Helping the public to decipher health fact from fiction

Catherine Reilly speaks with Dr Paula Byrne (PhD), lead researcher with iHealthFacts.ie, about the platform’s work examining the reliability of health claims

iHealthFacts.ie is a novel platform where members of the public can submit health claims which are fact-checked by a team of researchers who develop evidence-based responses.

The platform is an initiative of the Health Research Board-Trials Methodology Research Network (HRB-TMRN), Evidence Synthesis Ireland and Cochrane Ireland, which are based in the University of Galway. It is funded by the HRB and HSE.

As well as providing evidence-based responses, the initiative aims to help the public to use evidence to make informed decisions about their health and encourage critical thinking about health claims.

iHealthFacts.ie is run by a small core team of evidence synthesis experts, who work with a wider network of evidence researchers and advisors. The Principal Investigator is Prof Declan Devane, Professor of Health Research Methodology at University of Galway.

The team endeavours to answer as many of the submitted questions as possible. Newly submitted questions are prioritised based on how often the question is asked; how serious the consequences might be if someone acted on the claim; and the potential for the spread of the claim and for improving health decisions by answering the claim. The process of submission is anonymous and iHealthFacts.ie cannot offer medical advice to an individual or reply to individual questions.

Covid-19

The platform was born in the early days of the Covid-19 pandemic and the accompanying infodemic.

Dr Paula Byrne (PhD), Senior Postdoctoral Researcher with the HRB-TMRN and Evidence Synthesis Ireland, is the lead researcher for iHealthFacts.ie.

Commenting on its beginnings, she told the Medical Independent: “The researchers in our unit, who are involved in what is called ‘evidence synthesis’, realised that while there was work being done to synthesise evidence for policymakers and decision-makers, the general public didn’t have that kind of service and it was very difficult to figure out what was true and what wasn’t true, and that was why it was set up.”

“Then we relaunched in November 2022, and we pivoted to cover all sorts of health-related questions and things that people hear on social media or elsewhere.”

Since November 2022, approximately 6,000 users have visited iHealthFacts.ie. There have been 40,000 event counts on the site from July 2023 to date. Since the relaunch, 181 questions have been submitted and 60 answered. Twelve questions are under review at present.

The responses provide the details of the studies reviewed and an evaluation of the quality and certainty of the evidence. There may not always be definitive answers to the questions as good quality studies might not have been conducted on the topic.

A section of the response also includes a synopsis of the relevant guidelines and recommendations on the topic (where they exist) published by major public health bodies such as the World Health Organisation.

Supplements

Dr Byrne said the submitted questions suggest a “huge interest” in the evidence relating to food supplements and vitamins and minerals. Sleep and cancer are other common topics.

Examples of recently analysed questions include: ‘Do drinks containing aspartame increase the risk of cancer in the future?’; ‘Can a menstrual cup dislodge an intrauterine device (IUD)?’; and ‘Does vaping (using e-cigarettes) make a difference to our health and are there harms with second-hand vaping?’.

Asked if there were some claims for which they would not contemplate a response, Dr Byrne said the team rejects questions that are too broad or extremely specific (such as ‘I have X, should I take Y?’).

She said the question should be compatible with the PICO (Population, Intervention, Comparison, and Outcome) framework widely used by evidence researchers.

Dr Byrne outlined that if there is enough interest in a question and it fits the criteria to develop a response, the team will look to address it. She added that the initiative’s neutrality is “really important”.

“I wouldn’t like to think we shy away from anything. If the questions are out there, they are out there,” she said, noting there are harms associated with not addressing misinformation.

Process

The website outlines the process by which health claims are examined. In summary, each question is assigned to a member of the research team who undertakes the preliminary research and writes the first draft of the response.

This involves looking for evidence that supports or disproves the health claim. As noted on the website, the best type of study design to help inform a response is usually a systematic review. If these are not available, the researcher searches for individual studies. Where appropriate, they also search for statements from health agencies. The response includes an evaluation of the quality and reliability of the information from the studies.

Another researcher checks the draft answer independently. Then, a healthcare expert and a public/patient advisor review the answer. Finally, a health journalist undertakes a final review to ensure the text is in line with plain English requirements.

The publication of a response may take anything from a month to several months.

“All of our reviewers are working on different projects so they volunteer their time with us, so it depends on the availability of somebody… each review goes through a very rigorous process and it is reviewed by five people before it comes out the other end…,” noted Dr Byrne.

One of the stated aims of the initiative is to help people think critically about health claims. Asked if there were plans to measure this impact, Dr Byrne said: “We are actually hoping to do some trials on the way that we communicate answers, because that would really feed into the whole idea of science communication and explaining the uncertainty of scientific evidence.”

“So we are planning on running some randomised controlled trials trialling different ways of communicating answers…. It is quite tricky to measure success in that area, but we are designing and planning [the trials] at the moment.”

A member of the team, PhD candidate Ms Johanna Pope, is also undertaking a concept analysis of health misinformation. This research seeks to develop a shared understanding of what it means for health information to be termed ‘misinformation’ as an important first step in accurately identifying at-risk groups, clarifying pathways of vulnerability, and agreeing goals for intervention.

Another aspect of its work is outreach to community organisations to ascertain the relevance to them of iHealthFacts.ie and how the platform could be improved.

Dr Byrne said there were many exciting areas that the project could potentially expand into.

“Communicating health information to the public, and improving how we do that, is really important and expanding our outreach. But I think there are other areas, like how do we communicate health information to policymakers… how do we raise awareness of evidence synthesis among the media as well…. There is huge potential for iHealthFacts or similar projects to raise awareness on the broad production and use and communication of evidence.”

For further information visit https://ihealthfacts.ie.