Medical & Health News Reporting 媒體技能：Medical & Health News Reporting

Distilled from health-journalism curricula at Stanford Medicine+Muse, Johns Hopkins SFDH, AHCJ (Association of Health Care Journalists), Columbia Mailman, NTU Public Health, and Taiwan health-media ethics standards. Covers five sub-types: research breakthroughs / public-health alerts / drug approval / health policy / patient stories. Core challenge: translating statistical evidence for public understanding without misrepresenting risk or false certainty.

IRON LAW: Relative Risk Without Absolute Risk Is Misleading

Every medical claim in the form "X% increase/decrease in risk" MUST cite
absolute baseline numbers: baseline incidence, NNT (Number Needed to Treat),
absolute risk reduction, or absolute risk change. "50% reduction in risk of
heart attack" is meaningless without "from 4 in 1000 to 2 in 1000 per year".
LLM default: lead with the relative risk (sounds dramatic), omit baseline.
Readers then overestimate the clinical significance. Override that default
by naming the denominator first, then the percentage.

Why this is non-obvious: "50% reduction" sounds much more impactful than "2 fewer heart attacks per 1000 per year", yet both describe the same result. Research-to-media translation routinely inverts this — the press release says "50% reduction", the outlet runs that number, and readers assume a larger clinical effect than evidence supports. This is the single most common source of health-news overclaim.

Rationalization Table — these justifications DO NOT override the Iron Law:

Trigger conditions:

• User supplies health/medical material — journal abstracts, clinical trial results, drug approval announcements, public health advisories, epidemiological data, health-policy statements, patient interviews — and asks for a news piece.
• User asks for "醫學新聞", "健康新聞", "health story", "research reporting", "drug news", "epidemic coverage", "health policy piece", "clinical breakthrough".
• User paraphrases: "寫一篇醫學新研究", "整理流行病新聞", "幫我把這份臨床試驗結果寫成新聞", "turn this NIH press release into a story", "draft a piece on this WHO alert".

Input signals:

• Named disease, drug, treatment, researcher, institution, study name, clinical trial identifier, or epidemiological data.
• Direct quotes from clinicians, researchers, health authorities (CDC, 衛福部, WHO, etc.).
• Statistical claims (relative risk, incidence, prevalence, mortality, efficacy, confidence intervals).
• Regulatory status (FDA approval, 食藥署 listing, Phase III trial completion).

When NOT to use:

• "What do I have?" / personal medical symptom advice → direct user to healthcare provider, not journalism skill.
• Pharmaceutical company press release in the company's own voice → use pr-press-release.
• Hospital marketing / institutional PR ("Our Advanced Surgery Center Achieves...") → use pr-*.
• Promotion of unproven remedy or supplement as scientific fact → refuse; suggest user consult source integrity first.

Step 0: Defer general workflow to med-news-reporter

Read or have already loaded med-news-reporter for: material audit, fact-checking, source-strength tagging, balance principle, media-ethics check, media-literacy self-check. Do not re-implement those steps here. This file specializes Steps 1, 2, 3, and adds health-specific Step 7 (Evidence Hierarchy & Risk Framing Audit).

Step 1: Classify the health-story sub-type

If material spans sub-types (e.g. a policy change triggered by a study), classify by the primary news driver.

Step 2: Source vetting & evidence-hierarchy tagging

Every health claim must carry evidence-level tag at first mention:

Evidence Hierarchy (strongest → weakest):
1. Meta-analysis / systematic review of RCTs
2. Large RCT (n > 500)
3. Small RCT (n < 500)
4. Cohort study / case-control study
5. Case series / case report
6. Expert opinion / editorials
7. Anecdote / single patient story

Bad tagging: 「新研究表示...」(which study? what strength?) Good tagging: 「今年發表在 Lancet 的一項 1,200 人隨機對照試驗表示...」or 「基於個案報告（證據等級 5）...但尚未進行人體試驗」

Source tier (extends med-news-reporter):

Step 3: Health-specific risk check

Beyond med-news-reporter's general ethics check, add:

1. 個人資料保護法 (PDPA) + 醫療法 §72 (Patient Privacy):

   • Patient case reports must be de-identified: age range (not exact), no named institution/hospital, no unique medical conditions that allow re-identification.
   • Example: ❌ "63-year-old Mr. Chen A treated at NTU Hospital on March 15 for liver cancer with rare genetic mutation" (re-identifiable)
   • Example: ✅ "A 60–65-year-old male with common cancer type" (anonymized)

2. WHO Suicide Reporting Guidelines (essential, non-negotiable):

   • Do NOT name the method, location, or date of death.
   • Do NOT publish a suicide note or detailed narrative.
   • ALWAYS include helpline number(s) (1925, 安心专线, international).
   • Do use framing: "died by suicide" or "suicide" (not "committed suicide", "successful attempt").
   • Breaking this rule increases copycat risk (Werther Effect documented by WHO); this is a professional liability.

3. 醫療廣告法 (Medical Advertising Law):

   • If a source has financial interest in the product (pharma company, researcher with stock, hospital with proprietary treatment), disclose it.
   • Do not amplify unproven claims (e.g., supplement "cure" claims without RCT evidence).

4. 藥物名稱使用合理性:

   • Generic name preferred over brand name ("ibuprofen" not "Advil") unless brand is essential to the story.
   • New drugs: include both generic + brand on first mention; thereafter use generic.

5. 傳染病防治法 (Communicable Disease Control Act):

   • Early epidemic numbers are often revised as data accumulates. State explicitly: "as of [date], [source] reports X cases".
   • Avoid implied causation ("after the vaccine" ≠ "caused by the vaccine"); use temporal language precisely.

Step 4: Evidence Hierarchy & Risk Framing Audit (health-specific addition)

Before output, apply:

1. Evidence Strength Audit: for each medical claim, verify it cites the evidence level. Single case reports must not be presented as "research shows".
2. Relative → Absolute Conversion: every claim of "X% increase/decrease" must be paired with absolute baseline (see Iron Law above).
3. NNT / ARR / Baseline Incidence: include at least one of these metrics to ground clinical significance.
4. Replication Status: if this is a single study, state so ("first evidence" / "needs confirmation" / "confirms earlier findings").
5. Confidence Interval / Uncertainty: include the range, not just the point estimate. "30% to 40%" not just "35%".
6. Funding Disclosure: if any source has financial stake in the result, disclose it early ("funded by Pharma Corp X").

Use the med-news-reporter base format, with health-specific additions to the meta footer:

[Headline / sub-headline / body paragraphs per med-news-reporter]

---

**稿件類型**: 醫學研究報導 / 公衛警訊 / 藥品核准 / 健康政策 / 患者故事
**字數**: approx. XXX
**消息來源層級**: 政府公衛機構 N / 同儕評審期刊 N / 預印本 N / 企業新聞稿 N / 專家意見 N / 患者訪談 N
**醫學證據稽核**:
- 每項醫學宣稱之證據等級: ✅ / ⚠️ (列出未標的)
- 相對風險 + 絕對風險配對: ✅ / ⚠️ (列出缺項: RR 未伴絕對值、NNT、基礎風險)
- 單一研究 vs 系統性評論: ✅ / N/A / ⚠️
- 95% CI / 不確定性表述: ✅ / ⚠️ (列出未含的宣稱)
**患者隱私檢核**:
- 去識別化: ✅ / ⚠️ (列出仍可追蹤身份的資訊)
- 同意書揭露: ✅ / N/A / ⚠️
**WHO 自殺守則**:
- 適用: N/A / ✅ (已遵守) / ❌ (違反項目)
**利益衝突揭露**:
- 資金來源: ✅ / N/A / ⚠️ (列出未揭露的利益相關)
**待查證事項**: ...
**倫理 / 識讀檢核摘要**: 〔交給 med-news-reporter 的 Step 4-5 footer〕

See examples/ directory for:

• sample_input.md — realistic health-news source material (clinical study press release + health authority statement + medical society response + patient anecdote)
• sample_output.md — produced piece + meta footer + skill-trace explanation

Related skills:

• med-news-reporter — general news workflow (this skill specializes it)
• med-political — health policy & regulatory news
• stat-hypothesis-testing — deeper statistical literacy on RCTs and meta-analyses
• stat-causal-inference — for causation claims in observational studies
• hum-source-criticism — source vetting frameworks