Navigating the Medical Misinformation Age

IN THE DIGITAL age, access to health-related content has never been easier. From social media platforms and celebrity-endorsed product testimonials to miracle cures sold on slick professional websites, information addressing health concerns can be acquired within seconds. Unfortunately, this vast availability of information comes with a significant drawback: the proliferation of medical misinformation.

Medical misinformation refers to false or misleading health-related content that is typically accessed and spread online. Inaccurate, misleading and blatantly fake information creates confusion, causes mistrust of health professionals and prevents people from getting the healthcare they need. Common topics rife with inaccuracies include inquiries about disease symptoms and treatments, vaccine efficacy and safety, and public health guidelines. Unlike disinformation, which is content that is deliberately false and shared with the intent to deceive, misinformation may be unwittingly accessed and unknowingly shared by individuals who have no malintent — they simply believe it to be true.

A 2023 survey conducted by the Kaiser Family Foundation (KFF)¹ found that when presented with a series of false statements regarding everything from COVID-19 vaccines to reproductive health, roughly half to three-quarters of survey participants were unsure whether each of the claims was true or false, describing many as “probably true.” For example, when presented with the false statement: “More people have died from the COVID-19 vaccines than have died from the COVID-19 virus,” at least 20 percent of respondents said it was definitely or probably true.

In a 22-page advisory about the dangers of inaccurate online health information,² U.S. Surgeon General Vivek Murthy, MD, MBA, warned that it has the potential to thwart public health initiatives. “Health misinformation is a serious threat to public health. It can cause confusion, sow mistrust, harm people’s health and undermine public health efforts,” he stated. “Limiting the spread of health misinformation is a moral and civic imperative that will require a whole-of-society effort.” The advisory urged individuals to take personal responsibility for the spread of misinformation.

Of course, getting your patients to alter their online behavior is no easy task. “Once people start accessing and sharing misinformation online, it can be difficult for them to disengage because of the connections they form,” said Deen Freelon, PhD, a computational social scientist and a professor at the University of Pennsylvania’s Annenberg School for Communication.³ “Information transfer is a highly social experience that offers a rush of positive feedback — even well-intended people fall into echo chambers where others reinforce their inaccurate information or harmful beliefs,” he said.

The Role of Social Media

About a quarter of KFF survey participants said they used social media at least weekly to “find health information or advice.” It’s interesting to note that health misinformation differs from other forms of inaccurate online content, such as political opinions, in that health misinformation purveyors often stand to benefit financially by selling a product or service, often through social sites such as TikTok.

Of the people who regularly use the news aggregation and discussion site Reddit, one in six say they “have a lot of trust” in the health and medical information found there. Weekly TikTok, YouTube and X users also expressed a lot of trust in the health information they see on those platforms.³ From a demographic perspective, young adults tend to be at a higher risk for believing false information accessed via social media. In one Canadian survey,⁴ 73 percent of 18- to 25-year-olds reported following at least one social media influencer who promotes antiscience views.

A recent review of 69 studies of health misinformation on social media sought to identify the main health misinformation topics and their frequency on different social media platforms.⁵ The studies surveyed used a variety of research methods, including social network analysis, evaluation of content, evaluation of quality, content/text analysis and sentiment analysis. Researchers concluded that the incidence of health misinformation was highest on X, especially regarding the use of tobacco and other drugs, with some studies citing 87 percent of such posts containing misinformation. Health misinformation about vaccines was also a trending topic, with around 43 percent of posts containing misinformation. It also uncovered that most frequently discussed topics were regarding vaccination and infectious diseases, including Ebola and the Zika virus. Other topics such as nutrition, cancer, water fluoridation and smoking were also prevalent.

Combating this type of activity online is complex. The very nature of social media allows users to self-curate their feeds and content, which means that those who follow anti-vaccine content, for example, are much more likely to be flooded with similar content based on automated algorithms. These algorithms in turn reduce the likelihood that individuals who regularly consume misinformation will be exposed to content that contradicts the prevailing viewpoints of their social media network. Additionally, there is the very human tendency toward confirmation bias — our penchant for believing and sharing information that agrees with our existing beliefs — that makes any attempt at debunking misinformation ineffective and even counterproductive. That’s why online debates about hot topics like vaccine safety quickly escalate into heated debates and arguments.

“Most myths actually don’t survive. It’s really just a few that get pushed and pushed and pushed that do survive,” said Lisa Singh, PhD, a professor of computer science and public policy at Georgetown University and the director of the Massive Data Institute at the McCourt School of Public Policy. “As misinformation circulates, it becomes more familiar and starts to feel ‘more real and true.’ Moreover, if myths align with people’s core beliefs or feelings, or are promoted by sources they trust, there is a greater chance they will be accepted.”⁶

The Erosion of Trust in Medical Science

The effects of healthcare misinformation can be profound and far-reaching, impacting individuals, families, healthcare institutions and entire communities. Incorrect information about health and disease prevention has led people to make dangerous decisions about their treatment and care, engage in harmful practices, avoid beneficial and lifesaving preventions and otherwise put themselves and others at risk. The results include avoidable clinic and hospital admissions, billions of dollars in additional healthcare costs, needless illnesses and deaths that could have been prevented.

To address these challenges, Brian Southwell, PhD, adjunct professor in the Department of Medicine at Duke University School of Medicine is engaging with other researchers, medical professionals and organizations to tamp down medical misinformation.⁶ “Misinformation itself has become a buzzword. We sometimes use the term without really thinking about what it means, but belief in false claims can lead to real harm if it undermines trust in established medical practices and institutions,” he explained.

Dr. Southwell, along with Nadine Barrett, PhD, associate professor in family medicine and community health, is working with the National Academy of Science, Engineering and Math (NASEM) committee on understanding and addressing misinformation about science. That eventually will result in a consensus report on the scope and consequences of misinformation about science. “As we look across the country, we see a lot of headlines about misinformation in health and medicine,” Dr. Southwell added. “We need better engagement and widespread collaboration between many different types of organizations. Duke is helping to provide that.”⁶

Trust also plays a central role in health communication, and research shows that formally trained healthcare professionals and scientists do garner ample public trust. According to 2023 data from the Pew Research Center, 77 percent of U.S. adults trust medical scientists to act in the public’s best interest — the highest rating given to any group or institution in society. By contrast, elected officials were the least trusted, with just 24 percent of U.S. adults expressing the same degree of confidence.⁷

That said, trust can also be exploited by healthcare professionals who share or recommend false healthcare information. One recent example is when Joseph Ladapo, MD, PhD, the surgeon general of Florida, shared a far right-wing website article claiming that mRNA COVID-19 vaccines have “deadly side effects.” The article, which was originally published on a site with a history of promoting false claims and conspiracy theories, cited unverified Vaccine Adverse Event Reporting System data and quoted a controversial writer known for promoting anti-vaccine conspiracies.⁸ In the piece, the surgeon general called the Centers for Disease Control and Prevention (CDC) “unethical” for continuing to recommend COVID-19 vaccines. Some responses to the post questioned the credibility of the article and its source, while others thanked Dr. Ladapo for speaking out.

In response, several U.S. health agencies drafted and published a letter signed by U.S. Food and Drug Administration (FDA) Commissioner Robert Califf, MD, and CDC Director Rochelle Walensky, MD, MPH, stating: “It is the job of public health officials around the country to protect the lives of the populations they serve, particularly the vulnerable. Fueling vaccine hesitancy undermines this effort.”⁹

Staying Safe in the Misinformation Age

In today’s digital age, discerning fact from fiction is more difficult than ever before, but there are some safeguards that can be used to identify misinformation. When discussing healthcare claims, here are some best practices physicians can recommend to their patients:¹⁰

Verify the source. Not all websites, social media accounts or publications are credible. When accessing health-related information, be sure to check the credentials of the author or organization. Is the content created by a qualified healthcare professional or a recognized institution? Also, look for websites ending in .gov, .edu or those belonging to well-known health organizations like the World Health Organization (WHO) or CDC. Avoid sources that prioritize sensationalism over evidence.

Look for evidence-based information. Ensure that claims are supported by peer-reviewed studies or data from reputable journals. Also, be wary of anecdotal evidence or unverified testimonials, as they often lack scientific support. It’s also a good idea to cross-check information with multiple trusted sources to ensure consistency.

Watch for red flags. Claims of a “miracle cure” or “secret solution” that mainstream medicine is hiding or statements that demonize entire groups of healthcare professionals or organizations are cause for concern. Also, watch for overly emotional language designed to instill fear or urgency.

Exercise caution on social media sites. Avoid sharing content unless you’ve verified its accuracy. Make it a habit to follow credible accounts of medical professionals and organizations.

Use trusted fact-checking tools. Websites like Snopes, FactCheck.org and HealthFeedback.org can review and debunk misleading claims.

Consult a healthcare professional. When in doubt, consult a doctor or a licensed healthcare provider. They can provide personalized advice and help patients interpret confusing or conflicting information. Patients should also avoid self-diagnosis based on online content, as it may lead to unnecessary anxiety or incorrect treatment.

While efforts to address online healthcare misinformation are underway, the problem is both widespread and persistent. Turning the tide against the onslaught of misleading content will require a multifaceted approach at both the public health and individual consumer levels. As we look to the future, healthcare institutions and public health agencies are tasked with:

• Promoting health literacy: Education campaigns should teach individuals how to critically assess online health information, including recognizing credible sources such as peer-reviewed journals and official health organizations.
• Strengthening platform policies: Social media companies must take responsibility for reducing the spread of false health information. This can include flagging or removing misleading content and amplifying verified information from trusted sources.
• Empowering healthcare professionals: Doctors, nurses and other healthcare workers should be trained to address patients’ concerns about misinformation effectively and empathetically.
• Enacting legislation: Governments can enact laws to penalize the deliberate spread of harmful misinformation while balancing freedom of speech concerns.
• Community engagement: Engaging local communities and influencers in spreading accurate health information can increase its reach and acceptance.

Healthcare Professionals Play a Role

Navigating the sea of healthcare information available online can be overwhelming, and the general population’s tendency to just “Google” unexpected aches, pains or symptoms has become an ingrained behavior for most. Healthcare professionals can encourage patients to apply critical thinking and use reliable resources to protect themselves from accessing misinformation and encouraging others to do the same. By prioritizing education, regulation and technological innovation, we can all create a safer and better-informed digital healthcare world.