Did you hear about the latest breakthrough, offering a potential cancer cure? What about the new clinical trial leading to better outcomes for an incurable problem? Or even the scandal regarding hitherto inappropriate treatment requiring a new approach to a medical condition? If you answered yes to any of the above, the chances are you have been ‘click baited’. Although the term ‘fake news’ seems to have been first conceived only around 2015, its reach into society since then has been profound, with the term gaining popularity during the recent USA presidential election. Fake news was named the Macquarie Dictionary's 2016 word of the year 1, and the development of fake news ‘sausage factories’ 2 have taken advantage of the effect of this phenomenon. Broadly defined, such fake news represents fictitious information designed to mislead the reader into believing the established credibility of the source, to then benefit the promoter via ‘clickbait’. Clickbait is a derogatory term describing web content that is designed to generate revenue. This is usually at the expense of quality or accuracy and relies on sensationalist headlines or eye-catching thumbnail pictures to attract and to encourage forwarding of the material over online social networks 3. This concept already is being exploited in contemporary medical practice, where every patient has access to the internet, but few have the insight to correctly interpret results of medical research. Fake news headlines understandably grab the attention of those concerned about a medical condition, and the consequent clickbait may direct the user to a website or source designed to profit the ultimate promoter of the story. In a medical context, this may involve the sale of medications, supplements, tests and procedures not yet confirmed to be of benefit in such situations. It would appear this is a concept in its ascendency. Consequently, all medical practitioners would do well to be aware of its existence and the need to subject such information to the standard evaluations of medical research. Was there ethics committee approval for the research and from which institution was this obtained? Is there a logical scientific basis for the outcomes? Have the data been peer reviewed and published? If so, was this in a reputable journal or one where open access publication may be obtained for a fee? Have the outcomes proven reproducible? Have they been tested in a blinded manner against best practice therapies? And (sceptically) do the costs involved justify the likelihood of potential benefits? As Henry Louis Mencken stated – ‘when someone says it's not about the money, it's about the money’. A new task for all urologists in reference to this phenomenon now is to convey the relative merits of ‘fake news research’ to patients, especially when credibility of the source seems to be implied by the website name or headline banner. An unpleasant task of any medical practitioner already is to deflate the unrealistic hopes a patient may have in unproven alternative therapies. This becomes much more difficult when information on the internet attests to excellent outcomes. In the current age of fake news and clickbait, we have an obligation to educate patients, where required, as to the relative merits of these concepts of headline-promoted medical research, in the same way we would critique a manuscript as per the points described above when assessing its value with trainees and researchers. To think this concept will not affect patient decision making and consequent clinical outcomes is naïve. The use of alternative practices instead of conventional medical therapy may well potentially increase cancer-specific mortality 4. The role of professional societies also now needs to expand to counter the rise of fake news and clickbait in medical practice and instead to promote outcomes of valid research, in a fashion akin to that which has been used to provide legitimacy to other activities in our professional space 5. Registrar training also must now include insights on how to assess the validity of research promoted in generic digital media rather than through traditional methods, in order that clinicians can provide optimal advice and clinical care of patients 6. There will always be someone seeking to profit in one form or another from the message behind fake news. Having clinicians and patients appreciate this is the key to evaluating the motivation behind its presentation as a new medical advance. A wider understanding of the true process of medical research also will help put unrealistic claims into context. Like most things in life, if fake news in medicine sounds too good to be true – it probably is. None.
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Bolton et al. (2017) studied this question.