Science is easy; explaining it is hard. Back in 2009, Evidence Soup recommended the excellent Health News Review, whose mission is to "hold health and medical journalism accountable" (more about them at the end of this post). They've published Tips for Understanding Studies (available for purchase here). One of their free online writeups is a must-read for anyone working with evidence. Yes, it's basic – but depending on your level of experience, will be a valuable refresher, an intro to research methods, or a guide to science writing.

Does The Language Fit The Evidence? – Association Versus Causation was put together by Mark Zweig, MD, and Emily DeVoto, PhD, "two people who have thought a lot about how reporters cover medical research". (I've been acquainted with Emily DeVoto for several years; I like that her catchphrase is "The plural of anecdote is not data.").

Passive language vs. active voice. The authors describe how an 'association' can be inadvertently misconstrued as a cause/effect relationship:

"A subtle trap occurs in the transition from the cautious, nondirectional, noncausal, passive language that scientists use in reporting the results of observational studies to the active language favored in mass media…. For example, a description of an association (e.g., associated with reduced risk) can become, via a change to the active voice (reduces risk), an unwarranted description of cause and effect. There is a world of difference in meaning between saying 'A was associated with increased B' and saying 'A increased B.'" [emphasis is mine]

These are subtle things with tremendous importance. When I was in school, I often heard "Correlation doesn't mean causation." Evidently, the difference is still be a big hurdle both for experts and non-experts. Zweig and DeVoto illustrate how things can go awry in this helpful example:

Study designProspective cohort study of dietary fat and age-related maculopathy (observational).
Researchers’ version of resultsA 40% reduction of incident early age-related maculopathy was associated with fish consumption at least once a week.
Journalist’s version of resultsEating fish may help preserve eyesight in older people.
ProblemPreserve and help are both active and causal; may help sounds like a caveat designed to convey uncertainty, but causality is still implied.
Suggested language“People who ate fish at least once a week were observed to have fewer cases of a certain type of eye problem. However, a true experimental randomized trial would be required in order to attribute this to their fish consumption, rather than to some other factor in their lives. This was an observational study – not a trial.”


Abstracts stick to the facts. The authors note that the "language in a scientific publication is carefully chosen for the conclusion in the abstract or in the text, but not used so strictly in the discussion section. Thus, borrowing language from scientific papers warrants caution."

You can follow @HealthNewsRevu on Twitter. The project is led by Gary Schwitzer and funded by the Foundation for Informed Medical Decision Making.

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