Medical review artlcles, physician opinions, news media coverage and the state-of-the-science gap in hormone therapy usage

TitleMedical review artlcles, physician opinions, news media coverage and the state-of-the-science gap in hormone therapy usage
Publication TypeConference Paper
Author(s)Chew, F.
Affiliation (1st Author)Syracuse University
Section or WGEnvironment, Science, and Risk Communication Working Group
DateFri 28 June
Slot CodeENVF1a
Slot Code (Keyword)ENVF1a
Time of Session9:00-10:30
RoomHelix Blue Room
Session TitleMedia, Science and Public Understanding/ Engagement
Submission ID7285
Abstract

Background and study objectives. In America’s youth-oriented culture, menopause, a natural stage in aging has been considered a condition to be postponed or prevented with the use of hormone therapy (HT). In 2002, when findings of the landmark Women’s Health Initiative study (WHI) established a causal link between HT use and increased risks of breast cancer, heart attack, stroke, and blood clots, HT use dramatically declined. However, through various proxies such as medical review articles, pharmaceutical companies marketed the allure of youth and larger protective benefits promised by hormonal drugs, and HT use increased. Scientific reviews and research comprise a primary information source for news media stories on medical therapies and innovations as well as for physicians in updating their practice. The present study examines medical review journal articles and news media coverage of HT to assess the relationship between the two information sources and whether/if they contributed to a state-of-the-science gap (a condition when the evaluation of a medical condition or therapy ascertained by the highest standards of investigation is incongruent with the science-in-practice such as physician recommendations and patient actions). The state-of-the-science in HT use is represented by the HT Consensus Statement of the National Institutes of Health that references the WHI’s risk factors in HT use. In addition, we analyzed surveys of physicians’ HT attitudes and recommendations. We postulated that the HT recommendations in scientific review articles would be reflected in physicians’ HT attitudes and also in news media coverage. Method. For the period 2002 to 2008 we analyzed a random sample of medical review journal articles on HT, and all published surveys of US physicians’ HT attitudes and recommendations. For two periods, 2002, just after the WHI study and 2008, six years later, we content analyzed HT news media coverage in major TV news media, newspapers and magazines including their internet sites for their HT valence. Results. We found that 156 randomly selected medical review articles of HT use yielded a mixed picture about benefits, risks and both benefits and risks of HT. Also, a majority of physicians believed that HT benefits outweighed the risks. HT media coverage from the two periods in three major US newspapers and three television networks reflected a decrease in news story frequency attributable to the absence of new developments. There was an equivalent focus on both HT risks and benefits. In contrast, magazine stories from three magazines trended pro HT use in 2008. Conclusions. The mixed HT medical review journal record reflected a state-of-the-science gap in hormone therapy assessment. As well, in assuming a pro-HT stance, physicians likewise contributed to this gap. HT coverage in newspapers and television likewise did not reflect the established HT science in reporting both risks and benefits rather than emphasizing the risks revealed by the WHI study. Finally, magazines were equally complicit in promoting HT benefits and the HT state-of-the-science gap. Ultimately, women remain uninformed and will bear the burden of the afflictions linked to HT use. The public needs better information to make informed decisions about healthcare.

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