Suddenly, the world is talking about fake news on social media and how it can hurt many aspects of our society.

Do these dangers extend to ophthalmology? The answer may be. “yes and no.”

Yes: ophthalmologists have been subjected to misinterpretations of research and its application to clinical care. These misinterpretations sometimes occur by well-intentioned experts who fail to recognize a study’s methodologic flaws or appropriate understanding of the relevance of a result. These limitations as well as honest errors in research don’t lead to fake news. Alternatively, there may be unconscious bias of presentation of results or their interpretation due to financial or academic affiliations of writers. Rarely, intentional bias, perhaps associated with research misconduct, may lead to fake news if fabrication (making up data or results and recording or reporting them) or falsification (manipulating research materials, equipment, or processes or changing or omitting data or results such that the research is not accurately represented in research records or reports) occurs.

No: I’m not aware of systematic attempts to flood social media with fake news about ophthalmology research that could affect clinical care. However, if it’s happening on Facebook or BuzzFeed, what’s an ophthalmologist to do?

Fortunately, the medical community, including ophthalmologists, have many protections in place against fake news in our industry—it’s called the peer-reviewed medical literature. How does this process help us separate out “real” research from “fake” research and “real” clinical relevance from “fake” clinical relevance?

If an ophthalmologist or one of her or his patients wants to determine if a news report is real, the physician can search the peer-reviewed medical literature. What’s so good about that?

Good peer-reviewed medical literature has experts or peers in the subject matter critically appraise the research before it is published, hopefully improving the final product beyond what the authors might do on their own. Furthermore, peer-reviewed journals have editors who serve as filters of what gets published after review. If editors are doing their jobs correctly, they should be trying to filter for their readers what should be published, and filter out what might have a lower priority for publication or be rejected altogether. This is a great service in this era of seemingly endless sources of medical information.

But who watches the editors? First, there’s the readers—they are free to submit letters to the editor on published research. Usually, if these letters offer additional new and clinically relevant information to the publication, they’ll be published, often with a response from one or more authors of the research. A good journal will make it easy to link these letters to the publication whenever the original research is identified through a search. Occasionally, the editors will invite commentators to discuss the research, often distilling the clinical relevance from another perspective, highlighting strengths and weaknesses, and addressing gray areas (not all research or its conclusions are black and white).

Second, there’s the world of other researchers in the field. When these researchers publish their materials, if they promptly reference a publication, it adds to that journal’s Immediacy Index (the average number of times an article is cited in the year it’s published), and over time, to that journal’s impact factor (a measure of the frequency with which the average article in a journal has been cited in a particular year).

Third, there’s medical reporters and social media. The greater the strength of the evidence of an article (eg, a randomized clinical trial), the more likely it’s picked up by the media. Some journals, like JAMA Ophthalmology, even have some procedures in place wherein an Editorial Board provides formal, periodic feedback to the editors, and Deputy Editors provide feedback to the Editor-in-Chief, as do other editors and staff of The JAMA Network. So when trying to evaluate the peer-reviewed literature itself, check out its Immediacy Index, its impact factor, and its reach in the press and social media relative to other journals in the field.

If something in the ophthalmic news is not in the peer-reviewed literature, that doesn’t mean it’s not true, but the reader should be cautious about such news. And just because it’s in the peer-reviewed literature doesn’t mean the final word is out. Medicine, like any field of science, goes through evolution and occasional revolutions, as our understanding grows.

So the next time you hear about fake news and wonder if it could affect what you’re reading about the field of ophthalmology, take some comfort that the peer-reviewed medical literature is set up in a way to minimize or eliminate such possibilities for physicians.

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