Spotting the Myth
An important part of a Mythbuster is establishing the myth's existence. A myth is a widely held but false belief.23 CHSRF's Mythbusters series aims to debunk popular healthcare myths by revealing the research evidence that is contrary to accepted wisdom in Canadian healthcare debates. Spotting a myth is not impossible, but it certainly is challenging. Fortunately, this section provides insights into how to spot a myth while keeping personal biases in check.
Proposed objective
Students should be able to demonstrate a myth's existence, drawing on information from such sources as the news media, Media Doctor Canada or public opinion polls. To be an effective Mythbuster subject, the myth should be one that is widely believed.
Looking for myths
As a former Massachusetts state legislator, John McDonough saw firsthand the beauty and peril of allowing storytelling into the policy process.24 Despite the existence of reams of scientific evidence, McDonough found perspective often mattered more to policy decisions. Interestingly, when asked for the evidence behind these perspectives, McDonough heard many choice responses including, "I read it somewhere, but I can't remember where"; "My brother told me"; and his personal favourite, "Everyone knows that!" McDonough's experience raises a useful and powerful question that should underlie every research summary — "How do you know that?"
There are some obvious and less-obvious sources for finding myths. In an indirect way, Haines et al.25 provide examples of how to find myths in their description of the barriers to transferring research evidence into practice. From CHSRF's perspective, some of these barriers (which follow) provide insights as to some of the reasons people think they know things.
- Failure of curricula to reflect research evidence
- Influence of media in creating inappropriate demands/beliefs
- Influence of social fads and trends
- Ideological beliefs that may be inconsistent with research evidence
- Dominance of short-term thinking
- Obsolete knowledge
- Influence of opinion leaders that goes against research evidence
- Beliefs and attitudes
- Perceptions or cultural beliefs about appropriate care
Perhaps the most obvious source for finding myths is the news media. When the news media (or other sources for that matter) make claims with little to no reference to research evidence or reference to poor-quality research, then the claims may be false or inaccurate. A popular example from recent years is the news media dialogue on private versus public healthcare. Among the many myths on this subject is the one that purports that a public-sector monopoly creates waiting lists.
In reality, many countries that mix public and private financing of healthcare (including England and New Zealand) struggle with even longer waiting lists in their public sectors than our own.26
Media monitoring can be time-consuming and fruitless, especially without access to a range of news media. Fortunately, many university libraries offer access to electronic news databases such as Lexis Nexis,27 FP Infomart,28 Factiva29 and others. Nowadays, resources like Media Doctor Canada,30 Media Doctor Australia,31 Health News Review32 in the U.S. and Hitting the Headlines33 in the U.K. offer reviews of recent print news media too. There is also a body of literature that studies how the mass media (including the news media) represent health and healthcare. All of these sources can be great starting places for searching for potential myths.
Public opinion polls or perception studies are also possible sources for spotting myths, particularly when the results indicate that perceptions contradict the best available body of research evidence.
Another tactic CHSRF has used for finding myths is to ask researchers and managers for their insights. For example, to a group of researchers we have posed the question, "What really bugs you about policy and management decision-making because you know that what is practiced is contradictory to the research evidence?"
In the end, finding possible healthcare myths involves keeping a critical eye on healthcare debates. In journalism, this has been referred to as playing the role of watchdog, which involves exposing failings in how decisions are made and power is exercised.34 However, this watchdog principle can sometimes be misunderstood to mean "afflict the comfortable."34 Keep in mind that the goal for a Mythbuster is to debunk widely held myths by revealing the best available body of research evidence in a way that is a pleasure to read.
Avoiding interjecting personal bias
It can be tempting to use a Mythbuster as a venue to voice personal bias. For example, one may attempt to use a Mythbuster to make claims about a personal belief or opinion that is not adequately supported by research evidence. Personal biases may, in fact, motivate a person to falsely identify a given topic as a myth in the first place. Expert review (step five of this resource) is one way to ensure a research summary is solidly positioned from the point of view of the best available research evidence. However, to facilitate this review process, it is best to reflect on what factors have motivated the selection of a particular myth. In this early stage, it is wise to consider some of the review questions that arise in step five. The most important question to be asking at this stage is: "Have I considered all of the different perspectives or views that exist about the myth I have selected?" Of course, the question, "How do you know that?" is also an important question to ask when challenging a myth, with the answer necessarily being grounded in research evidence.