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- What is the message?
Get past the presentation to the facts. - Is the source reliable?
Think about the quality of the information. Information comes from many sources, good and bad. - How strong is the evidence overall?
Understand how this information fits in with other evidence. - Does this information matter?
Determine whether the information changes your thinking and leads you to respond. - What do the numbers mean?
Remember that understanding the importance of a risk requires that you understand the numbers. - How does this risk compare to others?
Put the risk into context. - What actions can be taken to reduce risk?
Identify the actions you can take to improve your health. - What are the trade-offs?
Make sure you can live with the trade-offs associated with different actions. - What else do I need to know?
Focus on identifying the information that would help you make a better decision. - Where can I get more information?
Find the information you need to make a better decision.
- What is the message?
Get past the presentation and to the facts. Consider that:
Sources personalize information to make it more interesting, but not everyone relates to the same things. Your perception of information can depend on whether it is presented as positive (half-full) or negative (half-empty). Flipping the statements and looking for alternative ways to state them might change your perception. For example, if you hear about a small number of people being affected, remember that this means a large number are not affected, and vice versa.
When the facts seem confusing, keep in mind that you might have been given false or incomplete information or you may have misunderstood the information given.
5/20/98, Jim Borgman, Cincinnati Enquirer. Reprinted with special permission of King Features Syndicate.
« back to top - Is the source reliable?
Information comes from many sources, good and bad. Think about the information's quality. Consider that: - All sources have a motivation for providing information. Try to identify the source and its funding so that you can consider any possible biases. The fact that a source or its source of money may benefit from the information does not necessarily mean that the information is false.
- Health information can be based on untested claims, anecdotes, case reports, surveys, and scientific studies. Scientific studies, which take samples and apply the results to the whole population, often provide the best clues about health. Nonetheless, many studies are needed to be confident about an answer. Below are some factors that might help you judge the information:
Less Reliable (less certain)
One or a few observations
Anecdote or case report
Unpublished
Not repeated
Nonhuman subjects
Results not related to hypothesis
No limitations mentioned
Not compared to previous resultsMore Reliable (more certain)
Many observations
Scientific study
Published and peer-reviewed
Reproduced results
Human subjects
Results and tested hypothesis
Limitations discussed
Relationship to previous studies discussed - How strong is the evidence overall?
Understand how this information fits in with other evidence. Some sources are generally encouraged to provide unbiased coverage, while others may be intentionally biased. Consider how many sides of the story you hear and whether your source tells you about all of the possibilities.
Remember that extensive coverage of a story can be misleading if it does not reflect the amount of evidence that supports the claim. In particular, the results of early studies can turn out to be right or wrong after time. Americans have mistakenly rejected results that later proved true, and accepted results that later proved false.
« back to top - Does this information matter?
Determine whether the information changes your thinking and leads you to respond. Just because information appears in the media does not mean that it affects you or someone you care about. Some newsworthy risks (like accidents and homicide) may be overreported in the news media, while other, less newsworthy risks (like heart disease and stroke) may be underreported. The result is that you might be led to worry about small risks that appear to be big and to ignore big risks that appear to be small.
« back to top - What do the numbers mean?
Remember that understanding the importance of a risk requires that you understand the numbers. Information about health risks gives the chances of an outcome occurring. To avoid confusion, put the numbers into a format that you can understand. Remember that 1 in 100 can also be written as 1%, 10 in 1,000, ten thousand out of a million, 0.01, 1x10 -2 , or one penny out of a dollar.
Researchers report their findings as expected values within a range. The breadth of the range shows how confident they are about the results. When only one number is reported, it is probably pulled out of a range and it does not inform you about the researcher's confidence in the result. In such cases, it is important to understand whether the number reflects the worst case, the best case, or something in the middle.
Remember that risks change with time, and that some people have higher or lower risk numbers than other people. Think about any habits or behaviors you have that put you at a higher or lower risk for a particular outcome.
7/19/98 Jim Borgman, Cincinnati Enquirer. Reprinted with special permission of King Features Syndicate.
« back to top - How does this risk compare to others?
Put the risk into context. One important risk comparison is that of the chances of the same outcome, like the numbers of U.S. deaths per year per 10 million people:
200,000 from heart disease (people over 64) 6,000 from lung cancer 3,000 from accidents 1,000 from homicides 400 from accidental poisoning 20 from train accidents 2 from lightning
Since numbers about risk can be presented in many forms (like the chances of dying from a cause over a lifetime, during a year, or during an event), make sure you compare similar forms. Consider that reporting different parts of a range for different risks (best case for one vs. worst case for another) can be very misleading. Finally, in making comparisons, other factors may be important to you. For example, consider the extent to which you:
- Think the risk is new
- Choose the risk
- Can control, manage, or prevent harm
- Gain things you want by accepting the risk
- Fear the risk
- Feel anxious from lack of knowledge
Remember that science can not answer the question "Is it safe?" for anyone. You must decide what is an acceptable risk and make health decisions based on your personal judgment.
« back to top - What actions can be taken to reduce risk?
Identify the ways that you can improve your health. Be creative. Think about actions that can reduce your risk. For risks that are new to you, take the time to think about them before forming an opinion. Keep in mind that just because someone you know picks one action does not mean that the same action will be right for you.
« back to top - What are the trade-offs?
Make sure you can live with the tradeoffs associated with different actions. Every decision involves tradeoffs When talking about medications, tradeoffs are often called side effects, like when the medicine you take to get rid of your headache upsets your stomach. Ignoring potential tradeoffs when considering an action to reduce or eliminate a risk might ultimately put you (or someone else) at greater risk.
Taking action can also lead to tradeoffs of other important resources, particularly time and money. Some people object to the idea that they might be asked to trade between health and money or other factors. Most people make these choices automatically, however, by driving slower at the cost of a few extra minutes or spending money to buy a bicycle helmet for their child or a smoke detector. Remember that resources spent to reduce one type of risk are not available for other activities.
« back to top - What else do I need to know?
Focus on identifying the information that would help you make a better decision. Remember that scientific information is always somewhat uncertain even if it is not reported that way. Think about what information is missing and how you would use more information if you had it. Keep in mind that if you rely on the headlines as a basis for managing your health, you are likely to overlook the well-established (and consequently not newsworthy) strategies for improving your health.
« back to top - Where can I get more information?
Find the information that you want. Try: - Your health care provider
- Manufacturers and the manuals or labels that come with their products
- Libraries
- Your original source
- Your local Department of Health
- Government agencies like the Department of Health and Human Services, the Department of Agriculture, the Consumer Product Safety Commission, the Environmental Protection Agency, or the Occupational Safety and Health Administration
- Consumer groups
It is important to read between the lines. Look for the assumptions that make the observations relevant to other members of the population. For example, do you have to assume that the same effects occur in humans as in rats? in women as in men? in children as in adults? These types of assumptions raise questions about how well the conclusions from the sample apply to the larger population. They do not necessarily mean that the conclusions are wrong or that more studies are needed.
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12/4/97 Jim Borgman, Cincinnati Enquirer. Reprinted with special permission of King Features Syndicate.
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