How to spot fake medical information

Be on guard against believing everything you read online, says Dr Deborah Lee, from the Dr Fox Online Pharmacy

It’s completely understandable that anyone who has a severe, chronic illness like multiple sclerosis (MS) would want to scour the internet looking for answers. But sadly, there is a high risk that doing this could cause more harm than good. Let’s look at all the reasons why.

What is medical misinformation?

Medical misinformation means any health-related claim, based on anecdotal, false or misleading information, owing to a lack of existing scientific knowledge. In a recent 2021 review and meta-analysis, the authors reviewed 69 studies, covering a range of topics and media platforms. A staggering 87% of these posts contained fake medical information.

Why does it matter?

This is of great public health concern. The deluge of irresponsible health messages on social media has been dubbed an ‘infodemic.’ Misinformation is most commonly found on platforms such as X (formerly Twitter), YouTube, Facebook and Instagram. Fake medical information is everywhere – on social media, videos, websites, TikTok and online forums – and instantly available on the smartphone with a click of the finger.

The World Health Organisation (WHO), in a 2022 review, concluded that misinformation on the internet is causing mental, social, political and economical distress. Believing inaccurate medical information from social media leads to fear, panic and reduces access to healthcare.

Why do we believe this fake information?

When we read something on the internet that gives us hope, such as a new treatment for a medical condition, of course, we want to believe it. But so often these one-off, sensational claims have little or no medical research behind them. The danger is that someone will take this product, perhaps instead of their prescribed medication, which can worsen their condition, land them in hospital, or it could be fatal.

Some examples

There are numerous examples. Take the very sad case of a patient in his 70s who after a diagnosis of lung cancer was advised by his oncologist to have chemotherapy and radiotherapy. He chose to take an alternative treatment involving intravenous hydrogen peroxide – which has no medical evidence to recommend it and can cause death due to gas bubbles in the bloodstream. While on this treatment, not only did his cancer progress, but he became extremely breathless and had to be admitted to a hospice where he died. This treatment cost him $50,000. Why did he choose to accept this anecdotal and unsubstantiated treatment instead of evidence-based cancer treatment? This is what happens when patients read and believe false medical misinformation.

The situation is no different for people with MS. In a 2018 Italian study, the investigators studied an MS social media network (SMsocialnetwork.com) – a dedicated site for MSers. They analysed the posts on this site over a three-month period. They found that 308 posts contained useful medical information. However, 72 posts contained fake or misleading medical information.

How does medical misinformation occur?

An article containing medical information can appear on an isolated website. It is then picked up by a journalist and published online with access to everyone. Those who like it then add a hashtag and spread it on X (formerly Twitter). Suddenly this specific claim has gone viral.

Why is there so much medical misinformation on the internet?

Remember that a lot of what you read is driven by profit. Someone wants you to read this and part with your money. They are not concerned about you or your welfare and have no scruples or decency. It’s almost always because they want you to buy something. Websites make money by advertising and by your clicks. Internet algorithms mean they know what you are searching for and will automatically bombard you with more information and products.

How is medical misinformation created?

Medical misinformation can be created quite inadvertently or done on purpose. It could be that the writer failed to fact-check before producing the article. The writer wants the article to be a success, so they exaggerate their claims. They may cherry-pick one small issue out of a sea of information that was not the major aim of the original article. Sometimes the reported information only gives one side of the story, so the reader cannot get a balanced view. Unfortunately, there are also many occasions where the information is totally fabricated.

Red flags

Look out for the hype promising a wonder drug or a miracle cure. This is the type of language used in advertising to draw you in. Use your common sense. If treating a condition is so easy, why isn’t everyone doing it?

How does the post you’ve seen make you feel? Sometimes journalists use tactics like shock, fear or anger to get you on board.

Where has this information been published? Is it on a reputable website or in a reputable journal? Who wrote it? Was the person medically qualified? Has the medical paper quoted been peer-reviewed – which means it has undergone scrutiny from a body of other suitably qualified academics?

The over-riding rule is that if anything sounds too good to be true, it will be just that! Below is a check list of pointers and checks you can make, taken from this 2020 Oxford University publication in the Royal Society of Medicine Journal, which is properly referenced and has been peer-reviewed

Find the original source of the information – This means tracking down the original medical paper and evidence supporting the claim. If you can’t find this, it’s highly unlikely to be true.

Beware, however, that even published medical papers can be poor research and the results can be biased, misrepresented and unreliable. If you are contemplating any new drug or treatment or discontinuing any medication, always speak to your GP or neurologist first.

2. Do a Google search – See if others have reported the same thing. Is it reported on trusted websites, such as the NHS website, or those of the Royal Medical Colleges?
3. Use a fact-checking site – For example, com, Factcheck.org, or HealthNewsReview.org. You might be interested to read the excellent commentary on Snopes.com about recent medical misinformation regarding aspartame and MS, for example.
4. Could this be a satire publication? Check the title of the publication – this could have been written as a spoof
5. Consider the health claim you are investigating – has it been described in context? What was known to-date? How has the advice changed? It’s highly unlikely a medical breakthrough will occur with no background research to substantiate current practices and the direction of future research

• Can causality really be established? For example, a paper may show that those on a high-sugar diet have a higher risk of cancer than those on a low-sugar diet. However, this does not prove that it is the sugar that ‘causes’ the cancer. People who eat more sugar are likely to be overweight or obese, have type-2 diabetes, and high blood pressure and do less exercise, all of which are proven risk factors for cancer. So simply saying a high-sugar diet causes cancer isn’t true
• Understanding risk – There is a difference between relative and absolute risk. For example, let’s say (fictiously) that the absolute risk (background risk) of developing cancer in a smoker is four in 100. If a study showed that eating tomato sauce increased the relative risk of cancer by 50%, this means 50% of four – so if you do the maths, this means the absolute risk of developing cancer in a smoker who eats tomato sauce is now six in 100 – only two extra cancer cases. However, journalists, who want to sell newspapers, sensationally report that tomato sauce increases the risk of lung cancer by 50%! They fail to tell you this only represents a very small increase in the number of people with lung cancer. But when the headline appears, tomato sauce sales fall through the floor!
• Extrapolating findings – Much scientific research is done on animals. Animals are not the same as humans. Check if studies were done on humans. Although animal studies are useful, they do not prove safety or effectiveness in humans
• Credibility – Only take note of publications from respected sources. Any medical article you read should include identifiable references, either within the text or listed at the end. Look for papers form well-known journals such as The British Medical Journal (BMJ), the Lancet, and The Royal Medical Colleges. Results from systematic reviews and meta-analyses are far more likely to be believable than one-off observational studies

Final thoughts

This blog post has been a rollercoaster of negativity about the current infodemic. However, I would like to end on a positive note. Knowing all you can about MS and current treatments is absolutely the best thing you can do in terms of living with the condition. But – trust the highly qualified, experienced specialists looking after you. If there is a breakthrough treatment for MS, they will be the first to let you know when it is available.

Always get your information from reliable sources including MS-UK.

If you have questions, you can always contact the MS helpline or send an email. Before you come to any conclusions about something you have read on the internet, please stop and run through the above checklist. Remember, if it sounds too good to be true, it more than likely is!

Dr Fox Pharmacy is a fully regulated UK online doctor and pharmacy service managed by NHS GPs.