Media coverage provides an essential link between the providers and users of health care. For health care industries, favourable reports on new drugs, procedures and treatments may translate into improved revenue streams from increased sales and rising share values. For medical researchers, media reporting of research findings enhances citation rates and boosts the public profile of their research institutions.2 For an increasingly educated and attuned public, access to developments in medicine affects individual health decisions.

Integral to this whole process are journalists, as they largely determine what information is reported. Equally crucial is the responsibility that their reportage be accurate, adequately researched and conveyed in a clear and unambiguous manner. Indeed, the 2001 Australian Press Council guidelines on reporting medical matters stress the need for a conservative and careful approach to this task.3

The Association of Health Care Journalists (AHCJ) in the United States is even more explicit. Its principles for health reporting note that “ journalists have a special responsibility in covering health and medical news”.4 This includes the “professional standards of truth, accuracy and context in every report”, free from any personal, financial or other conflicts of interest. The AHCJ principles provide pragmatic advice on such matters as being vigilant in selecting sources; understanding the medical research process; avoiding vague and sensational language; explaining research outcomes clearly; and outlining the risks and benefits of any treatment.4

With such an abundance of good advice, a high quality of media reporting of health and medical matters would be expected, but this confidence may well be misplaced. In this issue of the Journal (page 190), Smith and colleagues report on the quality of medical news stories published in three high profile Australian newspapers — The Age (Melbourne), The Australian and The Sydney Morning Herald — and two online outlets — “ABC news online” and “ninemsn”.5 Assessments of individual news stories are posted on the media doctor website (http://www.mediadoctor.org.au) and scored using a three-star rating system based on satisfying 10 criteria, such as evidence of disease-mongering, too much reliance on press releases, appropriate reporting of benefits, harms and costs, and the independence of information sources.

Twenty of the 104 articles surveyed scored no stars (overall score < 25% of criteria satisfactory), and 11 scored three stars (score > 75% of criteria satisfactory). Overall, both online and print media outlets scored poorly, with an average score of 56.1% for the print media, and 40.1 % for the online media. Criteria that scored poorly across both print and electronic media news reports included quantification of benefits, and harms and costs of treatment.5 Similar findings have been reported for media outlets in North America.6,7

Given that most people know little about the workings of the media, we invited media insiders — three high level journalists — to give their comments on the findings of Smith et al.

Herman and Morgan of the Australian Press Council (page 195) welcomed the findings, but cautioned against expectations that initiatives such as media doctor will lead to any spectacular improvement in the quality of health or medical reporting. They suggest that the somewhat better performance of print compared with electronic media may reflect the promulgation in the print media of the Press Council’s 2001 reporting guidelines. Indeed, such guidelines are conspicuously absent in the current Commercial Television Industry Code of Practice.8

Swan (page 194) and Sweet (page 194), both veteran health commentators, stress the need for better cooperation between researchers and journalists, and Sweet is sceptical that exercises such as media doctor will enhance the quality of medical or health reporting. There is an impression that, in the time-poor and chaotic world of journalism, quality is sometimes overwhelmed by the urgent need for copy, and that outside scrutiny of quality is not particularly welcomed or productive.9

There is, however, a more pertinent issue. At the core of the media, as in medicine, is the principle of self-regulation. In such circumstances, it is the attitudes of journalists, their editors and program executives that drive standards, and in this quest for medical reportage, Schwartz and Woloshin have recently advanced a number of simple principles:10

• Don’t report preliminary findings: This recommendation applies particularly to Phase 1 trials, studies using animals, and preliminary reports presented at scientific meetings. More than a quarter of meeting presentations are never published.11

• Communicate the absolute magnitude of differences: Convey not only the relative risks, but, more importantly, what these mean in absolute terms.

• Include study limitations: These should be highlighted along with potential conflicts of interest and funding sources.

To make health and medical reports as accurate and accessible as possible, there should be greater cooperation between researchers and reporters. To achieve this objective, the “single overriding communication objectives” (SOCOs) of the press release should be pursued. This strategy, developed by the US Centers for Disease Control and Prevention,12 ensures visibility of the main points that the researcher or health expert believes are important. Press releases should also include relevant caveats on the limitations of the research, industry funding and other financial matters.

Essentially, the public places a great deal of trust in the health care system and in medical news, particularly if it is based on peer-reviewed data published by medical experts. It would be a pity to destroy such trust through substandard reporting.