inclusive enough. And that extends to its pricing structure as well as to the social and gender profile (real and perceived) of players.
As with all our releases, the text was checked by the author, and in this instance, also reviewed by the journal’s editor, before it was issued. You may object to the content of the release, but it was a faithful summary of the Consensus Statement itself.
Kathlyn Stone, Associate Editor
October 3, 2018 at 10:05 amDear Emma,
Thanks for weighing in with your objections to our review on your news release. We understand that BMJ publishes about 50 journals and that this statement was not published in THE BMJ. But BMJ journals did publish this release and must take responsibility for its content.
I agree that the Consensus Statement does not claim to include original research. But following our 10 criteria for a well-written news release we do expect to see some data or evidence supporting claims such as that made in the news release. There are no data. The opinions of “industry leaders” are not science or evidence, particularly when those giving their opinions hold financial conflicts of interest with the sponsor of an intervention. As stated in the British Journal of Sports Medicine, the World Golf Foundation funded the Consensus Statement and that conflict of interest needed to be included in the news release in the interest of transparency. No other funders were mentioned in the Consensus statement.
Yes, we think elements like harms, alternatives, and limitations of research should be included in news releases where applicable. In this case, we thought they were applicable.
You made the point that the health recommendations were drawn from the Consensus Statement so it’s “hardly a fault of the press release itself.” But our primary concern is what’s in the news release for widespread consumption. Therefore, a subheading which reads “Evidence suggests it may not only be good for mind and body, but also for a long life” is unjustified. That IS from the news release, so it’s the responsibility of those writing/editing it.
Keep in mind that news release reviews are focused on the media messages going out to the public and not published research, or in this case, a Consensus Statement. If we were reviewing the latter, the approach would be much different. Journal articles are written for professional audiences but news releases are focused toward and made available to a very wide public audience, many of whom will not have access to medical journals, nor be able to interpret medical jargon.
Emma Dickinson, BMJ Media Relations
October 12, 2018 at 9:33 amDear Kathlyn
Thank you for your response. BMJ Journals is not trying to shirk its responsibility. But journalists frequently mix up The BMJ with other titles published by BMJ (the publisher). It would have been helpful if you had mentioned British Journal of Sports Medicine in your critique.
You say there are no data, but the evidence on which the Consensus Statement is based is clearly referenced throughout the text, which journalists have full access to via an embedded link in the press release.
Regarding conflicts of interest, as previously stated, all this information is clearly stated in the statement itself, but it’s a fair point to say that it would have been more transparent to include the funding sources in the text of the release.
You say elements like harms, alternatives, and limitations of research should be included in news releases where applicable. If these elements are included in the paper, we will include them in the release, but we always stick strictly to the text of the paper. What you are suggesting would require press officers to become instant experts on a whole range of topics, including, in this case, the shortcomings of the Delphi Method. That risks introducing serious errors.
You argue that the subheading which reads “Evidence suggests it may not only be good for mind and body, but also for a long life” is unjustified. But that is from the Consensus Statement. You might disagree with it, or think the evidence, such as it is, flimsy. But that is what the text of the statement says, rightly or wrongly.
You say that news release reviews are focused on the media messages going out to the public and not published research, but you can’t separate the two. The messages of the press release should reflect the content, good or bad.
Kathlyn Stone
October 12, 2018 at 10:59 amDear Emma,
Thank you for the follow-up comments. Our stance is that no one involved in the dissemination of news about health care can afford to blindly pass along information that is incomplete and imbalanced. That’s especially true in an environment where PR messages are passed along uncritically, sometimes verbatim, to the public. It’s true that taking on this responsibility may be novel for some press officers, but we believe it’s necessary and justified for these messengers to take a more journalistic role in vetting the information they put out.
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