Much like with an actual vaccine, people need to be “inoculated” against healthcare misinformation and disinformation prior to exposure, according to an expert panel.
While fact-checking and debunking misinformation can help lessen the damage after the fact, the most effective treatment is prevention, as in “pre-bunking,” said Sander van der Linden, PhD, of the University of Cambridge in England, at a session at virtual IDWeek, the annual joint meeting of the Infectious Diseases Society of America, Society of Healthcare Epidemiology of America, Pediatric Infectious Diseases Society, HIV Medicine Association, and Society of Infectious Diseases Pharmacists.
The three most prevalent techniques for medical misinformation are use of conspiracies, use of fake experts peddling fake cures, and use of emotions to get people riled up through fearmongering and outrage, van der Linden noted.
But fact-checking and debunking only go so far. He said that even after false information has been debunked, the previous “repetition of the falsehood strengthens the myth” and people forget about the correction.
“Even after people acknowledge the correction, they continue to make inferences based on false information,” he said.
Van der Linden and his research group performed a number of simulations about how people are exposed to misinformation, and determined that it’s “better to front-load inoculation,” he said.
“It is much more effective to prepare people with a weakened dose of misinformation and a preemptive refutation,” van der Linden said in response to a clinician question. “Just more facts [aren’t] necessarily going to help people develop the type of psychological antibodies they need to resist targeted manipulation attempts.”
Once someone has been exposed, fact-checking and debunking act as a sort of “therapeutic vaccine,” van der Linden noted, where there are some benefits to inoculating exposed people. “Ultimately, it’s not going to be effective unless we achieve psychological herd immunity,” he added.
Combating misinformation and disinformation has garnered attention in the research world. Irene Pasquetto, PhD, of the University of Michigan in Ann Arbor, noted how little knowledge there is on whether interventions to combat misinformation actually work. In addition to fact-checking, debunking and “pre-bunking,” she noted that platforms can perform algorithmic de-ranking and account de-platforming, redirect users to more accurate information, and demonetize accounts that spread misinformation.
A clinician asked if there should be more stringent policies when disinformation comes from people in healthcare, such as losing their medical license.
Arleen Brown, MD, PhD, of the University of California Los Angeles (UCLA), mentioned a California law that makes it a misdemeanor to propagate false information knowing the information is false. Still, she noted that she’s uncertain about how the law will be enforced or if it will even stand up.
Brown added that she has had experience with certain UCLA faculty in that regard, that they have “supported some information that most of us disagree with.”
“In the setting of an academic institution where you have academic freedom, it’s hard to shut something like that down,” she said.
Pasquetto noted that misinformation campaigns have the tendency to adapt to certain racial and ethnic groups, and these purveyors “masquerade themselves as being part of specific groups.”
Brown put forth strategies to combat misinformation among these underrepresented groups, who are often targets of misinformation. She emphasized the importance of partnering with both academic experts and experts in the community — for example, noting that “mRNA technology is older than cell phones,” and sharing the risks associated with COVID-19 infection versus the risks associated with vaccination.
And people tend to believe misinformation not because of lack of trust in experts and science, but because of “misleading evidence,” she said.
Pasquetto previewed “Misinfo Rx,” a toolkit for healthcare providers whose patients have been exposed to misinformation, which should be released in the coming weeks.
“But there’s not one intervention to make misinformation magically disappear,” she said.
The speakers disclosed no conflicts of interest.