Communication Currents

New technologies have radically changed the ways people around the world access information. For example, the Internet is an information source that did not exist a few decades ago. Historically, the rise of a new technology is accompanied by growing concerns for its users’ personal health and well being. Accordingly, there is growing interest in the Internet and health—particularly the kinds of health information communicated via the Internet.

Email use tops nearly every list of popular online tasks; however, search engine use and news seeking typically are the second and third most popular online tasks, trumping even social media use on many lists. Furthermore, more than 100 million Internet users have reported seeking health information online, and nearly 50 million have reported seeking news information. News aggregation sites(e.g., Google and Yahoo! News), or websites that search and gather news from several other news agencies as opposed to creating their own primary articles, blend search technologies with news information, creating an entirely unique news experience for users.

Examinations of people’s online search habits have revealed many interesting trends, including the public’s fascination with health information. In 2007, Google reported thatcancer was the third most popular search for all of 2006 on Google News, following Paris Hilton and Orlando Bloom respectively. That finding speaks volumes about Internet news seeking and provides clear evidence that health news is a highly sought commodity. It goes without saying that cancer is a pervasive and devastating disease. The National Cancer Institute (NCI) provides a plethora of information for cancer physicians, patients, and researchers alike. Perhaps surprisingly to some, NCI acknowledges that communication might impact both the emotional and the physical well being of patients dealing with cancer. Considering the public’s clear interest in online health news and the impact of communication on cancer patients’ health, we decided that online cancer news warranted closer examination.

In particular, we were interested in the relationship between uncertainty and online health news. Uncertainty is a psychological state that is experienced when situations or events are difficult to interpret, ambiguous, and/or probabilistic. Uncertainties regarding health issues have been the object of study for years because, as NCI acknowledges, anxiety regarding cancer can have serious detrimental effects on a patient’s quality of life. In response to illness-related uncertainties, many people seek information in an attempt to reduce those uncertainties. What is considerably less studied is the fact that information might produce or even increase uncertainty when that effect is not desired. Although a person might seek information for the purpose of reducing his or her uncertainty, some information encountered might produce the opposite effect. Before jumping the gun and presuming effects of a particular type of content, it is best to first understand the characteristics of that content. In other words, there is no sense worrying about uncertainty-provoking content unless it is prevalent in messages that might be used for uncertainty reduction.

With that in mind, we designed a project around three main goals. We desired to (1) track and quantify uncertainty-related content within cancer news messages, (2) to examine how uncertain terms are dispersed across types of cancer news, and (3) to determine if content retrieved from news aggregators would differ from non-aggregated news content.

News articles about cancer were gathered randomly from four contiguous months in 2008, from four of the most popular news websites at that time (MSNBC.com, CNN.com, Yahoo! News, and Google News), four times daily (on the 12:00s and 6:00s). These four websites receive the most traffic from online news seekers and represent news aggregator (Google News and Yahoo! News) and non-aggregation news websites (MSNBC and CNN), which allowed us to test for content differences between these two distinct types of news dissemination services.

Our analysis of the 862 articles retrieved revealed that uncertain terms were used in 65% (562 of 862) of cancer news articles sampled to describe the cancer experience. At the paragraph level, about 12% (1,656 of 13,318) of cancer news paragraphs contained information that was either complex, conflicting, ambiguous, or of problematic volume (i.e., too much or too little information on the topic). Findings from this sample also suggest that uncertainty-related content is scattered inequitably across the different stages of the cancer experience (e.g., prevention, detection, treatment, survivorship, and end of life). For example, notably few stories in this sample discussed end-of-life issues, and still fewer end-of-life stories contained uncertainty-related information.

Our findings also indicated that cancer treatment news was riddled with ambiguity, or language that indicated that cancer information could be interpreted in multiple ways. In other words, treatment information was frequently accompanied by language that hedged or downplayed the treatment’s efficacy and/or impact on its recipients (e.g., “chemotherapy may be ineffective in some cases”).

We also found that cancer information characteristics differed between aggregation and non-aggregation (traditional) news websites. For example, where CNN and MSNBC combined to return significantly more cancer news containing indications of too little, too much, and ambiguous information about cancer, Google News and Yahoo! News delivered significantly more cancer news containing complex and conflicting information about cancer.

Perhaps one reason we discovered that nearly two-thirds of cancer news contained uncertainty was because reports of research are inherently uncertain and/or probabilistic. Therefore, accurate reporting of research findings should contain uncertainty-related content. How the public interprets that content might be another matter. In fact, it would appear that both producers and consumers of media content must take on certain responsibilities regarding the production and consumption of messages containing uncertain terms.

For journalists, reporting accuracy should trump other journalistic norms. Reporters have been noted to strip away contextual clues and hedging language in order to craft an article that is easier to digest. Erring on the side of clarity as opposed to accuracy comes with several pitfalls. First, it means that imprecise information has been disseminated. This might have serious ramifications for those seeking information in order to make life-or-death decisions about their cancer. Furthermore, some research has demonstrated that the use of uncertain terms might increase perceptions of journalistic credibility. In short, accurate reporting, which probably includes uncertain terms, might be good for both producers and consumers.

Furthermore, as we have learned from studies of other media, knowledge of a particular medium and/or message is the first step in minimizing problematic effects. To be specific, our findings would suggest that those seeking to reduce uncertainty about cancer treatments are unlikely to receive satisfaction from Internet-based news reading considering treatment news frequently contained uncertain terms. For the cancer information seeker, knowing that Internet news about treatment contains many uncertain terms might better prepare them for the inevitable ambiguity associated with all cancer treatments and their efficacy. Some researchers have suggested that uncertainty might be desirable to those attempting to maintain hope when faced with difficulties. A person desiring to maintain hope through uncertainty might be dissatisfied with news presentations of cancer death, which were least frequently associated with uncertain terms.

So, is finding that nearly two-thirds of the cancer news we sampled contained uncertainty-related content a bad thing? No, not necessarily. It simply means that those receiving the information might need some guidance to make the best use of this information.