Healthy Skepticism

Accurately interpreting medical research doesn’t require a PhD. All it takes is some baseline knowledge and what F. Perry Wilson of the Yale School of Medicine calls “scientific intuition.” That’s the message he wishes would go viral instead of the misinformation that pops up on social media every day, whether it’s claiming the next big COVID breakthrough or the next surefire cure for cancer.

Wilson, a kidney specialist with a master’s degree in clinical epidemiology, is fighting back with a free course on the online learning platform Coursera titled “Understanding Medical Research: Your Facebook Friend Is Wrong.” With more than 36,000 enrollments and counting, Wilson is helping people become more discerning consumers of what may be the most important information they’ll ever need.

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Wilson’s concerns about general medical literacy were piqued by his “side gig” writing a column on interesting new research studies for Medscape.com, a popular resource for medical professionals. “As I did that week after week after week, I realized a lot of the same were coming up again and again and again” even among the researchers themselves, Wilson says. When the Yale Center for Teaching and Learning put out a call for suggested courses to launch on Coursera, Wilson jumped at the chance to explain what he was seeing.

“Understanding Medical Research,” which took about 18 months to develop and film, is presented in a seven-week format, including videos, readings, interactive discussion board posts and quizzes. Topics include sampling, relative versus absolute risk, p-values, causality and a wealth of other factors that are relevant to assessing what you’re reading. After the pandemic hit, Wilson added bonus COVID-related material that illustrates some of the points in the course. In one extra video, for example, he addresses a media report that claimed smoking could prevent death from COVID-19 and explains what reporters saw in the data that led them astray.

Feedback from learners has been overwhelmingly positive—4.9 out of 5 stars from 677 ratings to date—and Wilson has heard privately from a wide range of students, from PhDs to a 7th-grader. “That’s what I was going for,” he says. “As long as you’re willing to have your brain ask logical questions and let data drive the answers, you can do this course.”

Why, then, are we exposed to so much faulty information in the first place? Wilson says medical school education is part of the problem. While researchers learn methods and statistics, “sometimes not taught specifically where things go wrong. That really takes experience,” he says. “It was doing clinical research and writing studies again and again and again that really taught me, ‘Oh, I’ve come across this problem before.’”

For example, researchers are taught to adjust for additional factors that might “confound” their data, but “what you’re not taught is that adjustment isn’t magical,” Wilson says. Adjusting for income disparities isn’t all that useful if your top income category is “greater than $100,000 a year,” he points out. “The people who make $10 million a year and the people who make $110,000 a year aren’t actually the same in all that many ways.”

The problem has been compounded in an age of social media, when reports of studies are “retweeted, misinterpreted, retweeted again.” Wilson likens the distortion to an old-fashioned game of Telephone. Raw data is interpreted in a research paper, which is then filtered through peer review, published in a journal, reinterpreted by medical and science writers, picked up by the general media and, finally, shared on social media, where it continues to morph. At each pass, the original data tends to lose some of its integrity. Layer on top of that a pandemic, driving a surging interest in “preprint servers” that release drafts of medical studies that haven’t been through peer review yet, and the potential for accepting misinformation as fact becomes ever greater.

There is hope of getting it right. If you do nothing else, Wilson says, check for replication—multiple studies that have reached the same conclusions. That will protect you from being taken for a ride most of the time, he says. Additional research may not always be available, however. New studies cost money, and funding is biased toward innovation rather than testing someone else’s findings.

Your other best defense is some basic knowledge that will help you develop an intuitive sense of whether claims are justified by the underlying research. Approach “with interest,” Wilson says, “but full of wary skepticism.”

Written and photographed by Kathy Leonard Czepiel.