Health professionals are acutely aware of the influence that news claims can have on the public’s attitudes to prevention, treatment options and medical compliance. This is particularly true in times of crisis.

The participants in this study strove to balance commercial imperatives with the need to inform through checking accuracy, balancing sensational headlines with sober reporting, finding respected expert sources and remaining ‘objective’ (aware of but not actively supporting any agenda). Specialist health reporters were seen as having greater capacity to produce better quality stories.

What makes a story newsworthy?

It’s not just a matter of how newsworthy you think your story is but how well it satisfies a core set of traditional news values. These include: Prominence (the more prominent the people involved the more newsworthy it is), impact and scale, and timeliness.

Timeliness is a key news value because stories that happened yesterday are old news and don’t appeal to journalists as much. For example, a plane crash that killed hundreds is newsworthy but one that only affected a dozen would not be. Impact and scale are also newsworthy because the more significant the impact, the better – whether that’s the number of people involved or the magnitude of the event.

The human element is a hugely important part of newsworthiness because people engage with stories about other people. It can be funny, tragic or shocking and it is often the reason why people share the news. Change and trends are also highly newsworthy because journalists are interested in how new initiatives could shape the future.

Finally, conflict and controversy are often considered to be newsworthy because they create tension and stir the emotions. This is why we see a lot of political stories making the headlines, but it can also apply to business news like directors disagreeing with council plans or rebrands.

What are the media’s priorities?

Our survey suggests that news organisations are focused on meeting their core roles of informing audiences, being watchdogs and campaigning on social issues. They are also focusing on building up their specialisms. ‘This crisis has reminded us of the value of experts who can explain complex topics to a broad audience,’ says one editor.

Our analysis of pandemic coverage found that, compared with the U.S., newspapers on the political left had more exposing and warning coverage that addressed misinformation, policy failures and public health risks. On the other hand, newspapers on the right had more sensational stories. The results reflect a complicated balance of priorities for different types of media.

The global average scientific quality for COVID-19-related news media reporting was low, but it increased over the course of the pandemic, with the highest scores in the Netherlands, Finland and Norway (Table S7 and SI Fig S8). Overall, the average sensationalism was lower in syndicated articles than in original news media reports.

Publishers are seeking a more level playing field with tech and social media platforms, with many wanting them to pay a greater share of revenue and to invest more in news literacy and innovation. But they also want them to provide richer data about what they are doing and to communicate more clearly when their algorithms change.

How do journalists cover health issues?

Journalists are important sources of news and information about health issues, including medical tests. Given research evidence that media coverage presents the benefits of testing healthy people far more frequently than harms, and fails to communicate about overdiagnosis, strategies for improving critical reporting on medical tests and communicating better about their downsides are needed.

A qualitative interview study was conducted with 22 journalists (mean 14.5 years’ experience). Interviews were audiorecorded, transcribed verbatim and analysed using framework thematic analysis.

Most journalists acknowledged the potential for overdiagnosis from medical tests but felt knowledge of this was low among their peers and the public at large. They commonly viewed information about harms as difficult to access and communicate, particularly in the context of prominent public health efforts to promote the benefits of early detection.

The majority of participants believed that news about new medical tests would be most newsworthy if they could be shown to have a significant public health impact, especially in terms of reducing deaths or lowering treatment costs. They also recognised the importance of the personal touch and finding an average ‘Joe Blow’ angle to their stories. The majority reported that they were more likely to consider a story if it came from their own contacts rather than a press release, and they regarded themselves as gatekeepers of quality, excluding stories that fell below their own standards.