Efficacy and Public Disputes: From Epidemics to Healthcare in the Media

Here are some feedbacks for the topic on media and science, the rhetorics and interactivity within the science community, journalistic/mass media, as well as the public consumers:

Great topic on how media portrays scientific explanations and how the media is a powerful tool in engaging the authoritative/ scientific community with the general public. As the linear chain of communication is gradually diverging in to many other complex, multidirectional directions, more controversial issues are to be addressed.  Some issues to pinpoint includes: ethical, moral panic, social justice, scare tactics, political propaganda, journalists’ competency, public engagement, proprietary concerns etc….The rhetorical aspects of science portrayal is also interesting, using sci-fi, imagery depictions, etc….As new media come into creation, one should develop the skill to assimilate only information that is necessary, shut out all perplexities that obscures one’s judgement on a certain issue (eg: when dealign with helathcare in social media). Also with the increasing development of digital/social medias, as well as the increasing critical participation of the public, calls for more regulatory ways of governing science dissemination. On the other hand, as the public depend upon more technological advanced media platforms, more differentiation of dissemination are to look forward to. publications and media discourse on the web can be further aggregate to suit specialised niched of user communities. Perhaps in fture studies, I can also discuss on public’s perceptions and participatory roles in media discourse. “Agnotology” is a rising study of how to “avoid (certain) informations”, involving certain level of ignorance in order to complete the cycle of a more efficient communication.

Apart from that, I will include several controversial issues discussed in the media, ranging from pharma fraud, mandatory vaccinations as well as media hype and the different point of views. I shall also cover the use of WEb2.0 by healthcare and pharma industries, the hype of social media.

…to be continued…

Consumers are deeply engaged when it comes to their health. And as they search online to educate themselves about disease states, cures, drugs and support, there’s one common truth: They trust discussions with other consumers. This presents a challenge for pharmaceutical companies to gain consumer trust and loyalty, especially in this age of multimedia. However, if companies can actually join in the conversation—known as social media—then they have an opportunity to gain this trust.

(Barrette J. & Becker B., 2007)

SOCIAL MEDIA is a collaborative communication which allows individuals, groups and institutions to effectively take part in creating, searching, using, sharing and spreading information together. This allows communities to stay connected and engage with radically improved speed and convenience. According to Barrette and Becker, Social Media includes what is identified as the User-Generated Content (UGC), which essentially is produced by the general public people instead of conventional media producers. Examples of UGC include blogs, podcasts, tagging, ratings, videos, photos etc. Statistically, 75% and 92% of all online adult and youth consumers respectively uses at least one form of UGC. Fundamentally it is a portal for self-expression made easier with technology. Social media is not a revolution nor a fad or an exclusive domain of a site. Consumers now expect collaboration and participation in virtually all aspects of their lives.  Take Healthcare for instance, the adoption of social media has increased as consumers are presented with the inherent trust that social media provides.

Although technology has been the provider, the people/users are essentially the motivating force behind social media. The more people contribute the richer the contents become, and the more impactful the engagement becomes. For example, medications/drugs can be rated, ranked, discusses and reviewed by millions of users online. With this essentially leads to the challenges of marketing to this online audience. A research shows that the hyper engagement and leverage of information sources to learn about disease conditions and prescriptions by online health consumers’ is twice as many as by the average consumers. Most consumers participate in UGC to share online health information with others, while health searchers crave information and interaction online.

With the interaction of UGC, search and personalization, global health communities are growing into powerful forces. These communities are built around people with a common purpose that want to participate, be heard and discover information that is relevant to their interests. And within these communities, dynamic differences are emerging. For every creator of content—a physician writing a blog, for example—there are roughly 10 synthesizers actively commenting, sharing, rating and reacting. For each group of synthesizers, roughly 100 consumers read, watch, listen and enjoy, while participating only occasionally. All three of these groups have a valid place within the community.

According to McNab (2009), until recently the communication models has predominantly been of ‘one’ authority to ‘many’, this includes health institution, ministry of health and a journalist, communicating to the public. The conventional ‘monologue’ has been changed into a ‘dialogue’ with the presence of social media. Those with access into ICT can be both creator and communicator. McNab states however, health professionals should ensure that information displayed in these social media are accurate and accessible. Social media platforms ranging from Facebook, Twitter, YouTube, Wikipedia etc. are commonly used by millions of users. It is therefore crucial for regulative frameworks/policies to be carried out. As pointed out, one new emergency health/outbreak message updated on Twitter can spread across the globe faster than the virus itself.

What’s the bottom line for growing social media and health communication? Be strategic and choose wisely. Identify what needs to be said and why, to whom and when. Focus efforts on the specific social media tools relevant to the audience and use them consistently. A string of abandoned or infrequently tended social media accounts hurts credibility. Critically, health professionals need to use social media to engage in a conversation, not only to “pass down” information. The global social media community expects to be able to add value to the conversation, to help correct rumours or misinformation, provide feedback or offer personal experience. Social media is a new and constantly evolving area. While there is a growing body of research on health information and social media, most is focused on how it can be used by advertisers to attract new consumers.

Much more needs to be known and shared about how best to use social media to achieve public health outcomes. Action research focused on “learning by doing” and sharing lessons among peers across the globe is vital. Public health professionals should also be aware of web-based analytical tools such as Google Insights16 and analytical tips from the social media community.

Ref:

Barrette J. & Becker B. (2007) Joining the Social Circle, Medical Marketing & Media.

McNab C. (2009) What Social Media Offers to Health Professionals and Citizens, Bulletin of the World Health Organization, 87:566.

In order to contribute to a sociology of negative expectations from a linguistic (metaphorical)perspective, we want to find answers to questions such as: Which rhetorical devices,be they pragmatic markers, metaphors or references to pertinent historical events, were used by experts and the media to create which type of images of the future in order to mobilize what kind of action in the present? What were metaphors and other devices used for – to inform, to warn, to blame, etc. – and by whom were they used, the experts or the media?

Pragmatics is used as a tool linking metaphor analysis and the sociology of expectations. Pragmatics roots in J.L. Austin’s philosophy of language developed in the 1950s. According to the pragmatics point of view, there can be three distinctions in verbal communication: locution (what utterances-say), illocution (what utterances do-perform) and perlocution (what utterances achieve). For example, the sentence ‘This dog is dangerous’ if said as ‘I hereby warn you that this dog is dangerous’ can have the illocutionary force of warning someone about the particular dog, as well as the perlocutionary effect of frightening or alarming the person who receives the message. The speaker’s intention is to warn the receiver, while the expectation is that the receiver would take appropriate actions. The forces of speech acts can be indirectly conveyed through the situation of use or directly through illocutionary force markers.

Scientists and experts issued warnings in the media by amplifying their illocutionary force in various ways. In most cases illocutionary force markers were used by newspapers to present quotes by experts or scientists indirectly, eg. ‘Bird flu could put Britain in quarantine, warns scientist’. Nerlich and Halliday also pointed out perlocutionary force markers were used in an instance (as quoted in The Express, The Guardian, The Time, and italics added) ‘I think it is very frightening to see such high case fatality rate’ – Cox of the American CDC. The quantitative study showed that journalists are not wholly responsible for overemphasizing the possibility of the avian flu threat. Scientists led a concerted campaign of fear and warning which utilizes the media’s attention to further stir up interest from government around the world. The pragmatic strengthening was further enhanced by scientists’ repetitive use of adjectives such as inevitable, ominous and overdue. The rhetorical enhancements add to a rhetoric of fear, based on negative visions, provoking negative expectations beyond the initial warnings of a pandemic threat.

Those early warnings delivered by the scientists and amplified by the media mobilized governments to execute pandemic preparedness plans, mobilized pharmaceutical industry towards increasing the production of vaccines, and even began prompting the public into searching for ways to avoid the avian flu infection, leading to unexpected rise in the uptake  of usual seasonal flu vaccination subsequently causing a shortage of vaccines.

The paper shows that it is not the media to take the blame entirely for hyping up fears about a global influenza pandemic (at least as fast as the coverage in the UK national newspapers in 2005 is concerned). The research communities, global and local, scientific journal editors, and various government officials and pandemic specialists were key players in producing awareness, fear and the attribution of blame. The media however can amplify the message that the scientists want to convey and hence intensify an emergent rhetoric of fear, blame and uncertainty. That emergent of rhetoric fear and blame in an uncertain atmosphere has consequences upon the relationship between science and the society, the public understanding of science as well as the policy-making process. It is a difficult balancing process to raise expectations of risk in the case of avian flu, between overstating and understating the case, between shoring up trust in promises/warnings and eroding it. The discrepancy between expectations and eventual realities can have serious costs on reputations, misallocation of resources and investment.

In the case of negative expectations, associated in our case with a pandemic of avian flu, the outcome for the promoter is not dependent on whether or not the expectation comes true, but on the actions that the audience takes. For this case then, there are two variables: whether people will take action or not based on the negative Avian flu, expectations, interplay and the media expectation and whether or not the expectation will come true or not. First scenario: the audience does not take any action. If the pandemic arises then the promoters of the negative expectation are vindicated. However, if the pandemic does not arise, then the promoters are discredited. Second scenario: the audience takes some sort of action. If the pandemic occurs, the promoters can say that the audience did not take enough action. If the pandemic does not occur, the promoters can say that whatever measures taken by the audience (slaughter, vaccination, antivirals, quarantine, etc.) were enough to contain the pandemic. There therefore seems to be a difference between positive and negative expectations that needs to be further explored. One could say that negative expectations are a self-fulfilling prophesy to the extreme. The outcome affects the promoter negatively only if the audience does not act. The important thing here is that once the audience takes some form of action, the promoters are vindicated. The blame is not on them. In fact, there is only one way in which the blame can go to the promoter, if the audience does not act and the predictions do not come true. Expectations have to be performative then, in the sense of making the audience act in certain ways. But there are differences between early promises and early warnings, differences that have to be examined in more detail in the future

Ref:

Nerlich B. and Halliday C. (2007) Avian flu: the creation of expectations in the interplay between science and the media, Sociology of Health & Illness, Vol. 29 (1), pp. 46-65.

Here’s another related article. Read Paul McKensie’s Recipe for Success with QbD

I’ve linked to their July/August 2009 issue online as an example of their publications HERE. I’d like to highlight page 18-19 on the importance of professional and qualified translation resources for clinical trials overseas.

With the recent deabte over media exaggerations and pharma-conspiracy with regard to the H1N1 vaccines, I would like to draw your attention on the increasing web/media dependency of some big pharmas. It is interesting to note the “control” of what is said and how these companies use various media to create healthcare awareness.

The increasing engagement with the net surely calls for more regulatory means. Here are some useful links:

The FDA, Big Pharma and Social Media

Pharma and Healthcare Social Media Wiki

Pharmaceutical Conspiracy

Potential FDA Guidance on Web2.0 and Social Media