Medical Literacy
10/25/2021
As we learned last week there is a lot of medical and health information online. We need to evaluate that information for credibility, scientific and evidence-based information, and learn to critically think about the information being presented, who is the authority presenting it and any biases in logic or argument. When looking at this information, you may realize information is false or inaccurate. We will learn more about that type of information today, how it is spread, and the effect of that spread of information. We will also look at a case familiar to most parents.
INFORMATION
MIS- OR DISINFORMATION
Misinformation is false or inaccurate information that is spread regardless of intent. Disinformation is the misinformation that is deliberately spread. Disinformation can be a powerful tool that is destructive and divisive.
Types of Misinformation or Disinformation
Disinformation can come in many forms and have many goals. Disinformation may intentionally be harmful by
- Trying to create a false connection
- Manipulating content or information
- Providing misleading content or information
- Providing imposter content
- Providing fabricated content
- Creating false context
- Acting as propaganda
There are also times that information is shared but harm is unintentional. This may occur in these situations
- As a satire or parody (this may cause unintentional harm) that is taken to be true
- Unintentional errors in providing or interpreting information
Information algorithms
Information spreads quickly, especially online. Misinformation and disinformation spread six times more quickly than credible information! Mis- or disinformation is 70% more likely to be shared than true information. This mis- or disinformation is often disseminated without verifying its accuracy and truth.
The algorithms used by social media sites, such as Twitter, Facebook, and Instagram, incentivize people to share information. Engagement is rewarded regardless of whether the information is accurate. Once you see mis- or disinformation and engage with that link or post, the algorithm will show you more of this type of information about a certain topic. This is particularly true when there is significant societal divisions, animosity, and distrust around an issue. The algorithms target political differences and racism.
Effect of Mis- or Disinformation
The spreading of mis- or disinformation is a multibillion-dollar industry. People who spread mis- or disinformation benefit financially from advertising, selling products or systems based on that disinformation, or having people pay to receive the disinformation.
Seeing mis- or disinformation, even briefly, can have devastating effects. It can result in people questioning vaccines or other medical information. The antivaccine movement has resulted in many outbreaks of disease-preventable disease. It has also prolonged the fight against the current COVID-19 vaccine pandemic. Disinformation about alternative cancer treatments has caused cancer patients to refuse treatments due to fear. People who follow recommendations based on disinformation are 2.5 times more likely to diet of their cancer than people seeking traditional treatments.
Characteristics of Disinformation
How can you identify that something is disinformation? Disinformation is often framed in an emotional or sensational manner. The goal of disinformation is to elicit a visceral or gut reaction. Emotional reactions can distort memory, align cognitive biases, heighten psychological responses like fear, and create a sense of urgency. This sense of urgency and heightened emotion urges you to share this information and react quickly to this information. Fear is a powerful emotion and a powerful motivator.
Red flags that what you are reading is disinformation include:
- Being heavily opinionated or one sided
- Using unsupported claims
- Using extreme language
- Appealing to emotions
- Not using facts
- Appeal to ideology or personal identity over facts
- Present philosophies of a community and stressing the importance of aligning with views of that community over facts
- Presenting over-generalizations
- Trying to sell a product
- Tries to provide entertainment
- Using persuasive language without evidence
- Not identifying an author
- Author lacks expertise in the area discussed
- Information is cherry-picked to prove their point
- It lacks consensus with other experts in the area
How to Stop Mis-or Disinformation
We must be proactive to stop the spread of mis-or disinformation. How can we do this? We need tools that help us identify this information and tools on how to address this incorrect information. We need additional research into how mis-or disinformation spreads, how it evolves, why it impacts people, and why certain people are more susceptible to mis-or disinformation.
We need to change technology platforms and algorithms to reward accuracy and not just engagement. We also need methods for reporting and deleting mis- or disinformation. We also need the media and journalist to stop amplifying the spread of mis- or disinformation. We need to encourage the media to proactively ask questions, give context to information, and use a broad range of credible, and if possible local, sources. We also must stop the use of headlines that provide shock instead of information.
We need to build up resiliency towards mis- or disinformation by teaching people how to spot inaccurate information as well as evaluate information for credibility. What are some steps you can use to evaluate information?
- Check the author for credibility/expertise<
- Check the author’s sources
- Read beyond headlines to get all the information
- Check to see if the article is using credible data and sources or using anecdotes or emotional arguments
- Confirm that the information is not mean to be a joke or satire
- Check the publication date to make sure it is the most current information
- Confirm the article is intended to provide information and is not an advertisement
- Check to see if the source is endorsing a product or link to a sales site
- Does the information seem too good to be true
- Check to see that the argument is balanced
- A balanced argument doesn’t weight 2 sides equally, it weighs the strongest evidence more heavily and checks for alternative views and biases
To stop the spread of mis- or disinformation you can
- Share good information to help change the algorithm to favor correct information
- Don’t’ share images to get emotional responses
- Report mis- or disinformation that you see on Facebook, Instagram, and Twitter
- Do not engage with disinformation online, this will increase it visibility
- Use private messaging or personal contact to correct disinformation
- Look for verification of a sources (blue check on Instagram, badge on Twitter) which means these sites are vetted and verified
DISINFORMATION IN ACTION
THE ANTIVACCINE MOVEMENT
How it Started
The most known example of the disastrous spread of disinformation is the antivaccine movement. The antivaccine movement gained momentum in 1998 when Andrew Wakefield published a study linking the MMR vaccine with autism. The original study was very flawed. It involved 12 children (a very small sample size). The children were pre-selected by him (not randomized) and the study was based on parental anecdotes (not hard data or evidence). Wakefield was also found to falsify data and exclude data that didn’t support his predicted hypothesis and conclusion.
Why would he do this? He was paid by a personal injury lawyer to provide evidence that helped his case! He was paid over $500,000 to create this evidence that supported the lawyer’s case. He also was attempting to develop his own vaccine. If he sowed doubt in the current vaccine and it was replaced with his vaccine, he would financially benefit. He also planned to develop a fake autism diagnostic test kit to sell to parents. His study was retracted by the journal, and he lost his medical license.
Since 1998, there have been hundreds of studies that have proven the MMR vaccine does NOT cause autism. A 2014 review of 338 vaccine safety studies, that involved millions of children, showed NO increased risk of autism due to the MMR vaccine. In 2019, another study, done in Denmark, involved over 650,000 children of which one percent were diagnosed with autism. This rate was identical in the nonvaccinated and vaccinated group.
Despite there being no evidence for a link between autism and vaccines and LOTS of evidence this link does not exist, why is the anti-vaccine movement growing? And why does there continue to be fear related to vaccine and vaccine safety.
The antivaccine movement spreads disinformation. They use logical fallacies to reason their argument. They appeal to false authorities, and they appeal to emotion. Opponents of vaccines amplify anecdotes of those who claim severe side effects. This amplification creates fear and hesitancy even if those cases are rare and not confirmed. They never provide scientific date and refuse to look at that data ensuring vaccine effectiveness and safety due to the cognitive dissonance it creates.
Disinformation Dozen
The Disinformation Dozen are a group of antivaccine movement leaders who put out 75% of all the disinformation spread online about vaccines. This groups leads the antivaccine movement. This group is savvy. They have learned to target specific people including alternative health advocates, conspiracy theorists, BAME (black, Asian, and minority ethnic) COMMUNITIES, and THE PARENTS OF YOUNG CHILDREN. They use sophisticated techniques and algorithms to identify these individuals. They create “safe” spaces for people to ask questions then provide disinformation in their answers. They use research-based techniques to test these people’s receptiveness to their content. They start to sow doubt in the science of vaccines. They provided targeted information that often uses anecdotes and imagery to increase emotions of fear and anxiety. They prey on every parent’s fear. Then they encourage, “groom”, or provide training for people to spread this information.
The Disinformation Dozen also sow distrust with the scientific and medical community through financial claims that they cannot back up. They claim that “Big Pharma” is making large profits off vaccines. The truth is that vaccine development is costly, and vaccines are much less expensive than the treatments marketed for these diseases. Vaccines costs are quite low. Much lower in fact that the cost of treating the disease.
For example, a Tdap (tetanus, diphtheria, and pertussis) vaccine costs $45. The cost for treating a pediatric patient who develops any of these illnesses is:
- $22,000 to $1,000,000 to treat tetanus, with 100% of patients who contract tetanus requiring hospitalization
- $17,000 to treat diphtheria, with 100% of patients who contract diphtheria requiring hospitalization
- $ 95-$250 for antibiotic treatment for outpatient pertussis treatment or
- $100,000-$1,000,000 for the 30% of pediatric patients who are hospitalized with pertussis
In fact, vaccines only make up 2-3% the pharmaceutical industry profits. Most of their profits comes from medications to treat diseases and conditions. The Disinformation dozen also claim that doctors push vaccines because they make a profit. This is not true. There is no incentive to give vaccines and often reimbursement is so low that it costs providers money to administer vaccines when accounting for administration, nursing time, billing, and cost of supplies.
What this movement doesn’t tell you, is that THEY, the Disinformation Dozen, are making HUGE profits off spreading disinformation. The antivaccine movement has 62 million followers and get over 29 million views every month. And guess what followers and views gets you? MONEY! Antivaccine informational sites are a multibillion-dollar industry. Social media sites, including Facebook, Instagram, YouTube, and Twitter, have been slow to stop the spread of their disinformation because antivaccine sites are such money makers. They are hesitant to act and stop the spread disinformation even when it is brought to their attention.
It’s not just the social media sites that are making money, the antivaccine advocates make money from this social media ad revenue too. One antivaccine advocate made over $1.4 million dollars in YouTube based ad revenue last year. Based on the revenue splitting formula YouTube uses, that advocate made $800,000! Twitter revenue is upwards of $7.2 million yearly.
In addition to ad revenue, there are other revenue channels these people use to profit off disinformation. Antivaccine advocates sell products, use affiliate marketing schemes, and charge for webinars and speaker fees. They hide their financial information while pointing fingers at others.
There are groups currently working to limit the Disinformation Dozen and the spread of disinformation on social media. One such group was able to attend a Zoom meeting in October where they witnessed the Disinformation Dozen planning how they were going to campaign against the COVID-19 vaccine as well as how they could profit off the spread of this information. At the time the data had not been released on the COVID-19 vaccine, yet they were already planning an attack. They continue that attack despite that fact that 2.8 million vaccines have been given and no long-term side effects have been seen. They continue to claim we do not have enough science to prove they are safe. This is the most data when have ever had, the most data we have had available this quickly with any vaccine campaign, and it is overwhelmingly proven that the vaccine is effective and safe. We are well beyond the wait-and-see period of determining effectiveness and safety.
Fighting the Antivaccine Movement
Groups that are fighting this spread of disinformation recommend not engaging on antivaccine sites or with disinformation. They recommend privately speaking with friends or family who are spreading this information and providing facts and evidence-based science. They also recommend sharing pro-vaccine information to help increase the visibility of this information online and help change the algorithm.
What are some safe science-based social media accounts?
This podcast has a great website, Instagram page, offers a newsletter, and lists all their sources for easy reference. They have great information on COVID-19, vaccines, and health issues. It is run by an Immunologist and Public Health Scientist.
Science by Sam is a site and Instagram page run by Neuroscientist and Cellular and Molecular Biologist Samantha Yammine. Her videos make science accessible and entertaining.
@healthychildrenaap
Healthy Children has an Instagram page with friendly, easy to read infographics on a variety of health issues. These infographics are in Spanish as well as English.
Teen Health Doc or @teenhealthdoc
Dr. Hina Talib is an adolescent medicine specialist. She provides newsletters, links to articles and podcasts she had contributed too as well as provides great information on her Instagram teen to help ensure the mental and physical health of our teens.
@bostonchildrens
Boston Children’s Hospital’s Instagram page provides easy to read information about current health topics, and current research.
We have more information than we ever have before but that isn’t always a good thing! We must learn to comb through this information to make sure it is current, accurate, and bias-free. Learning how to spot mis- or disinformation as well as logical fallacies and false authorities can help you weed out the good from the bad information and critically think about what you are reading and learning. If you would like to discuss any health information you have found or are questioning, please do not hesitate to speak to your primary care provider.
Children’s Health Care of Newburyport, Massachusetts and Haverhill, Massachusetts is a pediatric healthcare practice providing care for families across the North Shore, Merrimack Valley, southern New Hampshire, and the Seacoast regions. The Children’s Health Care team includes pediatricians and pediatric nurse practitioners who provide comprehensive pediatric health care for children, including newborns, toddlers, school aged children, adolescents, and young adults. Our child-centered and family-focused approach covers preventative and urgent care, immunizations, and specialist referrals. Our services include an on-site pediatric nutritionist, special needs care coordinator, and social workers. We also have walk-in appointments available at all of our locations for acute sick visits. Please visit chcmass.com where you will find information about our pediatric doctors, nurse practitioners, as well as our hours and services.
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.