The public relies on honest and transparent science reporting in the media to make informed choices about the risks they take with medical interventions. For patients seeking to reduce their risk of contracting or developing a disease, accurate reporting of how much the risk is reduced by various screening or drug treatment options is essential, given that many of those medical interventions come with risks of their own. Pharmaceutical corporations, working with the mainstream media, routinely mislead the public in their reporting of the risks and benefits of medical treatments. When the public becomes aware of that manipulation, they use the same power of persuasion to paint anyone who questions them as spreading misinformation.
Gerd Gigerenzer is an expert in the communication of risk who works at the Max Planck Institute of Human Development. In a 2010 editorial for the British Medical Journal, he examines how the misleading communication of risk is used to promote medical interventions. One example he looks at is mammography screening. He refers to advertising promoting mammography as reducing breast cancer mortality risk by at least 20%. In reality, the reduction in breast cancer mortality risk from this intervention corresponds to reducing the number of deaths from about five women in every 1000 to about four women in every 1000, a reduction of only 0.1%. Surveys of women showed that 92% of them overestimated the reduction in their risk of dying from breast cancer by up to 100 times. These statistical tricks don't only mislead patients; 31% of gynaecologists also vastly overestimated the reduction in risk of death from mammography based on those numbers.
The perception of medical risk is manipulated through the misleading use of statistical measures. For example, if five people out of 100 in a treatment group get sick while ten people out of 100 in the control group get sick, they can say, according to a statistic called relative risk reduction (RRR,) that the treatment is 50% effective (five infected compared to ten infected.) But according to another type of statistic, absolute risk reduction (ARR,) the risk is only reduced by 5% (five infected out of 100 in the control group,) because there was only a certain amount of risk to begin with. In this case, quoting RRR in isolation, it can be made to appear that the treatment halves the risk, but in reality, it only gives you a 5% benefit over not taking the treatment.
It is only with ARR that a real risk-benefit analysis can be made, because to make informed consent we need to compare the risk of adverse events from the treatment against the risk of getting infected without the treatment. This cannot be accurately assessed using only RRR because it does not reflect the baseline risk. But this is the only measure being reported by many medical and pharmaceutical companies and their media partners.
Doctor A K Kobang, also of the British Medical Journal, writes:
'Relative risk measures have the advantage of being stable across populations with different baseline risks... However, they have the major disadvantage of not reflecting the baseline risk of the individuals with regard to the outcome being measured.'
‘… relative risk measures do not take into account the individuals’ risk of achieving the intended outcome without the intervention. Therefore, they do not give a true reflection of how much benefit the individual would derive from the intervention...'
'They usually tend to overestimate the benefits of an intervention and, for this reason, drug companies and the popular media love relative risk measures!'
This type of misleading reporting of risk reduction was used to promote the Covid-19 vaccines. One study, reported on in Forbes, compares the effectiveness of three Covid vaccines and claims effectiveness of between 71% and 93%. These numbers are based on RRR. If ARR is calculated from the data in the study, the effectiveness drops down to between 5% and 28%. When a person’s risk of being hospitalised or dying of Covid 19 is already extremely low, as it is for anyone under 60, reducing that risk amount by another 5% - 28% makes almost no difference in the overall risk.
Considering the experimental nature of these new vaccines and the lack of long-term safety data they obviously carry risks of their own. With a reduction in risk of severe illness as low as 5% and only as high as 28%, many well informed people would decide to reject the vaccine based on the competing risks and benefits. A person who only had access to the reporting in the media, and believing the vaccines were up to 93% effective, might make a different decision, thinking the reduction in risk is enough to outweigh the risks of the vaccine. In this way RRR was used in isolation to create the perception of high efficacy in the public's mind, making them more likely to accept the vaccines despite the risks. It also gave governments the necessary ‘scientific’ justification for the mandates they introduced.
With the expansion of alternative media sources, public awareness of this type of manipulation began to spread. Information regarding the difference between ARR and RRR and the use of RRR in isolation to make the vaccines look more effective was quickly labelled 'misinformation' by the mainstream media and big tech corporations, and a 'fact check' was published by Reuters news service.
In their fact check, titled 'Why Relative Risk Reduction, not Absolute Risk Reduction, is most often used in calculating vaccine efficacy,' the media giant tries to justify the use of RRR over ARR by claiming that the two numbers do not contradict but complement each other. If that is the case, why is ARR not quoted alongside RRR in reporting on vaccine trials for full transparency? Why is RRR the only statistic given by the drug companies?
We are also told RRR is 'more meaningful' without any explanation of why that is. No analysis is made comparing the numbers to illustrate why RRR is more meaningful than ARR. Probably because such an analysis, as we have done here, would reveal the opposite. What is not disclosed in this 'fact check' is that the Chief executive officer and director of the Thomas Reuters Corporation, parent company of Reuters news service, is also on the board of pharmaceutical corporation Pfizer, meaning there is a financial conflict of interest when Reuters reports on the effectiveness of vaccines or 'fact checks' people who question the way it is reported in the media.
On the one hand we have an established understanding within the medical community that RRR, reported in isolation is a common way for drug companies and the media to promote vaccines and other interventions. On the other hand, we have a drug company, with financial ties to the media that is reporting on their product, quoting RRR in isolation and calling it ‘effectiveness’ in relation to the covid vaccines. It would seem a clear-cut case of what the British medical Journal warned of – a drug company working with the media to not only mislead the public by the misreporting of the competing risks of a medical treatment but also using that same corporate power to cover it up with an equally misleading ‘fact check’ once the truth started to come out.
As non-experts in medical science, we expect accepted experts to report their results transparently; to provide all the information we require to make an informed choice in the risks we take with medical screenings, treatments, and vaccines. We also expect the press to hold corporations to account when their scientists abuse this trust with the misleading use of statistics to manipulate public perception. The misleading use of statistics in the promotion of the Covid vaccines is only the most recent example of this type of manipulation, and subsequent ‘fact-check’ cover-up.
References
Dr A K Akobeng (2005) Understanding measures of treatment effect in clinical trials, British Medical Journal, accessed 23 May 2022.
https://adc.bmj.com/content/90/1/54
Gerd Gigerenzer (2010) Misleading communication of risk, British Medical Journal, accessed 23 May 2022.
https://www.bmj.com/content/341/bmj.c4830.full
Joe Walsh (2021) Moderna Covid Vaccine More Effective Than Others In Preventing Hospitalization, CDC Finds, Forbes, accessed 23 May 2022.
https://www.forbes.com/sites/joewalsh/2021/09/17/moderna-covid-vaccine-more-effective-than-others-in-preventing-hospitalization-cdc-finds/?sh=5d02fc2a7bc5
Reuters Fact Check (2021) Why Relative Risk Reduction, not Absolute Risk Reduction, is most often used in calculating vaccine efficacy, Reuters, accessed 23 May 2022.
https://www.reuters.com/article/factcheck-thelancet-riskreduction/fact-check-why-relative-risk-reduction-not-absolute-risk-reduction-is-most-often-used-in-calculating-vaccine-efficacy-idUSL2N2NK1XA
