What are the chances? The perils of communicating risk

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Dr Alexandra Freeman is executive director at the Winton Centre for Risk and Evidence Communication, based at the University of Cambridge’s Department of Pure Mathematics and Mathematical Statistics. We asked her about the new centre’s aims and why organisations like these are needed in a ‘post-truth’ age.

In a world where new breakthroughs in science and technology are giving us ever increasing amounts of data, we are often faced with complex decisions to make about our health, lifestyle, and how we navigate our way through everyday life. With so much information now available at our fingertips, it’s not surprising that some of us are finding it difficult to find – and understand – what’s out there.

There are an increasing number of bodies now springing up to help us make sense of it all. The Winton Centre for Risk and Evidence Communication is one such organisation. Funded by a philanthropic donation, the Centre was set up to present evidence ‘in a transparent way, to inform but not persuade’.

‘We want to help get accurate and impartial evidence to people who have important decisions to make in any realm of their life - professional or personal,’ explains Alex Freeman. The organisation works with clinicians, patients, analysts advising government decision-makers and barristers presenting evidence to judge and jury.

Alex explains how the centre is focused on helping people understand concepts such as risk. ‘Despite the fact that we’re based in the statistics department in Cambridge, the Centre is not about maths - it’s a science communication centre,’ she says. ‘We don’t generate the evidence. We critique it to a degree - what’s the level of certainty, and trying to get under the bonnet a bit to see whether what we’re being shown is likely to be fair and balanced, which requires a certain amount of expertise within the team - but more importantly we get the message of it to the people who need that information.’

One of the experts within the centre is RSS president David Spiegelhalter, Winton Professor for the Public Understanding of Risk. David spends much of his time explaining, through presentations, advisory work and blog posts, concepts such as the difference between absolute and relative risk, confidence intervals, and just how dangerous burnt toast really is.

Communicating to the wider public means working with the media; it's an area in which Alex has extensive experience having worked at the BBC for 17 years on science programmes such as Bang Goes the Theory, Climate Change by Numbers and, most recently, Trust Me, I’m a Doctor.

‘I think that my years of being “on the other side”, as a user of information coming from academia, gives me a really useful perspective,’ she says. ‘I know what pressures journalists are under. Actually, I think in the UK we have one of the best - if not the best - science reporting communities in the world. We have specialist science reporters who really know their stuff, and we have the Science Media Centre which provides a lot of support for them. Science journalists in many other countries are in awe of that kind of set-up.’

The problems in science reporting, Alex says, reflect a couple of more fundamental issues. ‘At the root of it is the pressure for a constant churn of “news” which can mean that some “non stories” get written up that, in an ideal world, wouldn’t. Academics are under exactly the same pressure to “publish or perish” and press officers, in the middle, have their part too.’

The consequences of a badly reported scientific study can be wide-reaching. Alex gives a well-known example of an epidemiological paper which came out in 1995, on the risks of venous thrombosis from the 3rd generation contraceptive pill. The media reported the relative risk given in the original academic paper – that the risk doubled compared with the second generation pill –  and as a result, a lot of women stopped taking it. So even though the absolute risk only changed from a 1 in 7,000 chance to a 2 in 7,000 chance, the news story resulted in an estimated 30,000 extra conceptions and 10,000 extra abortions. ‘Academics have to report responsibly themselves - and then press officers have to summarise the figures accurately,’ says Alex.

The trouble with facts and responsible reporting is that sometimes they are not as eye-catching as a sensationalised headline. But Alex believes that informative material can still be entertaining if approached in the right way. 'I think back to a particularly successful three-minute video that we made as part of my role on Trust Me, I’m a Doctor which was about an experiment we did with UCL swabbing people’s beards to look at the range of bacteria and other microbes found in them. It got 14 million hits in about a week, because it was funny, surprising and "self-defining". People who had beards liked it, and sent it to others who had beards etc. It went all around the world, and was packed with quite a bit of information about antimicrobial resistance.’

Making scientific research findings more accessible for non-scientists is one of the Winton Centre’s core aims. A key project currently in development is an app that takes the numbers from a press release and describes the risks/benefits with infographics to illustrate it. The centre is also redesigning the NHS’s online breast cancer tool, Predict – currently used by doctors to help them choose treatment options for women – to make it more user-friendly so patients can use it too. A third project is looking at how to report genetic test results – currently highly technical – so that people understand them and don’t worry unnecessarily, or to fail to act when they should.

But it’s not just medical information that the Winton Centre hopes to make more accessible. Another project aims to develop ways of communicating the evidence around different policy options and explain how those decisions could affect different people. ‘This can be difficult as there are so many things to compare - how can it be done in such a way that people can ‘at a glance’ see the likely effects of different policies?’ Alex says. ‘If we can find ways that work, then we think this could be really important in political debates, such as the potential effects of Brexit!’

Alex adds: ‘In the short-term at least, I see the most important role for the Winton Centre in this arena as working with others to help support press officers and journal publishers in challenging academics to make their results clear and well-expressed for lay readers, to help support journalists in selecting the best research stories to report and reporting them as accurately as possible, and helping the public spot bad science reporting when it slips through the net.’

So far, Alex has found the response to the Centre’s work encouraging. ‘I’ve actually been amazed at how keen everyone is for any additional help and support - everyone wants to improve science and statistical communication, it’s just a question of having the right training, tools and knowledge to do it.’

 

Absolute risk Relative risk David Spiegelhalter

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