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Identifying Credible Sources of Health Information in Social Media: Principles and Attributes

By Raynard S. Kington, Stacey Arnesen, Wen-Ying Sylvia Chou, Susan J. Curry, David Lazer, and Antonia M. Villarruel

Background

In March 2021, the National Academy of Medicine (NAM) launched a project to help identify principles for identifying credible sources of health information in social media, of which this paper is the principal output. Sponsored by YouTube’s Healthcare and Public Health Partnerships arm [c], the project was inspired by the goal of enhancing public access to evidence-based health information during the COVID-19 pandemic, although the issue has relevance beyond the current crisis.

The project involved an independent expert advisory group composed of multi-disciplinary experts in information governance, health information development, public health and health equity, social media and misinformation, and science communication (members of which also authored this paper), a public webinar, a public comment period, and other information-gathering activities. This paper does not constitute official recommendations from the NAM or the National Academies of Sciences, Engineering, and Medicine (NASEM), nor does it represent an endorsement of any actions taken by YouTube or other SMPs following its publication.

Foundational Principles

Based on their information gathering and deliberation, the authors developed the following foundational principles to guide the identification of credible sources of health information in social media.

 

Principle 1: Science-Based

Sources should provide information that is consistent with the best scientific evidence available at the time and meet standards for the creation, review, and presentation of scientific content.

This principle reflects the authors’ conviction that scientific evidence is the only reliable predictor of health outcomes and therefore should be the foundation of health information provided to consumers. There are a number of attributes (e.g., use of citations) that help to indicate whether a source is sharing information that is consistent with the best scientific evidence available at the time, described in the following section.

Principle 2: Objective

Sources should take steps to reduce the influence of financial and other forms of conflict of interest or bias that might compromise or be perceived to compromise the quality of the information they provide.

This principle acknowledges that all sources have COIs or inherent biases. However, in order to be considered credible, sources should strive to separate the presentation of health information from profit motives and other biases (e.g., political). Sources should also disclose conflicts, as noted in the next principle.

Principle 3: Transparent and Accountable

Sources should disclose the limitations of the information they provide, as well as conflicts of interest, content errors, or procedural missteps.

The final principle acknowledges the fallibility of both organizations—which cannot eliminate COI and errors—and science itself. At the frontiers of understanding, scientific knowledge changes over time as more evidence becomes available and as existing evidence is analyzed in new ways. Scientific evidence, no matter how rigorous, can never guarantee a certain outcome for every individual or every context. Furthermore, Black, Indigenous, and People of Color (BIPOC) and other groups, such as LGBTQIA+ individuals and people with disabilities, are underrepresented within organizations traditionally considered authorities in science, meaning that the best available science might not fully reflect their experiences (discussed further in “Structural Bias”).

To maintain credibility, sources must clearly acknowledge the limitations of the information they share so that consumers can reach fully informed conclusions. Fundamentally, this last principle reflects one of the key themes among the public comments the authors received—the importance of protecting the right of individuals to autonomy and independent evaluation of the information they consume and the sources they choose to trust. It also acknowledges sources’ right to freedom of speech [f], but at the same time, requires sources to be fully transparent and provide all the context necessary for consumers to reach an informed judgment. However, the protection of free speech and consumer autonomy must be balanced against the harms of misinformation and disinformation, as well as recent anti-science and “post-truth” trends in the media [16]. “Post-truth” refers to an environment in which scientific evidence is disregarded by some in favor of an alternative set of beliefs [17].

 Credibility Attributes

Using the foundational principles as a scaffold, the authors identified a set of attributes that generally describe credible sources of health information (see Table 1). Not every source can display every attribute, but this should not preclude a general assessment of credibility. For example, a professional association may have a lobbying arm, which is counter to one of the attributes under the “objective” principle. However, the same organization might have a research arm that nearly or fully aligns with the attributes under the “science-based” principle. Furthermore, this organization may clearly disclose its lobbying activities to the public and maintain a strict firewall between political messages and health information for the public, thereby aligning with attributes under the “transparent and accountable” principle. 

These guiding principles ensure what you read on Health Train Express is credible.

Identifying Credible Sources of Health Information in Social Media: Principles and Attributes - National Academy of Medicine