#EAPM: Are fake news and a post-truth world side-stepping fundamental realities? A question of values...

With all these allegations of ‘fake news’, well, in the news, and high-level governmental accusations being made via Twitter accounts (of all things), one could be excused for thinking that, with the explosion of social media down the years, it’s all gone a bit crazy, writes European Alliance for Personalised Medicine (EAPM) Executive Director Denis Horgan.

It has got to the point that major companies, such as Facebook, Google and even the IBM Watson computer, have been looking to develop new algorithms, partly to fact check (although catching everything would be impossible) and, in certain cases, to monitor whether inaccurate stories are actually being read before they are shared by people who want to believe the headline because it backs up their world view.

The latter is a disturbing development and we’ve seen it work its dark magic in the case of the Trump presidential campaign, as well as in the infamous use of the ‘£350 million per week for the NHS’ message on the side of a Brexit battle bus.

On the other hand, when social media users look for touch points, they could often be seeking advice, whether good, bad or indifferent. Does the upside outweigh the downside? Do they care if it’s totally true? And who decides whether they should? Some person (or AI computer) in Silicon Valley?  Politics lends itself greatly to persuading voters by the occasional bending of the truth. It always has. And a phenomenon becoming clear via the explosion on the internet is that many people live in a bubble of their own opinions and don’t actually want to know what’s true and what isn’t. The people running the Watson computer found this out to their surprise.

But, really, as noted, the mind-set is nothing new. Left-wing newspapers, right-wing newspapers - we buy the ones that match, at least in general, what we already think.  But it’s not just politics…doctors will tell you that the new breed of patients can and do spend a lot of time on the internet trying to self-diagnose.

A tricky (and possibly dangerous) game. But while nobody is saying that other patients sharing their stories count as ‘fake news’, the issues are complicated.  Not only that, but what about advertisers offering high-priced ‘miracle’ cures for one thing or another? And what do we make of those two stories that pop up again and again: 'Pretty much everything causes cancer' alongside 'Experts on the verge of cancer cure'?

So who and what does one trust in the post-truth world of fakery and, often, chicanery? The Oxford Dictionaries define ‘post-truth’ as “Relating to or denoting circumstances in which objective facts are less influential in shaping public opinion than appeals to emotion and personal belief.”  They use an example quotation: “In this era of post-truth politics, it's easy to cherry-pick data and come to whatever conclusion you desire.”

These are times of change, transition and continued adaptation for all of us when it comes to adapting to new ways of engaging each other in society. This also holds true for new types of work environments, novel ways to extend one's life (through personalised medicine in many cases) and more opportunities to balance the chance of life extension against the quality of remaining life.  And when it comes to healthcare, a debate has been ongoing for some considerable time about the benefits or lack of benefits of population-based screening.

Those in favour have their points as do those against. They can’t both be 100% correct, as there are cross-overs, but at least it’s not fake news and patients, as well as front-line health-care workers, at least have the opportunity (and desire) to take a look at the arguments and decide in a particular case.  Of course, this filters down to an individual patient level, at which a consultant may or not refer a patient for various tests (including the use of DNA, these days, with all the moral implications that throws up) and, when he or she does refer, the benefit of the treatment in view of the patient’s lifestyle, family support network, working situation and more comes into play.

One of the biggest arguments against screening, whether it be prostate, breast or even lung cancer is the risk of over-treatment, with its attendant issues of potential side effects for little or no benefit, the chance of invasive and life-changing surgery some years before it’s really necessary (due to the patient thinking ‘I just want to get rid of this thing in my body) and, lest we forget, cost.  There is no ‘fake news’ here, simply facts and opinion (hopefully based on demonstrable elements brought to us by science).

To add to the debate, the fifth annual presidency conference organised by the European Alliance for Personalised Medicine, will take place in Brussels on 27-28 March, 2017, under the auspices of the Maltese Presidency of the European Union.

Its title is 'Innovation, Guidelines and Screening: The Case of Lung Cancer’, and readers can register here. While the conference will take a close look at lung cancer screening (as it is the biggest killer of all cancers), its general subject matter will be much broader.

Experts from all stakeholder groups in health care will be examining the need for more recommendations and guidelines on health and preventative measures across the current 28 member states, affecting some 500 million EU citizens. And that’s true.

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