Narratives to Promote Evidence - Or Why the U.S. Preventive Services Task Force Should Get Ira Glass to Tell the Story of the Science

Nov 21, 2011, 12:00 PM, Posted by Zack Meisel

By Zachary F. Meisel, MD, MPH, MS

Since the commentary that Jason Karlawish, MD, and I published recently [Journal of the American Medical Association, November 9, 2011] recommending that scientists and guideline developers consider personal narratives to advance, translate and disseminate evidence, we have heard lots of comments on this concept (some supportive, some critical, and many requests to expand upon it).

To be clear, we recommended always leading with the science; the narrative piece comes after the evidence is in. Finding and telling stories that speak to the science may not be easy to do, but it is essential when confronted with the dual challenges of a) unscientific narratives that flood the news and talk shows, and b) that data, when presented void of context or connections to which people can relate, is unlikely to motivate trust and behavior change.

However, some of the pushback taps into legitimate concerns. A Scientific American forum on the article has become a deeply political discussion about the lines between advocacy and science. Our take: of course the line between science and advocacy should be as thick as possible. And yes, when scientists (and those charged with translating the science) tell stories, it might very well smack of personal bias.

What Jason and I were arguing is that it shouldn’t be that way. One of the reasons that narratives feel wrong to some who live in the space of science and data is that it isn’t tradition to engage in the realm of stories. But traditions aside, there are no inherent reasons to shun narratives if they are grounded in good science. We are advocating for an evolution (or revolution?) in these customs. If you start with the science or evidence, then use stories to promote and maximize their uptake and translation, it’s not bias.

Maybe it is advocacy, but it is advocacy for the science. Certainly in the case of guideline developers and regulation scientists, this type of advocacy is part of their mission.

So in the end, I believe this could go in many directions. On one hand, there are ideas about fighting fire with fire. Unscientific narratives can do lots of harm. Let’s mitigate it by being ready with our own science-based narratives that are equally rich and compelling.

Additionally, there is the story of the science: despite what many believe, I think the public is eager to learn about the nuances of science, they just don’t want it dumped on them from on high. Let’s tell them the stories of how we got from point A to point B. Let’s let them in to what is often a messy process of considering the body of evidence. It’s a lot more compelling and sticky that way.

So what is the next step? We would love to see the Food and Drug Administration or the U.S. Preventive Services Task Force tell their stories in a way that sounds like NPR’s “This American Life.” Maybe they need to hire Ira Glass or the equivalent -- or maybe they need to pitch their stories in a way that expert narrators want to tell them.

The gap between science and uptake can be bridged with stories that bring the science to life. Let’s embrace it and stop disparaging the idea as (unscientific) anecdote.



This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.