Advertising or evidence? Why we need system changes in academia to improve media reporting

“Whatever a patron desires to get published is advertising; whatever he wants to keep out of the paper is news.” In their Research Letter in this issue of JAMA Internal Medicine, O’Keeffe and colleagues have done us a great service. They analyzed media coverage of 5 tests promoted for use in early detection of disease. They found almost 1200 stories from 2016 to 2019 covering new techniques or devices, such as 3-dimensional mammography, blood biomarker tests for dementia, and the Apple Watch Series 4, which includes electrocardiogram monitoring. Almost always, the potential benefits of early detection were reported, yet the potential harms—for example, overdiagnosis—were reported only a third of the time. We are skewed, therefore, to receive unbalanced information. And when press stories quantified a benefit, the absolute numbers—which help to frame information contextually—were expressed only 14% of the time. These are the ingredients for overselling interventions.