Our health information needs and preferences vary greatly. We are increasingly turning to digital and social media for health information. These sources are easily accessible and often engaging, even when they contain the wrong information.

It is common to use ‘Dr Google’ to source digital and social media health information before consulting a health professional. But, if ‘Dr Google’ is wrong, we can be quickly set on the wrong path. This is because by nature, we don’t question new health information if it appears credible, confirms our existing beliefs or provides us information we want to believe. Once we adopt a belief, we typically reject conflicting information and accept further confirmatory information. This innate behaviour drives the acceptance of health misinformation.

7 Questions to help identify health misinformation

1. Is a wonder cure or treatment being promoted that sounds too easy, or too good to be true? If so, it probably is – dig deeper, no matter how much you want to believe the claims.
2. Is the health information being provided by a credible source? Are claims supported by a professional body (e.g. Australian Medical Association), University, or not-for-profit organisation. If not, dig deeper.
3. Is the health information coming from a credible and unbiased expert in the field? Check the credentials of any proposed expert. Are they really an expert on the topic in question? – have they completed research in this area? It is common for so called experts to either give themselves this title or speak on areas outside their expertise. If they are not really an expert, dig deeper.
4. Does the expert providing information have a conflict of interest? For example, if someone who claims a treatment or change in behaviour is needed also has a financial interest in people adopting the treatment or change in behaviour, dig deeper.
5. How strong is the evidence to support the claim(s) being made? Not all research studies are created equal. Firstly, ensure the research being used to support a claim comes from a peer reviewed journal. If the claim is based on multiple high quality randomised controlled trials and filtered by a systematic review than it should be believable. If it is based on only one high quality randomised controlled trial, it may be believable. But, in some cases future studies fail to replicate results so don’t be 100% confident. If information provided is based on other forms of research, dig deeper.
6. Is the information based on anecdote or individual cases? Using this approach as supporting evidence for a new treatment is common. However, it is open to bias and should be met with strong scepticism. Those promoting the new treatment are unlikely to provide information on unsuccessful cases. Importantly, there are many cases in research of successful cases being used to promote a medical treatment (e.g. key-hole surgery for arthritis), only to later find out that the treatment is no better than a control or placebo.
7. Is the new research reflective of correlation or causation? A lack of understanding of the difference between correlation and causation in research findings (even among some researchers) is a common driver of health misinformation. Just because two things are related, does not mean one causes the other. For example, if a person taking a certain vitamin supplement has better health than someone who does not take the supplement, it does not mean the supplement is the reason they are healthier. A person taking vitamin supplements is likely to pay more attention to their health generally, meaning the cause of better health may instead be eating better, exercising more or not smoking. This scenario is rife within the vitamins and supplements industry, with products promoted based on poor evidence later found not to be beneficial when tested in adequately controlled trials.

Acceptance of misinformation can be defined as “cases in which people’s beliefs about factual matters are not supported by clear evidence”.

Our growing use of digital and social media means the spread of health misinformation is now more prevalent and rapid than ever.

Examples of health misinformation include the measles, mumps and rubella vaccine-autism myth; countless other vaccine myths; nutrition myths; exercise and osteoarthritis; and kids and strength training. This list could go on and on.

Exposure to health misinformation influences our care seeking behaviour and discussions with health and medical professionals. Acceptance of health misinformation may cause us to form poor health behaviours, seek inappropriate healthcare, or make us highly resistant to a health professional providing recommendations contrary to our possibly misinformed beliefs. We are all prone to health misinformation, even health professionals and researchers.

How does health misinformation start and spread?

Whether digital and social media health information is provided by a regulated source or not, there is no guarantee against misinformation. Producing accurate, and balanced health information requires the publisher to:

1. Identify credible sources of information
2. Source unbiased and credible expert opinion
3. Identify potential conflicts of interest (financial and other) of those providing or helping interpret data and information
4. Make sense of often complex data and information in order to present it in a more understandable format

These requirements are challenging to begin with, but digital innovation in journalism has added further challenges. Journalists and writers now participate in a rapidly evolving 24-hour news cycle where competition for readership is high from a range of traditional (media companies) and non-traditional (e.g. bloggers) sources. The journalist must maintain a story and headline that is true to the facts but still provides a hook and keeps the reader engaged. This makes sensationalist and inaccurate headlines more likely.

The pressure for rapid publication combined with reduced staffing in media organisations means resources and time for fact checking, along with identifying and interviewing credible unbiased experts is minimal or absent. This easily leads to biased view-points and omission of key facts. Ultimately, misinformation is far more likely.

Research indicates that journalists are increasingly using public relations (PR) material verbatim to meet deadlines. This means a media release on recent low level evidence findings related to a new treatment (drug A) for a health problem (condition B) will be disseminated, along with expert opinion provided by the PR company. The lack of high quality research to support the treatment and need for caution may not be highlighted in this release. Acknowledgement of the clear conflict of interest or lack of credibility of the promoted expert providing opinion is also unlikely. But, a highly pressured journalist lacking time and resources to adequate research and fact check the claims may run with the story anyway. Drug A is quickly promoted in digital and social media as a wonder cure, and the story is replicated many times over by different individuals and organisations. A potential health myth is born.

Social media celebrities and bloggers have little or no regulations to consider, so are more likely again to promote drug A if they believe the initial story. Sensationalist stories (e.g. the wonder cure) are typically the most widely shared, so can help quickly build website traffic and following. This makes the saying “don’t let the truth get in the way of a good story” incredibly appropriate when considering health misinformation in digital and social media. Put simply, ignoring the truth is perhaps the biggest driver of health misinformation.

Later, high quality placebo controlled trials may prove drug A is ineffective for treating condition B, but it is too late. Once published, health misinformation spreads quickly for a number of reasons. Most people have good intentions when sharing health information, but the sheer volume of misinformation means we can easily share this form of ‘fake news’ without realising. This sharing via our own social networks contributes to the rapid spread of health misinformation via digital and social media.

What to do about health misinformation?

As a society, we must all work hard to avoid the spread of health misinformation. This is vital for our own health and well-being. Additionally, the high prevalence of health misinformation confuses and frustrates us all. For example, one day we read fats are bad for us. The next day we read they are good for us, and then later read some are good for us and some are bad for us. It’s confusing and in the end, we don’t know what to believe.

The best way to protect ourselves and those around us against health misinformation is to develop skills in order to identify it. Seven questions you should ask in order to identify health misinformation are outlined in the Table below.

If you identify health misinformation from a regulated individual or organisation, complaints and potential litigation can be made. However, due to the complexities of a rapidly evolving international digital and social media publication environment, complaints or litigation against health misinformation in most cases is highly challenging or impossible. But speaking up about health misinformation in digital and social media helps to reduce its spread. So, if you spot it, speak up via comments sections on digital and social media platforms. Let’s work together to stop the spread of often dangerous health misinformation.