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Fiona fox's blog
I’m not sure why now, but after 10 years of running weekly briefings on controversial science stories we have recently been challenged more by journalists about why we don’t have ‘all sides’ of any given row represented on our panels.
The SMC’s statins ‘Backgrounder’ is the latest example of a journalist objecting to what looks like a one sided line-up of experts who are all pro-statins. But there is actually a logic here. The fascinating debate about the medicalization of society prompted by the NICE proposal to extend the use of statins to low-risk patients is incredibly important and the media are rightly captured by the strength of feeling on both sides. But there is a real risk that the scientific facts have become the first casualty of what David Aaronovitch has called ‘statin wars’. As my friend Evan Harris always reminds me, people are entitled to their opinions but not to their facts, and while all science is messy there is a lot of good evidence on statins. A lot. The SMC’s statins backgrounder includes six leading experts who are very close to the clinical research on this drug and are well qualified to help science and health journalists navigate their way through the claims and counter-claims that must be extremely confusing for patients and public. It is true that there are some doctors who disagree and I don’t think anyone could say they are not getting their voices heard. But the vast majority of heart and statins experts on the SMC’s database argue that the evidence on statins is compelling and this briefing is designed to characterise and summarise that evidence. Putting a doctor on the panel simply because they disagree rather than on the basis of their expertise may make good copy and would certainly be more fun. But if that doctor makes inaccurate claims that are widely reported or is presented as proof that medical researchers are split on the evidence, the SMC will be responsible for perpetuating the misrepresentation that we are trying to tackle. That is too high a price to keep journalists happy.
The issue was also raised at our Care.data press briefing earlier this year when some of our friends in the media turned their questions on me as chair to ask why everyone on the panel was broadly supportive of the principle of sharing medical data with researchers when the debate outside the room looks completely different. Similar questions have been raised by journalists recently in relation to SMC briefings on Tamiflu and statins and of course we have long been accused of issuing round ups that appear to be pro-GM or one-sided on climate change.
So are we getting this badly wrong? I am definitely open to being challenged on this but I think I should first explain why we think we are generally getting it right.
The SMC is not a learned society or a debating chamber. I would pay good money to watch Rory Collins versus Clare Gerada on the medicalization of society and I have proposed just that event to several science organisations. But SMC briefings are not in the business of conflict resolution or entertainment. Our mission is clearly stated in our charitable objectives – to make it easier for the public to access the best science on the most contested issues through the mass media.
The SMC is a service for journalists and we like to think we are good at adapting the best science to the needs of a hungry 24-hour news machine. But there is a reason why we describe ourselves as an independent press office ‘for science’. We were set up by and are funded by the scientific community, have been hosted by the Royal Institution and now the Wellcome Trust, and most of our advisers and trustees hail from scientific organisations. While I would hate to think we are boring or predictable (and there are enough rows in mainstream science to keep this interesting), I do think it would be fair to say that what journalists should expect when they pay a visit to the SMC is the voices of and views of mainstream scientific research. We have never claimed to be the place to come to get all sides of the story and I am convinced we would fail in our mission if we went down that road.
Of course where there is a strong divide in science the SMC must and does reflect that. On cannabis, bees and neonics, HRT, Tamiflu and so on the SMC has rightly reflected the views of great scientists whose research brings them to different conclusions. But rarely on the same panel because it’s not the best way of clearly representing the science to the public. To do it this way would mean the row, not the science, becomes the story. The journalist who objected to the one-sided makeup of our Tamiflu panel wanted us to have other researchers whose studies have found that Tamiflu is more effective than Lemsip. But the SMC has reflected those views in the past and did so again through our ‘roundup’ of third party reaction on the day. The publication of significant new research in the BMJ and Cochrane was the right time for these particular experts to have their day in court – explaining and defending their complex findings and methodology to a room full of medical reporters rather than having yet another argument with those who came to different conclusions. The journalists at SMC briefings of course are always given free rein to interrogate the scientists and can bring other views into the room – that is their job. With cannabis I think we run as many briefings with Prof David Nutt as we have with Prof Robin Murray even though they reach different conclusions on the risks. Both use different approaches and methodologies, both publish in top journals and both want and need their time to brief key journalists on their work. I could go on. There are many science issues on which great scientists disagree and when that happens we do our very best to represent the different academics.
But there are very many more issues on which there is a broad scientific consensus based on a body of evidence pointing in the same direction. And here’s the thing. The SMC does not make up the scientific consensus over a bottle of wine. Nor do we lazily represent both sides of a debate to make sure the boxes are ticked. We are in touch with dozens of leading academics across a variety of fields and it can take weeks and months of consultation to figure out where the evidence lies on contested issues like badgers, bees and neonics and sugar. And we are not complacent about it. The science is rarely ‘in’ or ‘settled’ and we always follow new developments. Far from ignoring the pause in global warming, the SMC gathered a cast of top experts to explain what they thought was happening to a room full of journalists and admit to the gaps in knowledge and uncertainties. When and if there is good evidence challenging the consensus on all these issues we will be first in the queue to promote that to the press.
Nor is any of this a trivial issue for the SMC. Twelve years ago I wrote up the consultation conducted over 3 months that set out the general direction for this new and unique media relations operation. I was writing it smack in the middle of media frenzies about MMR and GM that had prompted the call for the SMC. Suffice it to say that if there was one thing that the scientists wanted the Centre to do above all at that time it was to challenge the misleading and inaccurate impression given by the media that science was divided on MMR and GM. It was made clear in that founding document that the SMC would reflect the scientific consensus on these rows – especially when that consensus is obscured by the ‘row’. Parents believing that medical science was split down the middle on MMR were being badly let down by everyone involved in the MMR debacle. The SMC was meant to try to stop that happening again by ensuring that the media, and thanks to them, the public, know where the weight of evidence lies on the science stories that become the subject of fierce societal debates.
None of this means the SMC is against the public and media debating all sides of these stories or that we want to close down discussion. Indeed we have recently annoyed friends in the climate science community by arguing that an independent media is fully entitled to feature climate sceptics. The most unfair accusation levelled against the SMC is that by putting on ‘one sided’ or ‘cast biased’ briefings we are not interested in debate. The opposite is the case. We get out of bed every morning in order to support encourage and facilitate more scientists to engage in these debates however messy and contested. But covering all sides of these rows is the job of the journalists not the Science Media Centre. Of course reporters can and should walk out of a briefing on Care.data where they have heard the view of the medical research community and call Med.Confidential or Liberty but the idea that we should get Sharmi (my hero) on the panel would be a massive departure from our stated aims. Privacy campaigners and some GPs oppose Care.data and the media have rightly given these concerns due prominence. The overwhelming majority of medical researchers support the principle of sharing medical records and the right thing for the SMC to do in the middle of that media row was to bring those views to the attention of the journalists.
I know some journalists hate this and I get that and it’s fine. Words like consensus and authoritative and orthodoxy are a big turn off to a media that loves nothing more than a heated debate and a maverick. When Lawrence McGinty, one of my all-time favourite science editors, spoke at our 10th anniversary, he urged the SMC to remember the minority voice that might be proved right. I saw Lawrence’s words not as a shot across our bows but a reminder that there should always be a healthy tension between a science press office like the SMC and a science journalist, a point forcefully made by Pallab Ghosh when he explains that science journalism is not science communication. Journalists are perfectly entitled to seek out minority voices and indeed we expect them to but they should not expect the SMC to do that for them. If we start scouring the country for the lone voice who opposes the consensus there is every chance we will amplify that voice and end up being responsible for the ‘false balance’ that scientists most fear. If the media do find the much sought after maverick who overturns the scientific consensus then good for them – it was never something in our mission statement and we can live with gathering reaction from scientists saying they got it wrong.
A former colleague once observed that “journalists come to the SMC to be told that a story is more complicated than they think”. I could not agree more, and if we offered a polarised boxing match instead, that complexity would be lost and we would not be doing our job.
Now tell me what you think.
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I agree with you 100 per cent Fiona.
Your job is to present us with the story as you see it at your briefings. Our job is to pick up the phone afterwards.
We are free to seek other views if we see fit – and,here’s a radical thought, make our own minds up.
Thanks for writing this Fiona – such an important message that is often missed or forgotten. Couldn’t agree more and couldn’t have put it half as well.
If only Evan’s maxim about people being “entitled to their opinions but not to their facts” were true. Life and science journalism would be so much simpler.
Regrettable as it may be, cutting-edge science routinely features leading scientists having differing opinions about what exactly constitutes “the facts”.
The current issue of Nature has a classic example of the genre, concerning the value of vitamin supplements:
“Pooled together, evidence from double-blinded, placebo-controlled clinical trials suggests that hardly any nutrient supplements have a consistent health effect on people in developed countries. But many argue that the null findings reflect research deficiencies, including poor study design, inappropriate mixing of different kinds of data and misunderstandings about how much of a nutrient is enough.”
Anyone who thinks that “facts” that emerge from research are beyond criticism based on “mere” opinion needs to stay in more, and read the refereed literature.
I think this is an excellent article, Fiona. The role of the SMC is to provide people with more information, to help them make up their own minds (paraphrasing Pallab Ghosh) in a more informed way! Keep up the clear, scientific, logical thinking, Fiona!
Yes good article. What I like about the SMC is that I always know what the line is going to be without actually attending 🙂
The more the public understand the importance of the scientific consensus, how it operates, how it is reviewed, how it may be changed and developed, how important it is, and why it trumps ‘balance’ (sensu ‘a balanced debate’) the better.
Unfortunately, SMC briefings can serve to not just omit important information and views, but also to seriously misrepresent the evidence.
In a briefing on the PACE trial for CFS it was claimed that CBT and GET led to a third of patients getting ‘back to normal’. What was not explained was that the researchers had re-defined (post-hoc) what was ‘normal’ in such a way that patients who had been classed as suffering from “severe and disabling fatigue” at the start of the trial could report a worsening of all symptoms during and after treatment, and yet still be classed as “back to normal”.
When patients were justifiably angry about the way in which data had been misrepresented, the SMC then started a campaign to try to portray critics as being motivated by militant anti-psychiatry (with the hint that violence was never far away). There was no mention of the fact that while PACE researchers attempted to portray FOI requests as being a form of ‘harassment’, they were refusing to release their data in the manner which they themselves had laid out in their own published protocol.
For more detail and references, my comment can be seen here: http://www.bmj.com/content/347/bmj.f5963/rr/674255
For an example of a recent attempt to get around the PACE researchers refusals, and finally see the release of this important data see: https://www.whatdotheyknow.com/request/selected_data_on_pace_trial_part#comment-51344
In my above comment I explained that “we do not currently have compelling evidence that CBT or GET are more effective medical interventions for ME/CFS than homeopathy, despite some of the claims made by proponents.”
Even though there is a strong consensus amongst homeopaths that their treatments are effective, it would still be important for any SMC briefing on homeopathy to include critics and skeptics. In the case of CFS, the SMC policy seems to be to represent only the views of those with a vested interest in the efficacy of CBT and GET as treatments.
Yes, well done Fiona. I’ve been around for a while too and I agree with you completely.
Yes.
There isn’t a consensus on ME/CFS. There are lots and lots of researchers who find the CBT and GET model for the illness very unsatisfactory, given the hundreds of studies that have found all sorts of abnormalities, many of which used sedentary controls. There is no need for the SMC to only use proponents of the CBT/GET model of the illness when covering the issue.
One aspect that concerns me is that medical research contains ever-increasing but vital statistical analysis. Very, very few of the students that I taught ever went into medicine because they were strong at maths or statistics (in fact the opposite was generally the case), and yet they are now required to make quite sophisticated statistical judgements.
I had to take early retirement after falling ill with ME after a post-op infection, and looking at the quality of research into ME/CFS I am truly shocked by the poor quality and usage of the data. Many of the errors occur at a fundamental error, but the analysis then goes on to “button-pressing spreadsheet frenzy” as increasingly sophisticated tests are applied to utterly unsound data. Often a statistician appears to be a part of the team: I can only conclude that the same communicational difficulties occur as when a member of management tries to talk to an I.T. specialist.
If only the SMC represented the consensus and science journalists sought other views and thought for themselves! Unfortunately, I fear the truth is that the SMC represents the views of the scientists on it’s database – the chosen ones – and journalists prepared to question and seek out other views in the ilk of Pallab Ghosh are not plentiful. SMC represents the views of scientists it agrees with and has created an era of lazy science journalism.
I think that’s more than a little unfair.
Sure, a few science hacks (esp those without a science background) are less questioning than they should be. But the SMC frequently quotes experts who stick the boot into research by other scientists (Prof Sir David Spiegelhalter being a wonderful case in point).
Indeed, I’d even say the SMC’s rapid responses (and esp its Before The Headlines emails) deserve credit for highlighting the long-concealed antipathy between those scientists trying to establish facts and those churning out click-bait cobblers.
If the SMC stuck to the facts, they wouldn’t roll out scientists who maintain ME/CFS is a psychological condition as the ‘experts’ on the condition. There are more than enough reputable research papers proving that ME/CFS is an illness of the CNS and immune system and yet the SMC never consults the experts that are working in the cutting edge of this exciting research. The SMC is responsible for a great deal of harm to ME/CFS patients because of the irresponsible use of inappropriate ‘experts’ (usually psychiatrists!) for this illness.
ME/CFS is a subject I know about and the SMC has lost any credibility for me in this area. I can only assume that it behaves the same way in other areas of science, which I know less about. To be a credible resource for journalists, such a centre needs to be completely impartial, objective and beyond reproach. Unfortunately the SMC has failed on all three accounts whenever it’s dealt with ME/CFS. I assume it’s integrity is also compromised with other scientific subject areas.
Agree with both Tom Kindlon and Dan Clarke. The SMC has been a platform for the biopsychosocial lobby. Actual science has been conveniently ignored, and ‘CFS’ narratives promoted, to the detriment of sufferers of the neuroimmune illness ME.
Apologies, I had not finished completing details when comment posted, am including my website now.
I have to agree with Caron Ryalls on this issue. Fiona seems to believe that presenting both sides of an issue will lead to a row or boxing match. That, however, is disingenuous, since it’s entirely up to the writers to decide how an issue is presented. Nothing says it has to be a fight, both sides can simply present the evidence in favour of their view and why they think evidence for the other view is incorrect. There, done, no fight involved.
Journalists SHOULD come to the SMC for a rounded view of the issues. Instead, however, they tend to take the views of sites like this and simply spit out what the site says without ever really investigating the facts and any alternative views. It therefore behooves the SMC to present those views weighted appropriately to their acceptance within the scientific community.
A quick perusal of ME/CFS, a subject close to my heart, indicates that Peter White is one of the go to guys for SMC. That’s great, the psychologists have their view of ME/CFS and it deserves to be mentioned. The rest of the medical community, however, has a radically different view, and that view needs to be presented as well. So far as I can see, it never is. Instead, all I see are Peter White’s views and those of his associates. Outside the UK, those views are in the minority. If the SMC’s goal is to present the majority view, it needs to look beyond the borders of the UK to do it.