Media Coverage of the Benefits and Harms of Testing the Healthy: A Protocol for a Descriptive Study

BMJ Open. 2019 Aug 24;9(8):e029532. doi: 10.1136/bmjopen-2019-029532.

Abstract

Introduction: Much testing in medicine is aimed at healthy people to facilitate the early detection of health conditions. However, there is growing evidence that early detection is a double-edged sword that may cause harm in the form of overdiagnosis. The media can be seen as a major generator of consumer demand for health services. Previous research shows that media coverage tends to overstate the benefits and downplay the harms of medical interventions for the sick, and often fails to cover relevant conflicts of interest of those promoting those interventions. However, little is known about how the benefits and harms of testing the healthy are covered by media. This study will examine the media coverage of the benefits and harms of testing the healthy, and coverage of potential conflicts of interest of those promoting the testing.

Methods and analysis: We will examine five tests: 3D mammography for the early detection of breast cancer; blood liquid biopsy for the early detection of cancer; blood biomarker tests for the early detection of dementia; artificial intelligence technology for the early detection of dementia; and the Apple Watch Series 4 electrocardiogram sensor for the early detection of atrial fibrillation. We will identify media coverage using Google News and the LexisNexis and ProQuest electronic databases. Sets of two independent reviewers will conduct story screening and coding. We will include English language media stories referring to any of the five tests from January 2016 to May 2019. We will include media stories if they refer to any benefits or harms of the test for our conditions of interest. Data will be analysed using categorical data analysis and multinomial logistic regression.

Ethics and dissemination: No ethical approval is required for this study. Results will be presented at relevant scientific conferences and in peer-reviewed literature.

Keywords: benefits; harms; media coverage; overdiagnosis; testing the healthy.

Publication types

  • Research Support, Non-U.S. Gov't