Medical tests promoted in media with no mention of potential harm, Australian study finds

Stories all reported potential benefits of tests, some using smartphone or watch, but 60% failed to mention limitations

Medical tests often offered through smartphones and watches and designed to detect the early signs of disease are being promoted by media without mention of their potential harms, an Australian study published in the leading US medical journal JAMA Internal Medicine has found.

Researchers from the University of Sydney and Bond University in Queensland analysed 1,173 news stories from between 2016 and 2019 from newspapers, blogs, magazines, broadcast and podcast transcripts, and wire news services.

Specifically, researchers examined stories about five new early detection tests, including liquid blood biopsies to detect cancers; using the Apple Watch to detect atrial fibrillation; blood tests for dementia; artificial intelligence tests for dementia; and 3D mammography for breast cancer.

While almost all the stories reported on the potential benefits of these tests, over 60% failed to mention any potential harms or limitations of the tests.

One story claimed: “A simple blood test can now detect dementia decades before any symptoms appear” and advocated using the test during routine health checks. It failed to mention the tests were yet to be proven to be definitive, and there was concern about them returning false-positive results.

Another story described liquid biopsy for cancer diagnosis as a “holy grail” that could “find very early-stage cancer in those with no symptoms”.

The premise of the tests is that because cancer cells can shed DNA into the bloodstream, sequencing this DNA can reveal mutations. But mutations can be found from all kinds of DNA, including from white blood cells, viruses and bacteria, and the difficulty with liquid biopsy cancer tests is that they may in fact be finding some of these benign mutations, and not ones related to cancer.

A senior author of the study, Dr Ray Moynihan, who is an assistant professor at Bond University, said media reports were one of the primary ways people learned about new tests and treatments.

“We know from strong evidence that media information can change healthcare behaviour,” he said. “As a result it’s vitally important that media reporting on new tests and treatments is balanced and complete.”

“No one had really previously studied how media is covering these new screening tests that pop up all the time, that are often targeted towards the healthy as a means of detecting disease before symptoms develop.”

Screening healthy people can have downsides, including over-diagnosis and over-treatment. Australian medical authorities were so concerned about healthy people receiving unnecessary tests and treatments that in 2017 they issued a joint statement calling for a plan to stop patients being harmed by the over-diagnosis and over-treatment of diseases.

The study also found widespread failure of media outlets to cover important conflicts of interest, such as commentators receiving payments from the companies marketing the new tests. For example, 19 of 22 authors of a key trial examining the ability of the Apple Watch to detect atrial fibrillation disclosed taking grants or personal fees from Apple, yet this information was rarely reported in news stories.

Moynihan said half the stories researchers examined quoted someone who had a financially relevant conflict of interest, but only 12% of stories disclosed that.

“These are very worrying findings that suggest that the public is being given an over-optimistic picture about these tests,” he said.

“Some of these tests will be lifesaving and will be incredibly valuable, but we’ve got to stop overhyping them. It is important to remember the test-makers make a shitload of money if they can maximise markets for their tests, but the companies selling the treatments also make a motza.”

Over-diagnosis occurs when people receive a diagnosis of a disease or condition that will never develop to cause any symptoms or early death. It is an unnecessary diagnosis that does more harm than good.

Evidence published last year in the Medical Journal of Australia shows that for common cancers, around one in five cancers may be over-diagnosed.

Medical technology is now so advanced that early abnormal cell changes and lesions, sometimes described as “pre-cancers”, can be detected at much smaller sizes.

However, for some types of cancers, these early changes or lesions will never go on to cause harm in the patient’s lifetime. But identifying these changes can cause distress and prompt patients to undergo treatment to get rid of them, with the treatments sometimes carrying risks.

The JAMA paper concluded that strategies to improve media reporting so that professionals, patients and the public can receive more balanced information about early detection tests were “urgently needed”.

Contributor

Melissa Davey

The GuardianTramp

Related Content

Article image
Untested stem cell treatments proliferate in Australia, study finds
A regulatory loophole allows businesses to offer potentially ineffective or harmful treatments, a researcher warns

Melissa Davey

04, Aug, 2016 @8:39 PM

Article image
Autistic Australians are being locked out of the workforce, study finds
Of unemployed people with autism, 54% surveyed said they had never held a job despite wanting to

Luke Henriques-Gomes

27, Mar, 2019 @5:00 PM

Article image
Australian government does deal to secure potential Oxford University Covid vaccine
Scott Morrison says the Oxford vaccine, which will be made available for free, is ‘one of the most advanced and promising in the world’

Katharine Murphy Political editor

18, Aug, 2020 @12:30 PM

Article image
Ibuprofen has little benefit in treating back pain and may cause harm – study
Anti-inflammatory drugs are not much more effective than placebo and patients taking them 2.5 times more likely to suffer from stomach problems

Melissa Davey

03, Feb, 2017 @1:49 AM

Article image
‘Disgusting’ study rating attractiveness of women with endometriosis retracted by medical journal
Fertility and Sterility took seven years to take down Italian study, which was criticised by doctors for ethical concerns and dubious justifications

Gabrielle Jackson

05, Aug, 2020 @7:34 AM

Article image
Gender health gap: Australian medical research ignoring drugs’ side effects in women
Clinical trials often failing to report results for sex and gender, despite the fact many drugs cause adverse effects in women

Guardian staff and agencies

25, Nov, 2019 @12:02 AM

Article image
‘Nonsensical’ to suggest moderate drinking improves health, says expert critical of Australian study
Monash University research fails to recognise moderate drinking and better health are both ‘reflective of middle-class lifestyles’

Melissa Davey Medical editor

08, Nov, 2021 @4:30 PM

Article image
‘I just needed a chance': from refugee to the heights of Australian medical research
After fleeing Vietnam by boat in 1981, a dishwashing job at St Vincent’s hospital was Tuan Nguyen’s lucky break

Ben Doherty

18, Jun, 2017 @7:30 PM

Article image
Australian scientists fear job insecurity as morale plummets amid Covid, survey finds
Professional Scientists Australia chief points to problem of short-term contracts, as one in five say they intend to leave the profession

Donna Lu

11, Oct, 2021 @1:30 AM

Article image
Hydroxychloroquine sales spiked almost 100% in Australia at start of Covid pandemic, study finds
There was also a rise in prescriptions for ivermectin being filled, despite no evidence either drug is effective against the virus

Donna Lu

30, Sep, 2021 @5:30 PM