The Media Using "Scare Headlines" to Increase Readership

While there have been charges of media bias from both sides of the political fence, I would like to use this article to examine the use of "scare headlines"

"Scare headlines" are used to call the reader's attention to a news item containing some minor bit of information that would ordinarily go unnoticed. As an example, consider the following headline used by Medscape (a subsidiary of Web MD): "Higher Mortality among Weekend Stroke Patients"

This headline was supported by a Canadian survey (reported in the journal Circulation's Early Access online edition) of the medical records of 26,676 patients that had been admitted to some 606 hospitals with a diagnosis of ischemic stroke (the type of stroke caused by lack of oxygen, usually due to small blood clots). Of these admissions, 6296 (24.8%) occurred on weekends and the "non-weekend" admissions were used as the control group (the "baseline" or comparative group) and the mortality rate at 7 days following admission was used as the "endpoint" (how many patients died within a week of admission).

And what did this study demonstrate? The 7-day mortality rate was 8.5% for those admitted on a weekend versus 7.6 for the weekday admissions, giving a difference of 0.9%.

Lest you think that the previous example was an isolated occurrence, take a look at this headline (from Medscape/WebMD): "More Heart Attack Deaths on Weekends"

This headline introduced a study, published in the March 15 issue of the New England Journal ofMedicine, examined the mortality rates for those admitted with a diagnosis of "first heart attack" on a weekend versus those admitted on a weekday in the state of New Jersey from 1987 to 2002.

This study evaluated the mortality rate among a total of 231,164 admissions at 1 day after admission, at 30 days, and after 1 year. The results of this study demonstrated the following findings:

Patients admitted on a weekend were less likely to undergo invasive cardiac procedures (angioplasty or heart surgery) than those admitted on a weekday.

The mortality rate at 1 day after admission was 3.3% for weekend admissionsvs. 2.7% for weekday admissions.

At 30 days after admission the mortality rate was 12.9% for those admitted on a weekend vs. 12.0% for weekday admissions. The findings at 1 year were, for all practical purposes, the same as the 30 day mortality.

Again we have a 1% difference.

Comment

I have a real problem with "scare" or "doomsday" headlines because they almost invariably appear above mediocre news items; items that normally might get half an inch of space on page 42 of the financial section. Although I don't recall the source of the following quote, I always think about it when I run across headlines such as those mentioned above:

WORLD ENDS! Women and children hit hardest!

Do you get my drift on sensationalist headlines?

Both the above studies used valid statistical methods to analyze the "raw data" and came to statistically correct conclusions. The problem isn't with the methods; it's with the way that the press reports those results. One percent may be important from a statistical sense but it doesn't mean a thing to the "real world." If you have a heart attack or a stroke on Saturday or Sunday are you going to wait until Monday before going to the Emergency Room just to beat a 1% disadvantage? Having had both a heart attack and a stroke, I can assure you that if you have symptoms of either condition that you will find the nearest ER; even if you have to crawl to it. And weekend or weekday will have absolutely no bearing on your decision.

All in all, never trust a headline.

References / For More Information

G. Saposnik; A. Baibergenova; N. Bayer; and V. Hachinski: Weekends: A Dangerous Time for Having a Stroke? Stroke 2007, Early Access doi:10.1161/01.STR.0000259622.78616.ea

W. Kostis; K. Demissie; S. Marcella; Y. Shao; A. Wilson, et al: Weekend versus Weekday Admission and Mortality from Myocardial Infarction, NEJM: Volume 356:1099-1109

Disclaimer

The information presented in this article and its included links is of an informational nature only and is not intended as a recommendation of any changes in the reader's health care program. Before making any changes in diet, medications, or other treatments the reader is strongly advised to consult with their health care provider.