Monday, September 16, 2013

The science of scientific reporting - we suck at communicating our results to the public

One of my favourite PhD comics is "The Science News Cycle." I think it adequately portrays one of science's fundamental flaws, communicating research findings to Joe Public. Or, in the case of the comic, grandma.

Knowledge exchange. Even the phrase is jargon. As researchers, we don't do it very well. We write up our research for the scientific community with the ultimate goal of publishing articles in scientific journals, and of course, eventually the Lancet or The New England Journal of Medicine. Although, most of us PhDs and post-docs are happy to have publications, period. 

Each discipline has its own jargon. You need to speak and of course understand the jargon to get published.  But what about cross-disciplinary endeavours? Can we understand each other? It's a resounding no. Take me for example. For topics related to but outside my domain of expertise, I often have difficulty reading and fully understanding what is being communicated to me (I had a PhD last time I checked). Statistical papers are my number one nemesis. I often come across papers with complex formulas derived from first principles, when all I am looking for is a more detailed "applied" understanding of the method. So, even within academia we speak foreign languages, it is no wonder Joe Public has a hard time. 

You may be familiar with the quote: "Data is not the plural of anecdote," from Roger Brinner. Based on my training and experience, you cannot plan programs or develop policy based on an anecdote, or an n of 1. But all too often, journalists reduce research to anecdotes, a story of how Sally used shark-fin soup to cure cancer and now lives life to the fullest with her three-legged, rescued cat named Jesus. Journalists do this because it's catchy, simple to understand, and brings the story to the reader or listener at a personal level; plays on emotions and perhaps, past experiences. Vincent Lam, award winning author and emergency medicine doctor, recently spoke about the importance of a narrative to a room full of Queen's University medical students, emphasising that telling a story can make you a better doctor. Anecdotes break through the jargon. But all too often, messages get twisted or misunderstood anyway.  

 I don't claim to know how to do this. I don't know how to report research results responsibly AND make them interesting AND catchy AND easy to understand. It's something I struggle with as an epidemiologist and public health researcher, especially with a topic as complicated as obesity.   

Obesity is not a behaviour like smoking. One of its main contributors is diet, but unlike smoking, we can't quit eating. It's complex. Take, for example, the work the Foresight Group has done to characterize obesity as a complex, adaptive system (CAS), complete with feedback loops. 

A CAS is defined as being: "composed of many heterogeneous pieces interacting with each other in subtle or non-linear ways that strongly influence the overall behaviour of the system" (SCPHRP, 2011)

I think this CAS perspective is important, but its incredibly messy. How in the world can we talk tangibly about this to the public? 

When considering obesity as a CAS, two basic principles also need to be underlined (SCPHRP, 2011):
1) Single interventions probably won't work on their own
2) Many small changes may lead to cumulative improvements

So, what does this mean? Reporting the results of single studies, then reducing them to anecdotes probably won't help in making things clearer. In fact, I think this is what we're doing when we do that:

Cartoon by Jim Borgman, first published by the Cincinnati Inquirer and King Features Syndicate 1997 Apr 27; Forum section: 1 and reprinted in the New York Times, 27 April 1997, E4.

Perhaps we need a new field - a degree that comprises an undergrad, masters, and PhD, which merges epidemiology, population health, and journalism/communication, and miraculously turns people into Dr. David Katz. Maybe we should stop making a big deal out of single studies? Open access journals are increasing and researchers are also paying traditional publishers to have their articles be made open access, so I doubt this is feasible. What are your thoughts? Should we only be reporting the results of well conducted systematic reviews and some how developing them into short narratives? How should we be reporting complex aetiological and intervention population health research that engages the public? Government Office for Science (2007). Tackling Obesities: Future Choices – Project Report 2nd Edition FORESIGHT Programme