Misinformation is a Patient Safety Issue

Misinformation is a Patient Safety Issue

By Michael Wong, JD (Founder/Executive Director, Physician-Patient Alliance for Health & Safety)

Misinformation is a Patient Safety Issue

As the Executive Director for the Physician-Patient Alliance for Health & Safety, I oversee our blog. I have the responsibility on a weekly basis for writing and vetting articles submitted to us for publication.

Many people rely upon PPAHS for health information (our articles receive more than 10,000 views per month). As we are not a health news agency, we don’t specialize in discussing the latest breaking news – we leave that in the hands of others. 

Rather, the PPAHS blog and website are filled with information and resources that may help improve patient safety and the quality of patient care. This information and resources are not “breaking news,” but rather a considered consolidation of best practices, clinical trial evidence, and experience. Understandably, then, the 10,000 plus website views that we receive each month are usually articles that were written months and even years ago. Hence, we must be extra diligent about citing misinformation.

Misinformation Types
Source: https://commons.wikimedia.org/wiki/File:Disinformation_vs_Misinformation.jpg

So, here are 5 things I do when checking articles submitted or preparing articles that I write for misinformation:

Tip #1 For Identifying Misinformation – Health Information on Social Media Can Not Be Trusted

GoodRx research found that social media is the biggest culprit for medical misinformation.

Social Media & Misinformation

Researchers concluded that social media is the biggest offender of medical misinformation, with 82 percent of those who reported seeing misinformation stating they encountered it on a social media platform. In addition, participants stated the majority of medical misinformation seen on social media platforms was concerning COVID-19 topics, such as vaccine credibility.

Twitter, for example, which gives users the ability to post content, reshare, and reply to posts makes it particularly susceptible to misinformation. 

The COVID pandemic has given rise to an onslaught of misinformation:

The COVID-19 pandemic has highlighted the rise of misinformation on social media, not just in terms of vaccine hesitancy, but also the initial denial of the pandemic which lead to conspiracy theories, opposition to masks and other public health policies, misinformation about scientists and health professionals, unproven treatments (such as bleach), and misinformation about the safety of the vaccine.

So, what do I do when I see information from social media or an article referencing social media?

If the information is from social media, I check to see whether this same information has been reported by a reputable source.

Tip #2 For Identifying Misinformation – How to Determine a Reputable Information Source

What’s a reputable source of information and how do I determine that?

The University of Wisconsin recommends this test, which they call the SMART Test:

  • Source: Who or what is the source?
  • Motive: Why do they say what they do?
  • Authority: Who wrote the story?
  • Review: Is there anything included that jumps out as potentially untrue?
  • Two-Source Test: How does it compare to another source?

Or, to put it another way, the University of Wisconsin also has the CRAAP Test to identify a less credible source:

  • Currency: Timeliness of the information
  • Relevance: Importance of the information for your needs
  • Authority: Source of the information
  • Accuracy: Truthfulness and correctness of the information
  • Purpose: Reason the information exists
Tip #3 For Identifying Misinformation – Has the Medical Information Been Researched Clinically?

I must confess that I read a lot of clinical trial reports. While this has no doubt led to the thickening of my eyeglass lenses over the years and constant eye fatigue, it’s an inherent and necessary part of being a patient safety advocate and using the information to make decisions about which articles to accept, educational programs to support, or patient safety projects to pursue. 

However, don’t just take clinical trial reports at face value. Be suspicious of misinformation even when reading clinical trial reports. Ask yourself:

  • Is the trial based on a double-blind protocol? A double-blind trial helps eliminate bias and hence misinformation – “A double-blind study is one in which neither the participants nor the experimenters know who is receiving a particular treatment. This procedure is utilized to prevent bias in research results. Double-blind studies are particularly useful for preventing bias due to demand characteristics or the placebo effect.”
  • Was there a sufficient number of people recruited for the trial? Whenever I think of this question, I recall the Trident gum ad that ran many years ago stating, “4 out of 5 dentists recommended …” This, of course, begs the question – is this the opinion of 5 dentists out of which 4 were used to draw the conclusion or 5,000 dentists from which 4,000 provided this recommendation?
  • Have the conclusions been overstated? Whenever I ask myself this question, I think about the research conducted on soda, which has found industry bias. Now, of course, just because the research was funded by a company, this doesn’t mean that the research is biased or will lead to misinformation. It only means that this could be a factor in deciding whether to dismiss the information.
Tip #4 For Identifying Misinformation – Presume Medical Treatment Plans from Politicians and Celebrities As Misinformation

Presume medical treatment plans from politicians and celebrities as misinformation, unless supported by a reputable health organization or healthcare professional (recall tips 1, 2, and 3 above for identifying misinformation).

You wouldn’t want your favorite actor or your country’s politician to be your doctor (unless he/she is a licensed healthcare professional) – and neither do I. 

The responsibility of politicians is to make public policy, not science or practice medicine. Drs. Richard Baron and Ezekiel Emanuel in their article, “Politicians should not be deciding what constitutes good medicine” write:

“Throughout the Covid-19 pandemic, many politicians have offered medical advice. President Trump endorsed bleach and hydroxychloroquine, an anti-malaria drug, as Covid therapies. YouTube suspended the account of Sen. Ron Johnson (R-Wis.) after he shared a clip touting the benefits of ivermectin and hydroxychloroquine. Similarly, Rep. Louis Gohmert (R-Texas) encouraged the use of ivermectin shortly after the Centers for Disease Control and Prevention and Food and Drug Administration had spoken out against its use.

“Few politicians are physicians. And most are decidedly not experts at parsing the evidence about what makes an effective therapy for Covid-19 or anything else, for that matter.”

The role of actors is to entertain us, not practice science or be your doctor. As the headline to the article by Timothy Caulfield (Canada Research Chair in Health Law and Policy at the University of Alberta) proclaims – “Celebrity wellness hype contributes to our ‘culture of untruth’ by both inviting an erosion of critical thinking and promoting what is popular rather than what is true.”

In short, if you want to go to someone to find out the best medical treatment for your condition, see your doctor.

Protecting Yourself from Misinformation Can Be Time-Consuming

Understandably protecting yourself from misinformation can be time-consuming. After all, you just wanted a quick answer to your question, not a 1-day research project.

In research published in the American Journal of Tropical Medicine and Hygiene, researchers found that approximately 5,800 people were admitted to the hospital as a result of false information on social media. Making sure you have correct medical information – rather than misinformation – could save you from being admitted to the hospital.

While the fast answer is what we all want when going online for information, misinformation is a patient safety risk, so take the time to evaluate how reliable the information is.


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