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Figure 3 in the original article [1] is incorrect; labels for secondary outcomes have been shifted and do not correspond to the numbers reported in the table (Additional file 8). The corrected version can be seen ahead. This figure should be used over the figure 3 seen in the original article. This error does not affect the results, interpretation, or conclusion.

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BACKGROUND: News stories represent an important source of information. We aimed to evaluate the impact of "spin" (i.e., misrepresentation of study results) in health news stories reporting studies of pharmacologic treatments on patients'/caregivers' interpretation of treatment benefit. METHODS: We conducted three two-arm, parallel-group, Internet-based randomized trials (RCTs) comparing the interpretation of news stories reported with or without spin. Each RCT considered news stories reporting a different type of study: (1) pre-clinical study, (2) phase I/II non-RCT, and (3) phase III/IV RCT. For each type of study, we identified news stories reported with spin that had earned mention in the press. Two versions of the news stories were used: the version with spin and a version rewritten without spin. Participants were patients/caregivers involved in Inspire, a large online community of more than one million patients/caregivers. The primary outcome was participants' interpretation assessed by one specific question "What do you think is the probability that 'treatment X' would be beneficial to patients?" (scale, 0 [very unlikely] to 10 [very likely]). RESULTS: For each RCT, 300 participants were randomly assigned to assess a news story with spin (n = 150) or without spin (n = 150), and 900 participants assessed a news story. Participants were more likely to consider that the treatment would be beneficial to patients when the news story was reported with spin. The mean (SD) score for the primary outcome for abstracts reported with and without spin for pre-clinical studies was 7.5 (2.2) versus 5.8 (2.8) (mean difference [95% CI] 1.7 [1.0-2.3], p < 0.001); for phase I/II non-randomized trials, 7.6 (2.2) versus 5.8 (2.7) (mean difference 1.8 [1.0-2.5], p < 0.001); and for phase III/IV RCTs, 7.2 (2.3) versus 4.9 (2.8) (mean difference 2.3 [1.4-3.2], p < 0.001). CONCLUSIONS: Spin in health news stories reporting studies of pharmacologic treatments affects patients'/caregivers' interpretation. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03094078 , NCT03094104 , NCT03095586.

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During 2005-2013, the award-winning website HealthNewsReview.org offered reviews of major media outlets' news stories related to health interventions, including tests, treatments, dietary changes, and prescription drugs. The reviews offered a measure by which the public and journalists themselves could assess the completeness and usefulness of health coverage across 10 criteria for quality reporting. This study produced an analysis of those reviews from 2005 to 2013, indicating significant changes in key areas. Analysis of 1,889 health news story reviews published by HealthNewsReview.org (HNR) between 2005 and 2013 showed that, on average, the stories reviewed during 2005-2010 successfully met just less than half of the criteria, but by 2010-2013, that average had improved to almost 70%. There were significant improvements over time in news organizations' success in meeting six of HNR's 10 criteria for a successful health news story related to drugs, devices, surgery and other medical procedures, and diet; however, when data for television stories were excluded, only the improvement in avoiding disease-mongering remained significant. In addition, there was a statistically significant decline in the percentage of stories rated satisfactory on establishing the true novelty of the intervention discussed in the story. There was no improvement in quantification of possible harms from medical interventions. Changes over time in meeting the criteria were related to outlet type and story topic.

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INTRODUCTION: We aim to compare the interpretation of health news items reported with or without spin. 'Spin' is defined as a misrepresentation of study results, regardless of motive (intentionally or unintentionally) that overemphasises the beneficial effects of the intervention and overstates safety compared with that shown by the results. METHODS AND ANALYSIS: We have planned a series of 16 randomised controlled trials (RCTs) to perform a prospective meta-analysis. We will select a sample of health news items reporting the results of four types of study designs, evaluating the effect of pharmacological treatment and containing the highest amount of spin in the headline and text. News items reporting four types of studies will be included: (1) preclinical studies; (2) phase I/II (non-randomised) trials; (3) RCTs and (4) observational studies. We will rewrite the selected news items and remove the spin. The original news and rewritten news will be appraised by four types of populations: (1) French-speaking patients; (2) French-speaking general public; (3) English-speaking patients and (4) English-speaking general public. Each RCT will explore the interpretation of news items reporting one of the four study designs by each type of population and will include a sample size of 300 participants. The primary outcome will be participants' interpretation of the benefit of treatment after reading the news items: (What do you think is the probability that treatment X would be beneficial to patients? (scale, 0 (very unlikely) to 10 (very likely)).This study will evaluate the impact of spin on the interpretation of health news reporting results of studies by patients and the general public. ETHICS AND DISSEMINATION: This study has obtained ethics approval from the Institutional Review Board of the Institut national de la santé et de la recherche médicale (INSERM) (registration no: IRB00003888). The description of all the steps and the results of this prospective meta-analysis will be available online and will be disseminated as a published article. On the completion of this study, the results will be sent to all participants. PROSPERO REGISTRATION NUMBER: CRD42017058941.

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From April 16, 2006, through May 30, 2013, a team of reviewers from HealthNewsReview.org, many of whom were physicians, evaluated the reporting by US news organizations on new medical treatments, tests, products, and procedures. After reviewing 1889 stories (approximately 43% newspaper articles, 30% wire or news services stories, 15% online pieces [including those by broadcast and magazine companies], and 12% network television stories), the reviewers graded most stories unsatisfactory on 5 of 10 review criteria: costs, benefits, harms, quality of the evidence, and comparison of the new approach with alternatives. Drugs, medical devices, and other interventions were usually portrayed positively; potential harms were minimized, and costs were ignored. Our findings can help journalists improve their news stories and help physicians and the public better understand the strengths and weaknesses of news media coverage of medical and health topics.

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BACKGROUND: Health care news stories have the potential to inform and educate news consumers and health-care consumers about the tradeoffs involved in health-care decisions about treatments, tests, products, and procedures. These stories have the potential to influence not only individual decision making but also the broader public dialogue about health-care reform. For the past 7 years, a Web-based project called http://HealthNewsReview.org has evaluated news stories to try to improve health-care journalism and the quality and flow of information to consumers. ANALYSIS: http://HealthNewsReview.org applies 10 standardized criteria to the review of news stories that include claims about medical interventions. Two or three reviewers evaluate each story. The team has evaluated more than 1,800 stories by more than a dozen leading U.S. news organizations. About 70% have received unsatisfactory scores based on application of these criteria: reporting on costs, quantifying potential benefits, and quantifying potential harms. CONCLUSIONS: Inaccurate, imbalanced, incomplete news stories may drown out more careful scrutiny of the evidence by many influential news organizations. Unquestioned claims and assertions about the benefits of medical interventions are passed on to the American public daily by journalists who are supposed to vet independently any such claims. Communication about these issues is, in itself, a major health-policy issue.

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BACKGROUND TO THE DEBATE: In December 2004 three news stories in the popular press suggested that the side effects of single-dose nevirapine, which has been proven to prevent mother-to-child transmission of HIV, had been covered up. Many HIV experts believed that the stories were unwarranted and that they would undermine use of the drug, leading to a rise in neonatal HIV infection. The controversy surrounding these stories prompted the PLoS Medicine editors to ask health journalists, and others with an interest in media reporting of health, to share their views on the roles and responsibilities of the media in disseminating health information.

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Many journalism organizations have published codes of ethics in recent years. The Association of Newspaper Editors, for example, lists 47 different codes on its website. But an organization of health care journalists felt that none of those codes addressed the unique challenges of covering complex health care topics. The Association of Health Care Journalists (AHCJ) is an independent, non-profit organization dedicated to advancing public understanding of health care issues. Its mission is to improve the quality, accuracy and visibility of health care reporting, writing and editing. AHCJ has written a statement of principles for its 750 members. In it, AHCJ states some of the unique challenges faced by journalists covering health care, and offers suggestions on how to face those challenges. Bioethicists are invited to comment on the statement, and to help generate continued discussion of the issues addressed therein.

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BACKGROUND: Over the past decade, health care consumers have begun to benefit from new Web-based communications tools to guide decision making on treatments and tests. Using today's online tools, consumers who have Internet connections can: watch and listen to videos of physicians; watch and hear the stories of other consumers who have faced the same decisions; join an online social support network; receive estimates of their own chances of experiencing various outcomes; and do it all at home. OBJECTIVE: To review currently-available Internet consumer health decision-support tools. METHODS: Five Web sites offering consumer health decision-support tools are analyzed for their use of 4 key Web-enabled features: the presentation of outcomes probability data tailored to the individual user; the use of videotaped patient interviews in the final product to convey the experiences of people who have faced similar diagnoses in the past; the ability to interact with others in a social support network; and the accessibility of the tool to any health care consumers with an Internet connection. RESULTS: None of the 5 Web sites delivers all 4 target features to all Web users. The reasons for these variations in the use of key Web functionality--features that make the Web distinctive--are not immediately clear. CONCLUSIONS: Consumers trying to make health care decisions may benefit from current Web-based decision-support tools. But, variations in Web developers' use of 4 key Web-enabled features leaves the online decision-support experience less than what it could be. Key research questions are identified that could help in the development of new hybrid patient decision-support tools.

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