Headlines usually are the first part of a news article people see — and, often, the only thing they read before sharing a story on social media. That’s why well-crafted headlines are critical. Incorrect, incomplete or misleading headlines spread misinformation.
Bad headlines on stories about health and medical research can be especially harmful considering many people make decisions that affect their personal health and safety — and the health and safety of loved ones — based on news reports.
Audiences might pursue a particular medical procedure or even brush off guidance from their doctor in response to something they read or heard in a news report, researchers write in “Defining and Detecting Fake News in Health and Medicine Reporting,” published last year in the Journal of the Royal Society of Medicine.
To bring attention to the problem, the watchdog site HealthNewsReview.org published a series examining patient harm from misleading news stories. The site, founded by veteran health journalist Gary Schwitzer, rated U.S. news outlets’ health coverage for many years before losing funding in December 2018. It also spotlighted problematic headlines on its blog and in its “Headline vs. Study” series.
We created this tip sheet to help newsrooms improve headlines on stories about health and biomedical research. To make sure we address some of the most common mistakes, we asked several prominent health and science journalists to identify problems they see regularly and how to avoid them.
Here’s their advice:
1. Don’t use these words and phrases when describing research findings: breakthrough, revolutionary, life-changing, game-changing, landmark, miracle, Holy Grail.
Journalists should take care not to exaggerate the importance or novelty of a new study. News outlets overuse these descriptors, which seldom apply to the research findings featured in their coverage.
“’Breakthrough’ is the one that leaps out to me because there so rarely is a breakthrough,” says Deborah Blum, a Pulitzer-prize winning science journalist who is director of the Knight Science Journalism Program at MIT and founding publisher of the nonprofit digital science magazine Undark. “I and most of my science journalism friends want to go screaming down the street when we see that in a headline.”
Journalists sometimes use these words and phrases to imply a new drug or other medical intervention will drastically improve people’s lives — even when it could be years before authorities are able to determine whether it’s safe and effective for public use, adds Cristine Russell, a senior fellow at Harvard Kennedy School’s Belfer Center for Science and International Affairs.
“When you’re a responsible [journalist] working in health and medical science, you really have to think of the audience and how vulnerable they are,” says Russell, also a past president of both the Council for the Advancement of Science Writing and the National Association of Science Writers. “You can be optimistic to some degree, but don’t overpromise.”
2. If your story examines research conducted on animals, make sure neither the headline nor the first sentence implies the findings apply to humans.
Scientists use animals in various types of research, including the study of human diseases and the development of new medical treatments. According to the National Association for Biomedical Research, about 95% of all lab animals are mice and rats. Scientists typically test new drugs on mice or rats, which are genetically, anatomically and physiologically similar to humans, before testing the most promising drugs on humans.
When news outlets report on studies conducted on animals, however, they often fail to make clear in their headlines that the findings don’t necessary apply to humans.
Research scientist James Heathers calls attention to incomplete headlines from a Twitter account he set up for that purpose, @justsaysinmice. He retweets these headlines after adding the phrase “IN MICE.” In his personal blog, he criticizes news editors and copy editors.
“So many stories about the Latest Thing That You Need To Know About What Will Kill You Next Tuesday can have their accuracy dramatically improved by the simple addition of IN MICE,” Heathers writes. “I am perfectly prepared to judge your outlet, out loud and in public, if you say ‘patients’ when you mean ‘genetically modified mice’… when you say ‘obesity’ when you mean ‘fat mice.’”
3. Don’t confuse correlation with causation. Even when researchers establish causality, remember that it’s almost always inaccurate to say a study “proves” anything.
When writing headlines about research, remember that when two variables are correlated, a relationship or link exists between them. For example, if nationwide demand for daikon radishes rises at the same time U.S. teenagers reduce their soda intake, there’s a correlation between daikon demand and youth soda consumption.
Never assume causation — that one variable causes the other to change or even contributes to a change. It would be wrong, in the instance above, to say or imply that teens giving up soft drinks causes a spike in daikon radish sales.
Keep in mind that research studies often examine correlations. But if scholars find or have reason to believe one variable affects another, they typically state that clearly in their publications. Look for phrases such as “causal relationship” and “causation.”
The Association of Health Care Journalists offers this guidance on covering research studies showing correlations:
“Seasoned health reporters will eschew wording in their leads or headlines that reads like this:
A new study shows that short sleep may cause weight gain.
Instead, they aim for wording that suggests a less direct relationship:
A new study shows that people who don’t get at least seven hours of sleep a night are more likely to gain weight compared to those who snooze less.
That’s the most accurate way of describing the comparison that’s being made in the study, but it can also be a little wordy. Here’s another way that would work if you’re tight on space:
A new study shows short sleep is linked to (or tied to or associated with) weight gain.”
4. Use absolute numbers rather than relative numbers in headlines (although it’s a good idea to include both in your story).
Journalists choose which numbers to emphasize when reporting on issues such as risk — the odds of dying from a particular disease, for example — and how much something has changed over time.
Journalists should include absolute risk and relative risk or absolute change and relative change in their stories because both sets of numbers convey valuable information. Spotlighting a relative number in a headline, however, can be quite misleading.
Case in point: The New York Times, Washington Post and USA Today drew sharp criticism a few years ago for running headlines proclaiming the obesity rate for young children had dropped 43% in a decade.
A closer look at the numbers, obtained from a paper in the Journal of the American Medical Association, reveals that the obesity rate fell from almost 14% to a little more than 8%. That represents an absolute decline of about 6 percentage points and a relative decline of about 43%.
Slate magazine responded with a piece chiding the decision to emphasize the relative figure.
“When evaluating the total sample across age groups, rather than just 2- to 5-year-olds, there hasn’t been any change at all,” according to the Slate article. “From the perspective of the researchers themselves, the continuing obesity problem seems to be the most important finding.”
Russell, who has written about health and science for four decades, urges journalists to distinguish between absolute and relative risk to avoid unnecessarily scaring audiences. In a working paper she wrote for Harvard Kennedy School’s Shorenstein Center on Media, Politics and Public Policy, “Covering Controversial Science: Improving Reporting on Science and Public Policy,” she explains how a focus on relative risk can confuse the public and make a drug appear riskier than it actually is. (The Journalist’s Resource is based at the Shorenstein Center.)
“British medical journals set off a ‘pill scare’ in England in 1996 with preliminary evidence that low-dose birth control pills doubled the risk of blood clots,” she writes. “A follow-up letter to The Lancet pointed out how small the risk was in the first place: it went from a risk of about one case per 10,000 users to two cases per 10,000 users. Going off the pill posed the obvious greater risk of pregnancy.”
5. When you turn your story over to an editor, include a suggested headline. Ask to see the final headline before publication.
Editors regularly write or rewrite headlines after reporters submit their stories. Reporters can help prevent errors by including a suggested headline at the top of their pieces, advises Brooke Borel, the articles editor at Undark. She’s also the author of The Chicago Guide to Fact-Checking and teaches science communication workshops at New York University.
Borel recommends reporters also ask to review headlines right before they’re published.
“Sometimes, editors will change a headline later in the game to make it punchier,” she explains, adding that some of those editors might not be as familiar with the subject matter as the editor who worked with the reporter on the piece. “The editors making those later changes are not usually the assigning editor and might be a few steps removed from the [reporting] process.”
Borel suggests journalists discuss the process for reviewing headlines well in advance and not wait to broach editors on deadline. Another recommendation: Because editors don’t like to make last-minute changes to stories, agree to only ask for a change to the final headline if it’s inaccurate or misleading.
“Quibbling over wording might not be something the editor is up for late in the game,” Borel adds. “Don’t ask for changes unless you can make the case that there is a better, more accurate word, and sometimes you can.”
The Journalist’s Resource would also like to thank Rick Weiss, the director of SciLine, based at the American Association for the Advancement of Science, for providing input on this tip sheet.