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ELAH FEDER: Today we're going to try something a little bit different.

ANNIE MINOFF: Ok

ELAH FEDER: We're going to help someone.

ANNIE MINOFF: Great, I love being helpful.

ELAH FEDER: We're going to help someone with their science question. Ok so this is an experience I think we are all familiar with. You see a headline like, tomatoes cause cancer.

ANNIE MINOFF: Nooo

ELAH FEDER: Bad news. The next day we get some good news we see a headline that says, drinking five beers a day reduces your risk of cancer. Obviously, these are not real examples.

ANNIE MINOFF: Right

ELAH FEDER: So you stop eating tomatoes, you start drinking a lot of beer, you're feeling really good about your health choices. Time passes and then oops you hear beer is out, tomatoes back in. And at a certain point, you start to wonder, am I getting good advice here?

ANNIE MINOFF: It's kind of whiplash.

ELAH FEDER: Exactly. So today we are going to help my friend David with one of these headlines. And hopefully we'll also get a bit of insight into why this happens. Like, how do you we get a piece of advice one day and then a complete reversal later? How much of that is the science actually evolving, and how much of that is science journalism that's getting stuff wrong?

I know that's us. So we're going to look inward today also.

ANNIE MINOFF: OK.

ELAH FEDER: Ok so here's what happened. My friend David is a very health-conscious guy. He cooks all the time-- very nutritious foods. He exercises. He flosses.

ANNIE MINOFF: Was he the guy--

ELAH FEDER: He does-- he wears a mouth guard at night. Yeah?

ANNIE MINOFF: Was he the guy who got you lifting weights?

ELAH FEDER: Yes. I had an ass like a shelf--

[LAUGHTER]

--for about six months.

ANNIE MINOFF: I thought there was a reason I remembered him. OK.

ELAH FEDER: OK. So David is a very healthy guy. And he's also vegan, which means that he's not getting B12 from his diet. B12, it's not found in vegan food unless that food is fortified. And Annie, let me tell you, B12 is a very important vitamin. You need it to make red blood cells. You need it to make DNA.

ANNIE MINOFF: It's a little bit crucial.

ELAH FEDER: It is. So David, being very responsible, takes B12 supplements. But then he reads that B12 supplements might give him lung cancer.

ANNIE MINOFF: Whoa, really?

ELAH FEDER: Yeah. And David, he's not the kind of person to unquestioningly accept things-- he does his reading. And understandably, he was deeply disturbed by this.

ANNIE MINOFF: Yeah.

ELAH FEDER: But at the same time, I was skeptical. We obviously hear a lot of scary headlines that turn out to be completely wrong. And so I wanted to investigate. Is this real or is this just a big misunderstanding? Because that never happens in health journalism.

ANNIE MINOFF: Never. never.

ELAH FEDER: So I thought, Annie, you and me, we, together, could get to the bottom of this.

ANNIE MINOFF: We're like sleuths. We're like science sleuths.

ELAH FEDER: So first step, super obvious, and I've already done this, is to look it up on Google.

ANNIE MINOFF: Are we just going to google it.

ELAH FEDER: We're going to to google it.

ANNIE MINOFF: This is the extra expertise that we bring?

ELAH FEDER: It's something I've learned in the biz. OK. So I'm going to google lung cancer B12. First hit, osu.edu-- that's the Ohio State University.

ANNIE MINOFF: Yeah. I knew that.

ELAH FEDER: So that's where the press release for this study came from. So headline--

ANNIE MINOFF: Long-Term, High-Dose Vitamin B6/B12 Use Associated With Increased Lung Cancer Risk Among Men. That's pretty clear-cut. That's not good.

ELAH FEDER: Yeah. Let's look at some other--

ANNIE MINOFF: OK.

ELAH FEDER: OK.

ANNIE MINOFF: Can B vitamins caused cancer? Good question headline. You can never get in trouble with a question mark headline .

ELAH FEDER: No. OK, this is going to take awhile. I obviously need some reading. So how about we break?

ANNIE MINOFF: You don't think people want to listen to us read aloud articles from the internet?

ELAH FEDER: I mean--

ANNIE MINOFF: OK.

ELAH FEDER: OK. Are you ready to hear what I found?

ANNIE MINOFF: Yes.

ELAH FEDER: So this was a bit of a roller coaster. At first, this looked really bad. I started with the news coverage, and pretty much all of it seemed to back up what David was saying. And then I followed up and looked at the actual study, in the journal of clinical oncology-- I started with the abstract.

ANNIE MINOFF: Like the executive summary at the top of the paper.

ELAH FEDER: Right.

ANNIE MINOFF: The TLDR of scientific studies.

ELAH FEDER: Right. It's a good place to start, and it did not look good either. Here's the key line. Use of vitamin B6 and B12 from individual supplements sources but not for multi-vitamins-- so this isn't like the B12 that's in your multi, it's a dedicated B6 or B12-- use of these vitamins was, quote, "associated with a 30% to 40% increase in lung cancer risk among men."

ANNIE MINOFF: That's pretty definitive.

ELAH FEDER: Yeah. And then it goes on to say, quote, "for vitamins B6 and B12, the risk was even higher among men who were smoking at baseline." Which is like, it sounds kind of obvious. If you smoke, it's going to make your risk of lung cancer even higher.

ANNIE MINOFF: Fairly Obvious

ELAH FEDER: Yeah.

ANNIE MINOFF: This is going to be a very short episode. David, you're right buddy. Lay off the B12. Sorry.

ELAH FEDER: Yeah, so at this point it seemed really cut and dry. It seemed like the study was in fact saying people who take B12 are at higher risk of lung cancer. Smoking will make that risk even higher. Or at least that's what I thought the study was saying. But what did the study actually say?

THEODORE BRASKY: Well, it didn't say that.

ELAH FEDER: Yeah, I called up the lead researcher. He’s at the Ohio State University. Theodore Brasky. He goes by Ted. And Annie, everything that I told you before is wrong.

ANNIE MINOFF: How?

ELAH FEDER: So let me back up a bit. I called Ted, because I read the abstract, I read these headlines, I had an impression. When I looked at the study-- the full paper, not just the little TLDR summary at the top-- I started to think that I had this actually very wrong. And I wanted to make sure I wasn't screwing this up.

So I contacted Ted. He was very down to talk. And I told him everything, starting from the beginning.

My vegan, nonsmoking friend who takes B12 religiously was like totally freaked out because--

THEODORE BRASKY: Great.

ELAH FEDER: --he read that B12 supplements cause lung cancer.

So let's just clear this up right at the top, this study does not say that these vitamins cause lung cancer. And I'm not talking about the word cause versus causation versus correlation, David has nothing to worry about. There is nothing in this paper that says he is at higher risk of lung cancer.

ANNIE MINOFF: But how could that possibly be true?

ELAH FEDER: Well, we're going to get there. So first, the reason that Ted and his team even did this study is because there was an earlier one in Norway that had found higher rates of cancer in people who took certain B vitamins. And it seemed like lung cancer was the specific cancer that was driving this association. And so what Ted wanted to check was, is there really something going on here? And so here's how he did that.

THEODORE BRASKY: We did-- this is a large what we call prospective cohort study. So there's a 13 county region in the state of Washington.

ELAH FEDER: 13 county region where there is a cancer registry.

THEODORE BRASKY: That means if a person is diagnosed with a serious cancer, basically any cancer other than non-melanoma skin cancer, it's reported to this 13 county region registry.

ELAH FEDER: Cancer registries super useful for cancer researchers. And Ted’s colleague had a big database of people in these counties. Bunch of people who filled out a survey about their lifestyle. Things like, what vitamins do they take, do they smoke? All the kinds of things that might be factors in their cancer risk. And these people also allowed the researchers to track whether they develop cancer over the years

ELAH FEDER: So about 77,000 people signed up for this.

ANNIE MINOFF: Holy smokes!

ELAH FEDER: Yeah, which is great from a statistical power standpoint.

ANNIE MINOFF: Yeah.

ELAH FEDER: And what they find is, first, like I said before, women no problem. No link found between vitamins and their cancer risk. But for men, like David--

ANNIE MINOFF: Who we also care about.

ELAH FEDER: We also care about-- and this is the part that sounds really bad, the men who took the highest average doses of B6 or B12 had almost double the risk of lung cancer.

ANNIE MINOFF: So I don't see how we're going to turn this around for David. I'm sorry.

ELAH FEDER: Yes. But believe it or not, we actually can. OK, to explain this, I have been working on an analogy.

ANNIE MINOFF: Oh, God.

ELAH FEDER: It's a little bit silly.

ANNIE MINOFF: Uh-huh.

ELAH FEDER: But I think it'll help. It involves bananas.

ANNIE MINOFF: Great. Don't the best explanations always?

ELAH FEDER: Ok. so imagine I do a survey of the people of Rhode Island, which is about a million people.

ANNIE MINOFF: OK.

ELAH FEDER: And I find, the more bananas people eat the more slip and falls they have.

ANNIE MINOFF: I feel like I know where this is going.

ELAH FEDER: OK, just-- just wait. OK. So I feel pretty confident about my result. It's based on a big sample size, one million people. I do some fancy statistics and decide there's a real pattern here-- more bananas, more problems.

ANNIE MINOFF: Yeah.

ELAH FEDER: OK. Why would this be happening?

ANNIE MINOFF: Ah-hah.

ELAH FEDER: My first idea, hypothesis number one, bananas make you clumsy.

ANNIE MINOFF: I'm going to go with, that's not the right answer.

ELAH FEDER: Maybe it's a neurological thing with the potassium. But you're probably right. That's probably not it. So my second hypothesis--

ANNIE MINOFF: People are like leaving the peels around.

ELAH FEDER: Banana peels-- they're eating bananas, dropping the peels on the ground, and slipping on them.

ANNIE MINOFF: Yes.

ELAH FEDER: Right. So what do I do next? You don't know.

ANNIE MINOFF: I don't know.

ELAH FEDER: I will tell you. I split up Rhode Islanders into groups. Group one, people who always drop their banana peels on the ground.

ANNIE MINOFF: OK.

ELAH FEDER: We'll call them--

ANNIE MINOFF: Slobs.

ELAH FEDER: Carefree.

ANNIE MINOFF: Messy.

ELAH FEDER: OK. Group one, we'll call them messy, but with no judgment.

ANNIE MINOFF: OK.

ELAH FEDER: Group two, people who are inconsistent. Sometimes they throw on the ground, sometimes--

ANNIE MINOFF: Semi-messy.

ELAH FEDER: Group number three-- I imagine you fall into this category-- tidy people who are always putting their banana peels away.

ANNIE MINOFF: I don't think it's a high bar for tidiness to throw a banana peel in the garbage.

ELAH FEDER: This is a hypothetical example--

ANNIE MINOFF: But, yeah. I am proud member of the tidy subgroup.

ELAH FEDER: Noted for the record. OK. So we have three groups. We have messy, semi-messy, and tidy. And what I find is that this link between high banana consumption and slip and falls, I'm only really seeing it in the super messy people. Tidy people, almost no slip and falls, which seems like like great news for you anyway-- not so good for the messy people.

ANNIE MINOFF: Yes, yes.

ELAH FEDER: You should be able to say, eating bananas in itself, not inherently dangerous. It's bananas plus this complicating factor of how messy you are. But here's where it gets tricky. It would actually be accurate for me to write up a headline that says, eating more bananas tied to higher injury rates. Because I actually saw this exact pattern. That was my original finding.

ANNIE MINOFF: Right.

ELAH FEDER: I looked across a million people--

ANNIE MINOFF: But can't you just do like subheading, but if you're tidy, no worries, dude.

ELAH FEDER: OK. So here's the problem. In the tidy group, very few slip and falls. There were so few that I couldn't even do that analysis if I wanted to. Say, in all of tidy-dom a measly 10 people fell.

ANNIE MINOFF: Yeah.

ELAH FEDER: Six of those people heavy banana users, four weren't. What do I do with that? The numbers are so small.

ANNIE MINOFF: Right.

ELAH FEDER: I can't analyze them. So sadly, as much as I want to, I can't say, hey, my study shows if you're tidy, no worries. Because I didn't even do that analysis.

ANNIE MINOFF: It's like the absence of a link, not--

ELAH FEDER: Exactly. It's harder to prove a negative. But I can still do better than my original headline-- more bananas, more problems. And I've got one that I think would cause a lot less banana panic-- eating more bananas tied to higher injury rates in messy people. Because I did find that.

ANNIE MINOFF: Right. I feel good about that headline.

ELAH FEDER: Yeah. So back to our real study.

ANNIE MINOFF: We are leaving banana-dom.

ELAH FEDER: Yeah, we are unfortunately coming back to reality. It turns out that in this B12 lung cancer study there was also a complicating factor, something that was pretty damn important when it comes to lung-- you have your hand up. Yes, Annie.

ANNIE MINOFF: Smoking.

ELAH FEDER: Right. Just like in the banana study, Ted split his data into groups based on smoking.

ANNIE MINOFF: Not tidiness.

ELAH FEDER: Not tidiness. So basically, they did the same thing. They split up their big pool into men who were smoking at baseline, men who had recently quit, and men who had quit a long time ago.

ANNIE MINOFF: What about people who'd never smoked at all?

ELAH FEDER: Aha! They were kind of like the really tidy people. There were so few cases of lung cancer. Actually, in this study it was less than a fifth of a percent of people who never smoked--

ANNIE MINOFF: Wow!

ELAH FEDER: --getting lung cancer, that you couldn't even run that analysis. You didn't have the statistical power. But they did look at the other groups. And this was their big finding.

THEODORE BRASKY: In men who are current smokers, those who took in high doses of B6 or B12 relative to not taking supplemental B6 to B12 respectively, had three to four-fold increases in lung cancer risk.

ELAH FEDER: What Ted's study found is that if you smoke and then you add these vitamins into the mix, for some reason your risk gets even higher. Which is weird.

ANNIE MINOFF: And new.

ELAH FEDER: And new. Ted was kind of frustrated, because he said a lot of journalists were like, so you're saying smoking causes lung cancer. I'm not going to write that up. I feel like we knew that. And he's like, no, no, no, no, no. That's not what I'm saying is, these vitamins, if you are male and a current smoker, they might make your risk of lung cancer even higher.

ELAH FEDER: So if you smoke, this might be a really important in finding for you. Although, first, an important qualifier, this needs to be replicated. So don't make big lifestyle changes based on this. But there's also something interesting here. If B12 somehow increases your risk as a smoker, why would that be?

Ted wanted to qualify all speculation. He's an epidemiologist. He's not a clinician. He's not a molecular biologist.

ANNIE MINOFF: So he doesn't know why this vitamin is doing this?

ELAH FEDER: He doesn't. Nobody knows. But he did have some ideas. So little pre-cancer cells could be forming inside us all the time, but not all of them necessarily develop into tumors.

THEODORE BRASKY: It could be that the B vitamins are simply feeding an initiated tumor that's not yet malignant. But I don't know. I can't study that. I don't have any way to study that myself.

ELAH FEDER: David wasn't really studied here. Like the analysis that I told you, where they looked at subgroups-- men who smoked, men who were currently smoking--

ANNIE MINOFF: Yeah.

ELAH FEDER: They didn't even do an analysis on never smokers like David. Because they don't--

BOTH: Have the statistical power.

ELAH FEDER: There are too few cases of lung cancer, which should be reassuring for David in itself.

Going back to my friend David, so whether--

THEODORE BRASKY: Oh, poor David.

ELAH FEDER: Poor David.

THEODORE BRASKY: David is clearly very angry with me.

ELAH FEDER: He was not angry, he was freaked out. He feels like it's a lose-lose situation. What should I tell him about his lung cancer risk?

THEODORE BRASKY: Don't smoke. That it's. It's that simple. If it's neither sufficient nor necessary, then don't smoke.

[MUSIC PLAYING]

ELAH FEDER: Coming up I give David the good news and I don’t get the reaction I expected.

ANNIE MINOFF: Yes, back.

ELAH FEDER: OK.

ANNIE MINOFF: Why are we here?

ELAH FEDER: I was very triumphant because I talked to Ted and cleared this up.

ANNIE MINOFF: Did you tell David?

ELAH FEDER: I solved a science problem! We were science sleuths! We sleuthed out. I called David to tell him. I caught him on a really crummy cell phone.

Are you there?

DAVID: Yeah.

[MUSIC PLAYING]

ELAH FEDER: What's that?

DAVID: Uh, what? The music?

ELAH FEDER: Yeah.

Apparently I interrupted David watching the latest Google Doodle. Which is what he does in his spare time. Google was wishing him a Happy Halloween.

DAVID: But I paused it. I'll watch it later.

ELAH FEDER: Very sweet of David to take a break from his--

ANNIE MINOFF: His Google doodle to talk to you.

ELAH FEDER: To you talk to me. So I told him, guess what, I tracked down the researcher. I have good news for you.

ANNIE MINOFF: Yay! Ted was emphatic. His study did not say that these vitamins were going to give David lung cancer. So I was triumphant. I got to the bottom of this little misunderstanding. And I asked David, are you feeling good? Are you reassured?

DAVID: I'm not reassured. I feel a little bit better. But I'm still not taking B12 like I was before.

ELAH FEDER: He wouldn't listen to me. He had every kind of counter argument, like--

ANNIE MINOFF: What possible counter argument?

ELAH FEDER: This was favorite-- he's like, oh, I live in a big city, and there's a lot of pollution in big cities. So technically, in some sense, maybe I do smoke.

ANNIE MINOFF: What?

ELAH FEDER: Yeah. I mean, it's an interesting point. Sometimes I think David is just too smart for his own good.

ANNIE MINOFF: He's like a little too clever. Yeah.

ELAH FEDER: But in the end, I think it came down to this for David. He saw a scary headline, this happens, I think, for all of us. You see a scary headline, it says something like, microwaves are leaking radiation.

ANNIE MINOFF: It plants that seed.

ELAH FEDER: Exactly. And then even though you hear a whole Science Friday segment that is reassuring you microwaves are safe, every time you walk by a microwave, when it's on you have the nagging doubt. Anyway, I want to try one last thing before I give up on this.

ANNIE MINOFF: Yeah. So is he seriously not taking B12 anymore?

ELAH FEDER: So he's taking it, but he's taking it every other day now. He used to take it every day.

ANNIE MINOFF: So he's taking it in fear.

ELAH FEDER: Yeah. He's scared, when he doesn't need to be.

ANNIE MINOFF: OK. So wait. So what's your what's your genius plan, genius.

ELAH FEDER: My genius plan-- I thought Ted was very convincing.

ANNIE MINOFF: Are you going to set them up?

ELAH FEDER: I'm going to set them up. Unfortunately, as I was starting to record Ted and David, my recording software just spontaneously stopped.

ANNIE MINOFF: Oh, no.

ELAH FEDER: I've never had this happen before.

ANNIE MINOFF: This is my nightmare.

ELAH FEDER: So I asked them to introduce themselves to each other again.

Can I get you guys to say hi to each other again? Just--

[LAUGHTER]

ANNIE MINOFF: Shame.

ELAH FEDER: Yeah, we were off to an awkward start.

THEODORE BRASKY: Yeah, no. It's not weird, I think I said something like, hi David.

DAVID: Oh yeah. And I was, hi, how's it going?

ELAH FEDER: Yeah, that's good.

THEODORE BRASKY: Yeah, this is good stuff.

ELAH FEDER: Really believable. Anyway, introductions out of the way, I got Ted to explain to David what his study actually said. And so we talked for a while about that. But you know, his findings were most relevant to people who smoke or used to. And of course what David wanted to know was, what did this mean for him?

Just taking your study, what can David learn from it? Does it say anything about him as a nonsmoker and whether he should take B12 vitamins?

THEODORE BRASKY: No, it doesn't. The entirety of the risk that we saw in men was restricted to current male smokers.

DAVID: OK, so this is where I kind of struggle with. Because I think that the way it was written, at least the abstract, and the way it was taken in the media was, you taking B12 supplements, if you smoke or not, you're going to have a higher risk of lung cancer. But if you do smoke, our study shows that the risk is even that much higher.

And perhaps if you're an epidemiologist, or some of your peers or colleagues would say, yeah. No, that makes sense. I don't know why people would think that way. But for the layman or someone who just doesn't read the studies, or for the science journalists, or whoever else out there who's taking your data and then sensationalizing it on the internet, I think that's where there was some sort of misunderstanding. And that's caused a bit of a panic.

THEODORE BRASKY: And that's difficult. It's difficult to address, right? I don't write for a lay audience. I wouldn't know how. I write for scientists. I write for clinician. The I write, really specifically, for other epidemiologists. The Journal of Clinical Oncology is not-- it's a subscription journal.

DAVID: Yeah. No, for sure

THEODORE BRASKY: And it's main audience should not be a lay audience. I'm writing for my peers. And it's mostly understood that there's not going to be enough men-- there's not going be enough people in this study to examine the situation of B vitamins or anything else with lung cancer among nonsmokers. There are no lung cancer cases among non-smokers. There are so few that we can't do any analysis among those.

ELAH FEDER: And Annie, just so you don't get the wrong impression, Ted definitely cares what lay audiences are getting from his research. He knows that journalists are always going to be sniffing around his papers, especially when they have interesting results like this.

ANNIE MINOFF: That's what we do, is sniff.

ELAH FEDER: This is why he writes out press releases. In case a journalist gets wind of one of his papers, they have something that's written-- or we, we have something that's written-- in our language in terms that we are more likely to understand.

ANNIE MINOFF: Thanks, Ted.

ELAH FEDER: I actually asked Ted for one more thing. He couldn't really analyze the non-smoker's, the never smokers, because they didn't have the statistical power. I kept badgering him until he gave me the data. I knew it's dangerous to conclude things from just data points that have not been statistically analyzed.

ANNIE MINOFF: Yeah.

ELAH FEDER: But I wanted to know, men who never smoke and take these vitamins

ANNIE MINOFF: Did anyone get lung cancer?

THEODORE BRASKY: There were zero cases of lung cancer among men who took B12 at greater than 55 microgram a day over 10 years. Zero cases.

ELAH FEDER: By the end of this conversation, I think we were all on the same page. David had the clarity that he was looking for. He was not in danger. But he was still kind of upset that he'd gone through all this.

ANNIE MINOFF: Yeah.

ELAH FEDER: He spent all of this time worrying-- lung cancer is worth worrying about. And if the science didn't actually say that he was at-risk, why was he ever told that he was?

THEODORE BRASKY: I understand the frustration. And I am sorry. Because you're absolutely right, there's nothing I can do to undo the amount of time that it's been since this has been published that you've been freaked out. And not to make it more than it is--

DAVID: Yeah, no, it's--

THEODORE BRASKY: But it's stressful, and it's unfair. And I agree. And I'm sorry for what-- somebody's got to tell you that they're sorry.

DAVID: That's fine. That's the thing. I want to say that I don't I don't view it as your fault per se. And you can't obviously know exactly how your paper is going to be misinterpreted or your findings are going to be misconstrued.

ELAH FEDER: So I'd actually talk to Ted a lot about this question. Why? How did this happen? What can we all do better so that we don't get these scare headlines?

And like Ted is doing what he needs to do in a lot of ways. He really puts in his time with journalists.

THEODORE BRASKY: Because I take it very seriously. I don't like having to receive panicked e-mails and phone calls from people I don't know, often times from cancer patients. This is not what I want to do with my life-- is not freak people out.

ELAH FEDER: Which is why Ted Brasky really puts in his time with journalists.

THEODORE BRASKY: Ultimately, what happens though, is that no matter what I say in a three-hour phone interview with somebody in Australia, it may come down to Brasky says these things cause cancer. And I'm like what? No. We had a long conversation.

ELAH FEDER: I believe that. Ted spent two hours with me the first time, another hour--

ANNIE MINOFF: Wow!

ELAH FEDER: --with David, trying to sort this out. We talked some more after that.

ANNIE MINOFF: Poor Ted.

ELAH FEDER: He's really doing his best to prevent misunderstandings, which, I think, is all that actually happened in this case. Talking to Ted and David, the problem they pointed to was journalism trying to sensationalize or taking findings out of context. Which when we're asking, why do we keep getting these flip-flopping headlines? That's probably the main reason, right?

It's easier, it's more exciting for a journalist to write up a headline that says this study found tomatoes or food X causes cancer, than it is to compile all of the different studies that have been done, put them in context, and say, results are mixed. We're not sure there's. An interesting pattern worth investigating. That's like not exciting.

But in this case here--

ANNIE MINOFF: That's not what happened.

ELAH FEDER: I don't think that's what happened. I think it was just misunderstanding. Which, this is why we have fact-checkers, which is why when we're paraphrasing a scientist and we're not sure we really understood them, we usually try to run that--

ANNIE MINOFF: Double-check.

ELAH FEDER: --and double-check. But even so, I think there's a deeper problem.

ANNIE MINOFF: You don't know what you don't know is the problem.

ELAH FEDER: Exactly. I don't think it ever occurred to Ted some of the misunderstandings that I would have or that David would have. If you're working in epidemiology, you know that lung cancer pretty much exclusively happens in people who smoke, maybe people who are exposed to asbestos, people who are exposed to secondhand smoke. There are certain things that are tightly associated with lung cancer. And so it doesn't occur to you that people would misunderstand that you're talking about an increased risk of lung cancer in people who have a risk.

So even though Ted spends hours of time talking to journalists, if it doesn't occur to him which mistakes they're going to make, he's not going to think to correct them. And they're not going to think to ask.

I still hope that this was a useful exercise for all of us. I actually told Ted how I would have wanted him to do better. I wanted him to put a line in his abstract, even though it was written for his peers, a line that basically said, by the way, we didn't do the analysis for nonsmokers, which is a weird line to put in an abstract-- we didn't do this. We didn't do this, and therefore didn't find anything.

ANNIE MINOFF: Right.

ELAH FEDER: But for me it would have been useful. And Ted was like--

THEODORE BRASKY: If I had the word count, I would probably do that. You just are limited by what you can say. The Journal has rules. You don't play by the rules, you don't get published. It's not like--

ELAH FEDER: Hey, man, I feel that.

THEODORE BRASKY: It's just how it is. Right? You're going to write something someday and you're stuck with deadlines, and sort of word requirements, and so on. You have to choose your words to get your point across to the people who are your audience.

ELAH FEDER: It's tough without having a million footnotes, which you obviously can't do at all in a podcast.

THEODORE BRASKY: Oh, dear God.

[MUSIC PLAYING]

ELAH FEDER: Undiscovered is recorded and produced by me Elah Feder

ANNIE MINOFF: and me Annie Minoff. Our senior editor is Christopher Intagliata, our composer is Daniel Peterschmidt and our production intern is Kaitlyn Schwalje. I Am Robot And Proud wrote our theme.

ELAH FEDER: This week we had fact checking help from Michelle Harris and we sure hope we got it right. For more on this episode including those sweet sweet footnotes we know you love and a link to Ted’s study go to undiscoveredpodcast.org

ANNIE MINOFF: And now that we have a taste for science sleuthing we want to do more of the stuff. If you have a science question like David’s or one of our episodes got you wondering about something and you demand answers we might help you.

ELAH FEDER: Maybe

ANNIE MINOFF: No promises. Write us on Twitter @undiscoveredpod or send us an email at undiscovered@sciencefriday.com

ELAH FEDER: Finally thank you for the super nice reviews on apple podcasts from Lovin the phone, LoveyBird and surprisingly nice review from Level4DeadlyVirus. We are lovin your usernames. If you want to leave us a review on Apple podcasts we always appreciate it. See you next week.

[music ends]

ANNIE MINOFF: It’s kind of like you don’t know or you don’t know. I was going to say you don’t know what you don’t know but you don’t know because you do know.

I’m sorry (laughing). I feel ya Ted.

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