We're all familiar with news talk shows where two individuals, both with impressive credentials, argue for completely incompatible positions. Unfortunately, these sorts of arguments aren't limited to social or political issues, but have increasingly extended into the scientific and medical realms. Aside from providing an indication that you can find someone with an M.D. or Ph.D. that's willing to say nearly anything (see infomercials for further evidence), these disagreements are likely to leave the public confused over where to find credible scientific information.

Separating the scientific wheat from the chaff

The importance of quality information was driven home by a recent study that revealed a tendency for false or misleading information regarding breast cancer to appear on web sites devoted to alternative medicine. So, how is the public supposed to identify quality scientific information? The recent American Association for the Advancement of Science meeting included a session devoted to understanding how the public receives and evaluates scientific information.

Carl Bialik, The Wall Street Journal's numbers guy, discussed the problems the public has in terms of receiving decent numerical information. Bialik cited various examples of news stories that pushed numbers with phony precision, originated from invalid samples, or presented inappropriate statistical measures.

Bialik suggested that part of the problem is with readers and viewers, who like to have concrete numbers to hang on to but rarely care enough to explore how those numbers are generated. On the production side, a lot of the unexpected statistics get played as human interest stories, drawing someone other than a qualified science reporter. Pressed for time, the stories go out without a detailed examination. Bialik's solution involved researchers working with journalists to ensure that numbers are presented properly; the American Statistical Association also keeps a list of members willing to work with the press. For the public, the message seemed to be that a story shouldn't be trusted simply because it had numbers attached to it.

David Goldston, the former staff director for Congress' House Committee on Science, focused on the challenges of communicating scientific information to lawmakers. His message was that, contrary to popular opinion, most members of Congress like science and want to be informed. Scientists, however, have a lot to learn about reaching them on their terms.

The first issue is where to reach them. Scientists, like everyone else, get a buzz out of visits to the Hill, but Goldston argued that they should visit members of Congress in their home district if possible—they'll be competing with fewer people for attention there. Once the visit starts, scientists should expect to be treated with respect, but they need to remember to return that; most members of Congress and their staffs do have the ability to understand scientific issues if they're well explained.

As for the actual communications, Goldston emphasized that researchers need to delineate when they're talking about science, and when they're talking about policy. As he put it, policy is acting despite residual scientific uncertainties, and the most reasonable action can't be determined scientifically, so it needs to be made clear when someone drifts into personal opinion. The science has to be conveyed in clear terms that make sense to a nonscientific audience. "Only use metaphors when what they're substituting for is actually confusing," Goldston said, "and make sure they aren't more confusing than the issue."

What to do when expertise doesn't matter



With the press and politicians covered, Anne Schuchat of the Centers for Disease Control talked about a public issue that never used to be contentious: vaccination. She cited estimates suggesting that public vaccination efforts have saved the US $43 billion and prevented 1.8 million cases that would have led to tens of thousands of deaths. Despite the lack of evidence for harm, however, vaccines are getting the blame for a variety of childhood ailments, and more parents are deliberately opting out of vaccination programs. In the US, about 0.3 percent of parents are now opting out; Schuchat says that these families cluster, demonstrating how opting out is a largely social phenomenon. Unfortunately, it also enhances the risk of disease outbreaks.

Schuchat mostly discussed how personal concerns fed in to vaccination decisions. "Fifty years ago, disease was very real to parents," she stated, noting that parents put forward 1.8 million schoolchildren to take part in testing of the polio vaccine simply because polio was a concrete risk, while the risks of the vaccine were abstract and minor in comparison. Now, with most vaccine-targeted diseases existing only in the memories of older family members, the risks of vaccination—discomfort, a rare adverse reaction, even unfounded rumors of an autism link—seem more concrete than the disease itself.

How do medical authorities overcome these perceived risks? Simply speaking from a position of authority isn't enough, Schuchat argued. She cited surveys indicating that, for credibility assessments in areas of "low concern" (she suggested Tsunami risk in foreign countries as one example), US citizens are happy to defer to expertise, rating it as accounting for 85 percent of their assessment. When the topic shifts to areas of personal concern like family medicine, the importance of expertise vanishes. Schuchat said that it drops to where it accounts for only 15 percent of the decision, equal to a sense of honesty and openness, and far below the value of empathy, which accounts for roughly half of the decision. The message was pretty clear; for the public, how decent medical information is conveyed counts for more than the quality of the information itself.

The clear message of the session was that a command of facts is never going to be good enough to convince most segments of the public, whether they're parents or Congress. How the information is conveyed can matter more than its content, and different forms of communication may be necessary for different audiences. As became clear in the ensuing discussion, most of the public act as consumers of information, with journalists acting as middlemen. To connect with the public, scientists have to work with the press to ensure that two things happen. Reporters have to overcome their ingrained aversion to the uncertainties of science, and have to avoid presenting uncertainties as a matter of balance that's addressed via material from crackpots with credentials.