July 18, 2007

why we need the best journalism on public health stories

My favourite bit of Sunday is when I finally get to sneak away to a quiet corner of our house and settle down to read my Observer. Last week however it ended up being the unsettling bit of my weekend. When I saw the headline I had to check that I hadn’t picked up theMail on Sunday by mistake – but there it was under the Observer masthead: “New health fears over big surge in autism. Questions over triple jab for children“. This front page splash linking a rise in autism with the joint Measles, Mumps and Rubella (MMR) vaccinecoincided with a two page exclusive interview on the inside pages with Dr Andrew Wakefield, architect of the MMR scare, who is due before the General Medical Council (GMC) Fitness to Practise Panel this week to face charges of misconduct in relation to his research on MMR.

“This had better be good”, I thought as I hungrily devoured the piece.

The article was based on a leak of unpublished research into the rising levels of autism. The top line was that as many as one in 58 children may have some form of the condition – much higher than the current highest estimate of one in 100.

You would think that was already a shocking enough story – but then in paragraph three the reason for the headline becomes clear. Apparently two of the seven researchers privately believe that the rise may be connected to the MMR vaccine. The claim is elaborated on in the fourth paragraph where the two researchers are named as Dr Carol Stott and Dr Fiona Scott. Though the paper made it clear that Professor Simon Baron-Cohen, leader of the research group and one of Europe’s most respected autism experts, does not accept the link, alarmingly almost ten years after Andrew Wakefield sparked off a frenzied debate over a link between MMR and autism, the Observer’s front page was suggesting that there is still a serious dispute amongst leading experts as to whether he was right. Predictably several papers repeated the MMR allegations the next day and countless columnists, including James Le Fanu and Peter Hitchins have cited the Observer piece as evidence that the MMR autism row is still alive and well.

One of the challenges for the Science Media Centre (SMC) was what to do about it. We were set up in the wake of media furores over issues like MMR and we know that poor journalism on public health is our territory. However we also know that the SMC philosophy (the media will ‘do’ science better when scientists ‘do’ media better) was a reaction against the culture of complaint within science which often saw top scientists complaining privately about coverage rather than pro-actively engaging with the story.

With this in mind, the SMC reacted to the article primarily by coordinating a joint media statement by 14 institutions involved with child health and vaccination to back the safety of the jab which we issued to coincide with the GMC hearing. However I did also send a note to Denis Campbell, the journalist who wrote the article and a friendly contact of ours, to make sure he knew that the SMC was unable to defend the piece to the angry scientists who were contacting us. The result was an invitation to meet with him, the readers’ editor and a variety of other Observer news editors at their offices. So, with two leading MMR experts at my side, I went to highlight the concerns.

One of the main points that I made at that meeting was my belief that in science reporting the rule of thumb should be that the more outrageous the claim the more the need for the best standards of journalism – a rule which is often interpreted in exactly the opposite way by journalists hungry for a sensational scoop. I then argued that I would take this rule even further in this peculiarly sensitive and important public health issue. The claim that MMR may cause autism, made by Dr Andrew Wakefield in 1998, produced one of the biggest rows in public health for decades and millions of pounds of public money have been spent on scientific studies researching the evidence for a link. Not a single reputable study has found any and just last year the SMC coordinated a joint appeal from many of those involved in child health that the media now draw a line under this row unless and until it has compelling new evidence. Many autism experts have echoed this call and issued their own plea for resources to move from the obsession with MMR to investigating the many other possible causes – including genetics, environmental factors and so on.

Given this context, I would argue that the bar for evidence in any newspaper splashing on a link between MMR and autism needs to be much higher than for other stories. In my view the Observer really needed to have produced stunning evidence of a link between MMR and autism to justify re-running this particular scare story.

Stunning evidence it wasn’t. The two researchers cited are experts in autism but not in MMR and the study they were involved with was nothing to do with MMR. In fact it had nothing whatsoever to do with what causes autism at all – it simply looked into prevalence of autism. As such, the authors private views on MMR are neither significant in terms of public health or in any way relevant to the Observer’s story. In fact I’m tempted to say that their private views as to what causes autism are no more significant than my mum’s view – something on which it seems Dr Fiona Scott agrees: when contacted the following day by the Telegraph she was not prepared to repeat any private views in public and instead voiced her support for MMR and her decision to get her daughter vaccinated.

One of the news editors pointed out that that any article reporting a dramatic rise in autism would prompt readers to turn to the question of MMR. I accept that but the way to answer those readers’ questions is with an accurate summary of the balance of evidence against any link. Instead, any Observer reader whose mind turned to the question “is MMR to blame?” was provided with the answer that two out of seven experts believe it is and one believes it is not – a reckless distortion of the real balance of views within the scientific community.

Ironically, if this piece had appeared in certain other campaigning papers, no would one would even bothered complaining. The fact that it was in the Observer, which has a reputation for excellent science and health coverage, made it worth challenging. The fact that senior editors invited us in and the acknowledgement by the readers’ editor Stephen Pritchard the following week that the MMR allegations should not have been included in the autism story reassure me that the Observer have seriously reflected on the scientific community’s concerns and their responsibilities as journalists – that should be welcomed.

This blog contains the thoughts of the author rather than representing the work or policy of the Science Media Centre.