Medical Misinformation: Vet the Message!

“M rs Jones, based on your risk factors for having a heart attack, I recommend that we start you on a statin.” “No, thank you, doctor, I’ve read too many scary things about those drugs on the internet. Plus, I worry that some in your profession make these recommendations for reasons of personal financial gain. I also found that online.” Undoubtedly, most cardiologists have had conversations just like this, urging a patient to take a statin, powerful cholesterollowering drugs with robust mortality benefit. Part of the reason these oftentimes “no brainer” recommendations are rejected derives from widely disseminated incorrect information that vastly overstates the risks of these drugs. (Of course, like anything in life, statin use is not entirely risk free; their application should always entail a thoughtful analysis of risks versus benefits.) Most patients do not recognize that the benefits of statin use are invisible (“I didn’t have a heart attack or stroke this past year.”), whereas the small and typically reversible risks (eg, muscle pain) are readily apparent. Many patients who would benefit from statin use do not take them. Cardiovascular disease is the No. 1 killer of both men and women around the world. Robust scientific advances, published in the pages of our journals, have fostered significant improvements that benefit individuals and society. Yet, cardiovascular disease continues to transform itself, emerging in new forms, such as heart failure. The struggle has shifted to new battlefields. These successes derive from an armamentarium of powerful tools (medicines, devices) and awareness of lifestyle-related hazards, such as high blood pressure, high cholesterol, and smoking. Sadly, however, we do not take full advantage of the tools at our disposal. One significant cause of suboptimal use of our prodigious tool chest is medical misinformation hyped through the internet, television, chat rooms, and social media. In many instances, celebrities, activists, and politicians convey false information; not uncommonly, authors with purely venal motives participate. We can point to numerous other examples, including the entirely unfounded concerns about vaccinations. The notion that MMR (measles, mumps, rubella) vaccination causes autism was based on a single, flawed study, long since refuted and its publication retracted. Seventeen much larger and properly controlled studies have proved otherwise. Nevertheless, the internet shouts unfounded warnings. Once again, celebrities, actors, activists, and politicians with no specific knowledge or training use their fame to promote a message that causes serious harm. Individuals who are neither physicians nor scientists, but often with a specific agenda, have outsized influence over our lives. They dispute scientific evidence without ever having studied it. Recognizing that it is impossible to prove “never,” scientists appropriately couch their statements in statistical terms, which may come across to the public as equivocation. The nuanced voices of scientists often do not resonate with the public as much as the strident alarms sounded by people of fame, speaking in absolute terms. Furthermore, scientists are appropriately skeptical, as any individual scientist or study can be wrong. Yet, science ultimately self-corrects. When a scientist gets it wrong, as happens, people sometimes vilify the entire, self-correcting scientific enterprise. We trust aeronautical science when we board an airplane; we trust the science buried within our cell phones; we trust mechanical engineering science when we cross a bridge; yet, many are uniquely skeptical of biological science. Sadly, we cannot exclude that some in the professions of science and medicine act on the basis of motives driven by financial considerations; incomplete declarations of potential conflict of interest persist. Recent examples of dramatic price hikes for important medications have reinforced this *The complete list of authors is provided in the Appendix at the end of the article. A complete list of all journals co-publishing this article, along with links to the individual articles, can be found online at https://www.ahajournals.org/circ/ medical-misinformation. The opinions expressed in this article are not necessarily those of the editors or of the American Heart Association. From the Cardiology Division, Department of Internal Medicine (J.A.H.), University of Texas Southwestern Medical Center, Dallas, TX. Correspondence to: Joseph A. Hill, MD, PhD, Cardiology Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, 6000 Harry Hines Blvd, Dallas, TX 75390. E-mail: joseph.hill@utsouthwestern.edu J Am Heart Assoc. 2019;8:e011838 doi: 10.1161/JAHA.118.011838. a 2019 The Author. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.