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Unraveling the Web of Health Misinformation

About Episode 25

Let’s Navigate...

How has knowledge transfer and communication changed for you in the age of social media? How do you know when social media medical information is the real deal or a bunch of nonsense? And, how do you help families or colleagues navigate reliable sources of health information? Let us know by leaving a voicemail at NemoursWellBeyond.org. While you’re there, check out our other episodes, subscribe to the podcast, and leave a review.

Navigating Misinformation and Becoming An Academic Sleuth In The Social Media Age: that was the topic presented as a panel discussion at the Pediatric Academic Societies annual meeting in Washington, D.C. Panel member Dr. Atul Malhotra advises healthcare professionals on how best to present evidence-based medical information on social media to avoid misinterpretation and he shares advice for parents and caregivers on how to steer clear of medical misinformation on social media.

We also dig into Dr. Malhotra’s neonatal cell therapy research at Monash University in Melbourne, Australia, where he serves as Associate Professor Consultant Neonatologist & Head of the Early Neurodevelopment Clinic at Monash Children’s Hospital.

Carol Vassar, producer

Guest: Atul Malhotra, MD, PhD, Associate Professor Consultant Neonatalogist
and Head of Early Neurodevelopment Clinic, Monash Children’s Hospital

Subscribe, review or let your voice be heard at NemoursWellBeyond.org.

Well Beyond Medicine Episode 25, Transcript

Carol Vassar, podcast host/producer (00:00):

Welcome to Well Beyond Medicine, the Nemours Children’s Health Podcast. Each week, we’ll explore anything and everything related to the 80% of child health impacts that occur outside the doctor’s office. I’m your host, Carol Vassar, and now that you are here, let’s go.

MUSIC (00:26):

Well Beyond Medicine!

Carol Vassar, podcast host/producer  (00:27):

Navigating misinformation and becoming an academic sleuth in the social media age. That was the topic presented as a panel discussion at the Pediatric Academic Society’s meeting in Washington, DC. Panel member Dr. Atul Malhotra joins us with advice for healthcare professionals at how best to present evidenced-based medical information on social media so that it is not misinterpreted. And for parents and caregivers on how to steer clear of medical misinformation on Twitter, TikTok, Snapchat, Instagram, Facebook, and the like.

(01:03):

We also dig into Dr. Malhotra’s neonatal cell therapy research at Monash University in Melbourne, Australia, where he serves as Associate Professor Consultant Neonatologist and head of the early neurodevelopment clinic at Monash Children’s Hospital. But first, here’s Dr. Malhotra to explain why and how social media misinformation prevention caught his attention.

Dr. Atul Malhotra, Monash University (01:29):

And what happened is around last year, we are quite active on social media ourselves, and we are a part of an organization called Evidence-Based Neonatology, where basically we source good quality evidence, which is coming up, and then we kind of break it down into very simple snippets and post it on social media, whether it’s Twitter, Facebook, Instagram, and so on.

(01:51):

And what we realize is that the audience of these academics, you can say snippets, not just from us, but from any source, there are many other people who do similar things like us in social media. The audience of that are two types of people, Carol. So one is obviously the health professionals themselves but then is the lay audience or the public. And sometimes, they’re very important stakeholders because they’re obviously looking at what is coming out on social media as a source of information for them.

(02:23):

So sometimes, that is their only source of information. So whether it’s a doctor, a nurse, or it’s a parent or just any layperson in the public, sometimes they pick up those things on social media and take it for granted. So what we are trying to do, especially in the Pediatric Academic Society Meeting, is we are trying to tell those people who are attending the society meeting, which is health professionals, as you can understand, most of them doctors, to be able to teach them how to be able to discern good quality evidence and not just go by face value because you might have something out there on social media which might be completely misinterpreting or misquoting, what is actually the evidence or the real truth behind it.

(03:11):

So basically telling people how to look out for those things which may not be reliable.

Carol Vassar, podcast host/producer  (03:17):

Becoming really social media savvy in terms of sourcing?

Dr. Atul Malhotra, Monash University (03:21):

Yes.

Carol Vassar, podcast host/producer  (03:22):

What should parents, laypeople, look for when they are on Twitter, when they’re on Instagram, when they’re on Facebook, LinkedIn, whatever it may be to make certain that the information that we’re getting is legitimate, it’s evidence-based and is something that is shareable and won’t actually be misinformation that we’re sharing?

Dr. Atul Malhotra, Monash University (03:46):

Yeah, so I think my starting point is there are probably a few points to think about there. My starting point is follow or look at social media posts from reliable organizations. Those reliable organizations might be research institutes, hospitals. It might be social media dissemination sites. It might be your local hospital. It might be anyone. But you need to know what are those institutions like to start off with.

(04:13):

If those institutions have a conflict of interest, you should know about those as well because if they are posting things in which they have a financial stake, you have to be careful around that. So the first point I want to make is the source of information is really important.

(04:30):

The second point after that is that even if the source of information, which is the site posting that social media post, is reliable or you think it’s reliable, let’s say it was the CDC or NIH or somewhere big, they might be reliable, but then what are they posting? How is it applying to you? Because sometimes, because of the character limit in some of those social media sites, the whole picture is not presented. And it’s a bit like you think about not just social media but print media or any other media.

(05:03):

Sometimes you have a clickbait kind of tagline, and you can completely be misinterpreted by not looking at what is the exact detail, the fine print around it. So first was the source of the post. The second is what actually did the post contain? And then third I talk about is if you are really going to make important decisions based on that, please do your own research, which is actually going to the real background source of that, try to look it up.

(05:37):

If you are not a health professional and you’re not sure, talk to your doctor, talk to your trusted colleague, whoever else you know about that because you don’t want to be misled by a biased information which may be easily misinterpreted.

Carol Vassar, podcast host/producer  (05:51):

There’s a lot of misinformation out there in your practice. How do you go about fighting that? I am guessing that at least in the clinical realm, you’ll have somebody coming in and saying, “I saw this study, and it tells me X, Y, and Z, and you’re doing A, B, and C?” But you know X, Y, and Z is just misinformation. How do you advise that parent?

Dr. Atul Malhotra, Monash University (06:10):

Absolutely. So parents frequently come not just to me to but to anyone. It could be a nurse, it could be another health colleague, and they would say, “We saw this. What do you make of this?” So to start off with, we go back to basics and kind of break it down for them. We ask them to go to reliable sources.

(06:28):

For parents, generally, I work in intensive care. So for us, we kind of direct them to the reliable sources ourselves. So we say, “We would advise you to follow these parent advocacy organizations or patient information sites because they will break it down for you in simple pieces.” What you guys do, and a lot of other podcasts do, is that they also produce information which is broken down into very simple lay terms. So these are health information sites instead of some commercial sites. So direct them to the right traffic.

(06:59):

If they’ve got a specific question, try to break it down for them. For this, I always talk about two things to my juniors when I tell them about this. First, be a patient listener. If you do not listen to the parents, they will not have trust in you. So building that trust is really important. Hear them out. What is the context? Where are they coming from? They must be thinking for the best interest of their child or family member, whoever they are looking after.

(07:25):

So hear them out, break it down, talk through it, tell them of examples of how misinformation can spread. It might be that their information is actually reliable. And sometimes families. There is a classic example many years ago in our hospital where the family actually found a treatment possibility for a child. And that treatment, you won’t believe it, Carol, is now standard treatment for that condition because the family actually found that information.

(07:51):

Now, that family was very well read and informed, but don’t dismiss them that, “Oh, I don’t think they will know as much as I do.” So be humble, be patient, listen to them, and then talk them through it.

Carol Vassar, podcast host/producer  (08:04):

The example you just cited though is probably the exception more than the rule?

Dr. Atul Malhotra, Monash University (08:10):

Absolutely. But it’s about the respect. It’s about paying every human being respect and listening to them. And it’s absolutely right. Those are very rare examples. There is more misinformation out there than information, unfortunately, these days.

Carol Vassar, podcast host/producer  (08:25):

And to back that up a step, it’s about that relationship between you and your clinician, me and my clinician, my child’s clinician. If I trust that relationship and you say to me, “Yeah, that’s not really the case.” I’m going to believe you, and I’m going to listen as you point me in the right direction. So having that relationship, it’s a lot deeper than just the misinformation, which is bad enough out there.

Dr. Atul Malhotra, Monash University (08:48):

So the trust is the starting point. If the client is not trusting you, then whatever else you say is not going to work. So work on the trust first. And sometimes, once you establish that trust, it’s very easy because then they’ll say, “Okay, I came to Dr. Atul, and he told me immediately, don’t worry about it. That’s not relevant to you. I’ll tell you what to go for.”

Carol Vassar, podcast host/producer  (09:08):

One of the things that you and I talked about in our pre-interview was you have a goal of collaboration, especially with research organizations here in the U.S. Talk about your efforts in that area?

Dr. Atul Malhotra, Monash University (09:21):

So besides obviously being active on social media and disseminating evidence-based information, I lead a big cell therapies program. So these are neonatal cell therapies. Lay people sometimes call it stem cells. Not all the cells we use are stem cells, but this is cell therapies program. And one of my endeavors when I come to the U.S., or actually any other country I go for presentations or academic conferences, is to connect with people to be able to collaborate with people.

(09:48):

I’ve had a very successful visit to the US this time, and you can imagine with the pandemic, this was not very easily possible. We were relying on Zoom and other channels to get contact, but the power of the human contact is very good. So coming over here and being able to talk to people, talk about our research, talk about our common synergies, and connect with like-minded people to be able to work together has been a big focus for me. And it’s been a very successful visit.

Carol Vassar, podcast host/producer  (10:17):

That face-to-face ask. And that face-to-face relationship is so very important in collaboration. You are also a researcher. Talk about the research you’re doing.

Dr. Atul Malhotra, Monash University (10:26):

Yeah, so I’m the head of the neonatal cell therapies program at Monash in Melbourne where we basically investigate, discover, and then try to translate, which means bringing new therapies, new ideas from the bench, from the lab to the clinic. We are running three cell therapy trials at the moment at Monash, and we have two more starting soon. So we are a leader in the cell therapy space around the world.

(10:52):

By working with like-minded people over here, that’s the main idea. But what we’re trying to improve by that program is basically give these vulnerable babies and families possible treatment solutions in the future. But as you can imagine, this is transformational or transitional research, which takes a long time to move from the concept to actually delivery. So it’s a long journey, but I enjoy it.

(11:14):

I’ve got a great team at Monash, at Hudson Institute of Medical Research at the hospital, Monash Children’s Hospital, and we work all together with the prime goal of making it work, making the translation through rigorous process and evaluation to be able to someday give these babies and families new treatment options.

Carol Vassar, podcast host/producer  (11:36):

This is often lifelong work for people. I’m curious about those three research studies, the cell studies that you’re doing. Give us a general lay synopsis of each one, if you would.

Dr. Atul Malhotra, Monash University (11:46):

So basically what we are doing is we are looking at different cell therapy options. So I’ll give you a very quick synopsis of what cell therapies are. So these are cells from biological tissue, normally from an alive individual where we have got and extracted those cells. We look at the power of the cells in the lab, and we know that there is properties in those cells to actually regenerate, revitalize or repair, protect tissue.

(12:13):

So we try to give those cells back to babies who are at risk of developing problems which can impact them lifelong. So, an example, preterm babies are at risk of lifelong lung, brain, and other problems. So by giving these cell therapies, or trialing evaluating these cell therapies, what we are trying to do is see if it can improve their outcome.

(12:31):

But before we do that, Carol, what needs to happen is we need to make sure that these cells, many of these cells have never been given back to a baby or given to a baby. We have to first see if they’re safe and feasible to do so. Those are called phase one trials. So these are early phase trials where we give those cells to the baby. Once we find that they’re safe and feasible to do we do bigger efficacy trials, which are called randomized control trials, which is basically one group of babies get those therapies. The other group doesn’t get those therapies.

(13:00):

So the three trials I’m doing, one is for lung disease in preterm babies, the other is for brain problems in preterm babies. And the third is brain problems in babies who are not preterm but actually are diagnosed with a brain insult while they’re still in mom’s womb, so in pregnancy. So it’s very fascinating stuff.

(13:18):

We are trying to change the outcomes, and it’s early stages, but we are moving on to bigger trials, and hopefully with a lot of North American sites, we’ll be getting on with the big trial next year. So it’s very exciting.

Carol Vassar, podcast host/producer (13:31):

Are you still doing clinical work?

Dr. Atul Malhotra, Monash University (13:33):

Good question. You might wonder how do I have time to do all these things? So I do part-time clinical work and part-time research. I’ve got a big team of my own, and then I belong to a big research team, a bigger, broader research team where we have scientists, we have clinicians, we have research assistants, nurses, and so on. So I do part-time clinical and part-time research work, but slowly, more of my work is becoming research as compared to clinical, as you can imagine.

(13:56):

One can’t do everything, but I still love to do clinical work in a part-time fashion.

Carol Vassar, podcast host/producer (14:01):

As you look back at your clinical work and the totality of the work that you’ve done, is there a patient or maybe a patient family that stays with you that continues to inspire the work you do?

Dr. Atul Malhotra, Monash University (14:11):

Oh, absolutely. I’ll mention Brooke Hanson because she’s very active socially. Brooke Hanson was Olympic swimmer, is an ex-Olympic swimmer in Australia. She won an Olympic gold medal and silver medal at the Athens Olympics.

(14:26):

Brooke, unfortunately, had a very premature and small baby with us many years ago, and this is all public knowledge, so I can share it.  Jack Hanson Clark was the name of the baby, to leave a legacy for Jack. Jack, unfortunately, passed away around nine months of life due to complications of prematurity, basically due to lung and heart problems. He had a very difficult time in the nursery, and he passed away.

(14:51):

And at that time, Brooke had asked me because she knew I was doing stem cell or cell therapy work already in the lab, but we were not ready to translate into humans at that stage. And she said, “Can you give anything to Jack, like stem cells, to improve his outcomes?”

(15:04):

And we said, “We are not ready right now.” But she is a very strong, staunch supporter of our work. And this is a shout-out to Brooke, Jared, and the family for supporting our work. Because I remember Jack, I was closely attached to his family, and I remember that very vividly the suffering of not just the baby but the family who is involved in this. And that’s what I want to change. This is what my team wants to change, that we give these babies, these families, opportunities to have a life which is not only do they survive but hopefully have as less complications as possible.

Carol Vassar, podcast host/producer  (15:40):

And thrive.

Dr. Atul Malhotra, Monash University (15:40):

Yes.

Carol Vassar, podcast host/producer  (15:41):

Survive and thrive.

Dr. Atul Malhotra, Monash University (15:41):

Absolutely.

Carol Vassar, podcast host/producer  (15:42):

So Jack is your inspiration?

Dr. Atul Malhotra, Monash University (15:44):

Absolutely.

Carol Vassar, podcast host/producer  (15:44):

And you want every child at some point to be alive and thrive?

Dr. Atul Malhotra, Monash University (15:49):

Yes. That’s actually the motto of our recent fundraising, which we did with the community at Monash Children’s Hospital, where we got the community behind our Survive and Thrive campaign for preterm babies. And we raised more than $1.5 million for that purpose to support our cell therapy work so that we can fast track. We can move our cell therapy work into human trials, evaluate them rigorously, to then be able to, hopefully, at someday give them as therapy. So it’s really exciting. I’m really privileged to be part of that.

Carol Vassar, podcast host/producer  (16:21):

Here at Nemours, we talk about being well beyond medicine, and health equity is a big part of what we do, and I’m sure it’s a big part of what you do at Monash. It’s big all over healthcare. How do you think research helps to bring the principles of health equity to life?

Dr. Atul Malhotra, Monash University (16:39):

Absolutely. You’ve asked me a question which is very dear to my heart. So when we do research studies, we source funding from various sources, whether it’s the government, philanthropy, community, whatever other sources are possible to be able to research these babies in a way that we are rigorously collecting data on, not just their outcomes in the early part of the study, but long-term. So by just being part of a research study, these babies have much better care because we are rigorously collecting those outcome data. So you can imagine if I saw a patient or anyone in the hospital and I did not follow them up because I did not have resources and funds to follow them up, it’s possible that they will be lost to follow up.

(17:22):

But if they’re part of a research study, we will make sure that they stay in touch with us, they stay in very close contact with us, and that relationship of trust and connection is there so that they continue to follow all the important time points for their evaluation, which is part of their research study, but it also improves their health outcomes by just being connected with the health profession.

(17:44):

So that’s one point. But I also, like you mentioned, I’m the head of the early neurodevelopment program at Monash, and one of the things is that this is not part of research, so this is standard of care. Every baby who gets discharged from the neonatal unit, who’s high risk, so these are born really premature or with a lot of sickness, we ensure that they come back to that clinic. Only a couple of weeks ago, we got taxi vouchers for a family who had a lot of equity issues, financial issues, to make sure that they were able to come to the hospital to see our team. But while they came to the hospital, they also got to see the other teams they were not able to see because of their financial constraints. And that’s big for me.

(18:25):

I do not want any family, any baby, to miss out because of their background, because of their financial situation, because of their mental health situation, any situation. So we want to have as much equity as possible. So it’s very close to my heart for my standard care, but also my research.

MUSIC (18:42):

Well Beyond Medicine

Carol Vassar, podcast host/producer  (18:43):

Thanks for listening to our conversation on preventing social media misinformation and the development of neonatal cell therapies with Dr. Atul Malhotra from Monash University in Melbourne, Australia.

(18:56):

How do you know when social media medical information is the real deal or a bunch of nonsense? Leave us a voicemail with your tips and tricks at nemourswellbeyond.org. That’s nemourswellbeyond.org. And while you’re there, check out our other episodes, subscribe to the podcast, and leave a review.

(19:16):

Thanks to Che Parker, Cheryl Munn, and Susan Masucci for their help with producing today’s podcast. Join us next time as we get an update from the Florida Panhandle from Dr. Mary Mehta, Vice President and Chief Medical Officer for Nemours Children’s Health, Pensacola. Until then, remember, together we can change children’s health for good well beyond medicine.

MUSIC (19:44):

Well Beyond Medicine!

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Meet Today's Guests

Carol Vassar

Host
Carol Vassar is the award-winning host and producer of the Well Beyond Medicine podcast for Nemours Children’s Health. She is a communications and media professional with over three decades of experience in radio/audio production, public relations, communications, social media, and digital marketing. Audio production, writing, and singing are her passions, and podcasting is a natural extension of her experience and enthusiasm for storytelling.

Atul Malhotra, MD, PhD

Guest
Dr. Malhotra is a senior neonatologist at Monash Children's Hospital, and research academic in the Department of Paediatrics, Monash University. He is the current recipient of an NHMRC Emerging Leadership Fellowship. He has published over 150 peer-reviewed journal articles, four book chapters, and his research has attracted more than $20 million of funding.

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