Susceptibility to Misinformation

The journal Nature Human Behavior is a wonderful rabbit hole for a holiday morning coffee. I barely avoided an article on the synchronization of steps relative to crowd density. The famous Shibuya crossing in Tokyo came to mind immediately. One warm September evening in 2019, we were on our way to a 5-stop izakaya adventure in Shinjuku. Poised patiently on all sides were clusters of young people thumb-swiping messages, men in suits heading out for a nomikai with colleagues, and mamachari packed with groceries and kids. In a moment, we all eased into a stream-of-consciousness flow over the wide white hashmarks, in all directions. Thankfully, the synchronized stepping article was not full text or I would have been subsumed!

This article on susceptibility to misinformation related to the COVID vaccines earned my attention because it was thorough, written by authors from reputable institutions, and tested a hypothesis methodically. This short review discusses some of the main findings, and implications for information sharing.

Sept 14, 2019 – Out to dinner on a Shinjuku izakaya adventure

The authors, representing top schools in the UK and the US, ran a pre/post trial to test the impact of misinformation on vaccine plans in September 2020. They selected 8,001 people in the US and UK each (4,000 in the UK, 4,001 in the US) with an embedded 1,000-person control group in each country. (I wondered about that 1 extra person in the US but I think it is unintentional. My best guess is they oversampled, hoping to get 4,000 at least in each group to complete the entire experiment, and just happened to get 4,001 in the US and 4,000 in the UK on the day the survey data collection period ended.)

The treatment group (3,000 in each country) was asked about their vaccine plans (definitely yes, unsure but leaning yes, unsure but leaning no, and definitely no). They were also asked about their education, income, demographics and daily social media use. During the test period, they were given 5 images of misinformation and then asked again about their plans for vaccine acceptance, for themselves and on behalf of others (i.e., altruism to protect friends/family).

At baseline (time “W”), the authors found that 54.1% of UK respondents and 42.5% of US respondents planned to get the vaccine. Exposure to misinformation dampened the likelihood of vaccine acceptance overall (for both self and others) about 6% in both countries (at time “Y”). The net migration was from the top (definitely yes, getting the vaccine) to the next category down (unsure but leaning yes) and so on. People were more likely to accept the vaccine for altruistic reasons, but their plans on behalf of others were also negatively affected by misinformation.

In the UK, people who trusted celebrities for information were more resilient to misinformation. In the US, people who trusted friends and family were more susceptible to misinformation. Social media use actually did not have much effect. The authors found some shared characteristics among those who were least resilient to misinformation: they tended to be more educated, employed, higher income, females, who tend to trust family and friends vs. experts for information. The reference group was 18-24 year old conservative white males who have the highest education and are employed. (This reference group was picked to allow the statistical analysis to measure a direction of influence; in other words, they picked the most populated characteristic (i.e., employed vs unemployed) or most extreme measure (i.e., no social media use vs. some) so they could detect movement away from that characteristic.)

Apparently, my hockey mom friends and I are statistically least resilient to misinformation. How do we fact-check? Do we outsource fact-checking to family and friends? I hope to find out their thoughts this weekend when we travel out of state for games. (We’ll be wearing masks, dining by take-out only, and traveling separately, just as we have for the entire season.)

How do you find sources of good information? Do you check sources? Where do you look?

As for me, I tend not to consume information as much as I ask myself questions, then search. I guess I’m a seeker. I don’t use social media at all for health-related information. I don’t ask family or friends, unless they are clinicians or academics, and even then I hesitate to put one of them on the spot for personal guidance. For a health-related question, I tend to look at consumer health articles at Mayo, Harvard, Kaiser, etc. If I’m concerned, or on the fence about a vaccine or procedure, then I look at peer-reviewed literature and read several articles. When asking my clinician for an opinion, I try to avoid starting off with “I was reading…” or “A recent study…” because it may induce a reflexive recoiling in response to all the misinformation on the web. I find it is easier to cut straight to the chase by: “What do you think about…” then ask directly whatever the hinge question is, such as “…an ultrasound guided needle biopsy to rule out…” The physicians I have encountered have nearly always been very receptive to specific questions that reflect an understanding of relative risks. They respect research and want to share their knowledge and experience.

Given that I am not a celebrity, I do not use social media for research, and I’m a freelance epidemiologist employed by no one, my views should have virtually no influence. But that also means I’m in no one’s pocket. I care only about my reputation for truth and transparency.

The proliferation of media choices today makes information dissemination particularly challenging. Nuance is lost in short sound-bytes, but this is not necessarily a new hurdle in pursuit of persuasive power. In the late 1700s, Patrick Henry was known for being a powerful orator, stirring emotions both for and against his viewpoints. In contrast, Thomas Jefferson tended to quietly research, write, and re-write his thoughts. He eventually distilled them into his draft of the Declaration of Independence, as durable and memorable as Henry’s “Give me liberty or give me death.” My son and I are doing some reading about both men because we now live in Virginia, birthplace of Jefferson and home to his University.

As a scientist and communicator, I also struggle with voice vs pen. In casual conversation, people want clarity, and they want it fast. A powerful, convincing argument harvests more “likes.” Twitter messaging benefits those who are emphatic. But scientific findings should never be adamant, the way I see it. Perhaps this is why the podcast is enjoying a surge of popularity, because it provides the time and space for nuance, humor, detail and the argumentation that results in eventual clarity. With sufficient preamble, one can justify the occasional explosive sentiment, either for or against a finding, opinion, perspective, study or policy. The best podcasts are an introspective refuge from blind dogma. They convey the depth of thinking and reflection required to arrive at a conclusion, the backstory to the Twitter post. Consider listening before following. Be selective. Your feed will be less susceptible to misinformation.

Note – the supplemental tables for the article can be found here. You’ll have to chase links to find the images used for the tests. Image 1 in both countries exerted the most influence, so of course I had to see them for myself. In the UK, the first image pertained to the chimpanzees in the AstraZeneca vaccine trial, and alleged that they all became sick anyway. Image 1 in the US test was the same as the second image in the UK trial (why couldn’t they use the same images in both countries and make it easy for me?). This one used scientific imagery and declared that the vaccine would alter your DNA.

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