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The quest for balance in a health news story can fail before the first sentence if the headline isn't appropriately calibrated. With that in mind, I looked at news stories and releases that we reviewed over the past month and compared the headline message with that of the study on which the news is based. About a third of news story headlines and a quarter of news release headlines either misstated the results or went beyond what the research could support.

Discusses a recent paper and press-release (a short summary circulated to the media by the people involved. In research, this is generally a summary of the paper often published by the university or organisation that has conducted the research). Do you think starting to eat nuts is likely to decrease your risk of heart disease? What other behaviours or characteristics do you think nut-eating might be associated with? Would any of them also be related to health factors?

"we pushed back against a misleading news release from Yale University that ran with the headline, "Yale researchers discover underlying cause of myeloma." The release claimed that the researchers identified "what causes a third of all myelomas," describing a faulty immune system response to compounds known as lysolipids as the culprit. But that characterization was wrong. First off, the research only demonstrated an association between lysolipids and this cancer - they didn't prove that one caused the other. And far from applying to a third of myeloma patients, the findings applied only to a tiny group of patients "

"Fenofibrate may reduce heart disease risk in some patients with type 2 diabetes" The release goes on to suggest that among patients with type 2 diabetes who also had high levels of triglycerides and low levels of "good" cholesterol, the drug lowered the risk of cardiovascular events compared with placebo. Sounds like it might be time to ask your doctor about the benefits of fenofibrate, right? Before you schedule that appointment, you might want to consider this detail that wan't included in the news release: The findings of benefit came from a small group of patients within a larger study whose results had previously been reported. And that larger study, known as ACCORD, found no overall cardiovascular benefit among patients treated with fenofibrate.

In this case, because pancreatic cancer is relatively rare, the impressive-sounding 50% reduction doesn't amount to very much. According to the American Cancer Society, a 60-year-old man has a 0.41% (1 in 241) chance of developing pancreatic cancer during the next ten years. (Risk varies greatly with age and is much lower at younger ages.) So cutting that risk in half might bring it down to about 0.2% (1 in 480). It's a 50% drop, sure, but the risk was already very small to begin with. In this case, it's more helpful to news and health care consumers to describe it as a 0.2 percentage point reduction. And then there are the harms of regular aspirin use; the Yale news release that the tweet links to doesn't mention any. But taking aspirin regularly isn't a harmless intervention - far from it. It's well known that taking aspirin every day can cause serious bleeding in the gastrointestinal system and, less frequently, in the brain. That's why guidelines for aspirin use in cardiovascular disease prevention don't recommend it for people at low risk of a heart attack. The potential benefits may be outweighed by the risks of a serious bleed.

The benefits and harms of medical marijuana can be debated, but more states are legalizing pot, even for recreational use. A new evaluation of marijuana's risks is overdue. Last year, the National Academies of Sciences, Medicine and Engineering released a comprehensive report on cannabis use. At almost 400 pages long, it reviewed both potential benefits and harms. Let's focus on the harms.

ASCO's news release about the screening study laments the "unfortunate" low rate of lung cancer screening and calls for an awareness campaign to encourage more smokers to get screened. Missing is discussion of legitimate reasons smokers might have to decline screening including substantial harms and a modest benefit. Following ASCO's lead, Bloomberg and HealthDay both echoed dramatic language about the finding without providing any perspective from independent experts who might voice reservations about screening.

Of the 6,916 news items examined in our research, more than 20% featured a statistic. Most of these statistical references were fairly vague, with little or limited context or explanation. Overall, only a third provided some context or made use of comparative data.

In August 2016, the Australian government released an "anonymised" data set comprising the medical billing records, including every prescription and surgery, of 2.9 million people. Names and other identifying features were removed from the records in an effort to protect individuals' privacy, but a research team from the University of Melbourne soon discovered that it was simple to re-identify people, and learn about their entire medical history without their consent, by comparing the dataset to other publicly available information, such as reports of celebrities having babies or athletes having surgeries.

Another example of news coverage over-stating the causal relationship between two things that research has demonstrated have some *association*. Good discussion of the particular headlines.