Medical Misinformation: The Other Pandemic – How Clinical Misinformation Causes Harm

Mark Perdue PA-CEmergency Medicine, Family Medicine, Internal Medicine, Nurse Practitioner, Nursing RN/PN, Pediatric Emergency Medicine, Pediatric Medicine, Personal Education, Physician Assistant, Urgent Care

Medical Misinformation

Medical Misinformation: The Other Pandemic

Medical Misinformation Blog Series, Part 1 of 3

Misinformation is nothing new.

I remember, as a child, standing in line with my mom at the grocery store and reading the headlines of a tabloid - a member of congress was reported  to be an alien, of the extraterrestrial variety, and to our shock, a particular celebrity was reported to be the love child of two other celebrities.

Even as a child my skepticism was piqued and Mom confirmed that the headlines were “a bunch of hooey.” A brief discussion followed about why such things were reported if they were not true. Mom’s explanation, as far as I can remember, was that people like reading that sort of stuff - even if they know it isn’t true.

I couldn’t help but wonder if there were people in the world that did believe the tabloid’s stories. How strange the world must seem if you believe a member of Congress is an extraterrestrial being?

The font and print of the tabloid look just like those used in legitimate newspapers and the tabloid was displayed right next to respected publications.

Medical misinformation frequently has a much more compelling presentation.

Published on websites with “sciencey” sounding names and disseminated by spokespersons with wide appeal, false medical claims have a much greater purchase in public belief.

In this three part series we are going to take a closer look at medical misinformation:

  • Part I Harm caused by misinformation
  • Part II Where does medical misinformation come from and why?
  • Part III What clinicians can do to counteract medical misinformation.
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Medical Misinformation Causes Harm

It doesn't surprise that misinformation can corrupt social awareness of medical or health-related issues. Here are five examples of how medical misinformation has negatively impacted society and ultimately caused harm.

Resurgence of vaccine-preventable disease

Medical misinformation is any false or unsubstantiated information about medical and health related issues. Whether it be false claims about vaccines causing autism or that apple cider vinegar will cure gastroesophageal reflux, these claims change behaviors in ways that can be catastrophic for the health of our patients.

In 1998 a paper was published by a British physician named Andrew Wakefield that proposed a correlation between childhood vaccinations and autism.

The consequences were devastating as vaccination rates plummeted, in some populations, causing a resurgence of measles.

The paper was later discredited and the author stripped of his license but the damage was done.

The anti-vaccine movement was underway and its consequences continue to threaten public health crises.

I recently reviewed a case of an unvaccinated child who suffered from mastoiditis, a painful and dangerous infection that moves from the middle ear to invade the surrounding skull.

Cultures of the infection grew out haemophilus influenzae- a bacterium that can be prevented by a simple vaccination.

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The Anti-vaxxer movement could cause status pandemicus

As most of the public eagerly awaits a safe and efficacious vaccine against SARS, the anti-vaccine lie machine is working overtime.

A recent article in Nature highlighted the activity of misinformation mongers in the time of COVID

“Campaigners are seeding outlandish narratives: they falsely say that coronavirus vaccines will be used to implant microchips into people, for instance, and falsely claim that a woman who took part in a UK vaccine trial died…”

Last week, a now deleted YouTube video promoting wild conspiracy theories about the pandemic and asserting (without evidence) that vaccines would “kill millions” received more than 8 million views.”[1] 

The problem is clear: if sufficient numbers of the public believe the antivaxxers’ misinformation and refuse vaccines, it will be difficult to establish widespread immunity against a life-threatening virus.

One can imagine the effects of status pandemicus - ongoing recurrent waves of infection, catastrophic death tolls, and economic devastation.

Medical misinformation creates mistrust of established medicine

The anti-vaccine movement has created a considerable background fear of not only vaccines but of established medicine.

Proponents of fringe misinformation movements characterize medical professionals as federalist elites who indiscriminately dole out treatments in order to receive kickbacks from Big Pharma.

Our evidence-based critiques of “alternative therapies” are seen as merely attempts to protect our “market.”

When mistrust creeps in between us and our patients, establishing a therapeutic relationship is an uphill battle.

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Therapy displacement

When patients choose ineffective therapies because of medical misinformation they turn away from legitimate therapies and the potential benefits that they provide.

How many times have primary clinicians recommended a statin to reduce the risk of heart attack only to be told by the patient that they heard “bad things” about the medicine on the internet.[2]

Instead they would prefer to take cinnamon and a fermented milk product that were recommended in an alternative medicine chat room.  Frustrating…

The high cost of medical misinformation

It is no secret that evidence-based therapies can be prohibitively expensive and are never guaranteed to be successful.

An operation to fix a herniated disc will cost the uninsured thousands of dollars without any guarantee of pain relief.

For a fraction of the cost, a device peddled by a “sciencey” looking website is advertised to immediately relieve pain, and it has a money back guarantee.

The desperation of the patient drives the desire to believe that this product will be the answer. 

After initial success, perhaps from placebo effect, the benefits wane and the patient is back to square one but now $400 poorer.

References:
[1] Nature 581, 251 (2020)Anti-Vaccine Movement Could Undermine Efforts to End Coronavirus Pandemic, Researchers Warn

[2] Circulation 2019; 139:571-572 Joseph Hill, MD, PhD et al

Next in this series: Where does medical misinformation come from and why?


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