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About the XRAY Program & Ratings

Why we developed this program

FORCE has frequently observed situations where the media misrepresented cancer research. Some news articles feature attention-grabbing, hyped headlines and inaccurate content. Because scientific journals are hard to access and understand, people may turn to the popular press for information about cancer research to inform their medical decisions. We saw a need for a reliable source of breast cancer information in the headlines. 

In response, FORCE developed “eXamining the Relevance of Articles for You” (XRAY). With initial funding from the CDC, we developed a program to review breast cancer topics reported in the media.

The XRAY content is produced by the FORCE Education Team which includes: Executive Director, Sue Friedman, DVM, Vice President of Education, Piri Welcsh, PhD, and Director of Education and Research, Kelly Owens, PhD. FORCE Vice President of Marketing, Karen Kramer leads our XRAY communication efforts. Dr. Welcsh is the XRAY Scientific Review Lead.

XRAY review process

Our XRAY Team chooses media articles submitted to the team, new or practice-changing research, and articles that have received significant attention, stimulated discussion, or generated confusion in the patient community. Drs. Welcsh and Owens read the primary literature scientific literature. This literature is where scientists present their data and interpretations. They compare what was found in the original research and what the media article reported. Drs. Owens and Welcsh write up a summary on the original research findings and use our rating scale to rate the relevance of the research, the strength of the science and the accuracy of the media articles that covered the research (see below).

Every summary is reviewed and approved by a member of the FORCE Scientific Advisory Board, which consists of active researchers and clinicians in the fields of cancer, genetics, surgery, behavioral health, policy, and survivorship

Rating Scale Information for Reviews

Each XRAY review uses a series of meters to help users understand how the science affects their medical decisions and clinical care. XRAY articles are scored on each of the following categories:

  • Relevance
  • Scientific Strength
  • Quality of Writing
  • Research Cycle

Relevance is rated on a scale of 1-12 based on the criteria below. Points are converted to a percentage, which is reflected by a meter scale ranging from low to high.

  • Topic: (0-2 points)
  • Organism: (0 to 2 points)
  • Clinical Utility: (0 to 2 points)
  • Generalizability (0 to 2 points)
  • Timeline to clinical relevance (0 to 4 points)

Scientific Strength is rated on a scale of 1-14 based on the criteria below. Points are converted to a percentage, which is reflected by a meter scale ranging from low to high.

  • Research Design:  (0 - 4 points)
  • Analysis of study (0 - 7 points)
  • Research context (0-1 point)

Quality of Writing is rated on a scale of 1-15 based on the criteria below. Points are converted to a percentage, which is reflected by a meter scale ranging from low to high. 

  • Depiction of Topic (0-4 points)
  • Execution of Article (0-6 points)
  • Factual Emphasis (0-5 points)

Research Timeline reflects the progress of the science on the research timeline. 

  • Lab Research
  • Animal Research
  • Human Research
  • Post Approval

Rating Scale Information for Media Coverage of Research

Media articles are rated on a 5-star rating scale.

To determine what rating the media article gets, XRAY looks at whether the writing is accurate:

  • Did the headline match what the article claims?
  • Did the article avoid exaggerating the research?
  • Did the article take into account conflicting research?

XRAY also takes into account how well the article was executed:

  • Did the story cite strong sources or experts in the field?
  • Is the writing clear and easy to understand?

Finally, the rating looks at how scientifically accurate the media report is:

  • Is the reporting factually correct?
  • Was scientific terminology used correctly and explained well?
  • Was the research covered in the story critically evaluated?
  • Were all the statistics presented correct and not misleading?

Any part of a story that does not meet these criteria will result in lost points on the star rating scale.  

Presentations and Papers

FORCE has presented XRAYS and XRAY program results at national conferences and published articles in peer-reviewed journals.

Robin Hilary Pugh Yi, Piri Welcsh, Craig Dearfield, Kelly Owens, Susan Friedman. Information needs, media use, and utilization of an online resource to support how young women with metastatic breast cancer evaluate breast cancer media reports. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS9-67.

Pugh Yi RH, Rezende L, Dearfield CT, Welcsh P, and Friedman SJ. Results of a pilot test of effects of an online resource on lay audience understanding of media reports on breast cancer researchHealth Education Journal. April 2019

Pugh-Yi RH, Rezende, Dearfield CT, Owens KN, Welcsh PL, Friedman SJ. Effects of online resource to support laypersons’ understanding of media reports on breast cancer research. Dec. 8, 2018. San Antonio Breast Cancer Symposium Abstract  P6-14-08.

American Public Health Association National Meeting, November 2015: Development, Implementation, and Evaluation of the eXamining Relevance of Articles to Young Survivors (XRAYS) Program to Summarize Recent Research Findings for Young Breast Cancer Survivors: Findings from the First Year

San Antonio Breast Cancer Symposium, December 2015: XRAYS (eXamining Relevance of Articles to Young Survivors) Program Survey of Information Needs and Media Use by Young Breast Cancer Survivors and Young Women at High Risk for Breast Cancer

Yi RHP, Rezende LF, Huynh J, Kramer K, Cranmer M, Schlager L, Dearfield CT, Friedman SJ.  XRAYS (eXamining Relevance of Articles to Young Survivors) Program Survey of Information Needs and Media Use by Young Breast Cancer Survivors and Young Women at High-Risk for Breast Cancer.  Health Commun. 2017 Sep 28:1-6. doi: 10.1080/10410236.2017.1372051.     

Thank You to Our Partners and Funders

The FORCE XRAY program thanks the members of our steering committees and our partner organizations: Asian Pacific Partners for Empowerment, Advocacy and LeadershipYoung Survival Coalition, Living Beyond Breast Cancer, Sharsheret, Tigerlily Foundation, the Gulf States Young Breast Cancer Survivor Network, National African American Tobacco Prevention Network, National Alliance for Hispanic Health, National LGBT Cancer Network, Susan G. Komen and the Cancer Support Community for helping us establish and improve the XRAYS program.

The initial establishment of this program was supported by the Cooperative Agreement Number, DP005404, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.

Thanks to generous support from Novartis, FORCE refined the XRAYS platform and process to focus on information and articles relevant to men and women living with metastatic breast cancer. The resulting eXaming the Relevance of Articles for You: Metastatic Breast Cancer (XRAY: MBC) helps people look behind the headlines to understand media articles related to metastatic breast cancer.

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