The Role of Medical Affairs in Combating Misinformation

Our digital world is both good and bad for disseminating information. More information is available at our fingertips than ever before. Publication and dissemination of communications, from memes to scientific studies, can be done more quickly than in the past.

It’s because we live in a world where information can be created and shared immediately that misinformation can spread rapidly too. Inadvertently false or incomplete data can damage public understanding and undermine trust in the clinical trial process — and in the treatments that result.

Medical Affairs (MA) teams play a key role in combating misinformation. MA teams also have an ethical responsibility to strive for clear, accurate communications at every stage of their work.

Popular Misunderstandings and Misinformation

The web, especially social media sites, has democratized the creation and sharing of information by vastly lowering the cost of doing so. In the pre-digital era, physical resources like printing materials, ink and paper, or broadcast equipment were required to share information broadly. Even conversations between people required physical proximity or the use of a telephone or mail system.

Today, creating and sharing communications is as simple as typing and clicking. Communications can be shared just as easily, and sharing occurs instantly.

Because online tools don’t evaluate the expression being created or shared, inaccurate and misleading communications can spread just as easily as accurate ones, if not more so.

Once lumped together under the colloquial heading “fake news,” multiple forms of non-accurate or misleading information often start from various factual bases and function in different ways. Psychology Today writers Susan A. Nolan and Michael Kimball note that researchers divide fake news into three major categories:

  • Misinformation is inaccurate information shared unintentionally. It may result from a simple mistake, a cognitive bias, or a lack of fact-checking. It often includes things “everyone knows” to be true but that have no real-world basis or have been proven false, such as the claim that humans use only about 10 percent of our brains.
  • Disinformation is inaccurate information shared with an intent to deceive. Disinformation is a deliberate untruth. The intent to deceive may be either malicious or well-intentioned: Telling a child the family dog ran away, instead of revealing that the dog died in a car accident, is an example of disinformation.
  • Malinformation is accurate information shared or used with a harmful intent. Half-truths, spin, and identity theft all fall under malinformation.

Misinformation is a common problem when the results of medical studies are shared with the public. In some cases, the study may be misinterpreted and misinformation may result; in others, a study that contradicts a bit of misinformation that “everyone knows” may simply be filtered out of the brain as inconsistent with a previously entrenched bias.

Both misinformation and disinformation may also be perpetuated for altruistic reasons. A study by Oberiri Destiny Apuke and Bahiyah Omar found that when participants shared incorrect information about COVID-19 online, they most often did so out of a desire to help or comfort others.

A desire to help, however, doesn’t always translate to a helpful result. As Nolan and Kimball note, “Much of the misinformation surrounding the COVID-19 pandemic is unintentional, perhaps even shared with positive intentions, but myths surrounding vaccines and other protective measures have likely led to thousands and thousands of deaths.”

For MA teams, addressing each form of incorrect information requires an understanding of its sources and motivations.

Missing the Mark: Speed vs. Accuracy in Medical Information

During the COVID-19 pandemic, pressure to find effective vaccines and treatments drove rapid advances in pharmaceutical science. This pressure also pushed researchers toward faster publication — in some cases, even before studies could be peer reviewed.

Preprint studies existed before the pandemic. The global pressure for COVID research, however, brought preprint studies to the fore.

As preprint studies became more familiar to both researchers and the public, issues regarding misinformation began to emerge as well. “The border between validated scientific knowledge and not-yet-validated scientific knowledge has become more blurred” due to the reliance on preprint studies, says Vincent Larivière, a professor at the University of Montreal who studies scholarly publishing.

While the retraction rate of COVID-19 preprint studies doesn’t appear to be higher than for preprints in general, a lack of information about retractions made early assessments difficult. For example, the database Retraction Watch only began tracking whether a withdrawal involved a preprint study after realizing it lacked complete data about COVID-19 study retractions without that data point, says Ivan Oransky, Retraction Watch’s cofounder.

Researchers are generally clear on the nature of preprint studies, including the need to read carefully and proceed cautiously. The general public, however, often lacks a clear understanding of the difference between preprint and peer-reviewed studies.

Medical journalism may further muddy the waters. A 2022 study in Health Communication by Alice Fleerackers and fellow researchers found that many preprint studies were not identified as such when discussed in medical journalism. Some publications made no mention of a preprint study’s non-peer-reviewed status, nor did they caution readers to view the results as preliminary, tentative, or conditional in any way. Among publications that did use such cautions, the form, tone, and vocabulary varied.

The diversity of approaches to preprint studies may drive misinformation. Readers may miss cautions that a study has not been peer-reviewed. If cautions are absent, readers may not realize the study is an early foray into the topic. A more consistent, standardized approach to identifying the foundation of scientific claims can help reduce misinformation.

How Medical Affairs Teams Can Fight Misinformation

In addition to distinguishing among misinformation, disinformation, and malinformation, medical affairs teams can target their efforts by understanding how audiences manage and respond to each type of inaccurate communication.

In a 2021 article in Science Advances, Ryan Calo and fellow authors made the following distinctions:

  • Misinformation is innocent, while disinformation is strategic.
  • Speech is protected by law, but actions may be prosecutable.
  • Mistaken beliefs are correctable, but convictions are ideological.

Each distinction requires a slightly different approach. Misinformation and mistaken beliefs, for example, may be addressed by providing correct information with a clear explanation of its factual sources. Combating disinformation requires an understanding of the strategic goals of those who share disinformation, as the goal is the root cause of the sharing. Addressing convictions likewise requires a deeper comprehension of the “why” behind the sharing of misinformation.

Medical practitioners, researchers, and MA teams must also be aware of their own vulnerabilities, including internal biases, information gaps, and ideologies. In addition, those who work in medical research may become targets of disinformation campaigns that seek to co-opt medical professionals’ voices to lend credence to disinformation, write Julian H. Neylan, Sonny S. Patel, and Timothy B. Erickson in a 2021 article in World Medical & Health Policy. MA teams may inadvertently contribute to the misinformation problem unless they remain aware of their own limitations and the risk that others may try to take advantage of their position to spread inaccurate messages.

To fortify their work against mis-, dis-, and malinformation, MA teams can tap into misinformation-fighting resources generated by the broader medical and scientific communities. One example is the American Association for the Advancement of Science (AAAS) series “AAAS Voices: Countering Science Misinformation,” which interviews researchers in order to fight misinformation on various topics.

“The series is positive in tone, focusing on constructive efforts to provide accurate science information. It allows [interviewees] to talk frankly about productive things they’re doing and suggestions they have,” says AAAS videographer and multimedia editor Neil Orman.

Our highly connected world allows us to communicate faster than ever before. We can access more information than at any previous time in history. Yet this ease of communication also poses major challenges. Medical affairs teams that understand the sources, transmission, and purposes of inaccurate information can better prepare to address it — both to their audiences and to themselves.

Image by: langstrup/©

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