Coronavirus (782) How to Fight an Infodemic: The Four Pillars of Infodemic Management. Editorial

28 June, 2020

With thanks to Irina Ibraghimova and LRC Network. An excellent editorial from Gunther Eisenbach, who first coined the term 'infodemic' in 2002. It links to a new WHO paper that I shall review separately.

CITATION: Eysenbach G. How to Fight an Infodemic: The Four Pillars of Infodemic Management. Editorial. J Med Internet Res. 2020 Jun 26.

DOI: https://doi.org/10.2196/21820

URL: http://pubmed.ncbi.nlm.nih.gov/32589147

ABSTRACT: In this issue of the Journal of Medical Internet Research, the World Health Organization (WHO) is presenting a framework for managing the coronavirus disease (COVID-19) infodemic. Infodemiology is now acknowledged by public health organizations and the WHO as an important emerging scientific field and critical area of practice during a pandemic. From the perspective of being the first "infodemiolgist" who originally coined the term almost two decades ago, I am positing four pillars of infodemic management: (1) information monitoring (infoveillance); (2) building eHealth Literacy and science literacy capacity; (3) encouraging knowledge refinement and quality improvement processes such as fact checking and peer-review; and (4) accurate and timely knowledge translation, minimizing distorting factors such as political or commercial influences. In the current COVID-19 pandemic, the United Nations has advocated that facts and science should be promoted and that these constitute the antidote to the current infodemic. This is in stark contrast to the realities of infodemic mismanagement and misguided upstream filtering, where social media platforms such as Twitter have advertising policies that sideline science organizations and science publishers, treating peer-reviewed science as "inappropriate content."

DOI: https://doi.org/10.2196/21820

URL: http://pubmed.ncbi.nlm.nih.gov/32589147

SELECTED EXTRACTS

'In the [WHO] paper, the authors collected and organized global ideas to fight the current coronavirus disease (COVID-19) infodemic declared by the WHO on February 15, 2020. Impressively, this consultation meeting was entirely conducted online, and, as noted by the authors, turned out to be one of the largest meetings ever convened by the WHO...

I coined the term “infodemiology” in 2002 in a short guest editorial in the American Journal of Medicine [2], defining “infodemiology” as a “new emerging research discipline and methodology” comprising the “the study of the determinants and distribution of health information and misinformation—which may be useful in guiding health professionals and patients to quality health information on the Internet.”...

In a tweet posted on April 14, 2020, Secretary General of the United Nations (UN) António Guterres announced a UN communications response initiative countering the infodemic with facts and evidence [17]; however, what we have learned in 20 years of infodemiology research is that the quality of health information is an elusive concept, as in medicine, the truth is not always easy to determine, especially in a rapidly evolving situation... the proposal to fight the infodemic by spreading “facts” is easier said than done when it is not clear what the exact facts are.

The Information “Cake” Model... The current infodemic is a crisis to distill the sheer quantity of information, which is occurring on four levels: (1) science, (2) policy and practice, (3) news media, and (4) social media.

The wedding cake model (Figure 1) illustrates these four levels as layers. The size of the layers is proportional to the amount of information generated by these four groups of actors. The model also shows some information flows and knowledge translation activities that take place between these different levels. Science is the smallest layer of the wedding cake in terms of the amount of information, and it is depicted at the top of the information wedding cake...

The main problem is not so much the prevalence of misinformation in the science layer, but the challenge of translating this information into actionable recommendations and conveying conclusions for different audiences and stakeholders in other layers...

First Pillar: Facilitate Accurate Knowledge Translation

Between the levels, knowledge translation processes need to take place to translate the information from one audience to another, and these knowledge translation processes are, perhaps, the main mechanisms where information becomes misinformation, as the interpretation of “facts” is subject to multiple potentially influencing factors such as politics, commercial interests, selective reporting, and misunderstandings... The first pillar of infodemic management is to support, facilitate, and strengthen accurate knowledge translation. In the WHO paper hint at that when they write “knowledge should be translated into actionable behaviour-change messages presented in ways that are understood by and accessible to all individuals” [1], but this is of course just one example for a KT problem, while there are also other KT challenges, e.g. between science and policy makers...

Second Pillar: Knowledge Refinement, Filtering, and Fact-Checking...

The second pillar of infodemic management is to encourage, facilitate, and strengthen knowledge refinement and filtering processes on each level, to accelerate internal quality improvement processes. Within each layer, information in different stages of this "refinement" process can be found (for example, in the science layer, unreviewed preprints, laying right next to peer-reviewed scholarly communications)...

Third pillar: Build eHealth Literacy...

the end user is able to (but not always equipped) to consume information from any level, in any refinement stage, making eHealth literacy an essential skill in a networked world. eHealth literacy is defined as "the ability to seek, find, understand, and appraise health information from electronic sources and apply the knowledge gained to addressing or solving a health problem." [21,22]. In the information age (which is now perhaps shifting to the infodemic age!), the user carries a significant part of the responsibility to select and downstream-filter trustworthy health information... Thus, the third pillar of infodemic management is to enhance the capacity of all stakeholders to build eHealth literacy, to select and assess health and science information found on the different layers of the information cake...

Fourth Pillar: Monitoring, Infodemiology, Infoveillance, and Social Listening

The fourth pillar of infodemic management is continuous monitoring and analysis of data and information exchange patterns on the internet, a field I have called infodemiology and infoveillance [4]. My idea was that similar to surveillance in pandemics we want to be able to detect outbreaks of misinformation, rumors, falsehoods, to counter them with facts or other interventions...

The price for freedom of speech and improved information technology is an increased susceptibility to infodemics. We are entering the age of infodemics.

Best wishes, Neil

Let's build a future where people are no longer dying for lack of healthcare information - Join HIFA: www.hifa.org

HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with more than 20,000 members in 180 countries, interacting on six global forums in four languages (English, French, Spanish, Portuguese). Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org