Rebecca Blaylock and Clare Murphy

Sir David Spiegelhalter OBE FRS is a statistician and the Winton Professor of the Public Understanding of Risk at the University of Cambridge. He has recently published an article with Alexandra Freeman (Executive Director of the Winton Centre for Risk and Evidence Communication) on the responsibilities that researchers, journalists, and press officers have to accurately communicate risk. They claim that “research that is poorly communicated or presented is as potentially damaging as research that is poorly conducted or fraudulent”. This blog looks at the main points raised in the paper, and how they relate to the WRISK project.

 

A precarious balancing act

Daily life is a precarious balancing act, and we all have to weigh up our own series of risks when crossing the road, reaching for that extra cup of coffee, or having a night out with friends. We are bombarded with warnings that bacon sandwiches will give us colorectal cancer, and there is no safe level of alcohol consumption. This balancing act appears to become more perilous once a woman is pregnant, and mothers can be wracked with guilt over harms they may or may not have caused their baby in utero. Many messages about risks (in pregnancy and beyond) have a strong evidence-base, but others may overstate the available scientific evidence, or fail to reflect ambiguities or alternative explanations. While health messages which scientific papers help generate and inform are absolutely vital to protect the wellbeing of both the population and of individuals, they must accurately represent what we do and do not know, and be communicated in a respectful way. This isn’t always easy.

 

The long and winding road

The road from research findings to media headlines is long and winding, and results from scientific studies can certainly be distorted on the journey. Freeman and Spiegelhalter note that ‘the mainstream media’ and journalists have traditionally received the greatest criticism for inaccurately reporting study findings, something which has only increased in the era of ‘fake news’. However, they present examples to support their contention that the problem may at least sometimes lie with researchers themselves, not with press officers or journalists who communicate their findings. Freeman and Spiegelhalter acknowledge the pressure researchers are under to maximise the ‘publishability’ of studies – and the consequences of a climate of “publish or perish” have been a focus of increasing scrutiny.

The authors go on to emphasise that the majority of press officers and health journalists take their responsibilities very seriously, simply reporting results directly from papers or the researchers’ press releases verbatim. And this, say Freeman and Spiegelhalter, is where problems often arise. Inflammatory headlines which seem to disproportionately emphasise the risks are sometimes simply repeating the original research article word-for-word. The authors also recommend that researchers exercise caution when making claims that their research has “serious implications for public health” when these claims are “weakly supported at best”.

A complex art

The concerns raised in this article are directly relevant to what we hope to explore at WRISK. We start from the basis that all stakeholders in risk messaging want to secure the best possible outcomes for women and their babies. Communicating scientific results is a complex art, with multiple actors, and we don’t necessarily get the chance to think about how the messages that result are received.  We need to consider who the recipients of risk messages are, and what they are meant to do with the information imparted.

Maternal guilt and anxiety is experienced at the individual level, even when there may be little a woman can do to avoid specific risks. Research, for example, about the relationship between air pollution and fetal development is vital, and recent findings are troubling: “small but significant proportion of babies born underweight in London” and “air pollution particles found in mothers’ placentas”.  But the messages that may emerge, which include advising pregnant women to avoid busy roads, are not much use to mothers living in social housing who are unable to move away to cleaner air, or to pregnant women who must walk down polluted streets to get to work. It is a point also pertinent in the discussion around a recent study on how mothers’ exposure to chemicals in everyday personal care products may induce early puberty in their daughters. The association, which was in any event small, is difficult for women to act on, as Dr Ali Abbara, clinical senior lecturer at Imperial College London pointed out: “Generally limiting unnecessary exposure of chemicals if avoidable is sensible to avoid potential harm, however in practice this may difficult to do as they are so ubiquitously present.”

 

Responsible communication

Responsible communication is one of the three key responsibilities in scientific research, but until recently, little attention has been paid to giving women (and the public more broadly) the tools to critically engage with scientific evidence, or to think about how women respond to it. When it comes to pregnancy, a significant body of studies are based on animal models which may have limitations when applied to women and their babies.  It doesn’t mean these studies aren’t valuable – on the contrary – but women deserve to understand the science behind headlines which may influence their reproductive decision-making.

WRISK aims to unpick how risks are constructed and communicated to women and their families regarding pregnancy, how they are received, and how they acted upon. By gaining a greater understanding of this and by talking to women directly, we hope to propose some practical and respectful solutions. Please do contact us to get involved in our project.

You can read Freeman and Spiegelhalter’s full article (open access) here.