Review of the Hanford Thyroid Disease Study Draft Final Report (2000) / Chapter Skim
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8 Communication of Study Results
8 Communication of Study Results
Pages 114-136
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From page 114... ...
However, in the fall of 199S, problems-some controllable and some not arose that had substantial and unfortunate effects on the communication efforts that finally were made in late January 1999 for the release of the HTDS findings. The release of the Draft Final Report led to unhappiness and dismay among some citizens in the Hanford area, not only because of the main message, but also because of how the message was delivered.
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From page 115... ...
It includes not only a federal agency and a private contractor, but also health agencies in three state governments and representatives of nine American Indian nations, numerous citizen groups in the region, national and regional journalists, a class-action lawsuit involving many litigants, various consultants and potential expert witnesses, and a number of private individuals in the region who have suffered or whose family members have suffered from some type of thyroid disease. The public and private messages traded back and forth by these groups and individuals over the years have all shaped the Hanford and HTDS communication process.
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From page 116... ...
Section X of the HTDS Draft Final Report outlined a good communication plan to deliver the final information about the report that might have worked if it had been put into operation with its release in March 1999. Especially admirable was the concern shown for translating the technical information in the Draft Final
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From page 117... ...
However, three major factors interacted to bring about the early release the Draft Final Report, which contnbuted to the extensive communication problems encountered: public pressure to get the document out to the public and concern that CDC's internal review would alter the original findings of the HTDS investigators, the National Research Council's desire for open peer review of the draft report, and a subpoena from one party in a lawsuit that sought immediate release of the Draft Final Report. Concerning the first factor, in early October 199S, the director of CDC's National Center for Environmental Health received numerous written requests for immediate release of the Draft Final Report.
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From page 118... ...
Given the many audiences, including study participants who needed to be informed about the study findings, given the extensive communication plan already developed, and wanting to preserve the credibility of the review process, CDC officials decided to release the Draft Final Report before the Research Council's open review. On November 12, they met with the HTDS investigators and decided to release the report on January 28, 1999.
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From page 119... ...
COMMUNICATION ISSUES IN THE WRITTEN MATERIALS Besides the Draft Final Report itself, a number of written pieces were developed for the public, including the "Summary Final Report of the Hanford Thyroid Disease Study" and several HTDS newsletters. One featured a summary of the study results, another presented information on thyroid disease and how it was diagnosed, and a third included questions and answers about radiation and thyroid disease.
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From page 120... ...
Appropriateness Although the above statement is scientifically accurate, given the state of a draft not reviewed by outside scientists and a number of uncertainties that were already apparent to the HTDS researchers, some overstatements were made in the public summary, HTDS newsletters, the news release, and the executive summary of the Draft Final Report. In addition, there was little or no mention in any of these documents of the uncertainty issues involved in the study.
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From page 121... ...
. The study had sufficient statisticalpower to detect increases in thyroid disease risk that were predicted based on studies in other populations tCDC, 1999a]
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From page 122... ...
On a related matter, the printed HTDS public summary was titled "Summary Final Report of the Hanford Thyroid Disease Study" (FHCRC 1999b) , which was misleading, inasmuch as it was still a draft.
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From page 123... ...
The subcommittee recommends that contextual information be included in both the executive summary and the body of the final report and the public summary. Readability The public summary, fact sheets, newsletters, and Website information about the HTDS Draft Final Report were readable and relatively easily understood.
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From page 124... ...
The subcommittee recommends that an effort be made to remove excess technical language and to use consistent terms, particularly for types of thyroid diseases, in the executive summary of the final report. More charts should be used in the executive summary to provide visual aids to help understand the information.
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From page 125... ...
Although no link between estimated IT and amount of thyroid disease was identified by the HTDS in the study population, the study results do not prove that a link between IT and thyroid disease does not exist. There may be individuals in the overall population who were exposed to Hanford radiation and did develop thyroid disease because of their exposure.
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From page 126... ...
There was little worry that the messages in the HTDS Draft Final Report would reach an interested population, including national and regional journalists. However, as described earlier, three major unplanned factors led to an early release of the report.
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From page 127... ...
With the early release of the report, efforts had to be speeded up, and this possibly led to some problems because many audiences had to be dealt with: HTDS participants; the various advisory and citizen groups in the region; state public-health officials and state, county, and local government leaders in three states; tribal officials; Washington, DC, officials, including those at the Department of Health and Human Services (DHHS) and congressional delegations from the three states involved; and, of course, the mass media.
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From page 128... ...
On the 2Sth, at ~ pm, four citizen groups, including the HTDS Advisory Committee, were to be briefed by conference call. The media briefing was to occur at 3 pm, and the public meeting on the report was scheduled for 7 pm in Richiand, WA.
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From page 129... ...
Given that there were no transcripts, it is difficult to evaluate how well the briefings were done. One reporter at both the media beefing and the public meeting was surprised by "how absolutely confident the Hutch people were." She pointed out that subtleties and uncertainties were not discussed, nor were any problems with statistical power.
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From page 130... ...
CDC media officials starting faxing materials about the study results to reporters at 6 am EST on January 2S, not waiting for the 3 pm media briefing. They also began putting all the planned information about the report on the Web site at 3 am EST.
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From page 131... ...
The Message and Its Effect in evaluating the risk-communication process and the activities that occurred around the HTDS Draft Final Report, it is hard not to question whether the public dismay with the release of the report would still have come about if the message had been different. The main message no link between radiation exposure at Hanford and prevalence of thyroid disease was not expected by concerned members of the public in the region.
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From page 132... ...
People providing information to this subcommittee in Spokane questioned why CDC had not intervened to counter the overpositive message about the study given by the HTDS investigators in the briefings and the written materials. They said that the investigators were contractors and that CDC was ultimately responsible for what was said about the study.
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From page 133... ...
Several CDC officials noted that they had concerns that some of the messages were too strong, such as "this was a powerful study." Despite their concerns, after struggling with some of the language in the report, they decided to leave it as drafted by the HTDS investigators because of public pressure not to alter the report. The subcommittee recognizes and supports CDC's sensitivity to citizens' concerns and the needs of academic freedom for investigators, but it believes that there was a middle ground: both the HTDS investigators and CDC officials should have expressed their own views and interpretations about the Draft Final Report at the briefings and in the public documents.
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From page 134... ...
In writing and releasing the final report and its public summary, steps must be taken to explain alternative interpretations of the data and to ensure that findings are presented in an evenhanded method that does not overemphasize one point of view. Efforts must be made both in the report and its accompanying public documents to explain the implications of the findings for individuals and families sensitively, indicating, for example, that a statistical study does not necessarily negate the existence of thyroid disease in this population and explaining why that is so.
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From page 135... ...
It must take into account and acknowledge the problems encountered with the release of the Draft Final Report and include dealing with possible lowered public trust in the HTDS investigators and CDC in the Hanford region. Because of serious problems encountered in trying to maintain an information blackout, such efforts should be minimized.
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From page 136... ...
136 Review of the HTDS Draft Final Report discuss some of the important communication issues that have been raised in this case and the complex topic of the advisability of releasing unreviewed draft reports to the public. In particular, such a workshop would help to focus the growing body of socialscience risk-communication research on questions about audience response to such reports as the HTDS report and simultaneously produce new research questions for systematic study.
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