Evidence-Based Decision-Making in Public Health

    Evidence-Based-Decision-Making-in-Public-HealthScientists are having a rough go of it right now. They are being harassed at record levels, especially for sharing public health information related to the COVID-19 pandemic.

    It’s gotten so bad that scientists on Twitter are “heading for the exit.” In this climate, how can medical communicators increase the public’s trust in science? 

    What types of information and communication can help sort scientific evidence from misinformation and its evil cousin, disinformation? In an era of rampant disinformation and public skepticism, evidence-based decision-making — at both the personal and policy levels — has become arguably more important than ever before.

    Evidence-Based Decision-Making

    The Department of Health and Human Services’ Agency for Healthcare Research and Quality defines evidence-based decision-making as “the use of the best available evidence together with a clinician’s expertise and a patient’s values and preferences in making health care decisions.” 

    However, the proliferation of bad science and medicine online makes it tricky to get the “best available evidence” into the public’s view.

    Rising Threats to Scientists

    It’s not an easy time to be a scientist. In fact, since the pandemic, scientists have faced increased threats and harassment on social media. In a study published in JAMA Network, 359 study respondents (doctors, biomedical scientists, and trainees) reported alarming rates of harassment. 

    • 88% reported harassment due to advocacy
    • 64% reported harassment connected to comments they made on the COVID-19 pandemic
    • 45% reported harassment on the basis of gender
    • 27% reported harassment on the basis of race or ethnicity
    • 18% reported their private information had been shared online (doxxing)

    These threats and harassment often occurred when scientists used social media to post public health messages. The hostile climate changes the way medical professionals and scientists use social media, making it even more critical for medical communicators to help create and disseminate materials that promote a shared understanding of science. 

    The extreme, politicized response to the pandemic surrounding masks and vaccines provides an example of the perils of not sufficiently translating or conveying the principles of epidemiology to the general public.

    Understanding Epidemiology and Risk

    An article in the International Journal of Environmental Research and Public Health explores what the authors call a “shifting paradigm” of risk assessment. The piece focuses on an environmental public health issue: exposure assessments for certain chemicals that have been classified as “known human carcinogens.” 

    The authors found a number of shortcomings in the available studies and brought some concerns and questions to the fore. “What study elements would be required for a given study to be considered of high value? How is this being communicated to researchers, training programs, and funding organizations?” the authors ask. “While it will take time to reach a consensus on the best approach to conducting study evaluations (and there is no guarantee that consensus will be reached), still, the bar has been raised for environmental epidemiology regarding what kinds of exposure information will be considered acceptable for use in public health decisions. A better understanding of the evolving systemic approaches and the criteria by which research will be evaluated can lead to more science-based policies derived from epidemiology studies.”

    If there is any hope of reaching that elusive consensus, medical communicators will play a key role as translators and disseminators of solid scientific information.

    Meet Your Local Epidemiologist

    One exemplary example of a scientist who also plays a key role as a science communicator is Dr. Katelyn Jetelina, “Your Local Epidemiologist.”  She earned a master’s degree in public health and a PhD in epidemiology and biostatistics. She is a senior scientific consultant to the Centers for Disease Control, among other organizations. 

    “My main goal is to ‘translate’ the ever-evolving public health science so that people will be well equipped to make evidence-based decisions,” writes Jetelina. Her Substack newsletter and website, Your Local Epidemiologist, uses accessible, clear language to unpack complex and controversial topics such as COVID-19 vaccines, masks, mental health issues, and gun violence.

    Defending Scientists

    The June 27, 2023, edition of “Your Local Epidemiologist” is titled “Harassment against scientists is out of control.” Jetelina explores the case of Peter Hotez, MD, PhD, a professor of pediatrics and molecular virology. His latest book, The Deadly Rise of Anti-Science, has made the Nobel Peace Prize nominee a target of anti-vaccine zealots. 

    Hotez and his family have faced numerous online attacks, and some anti-vaccine activists even visited his Houston home to try to harass him into debating Democratic presidential candidate Robert F. Kennedy, Jr. 

    “A complete nightmare,” writes Jetelina. “These nightmares are now a common occurrence for scientists and physicians in public health. Both online and offline. For vaccines. For gun violence. For reproductive health. And apparently for wildfires now, too. It’s gotten out of control, which becomes an individual risk as well as a risk to the communities we serve.”

    Jetelina has experienced harassment, too, so she knows firsthand the risks scientists are taking on behalf of public health.

    In the Service of Science

    Can medical and science communicators provide some sort of buffer to protect scientists? One solution Jetelina proposes is to create what she calls a "bi-directional conversation with the public.” 

    That becomes more challenging because scientists are afraid to comment in public forums like Twitter. “Scientists are leaving Twitter in droves,” writes Jetalina. “When they stop interacting, the gap between science and community only grows wider, allowing misinformation and disinformation to fill the void.”

    Medical writing provides an essential public health function by creating and sharing accessible and accurate sources of data and evidence.

    Learn more at the 2023 Medical Writing & Communication Conference from 2023 Alvarez Award Recipient - Dr. Katelyn Jetelina

    July 24, 2023 at 9:00 AM

    American Medical Writers Association

    AMWA is the leading resource for medical communicators. The AMWA Blog is developed in partnership with community members who work every day to create clear communications that lead to better health and well-being.