Misrepresentation of Randomized Controlled Trials in
Press Releases and News Coverage: A Cohort Study
Ame ´lie Yavchitz1,2,3, Isabelle Boutron1,2,3*, Aida Bafeta1,2,3, Ibrahim Marroun4, Pierre Charles4,
Jean Mantz5, Philippe Ravaud1,2,3
1INSERM, U738, Paris, France, 2Centre d’E´pide ´miologie Clinique, AP-HP (Assistance Publique des Ho ˆpitaux de Paris), Ho ˆpital Ho ˆtel Dieu, Paris, France, 3Universite ´ Paris
Descartes, Sorbonne Paris Cite ´, Faculte ´ de Me ´decine, Paris, France, 4Department of Internal Medicine, Ho ˆpital Foch, Suresnes, France, 5Department of Anesthesiology
and Critical Care, Beaujon University Hospital, Clichy, France
Background: Previous studies indicate that in published reports, trial results can be distorted by the use of ‘‘spin’’ (specific
reporting strategies, intentional or unintentional, emphasizing the beneficial effect of the experimental treatment). We
aimed to (1) evaluate the presence of ‘‘spin’’ in press releases and associated media coverage; and (2) evaluate whether
findings of randomized controlled trials (RCTs) based on press releases and media coverage are misinterpreted.
Methods and Findings: We systematically searched for all press releases indexed in the EurekAlert! database between
December 2009 and March 2010. Of the 498 press releases retrieved and screened, we included press releases for all two-
arm, parallel-group RCTs (n=70). We obtained a copy of the scientific article to which the press release related and we
systematically searched for related news items using Lexis Nexis.
(intentional or unintentional) emphasizing the beneficial effect of the experimental treatment, was identified in 28 (40%)
scientific article abstract conclusions and in 33 (47%) press releases. From bivariate and multivariable analysis assessing the
journal type, funding source, sample size, type of treatment (drug or other), results of the primary outcomes (all
nonstatistically significant versus other), author of the press release, and the presence of ‘‘spin’’ in the abstract conclusion,
the only factor associated, with ‘‘spin’’ in the press release was ‘‘spin’’ in the article abstract conclusions (relative risk [RR] 5.6,
[95% CI 2.8–11.1], p,0.001). Findings of RCTs based on press releases were overestimated for 19 (27%) reports. News items
were identified for 41 RCTs; 21 (51%) were reported with ‘‘spin,’’ mainly the same type of ‘‘spin’’ as those identified in the
press release and article abstract conclusion. Findings of RCTs based on the news item was overestimated for ten (24%)
‘‘Spin,’’ defined as specific reporting strategies
Conclusion: ‘‘Spin’’ was identified in about half of press releases and media coverage. In multivariable analysis, the main
factor associated with ‘‘spin’’ in press releases was the presence of ‘‘spin’’ in the article abstract conclusion.
Please see later in the article for the Editors’ Summary.
Citation: Yavchitz A, Boutron I, Bafeta A, Marroun I, Charles P, et al. (2012) Misrepresentation of Randomized Controlled Trials in Press Releases and News
Coverage: A Cohort Study. PLoS Med 9(9): e1001308. doi:10.1371/journal.pmed.1001308
Academic Editor: Lisa A. Bero, University of California, San Francisco, United States of America
Received November 16, 2011; Accepted August 1, 2012; Published September 11, 2012
Copyright: ? 2012 Yavchitz et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: No direct funding was received for this study. The authors were personally salaried by their institutions during the period of writing (though no specific
salary was set aside or given for the writing of this paper). No funding bodies had any role in the study design, data collection, analysis, decision to publish or
preparation of the manuscript.
Competing Interests: Isabelle Boutron is a member of PLOS Medicine Editorial Board. The authors have declared that no other competing interests exist.
Abbreviation: RCT, randomized controlled trial
* E-mail: firstname.lastname@example.org
PLOS Medicine | www.plosmedicine.org1 September 2012 | Volume 9 | Issue 9 | e1001308
The media play an important role in the dissemination of
findings from health research. More than half of US adults report
that they follow health news closely . Further, 90% of the
general public gets most of its information about science from the
mass media . Press releases are a major source of information
for one-third of medical reports in US newspapers . Press
releases are widely used by the medical researchers to attract
favorable media attention [4–6] and to promote their research [7–
9]. A press release should provide journalists with the basic
information needed to develop a news story and publish it in the
Randomized controlled trials (RCTs) are considered the gold
standard for therapeutic evaluation . Adequate and undistort-
ed communication of the findings from RCTs is essential for
physicians, researchers, and patients because it allows for efficient
uptake of research into clinical practice . Theoretically, in
reports of RCTs published in peer-reviewed journals, the data
should speak for themselves. However, a recent study showed that
research findings can be distorted in published articles, by the use
of ‘‘spin,’’ which is defined as specific reporting emphasizing the
beneficial effect of the experimental treatment . The types of
distorted presentation or ‘‘spin’’ are diverse, with, for example, a
particular focus on statistically significant results (within-group
comparison, subgroup analyses, and secondary outcomes) or an
inadequate interpretation of nonstatistically significant differences
as demonstrating equivalence in treatment effectiveness or lack of
difference in adverse events.
We aimed to (1) evaluate the presence of ‘‘spin’’ in press releases
and associated media coverage and (2) evaluate whether findings
of RCTs contained within press releases and media coverage are
Selection of Press Releases, Related Scientific Articles,
and News Items
We identified all press releases indexed in EurekAlert! (onlinefree
database for science press releases; www.eurekalert.org) between
December 1, 2009, and March 31, 2010, using the following search
strategy: topic ‘‘medicine and health,’’ type of release ‘‘research
news,’’ keyword: random* [4,13]. We included press releases for
published results of two-arm, parallel-group RCTs defined as
prospective studies assessing health care interventions in human
participants. To have a homogeneous sample, we excluded press
releases for equivalence or noninferiority, cross-over, cluster, and
multiple-arm trials; follow-up studies; press releases not reported in
English; and those about more than one study. Duplicate press
releases (i.e., press releases published more than once in the
database) were systematically searched and excluded.
The title and full text of all retrieved press releases were
screened by one reviewer to exclude any non-eligible press
We obtained a copy of the scientific article related to the press
release from (1) the direct link or full reference citation reported in
the press release, if available; or (2) the PubMed single citation
matcher indicating the year of publication, journal, and author’s
name. Each retrieved scientific article (abstract and full text) was
assessed by the same reader to confirm eligibility.
Finally, for all selected press releases, we systematically searched
for related news items in the ‘‘general news’’ library of LEXIS-
NEXIS using (1) the name of the disease; (2) the treatment being
evaluated, and, if needed, the name of the first or second author.
All news related to the articles or press releases were retrieved, and
we selected the news that had the highest number of words
dedicated to the selected study.
Data were abstracted from the press release, news items, and the
related published scientific article. For this purpose, we developed
a standardized data-abstraction form using previous work on the
same topics [12–14]. The data-abstraction form and details about
the methods is available in Texts S1 and S2.
The data-abstraction form was preliminarily tested by two of the
reviewers with a sample of 15 press releases and original articles
indexed in January 2008. The data that involved some subjectiv-
ity, such as the type of ‘‘spin’’ were abstracted by two independent
reviewers, with discrepancies resolved by consensus. Other data
were evaluated by a single reviewer. The concordance between the
two reviewers for the assessment of ‘‘spin’’ is reported in Text S3;
the mean kappa coefficient for ‘‘spin’’ was 0.56 (range 0.43–0.69).
We systematically extracted data related to the characteristics of
(1) the RCT, (2) the press releases, and (3) the presence of ‘‘spin’’ in
the article abstract conclusions, in the press release and, when
available, in the news items.
We defined ‘‘spin’’ as a specific reporting (intentional or
unintentional) that emphasizes the beneficial effect of the
experimental treatment. We used a classification of ‘‘spin’’
described in a previous work . This classification was initially
developed in the context of trials with a nonstatistically significant
primary outcome. This classification was adapted for all RCTs.
We considered ‘‘spin’’ as being a focus on statistically significant
results (within-group comparison, secondary outcomes, subgroup
analyses, modified population of analyses); an interpretation of
statistically nonsignificant results for the primary outcomes as
showing treatment equivalence or comparable effectiveness; or
any inadequate claim of safety or emphasis of the beneficial effect
of the treatment.
The RCT results were interpreted independently from three
different sources: (1) from the full text of the scientific article, (2)
from the press release, and (3) from the news items.
For each source, different pairs of assessors independently
evaluated the results of the RCT and achieved consensus.
Assessment based on the scientific article relied on the results for
the primary outcomes, secondary outcomes, and harm. For
assessment of press releases, assessors were blinded to the authors
of the press release, the content of the scientific article, and the
journal of publication. For assessment of news items, assessors
were blinded to the content of the press release and scientific
article. All results reported represent the consensus of each pair of
Interpreting the RCT results.
interpreted independently by use of the same scale, from 1 to 5
. According to this scale, the assessors had to indicate whether
patients should (1) definitely get the experimental treatment
evaluated, (2) probably get the experimental treatment evaluated,
(3) decide for themselves (i.e., the article was neutral), (4) probably
not get the experimental treatment evaluated, or (5) definitely not
get the experimental treatment evaluated. If the interpretation of
the RCT results was classified as 1 or 2, the experimental
treatment was considered beneficial; 3, the trial results were
neutral; 4 or 5, the experimental treatment was considered not
The trial results were
Interpretation from Press Releases and News
PLOS Medicine | www.plosmedicine.org2 September 2012 | Volume 9 | Issue 9 | e1001308
Definition of misinterpretation.
defined as the interpretation of the press release or news items
differing from that based on the full-text article by at least one class
according to the above three-class system of scores. Misinterpre-
tation of the press release or news items could overestimate the
treatment beneficial effect or underestimate the treatment effect.
For example, an overestimation of the treatment beneficial effect
in the press release or news items occurred when reading the
published article led to rating the trial results as neutral, whereas
reading the press release or new items led to rating the
experimental treatment as beneficial.
Data for quantitative variables are expressed with medians and
IQRs. Data for qualitative variables are expressed with frequencies
and percentages. We planned bivariate and multivariable analysis
to identify factors associated with (1) ‘‘spin’’ in the press releases,
(2) an overestimation of the beneficial effect of the experimental
treatment from press releases, (3) ‘‘spin’’ in the news items, and (4)
an overestimation of the beneficial effect of the experimental
treatment from news items. For bivariate analysis, we used the chi-
square or Fisher exact test for categorical data and the Student t-
test for quantitative data. For the multivariable analysis, we
performed a Poisson regression with robust error variance 
with a bootstrap model selection variable method  to assess all
relevant variables. We used 1,000 bootstrap samples. Variables
with p,0.25 in bivariate analysis were selected for possible
inclusion in the multivariable model. Variables identified as
independent factors associated with ‘‘spin’’ in the press release in
at least 60% of the bootstrap samples were kept in the
Results are expressed as risk ratio (RR) and 95% CIs. We did
not perform multivariable analysis to identify factors associated
with overestimation of the benefit of the experimental treatment
because there were few events as compared with the number of
variables to include.
Statistical analysis involved use of SAS v9.1 (SAS Institute).
Selection of Press Releases and Scientific Articles
The search strategy in EurekAlert! between December 1, 2009,
and March 31, 2010, retrieved 498 press releases. The selection
process resulted in 70 press releases and related scientific articles
(Figure 1). Of these, 41 had associated news items. The list of press
releases and published articles included is available in Text S4.
Characteristics of RCTS
The description of the scientific articles is in Table 1. In total, 38
(54%) articles were published in a specialized journal; the median
(interquartile range) journal impact factor was 17.2 (4.8–28.4). The
funding source was for-profit (only or with a nonprofit source) for
about half of the reports. In 34 reports (49%), the primary
outcomes were statistically significant, and in 24 (34%), all primary
outcomes were not statistically significant. In all, 28 articles (40%)
exhibited at least one type of ‘‘spin’’ in the abstract conclusions.
The main types of ‘‘spin’’ in the abstract conclusions were no
acknowledgement of nonstatistically significant primary outcomes
(20%); interpreting p.0.05 as demonstrating equivalence (7%);
inappropriate extrapolation (9%); focus on statistically significant
results such as subgroup analyses (6%), within-group comparisons
(9%), and secondary outcomes (4%); or inadequate claim of safety
Characteristics of Press Releases
The general characteristics of press releases are in Table 2: 57%
were written by a press officer; half provided easy access to the
research article that had been press released (i.e., a direct link or
the full reference) and 25 (36%) reported the funding source. The
results for primary outcomes were reported with words only in 29
(41%) press releases. Safety was mentioned in 24 (34%) and
quantified in 14 (20%); the study limitations were reported in ten
(14%). A total of 58 (83%) press releases contained quotations
from authors or editors of the article. In 30 (52%), the interview
reported results with emphasis, such as ‘‘this work paves the way
for further study,’’ or in 22 (38%) with moderation, such as
‘‘further investigation is needed to establish (…).’’ Quotations from
the article were included in 22 (31%) of the releases. In 11 (50%),
the quotations reported results with emphasis, such as ‘‘clinical
findings are indeed very encouraging, said Dr…’’), or in seven
(32%) with moderation.
About half of the press releases (33; 47%) had at least one type
of ‘‘spin’’ (Table 2).
Factors Associated with ‘‘Spin’’ in Press Releases
From bivariate analysis (Table 3), ‘‘spin’’ in press releases was
more frequent in trials published in a specialized journal (58%
versus 34% in a general journal; p=0.05), trials with small
sample size (i.e., ,112) (63% versus 31%; p=0.008), and trials
with ‘‘spin’’ in the scientific article abstract conclusion (93%, yes,
versus 17%, no; p,0.001). The presence of ‘‘spin’’ in the press
release was not associated with funding source (45% profit versus
49% other: p=0.8), author of the press release (48% press officer
versus 47% other; p=0.9), the experimental treatment (47%
drug versus 47% other; p=1.0) or results of the primary
outcome (46% all nonstatistically significant versus 48% other;
p=0.9). In multivariable analysis including all variables with
p,0.25 in the bivariate analysis (i.e., journal, ‘‘spin’’ in the
abstract conclusion, and sample size), the only factor associated
with ‘‘spin’’ in the press release was ‘‘spin’’ in the scientific
article abstract conclusions (RR=5.6, 95% CI 2.8–11.0,
p,0.001) (Text S5).
Interpretation of the Trial Results from Press Releases
For the interpretation based on the full-text scientific articles, for
38 articles (54%), the experimental treatment was considered
beneficial, 18 (26%) neutral, and 14 (20%) not beneficial. In
contrast, for the interpretation based on press releases, for 55
releases (79%), the experimental treatment was considered
beneficial, two (3%) neutral, and 13 (18%) not beneficial. The
results were misinterpreted in 22 press releases (31%); for 19
(86%), the assessors overestimated the benefit of the experimental
treatment from the press release and for three (14%), they
underestimated the benefit of the experimental treatment from the
As shown in Table 4, on the basis of press releases, the benefit
of the experimental treatment was overestimated more often for
trial results published in a specialized journal rather than in a
general medical journal (45% versus 6%; p,0.001), for trials with
a small rather than large sample size (46% versus 9%; p,0.001),
for trials with nonstatistically rather than significant primary
outcomes (42% versus20%; p=0.05), and for trials with ‘‘spin’’
rather than without ‘‘spin’’ in the press release (48% versus 8%;
p,0.001). These results did not differ significantly by funding
source, author of the press release, or type of experimental
Interpretation from Press Releases and News
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Figure 1. Flow diagram of the selected press releases and related articles.
Interpretation from Press Releases and News
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‘‘Spin’’ and Interpretation of the News
For a sample of 41 RCTS we retrieved the scientific article, the
press release, and any news items. ‘‘Spin’’ was identified in 17
(41%) abstracts, 19 (46%) press releases, and 21 (51%) news
Figure 2 describes the reporting of ‘‘spin’’ in abstracts, press
releases, and news items. For the 17 abstracts reported with
‘‘spin’’, 16 press releases and related news items featured the same
‘‘spin.’’ For the 24 abstracts without ‘‘spin,’’ only three press
releases featured ‘‘spin,’’ which was subsequently reported in the
related news items. Examples of ‘‘spin’’ in the abstract and related
press releases and news items are in Figure 3. The factors
associated with ‘‘spin’’ in the news were specialty journals (67%
versus 35%; p=0.04), small sample size (68% versus 32%;
p=0.02), ‘‘spin’’ in abstract (100% versus 5%; p,0.001), and
‘‘spin’’ in the press release (100% versus 13%; p,0.001) (Text S6).
Overall, the assessors overestimated the benefit of the experi-
mental treatment from the news for 10 (24%) reports. Factors
associated with overestimation of the beneficial effect of the
treatment from the news items were small sample size (41% versus
Table 1. General characteristics of articles.
Type of journal, n (%) General medical journal32 (46)
Specialized medical journal38 (54)
Funding source, n (%) Profit or both profit and nonprofit33 (47)
None or nonprofit 33 (47)
Not reported4 (6)
Sample size median; [IQR]; (min–max)112; [54–435]; (16–94,370)
Experimental treatment, n (%) Drug36 (51)
Surgery/procedure 9 (13)
Device 5 (7)
Therapeutic strategy7 (10)
Participative intervention 12 (17)
Other 1 (1)
Comparator, n (%) Placebo29 (41)
Active treatment 32(46)
Other 9 (13)
Primary outcomes clearly identified, n (%)61(87)
Type of primary outcomes, n (%)Efficacy 61 (87)
Safety 1 (1)
Both 4 (6)
Unclear 4 (6)
Primary outcomes reported adequately, n (%)a
Results of primary outcomes, n (%) All statistically significant34 (49)
All statistically nonsignificant24 (34)
Some statistically significant/some not11 (16)
Unclear 1 (1)
At least one ‘‘spin’’28 (40)
Type of ‘‘spin’’b
No acknowledgment of nonstatistically significant
Claiming equivalence when results failed to
demonstrate a statistically significant difference
Focus on positive secondary outcome3 (4)
Focus on inappropriate subgroup4 (6)
Focus on within-group (or over-all within) comparison6 (9)
Nonstatistically significant outcome reported as if
they were significant
Ignored data of safety1 (1)
Inadequate claim of safety4 (6)
Inappropriate extrapolation 6 (9)
aAdequately, with effect size and precision or treatment effect in each arm with precision.
bNumbers do not add up as the types of ‘‘spin’’ were not mutually exclusive.
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Table 2. General characteristics of press releases.
Characteristics Subcharacteristicsn=70 (%)
Origin, n (%)Press officer40 (57)
Industry or institution30 (43)
Easy access to full article, (i.e., direct
link or the full reference) n (%)
Funding reported, n (%)25 (36)
Design reported, n (%)70 (100)
Sample size reported, n (%)65 (93)
Length of follow-up reported, n (%) 46 (66)
Primary outcomes reported, n (%)In words only 29 (41)
Per arms30 (43)
With effect size17 (24)
Safety reported, n (%)Mentioned 24 (34)
Quantified 14 (20)
Limits reported, n (%)10 (14)
Interview included, n (%) Authors only 40 (57)
Experts or editorialists only 6 (9)
Both 12 (17)
Article quotation reported, n (%) 22 (31)
At least one type of ‘‘spin’’33 (47)
Type of ‘‘spin’’a
No acknowledgment of nonstatistically significant primary outcome13 (19)
Claiming equivalence when results failed to demonstrate a statistically significant difference 7 (10)
Focus on positive secondary outcome 5 (7)
Focus on inappropriate subgroup4 (5)
Focus on within-group (or over-all within) comparison11 (16)
Nonstatistically significant outcome reported as if they were significant5 (7)
Ignored data of safety 3 (4)
Inadequate claim of safety5 (7)
Inappropriate extrapolation6 (9)
Other ‘‘spin’’2 (3)
aNumbers do not add up as the types of ‘‘spin’’ were not mutually exclusive.
Table 3. Bivariate analysis of factors associated with and ‘‘spin’’ in the press releases.
Characteristics Subcharacteristics ‘‘Spin’’ in Press Release n/Total n (%)p-Value
Journal General 11/32 (34)0.05
Funding source Profit 15/33 (45)0.8
Nonprofit or not reported18/37 (49)—
,11222/35 (63) 0.008
Experimental treatmentDrug 17/36 (47)1.0
Results of primary outcome(s) All nonstatistically significant11/24 (46) 0.9
Other 22/46 (48)—
Authors of press releasePress officer 19/40 (48) 0.9
Other 14/30 (47)—
‘‘Spin’’ in abstract conclusion Yes 26/28 (93)
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Figure 2. ‘‘Spin’’ in abstract conclusions, press releases, and news items.
Table 4. Bivariate analysis of factors associated with an overestimation of the benefit of the experimental treatment from the
press releases as compared with the interpretation from articles.
Overestimation of the Benefit of the
Experimental Treatment n/Total n (%)p-Value
JournalGeneral 2/32 (6)
Specialized 17/38 (45)
Funding sourceProfit 7/33 (21)0.3
Nonprofit or not reported12/37 (32)
Sample sizen,112 16/35 (46)
Experimental treatmentDrug 11/36 (31) 0.5
Other 8/34 (24)
Results of primary outcome(s)All nonstatistically significant 10/24 (42) 0.05
Authors of press releasePress officer 10/40 (25)0.6
‘‘Spin’’ in press releasesYes16/33 (48)
No 3/37 (8)
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5%, p=0.01), and ‘‘spin’’ in the news (43% versus 5%, p=0.009)
Our results highlight a tendency for press releases and the
associated media coverage of RCTs to place emphasis on the
beneficial effects of experimental treatments. This tendency is
probably related to the presence of ‘‘spin’’ in conclusions of the
scientific article’s abstract. This tendency, in conjunction with
other well-known biases such as publication bias, selective
reporting of outcomes, and lack of external validity, may be
responsible for an important gap between the public perception of
the beneficial effect and the real effect of the treatment studied.
Previous studies have highlighted the importance of press
releases for results communication and dissemination [4,5].
Indeed, as a direct means of communication between medical
journals and the media, press releases provide an opportunity for
journals to influence how the research is translated into news .
The press release is essential when considering the impact of press
coverage by the media on health care utilization, clinical practice,
and researchers’ behavior . This influence has been clearly
shown in a quasi-experimental study evaluating the impact of
media coverage . The authors compared the number of
scientific citations of articles published in the New England Journal of
Medicine that were covered by the New York Times to similar articles
that were not covered. They also performed this comparison
during a 3-mo period when the New York Times was on strike; the
New York Times continued to print an ‘‘edition of record’’ but did
not sell copies to the public because of the strike. The authors
demonstrated that the high citation of articles covered by the New
York Times was not present during the strike. Consequently, the
high citation was related to the media coverage, not the
importance of the research . A Cochrane systematic review
highlighted the impact of the mass media on health services
utilization . It showed a consistent effect after planned
campaigns and unplanned coverage. Another study showed a
clear association of the media coverage of invasive group A
streptococcal (GAS) disease and testing for GAS in pediatric
emergency departments, with an important increase in the
prescription of rapid tests for GAS in pediatric emergency
departments concomitant with a peak in media attention, despite
no increase in the number of children presenting symptoms that
might warrant such testing .
Unfortunately, as shown in our study, and previous work the
quality of media reports is questionable. An assessment of the
reporting of medical news in the mainstream media highlighted
the inadequate accuracy and balance of the news media in
reporting medical science [21–23]. The criticisms of the main-
stream media also applied to press releases. Woloshin et al., in
evaluating press releases issued by 20 academic medical centers,
showed that the releases frequently promoted preliminary research
without giving basic details or the cautions needed to judge the
meaning, relevance, or validation of the science (42% of press
releases evaluated in this study did not provide any relevant
caveats, and 90% about animal or laboratory studies lacked
caveats about extrapolating results to humans) . Furthermore,
press releases tended to overstate the importance of the research,
29% were rated as exaggerating the findings’ importance and 26%
of investigator quotes were considered to overstate the research
importance . Recently, a study showed that the quality of press
releases influenced subsequent media coverage content .
Of course, press releases are not meant to be condensed versions
of scientific papers; they are meant to summarize the most
important findings, contextualize these finding for journalists, and
provide contact details for authors and quotes. By being
Figure 3. Examples of ‘‘spin’’ in abstracts, in press releases, and in related news items.
Interpretation from Press Releases and News
PLOS Medicine | www.plosmedicine.org8 September 2012 | Volume 9 | Issue 9 | e1001308
condensed, they always lack details that are contained in the
papers. The use of ‘‘spin’’ or a particular emphasis could be a way
to increase the interest of journalists and subsequent citations in
the peer-reviewed literature.
However, this situation becomes problematic if it modifies
readers’ interpretation of research findings. Our results add to
these previous studies by showing the link between the distorted
presentation and interpretation of the results in scientific articles
and the distorted content and interpretation of press releases.
These findings raise the issue of the quality of the peer review
process and highlight the importance of this process for
disseminating accurate research results.
Our study has several limitations. Firstly, our sample included
only published reports of RCTs with a press release indexed in the
Eurekalert! database within a 4 mo period, and reported in
English; this sample may not be representative of all press releases
of RCT results. In fact, half of the press releases selected were
written by press officers of medical journals with a high impact
factor. Other sources of press releases exist on industry websites,
medical journal websites, or other databases for journalists.
However, the Eurekalert! database is one of the most important
sources of freely available press releases, and most research
published on press releases has used this database. Further, there is
no reason to believe that the selection of the sample over only
4 mo would bias the results. Secondly, RCTs represent only a
small part of the medical literature and the findings may not apply
to media reporting of medical or scientific research as a whole.
Thirdly, we searched for ‘‘spin’’ only in the article abstract
conclusions, not in the entire published article. Consequently, we
are not able to determine whether ‘‘spin’’ in the press release was
the same as the ‘‘spin’’ in the whole article. We chose the abstract
conclusions because it is the most accessible section of an article.
Readers often base their initial assessment of a trial on the
information reported in an abstract conclusion, and in some
geographic areas, the abstract of an RCT report may be all that
health professionals have easy access to [25,26]. Fourthly, the
content analysis and the interpretation coding were subjective
. However, two independent reviewers performed this
assessment with consensus. Fifthly, we focused on articles and
press releases of RCT results. We did not evaluate press releases
for other study designs or proceedings of conferences.
In conclusion, previous work showed that exaggerated and
inappropriate coverage of research findings in the news media is
linked to inappropriate reporting of press releases. Our study adds
to these results showing that ‘‘spin’’ in press releases and the news
is related to the presence of ‘‘spin’’ in the published article, namely
the abstract conclusions. Additionally, our work highlights that this
inappropriate reporting could bias readers’ interpretation of
Consequently, reviewers and editors of published articles have
an important role to play in the dissemination of research findings
and should be particularly aware of the need to ensure that the
conclusions reported are an appropriate reflection of the trial
findings and do not overinterpret or misinterpret the results.
Data abstraction form.
Details related to the method.
assessment of ‘‘spin’’ in press releases and in articles.
Kappa coefficient or agreement percentage for the
List of press releases and published articles examined.
Multivariate analysis of factors associated with ‘‘spin’’ in
news items (n=41).
Bivariate analysis of factors associated with ‘‘spin’’ in
overestimation of the benefit of the experimental treatment from
the news as compared with the interpretation from the article
abstract conclusions (n=41).
Bivariate analysis of factors associated with an
We would like to thank Elodie Perrodeau, Nizar Ahmad, Karima
Amazzough, and Guillaume Lonjon for their help in this study.
Conceived and designed the experiments: AY IB PR. Performed the
experiments: AY AB IM PC. Analyzed the data: AY. Contributed
reagents/materials/analysis tools: AY IB AB IM PC JM PR. Wrote the
first draft of the manuscript: AY IB. Contributed to the writing of the
manuscript: AY IB PR. ICMJE criteria for authorship read and met: AY
IB AB IM PC JM PR. Agree with manuscript results and conclusions: AY
IB AB IM PC JM PR.
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Editors’ Summary Download full-text
Background. The mass media play an important role in
disseminating the results of medical research. Every day,
news items in newspapers and magazines and on the
television, radio, and internet provide the general public with
information about the latest clinical studies. Such news items
are written by journalists and are often based on information
in ‘‘press releases.’’ These short communications, which are
posted on online databases such as EurekAlert! and sent
directly to journalists, are prepared by researchers or more
often by the drug companies, funding bodies, or institutions
supporting the clinical research and are designed to attract
favorable media attention to newly published research
results. Press releases provide journalists with the informa-
tion they need to develop and publish a news story,
including a link to the peer-reviewed journal (a scholarly
periodical containing articles that have been judged by
independent experts) in which the research results appear.
Why Was This Study Done? In an ideal world, journal
articles, press releases, and news stories would all accurately
reflect the results of health research. Unfortunately, the
findings of randomized controlled trials (RCTs—studies that
compare the outcomes of patients randomly assigned to
receive alternative interventions), which are the best way to
evaluate new treatments, are sometimes distorted in peer-
reviewed journals by the use of ‘‘spin’’—reporting that
emphasizes the beneficial effects of the experimental (new)
treatment. For example, a journal article may interpret
nonstatistically significant differences as showing the equiv-
alence of two treatments although such results actually
indicate a lack of evidence for the superiority of either
treatment. ‘‘Spin’’ can distort the transposition of research
into clinical practice and, when reproduced in the mass
media, it can give patients unrealistic expectations about
new treatments. It is important, therefore, to know where
‘‘spin’’ occurs and to understand the effects of that ‘‘spin’’. In
this study, the researchers evaluate the presence of ‘‘spin’’ in
press releases and associated media coverage and analyze
whether the interpretation of RCT results based on press
releases and associated news items could lead to the
misinterpretation of RCT results.
What Did the Researchers Do and Find? The researchers
identified 70 press releases indexed in EurekAlert! over a 4-
month period that described two-arm, parallel-group RCTs.
They used Lexis Nexis, a database of news reports from
around the world, to identify associated news items for 41 of
these press releases and then analyzed the press releases,
news items, and abstracts of the scientific articles related to
each press release for ‘‘spin’’. Finally, they interpreted the
results of the RCTs using each source of information
independently. Nearly half the press releases and article
abstract conclusions contained ‘‘spin’’ and, importantly,
‘‘spin’’ in the press releases was associated with ‘‘spin’’ in
the article abstracts. The researchers overestimated the
benefits of the experimental treatment from the press
release as compared to the full-text peer-reviewed article
for 27% of reports. Factors that were associated with this
overestimation of treatment benefits included publication in
a specialized journal and having ‘‘spin’’ in the press release.
Of the news items related to press releases, half contained
‘‘spin’’, usually of the same type as identified in the press
release and article abstract. Finally, the researchers overes-
timated the benefit of the experimental treatment from the
news item as compared to the full-text peer-reviewed article
in 24% of cases.
What Do These Findings Mean? These findings show
that ‘‘spin’’ in press releases and news reports is related to
the presence of ‘‘spin’’ in the abstract of peer-reviewed
reports of RCTs and suggest that the interpretation of RCT
results based solely on press releases or media coverage
could distort the interpretation of research findings in a way
that favors experimental treatments. This interpretation shift
is probably related to the presence of ‘‘spin’’ in peer-
reviewed article abstracts, press releases, and news items
and may be partly responsible for a mismatch between the
perceived and real beneficial effects of new treatments
among the general public. Overall, these findings highlight
the important role that journal reviewers and editors play in
disseminating research findings. These individuals, the
researchers conclude, have a responsibility to ensure that
the conclusions reported in the abstracts of peer-reviewed
articles are appropriate and do not over-interpret the results
of clinical research.
Additional Information. Please access these Web sites via
the online version of this summary at http://dx.doi.org/10.
N The PLOS Hub for Clinical Trials, which collects PLOS
journals relating to clinical trials, includes some other
articles on ‘‘spin’’ in clinical trial reports
N EurekAlert! is an online free database for science press
N The UK National Health Service Choices website includes
‘‘Beyond the Headlines’’, a resource that provides an
unbiased and evidence-based analysis of health stories
that make the news for both the public and health
N The US-based organization HealthNewsReview, a project
supported by the Foundation for Informed Medical
Decision Making, also provides expert reviews of news
Interpretation from Press Releases and News
PLOS Medicine | www.plosmedicine.org11 September 2012 | Volume 9 | Issue 9 | e1001308