Computer scientists have responded to the high prevalence of inaccurate political information online by creating systems that identify and flag false claims. Warning users of inaccurate information as it is displayed has obvious appeal, but it also poses risk. Compared to post-exposure corrections, real-time corrections may cause users to be more resistant to factual information. This paper presents an experiment comparing the effects of real-time corrections to corrections that are presented after a short distractor task. Although real-time corrections are modestly more effective than delayed corrections overall, closer inspection reveals that this is only true among individuals predisposed to reject the false claim. In contrast, individuals whose attitudes are supported by the inaccurate information distrust the source more when corrections are presented in real time, yielding beliefs comparable to those never exposed to a correction. We find no evidence of real-time corrections encouraging counterargument. Strategies for reducing these biases are discussed.

1. The Promise and Peril of Real-Time
Corrections to Political Misperceptions
R. Kelly Garrett & Brian E. Weeks
CSCW ‘13, San Antonio, TX
February 26, 2013
Kelly Garrett <garrett.258@osu.edu>

2. Online misinformation
• Information online can be startlingly inaccurate
• Sometimes naïve, sometimes intentional
• False information has a high profile
• Higher search volumes for political falsehoods than political
truths (Weber et al., 2012)
• A challenge to democracy (Gilens, 2001; Kuklinski et al., 2000)
Kelly Garrett <garrett.258@osu.edu> 2

3. Instant Online Corrections
• What if we could correct misinformation at its source?
• Maybe we can…
• Dispute Finder
• Truth Goggles
• Hypothes.is
• Rbutr
Kelly Garrett <garrett.258@osu.edu> 3

4. What Could Possibly Go Wrong?
• Declaring information false is threatening
• Ego-threats promote
• Counterargument (Lapinski et al., 2001; Nyhan & Reifler, 2010)
• Derogation (Lapinski et al., 2001; Bryne & Hart, 2009)
• Tagging misinformation with corrections could
exacerbate biased processing
Kelly Garrett <garrett.258@osu.edu> 4

5. Method
• Online between-participant experiment
• Demographically diverse sample (SSI, N=574)
• Topic: Electronic Health Records (EHRs)
Kelly Garrett <garrett.258@osu.edu> 5

6. Procedure
• Measure favorability on several issues, including EHRs
• Read “news article” providing background (443 words)
• Read “blog post” providing misinformation (367 words)
• Correction – 3 conditions
• Correction embedded in the blog post
• Correction after distractor task
• Correction after study completed (control)
• Post-test questionnaire, including accuracy measure
Kelly Garrett <garrett.258@osu.edu> 6

7. Misinformation
The invasion of our privacy starts now.
The federal government is pushing for Electronic Health Records–
known by policymakers as EHRs—to be used by all citizens as early as
this year… If EHRs become a reality, employers, insurers, and the
government will be able to find out if you’ve had a sexually transmitted
disease, if you’ve taken an anti-depressant, if there’s a history of cancer
in your family, and much more, all at the click of a button…
Kelly Garrett <garrett.258@osu.edu> 7

8. From FactCheck.org:
…
Who can access your Electronic Health Records?
“Claims that EHR will allow limitless access to patient health
information are absolutely incorrect,” said Nancy Szemraj,
spokesperson for the U.S. Department of Health and Human Services…
Corrections
• Correction attributed to FactCheck (378 words)
• Separate document following a 3-minute distractor task
• Or misinformation highlighted in text, with identical
correction appended at end of message
Kelly Garrett <garrett.258@osu.edu> 8

9. Measures
• Post-test accuracy
• How easy/difficult for 7 different groups to access EHRs
• According to correction: 2 easy, 5 difficult
• α = .75, M = 28.8, SD = 8.2, range 13-49
Kelly Garrett <garrett.258@osu.edu> 9

10. The Good News
Misinformation
only
Delayed
correction
Immediate
correction
AccurateInaccurate
Beliefaccuracy
Immediate > Delayed
F(1, 567) = 5.31, p < .05
Kelly Garrett <garrett.258@osu.edu>

11. InaccurateAccurate
Beliefaccuracy
Strongly
negative
Neutral Strongly
positive
Pretest favorability
Misinformation only Delayed correction
Immediate correction
The Not So Good News
Kelly Garrett <garrett.258@osu.edu>
• Accuracy
reflects pretest
favorability
• Real-time
corrections
augment this
effect
• They promote
questions
about source
credibility

12. Discussion
• Real-time corrections do slightly better overall, but they
trigger biased processing
• Least effective among those most likely to hold
misperceptions in the first place
• Fact-checking is about persuasion, not just learning
• Suggests several strategies for overcoming resistance
Kelly Garrett <garrett.258@osu.edu> 12

13. Reducing threat
• Present corrections in ways that lead users to be less
threatened
• After a delay
• After self-affirming experiences (e.g., using Facebook, see
Toma & Hancock, 2013)
• Couched in self-affirming messages
Kelly Garrett <garrett.258@osu.edu> 13

14. Choosing sources of correction
• Select trusted sources based on implicit measures
• Source that are frequently used or recommended to others
• Allow users to explicitly select trusted sources
• Organizations create their own databases of disputed claims
• Users opt in to one or more of these collections
Kelly Garrett <garrett.258@osu.edu> 14

15. Framing corrective messages
• Emphasize a subset of relevant considerations in order to
promote more careful consideration of evidence
• Risks of holding misperception, benefits of accuracy, moral
obligation to evaluate fairly
• Different frames work for different users
• Combine algorithm for predicting frame preferences with
database of corrections framed in different ways
Kelly Garrett <garrett.258@osu.edu> 15

16. Thanks!
• This work was funded in part by the U.S. National
Science Foundation under Grant No. IIS-1149599
• More about the larger project can be found here:
http://wp.comm.ohio-state.edu/misperceptions/
• Follow relevant news on Twitter @FalseBeliefNews
Kelly Garrett <garrett.258@osu.edu> 16

17. SUPPLEMENTAL INFO
Kelly Garrett <garrett.258@osu.edu>

18. Measures
• Pre-test issue favorability
• “Please rate your feelings about each policy initiative...”
• Seven-point scale (M = 4.8, SD = 1.6)
• Post-test accuracy
• How easy/difficult for 7 different groups to access EHRs
• According to correction: 2 easy, 5 difficult
• α = .75, M = 28.8, SD = 8.2, range 13-49
Kelly Garrett <garrett.258@osu.edu> 18

19. More measures
• Counterargument
• List what you learned about EHRs
• Rate each item as positive or negative
• Count negative thoughts
• Credibility of fact-checking message
• Sum of 3 item, each a 7-point scale
• α = .88, M = 14.3, SD = 4.5
Kelly Garrett <garrett.258@osu.edu> 19

20. Counterargument or derogation?
• Opponents do not generate more counterarguments
facing instant correction than delayed
• Instant correction
does promote
biased assessment
of message
DistrustTrust
Attitudetowardfact-checkingmessge
Strongly
negative
Neutral Strongly
positive
Pretest favorability
Delayed rebuttal Immediate rebuttal
Kelly Garrett <garrett.258@osu.edu> 20

21. Distractor Task
• Spot the differences between
three pairs of images
• 1 minute per pair
• Feedback on performance
after first pair
• 13 in pair shown
Kelly Garrett <garrett.258@osu.edu> 21

22. “News story”
Stimulus funds and incentives make electronic health records an easier pill to swallow for hospitals around the country
Electronic health records, or EHRs, are meant to enhance the quality of patient care, reduce or avoid medical errors, lower medical costs and
increase revenue, and facilitate more clinical research, but only 20 percent of doctors and 10 percent of hospitals use even basic versions of
them, according to the U.S. Department of Health and Human Services.
Digital records of individual and community health information can be shared electronically between health organizations and providers.
The system will improve health care quality, efficiency and patient safety, said David Blumenthal, national coordinator for health information
technology at HHS. A digital record is more accurate and complete, Blumenthal said.
The technology allows easier access, fewer errors and improved patient treatment by pooling information from diverse sources, Blumenthal
said.
The digital records will also allow researchers access to clinical study data, which can improve patient care and medicines in the future.
Opponents argue that the system is too expensive and takes too much time to implement.
Dr. Paul Felden, who works at a primary care office in New Jersey, said that the new equipment and technical support would cost each doctor
between $15,000 and $20,000. The time required to install and learn the system, and to transfer paper records will result in lost business, he
said.
“Certainly, the idea of electronic records is terrific,” Feldan said. “But if we don’t see patients, we don’t get paid. The economics of it just
seems so daunting.”
To provide motivation for health organizations to switch from paper medical records, Congress gave provisional approval to a plan to give
economic incentives to medical facilities that could demonstrate “meaningful use” of the system, Secretary of Health and Human Services
Kathleen Sebelius said.
At the end of last month, the federal government finalized the criteria health care providers would have to follow in order to receive aid.
To qualify, health care providers must use the records to benefit patient care, communicate with other health-care providers, and report clinical
quality measures to HHS, the agency said.
Over the next 10 years, health care providers could receive $27 billion for electronic records equipment. Doctors individually can receive up to
$44,000 under Medicare and $63,750 under Medicaid. A hospital can receive millions of dollars, depending on its size. Incentives will be paid
out starting in 2012 and medical providers are required to have systems in place by 2015 or face a financial penalty.
The Office of the National Coordinator for Health Information Technology and Authorized Testing and Certification Bodies will test and certify
the quality of the systems.
Kelly Garrett <garrett.258@osu.edu> 22

23. “Blog post”
The invasion of our privacy starts now.
The federal government is pushing for Electronic Health Records–known by policymakers as EHRs—to be used by all citizens as
early as this year. The system promises to create a centralized computer network allowing doctors, hospital administrators, and
health insurance companies to easily access patients’ digital health records, including their medical history.
Supporters say that digital records will lead to better, more efficient health care. But even if that’s true, the problems they will cause
far outweigh any good they might do.
EHRs make it easier for government and big business to pry into the private health records of people like you and me, accessing
information that could easily lead to discrimination and abuse. If EHRs become a reality, employers, insurers, and the government
will be able to find out if you’ve had a sexually transmitted disease, if you’ve taken an anti-depressant, if there’s a history of cancer
in your family, and much more, all at the click of a button. And you’ll never know that your information has been exposed.
Sure, the system is supposed to be private. But there’s no reason the federal government couldn’t turn around and sell the
information, the way states sell information about licensed drivers, turning EHRs into just another moneymaking machine. And if
the government lets a few for-profit businesses run the system, there is nothing to stop those companies from using the information
for their own financial gain. Hospitals, insurance companies, and pharmaceutical companies would all pay big money for insights
mined from EHRs.
The government could even use EHRs against its own citizens. A digital system for tracking medical issues isn’t just a way to
manage health care: it’s a way to manipulate people. With easy access to every citizen’s medical record, the government will have
unprecedented control over Americans’ lives. The government could even use EHRs to track medical practices, eventually telling
doctors what kinds of care they can and cannot provide.
Electronic Health Records take control of our personal health information out of our hands and out of the hands of our doctors.
They make our bodies a part of the public record, and that should worry everyone.
Kelly Garrett <garrett.258@osu.edu> 23

24. Correction
From FactCheck.org:
The blogosphere is on fire with rumors about Electronic Health Records.
The thought of easy-to-access digital records has people worrying about their privacy. By 2014, the federal government will move to digitize all
citizens’ medical records. We set out to check the facts, reviewing the bill defining Electronic Health Records as well as current privacy laws,
and checking in with officials in the U.S. Department of Health and Human Services.
Who can access your Electronic Health Records?
“Claims that EHR will allow limitless access to patient health information are absolutely incorrect,” said Nancy Szemraj, spokesperson for the
U.S. Department of Health and Human Services. There are clear policies about who can, and who cannot, access electronic health records that
apply to any system being put into place.
Szemraj said that access to digital health information will be limited based on the parties’ role in a patient’s care. Only doctors, surgeons and
nurses treating a patient will have access to appropriate medical records. Those who aren’t involved in treating a patient, including insurers,
hospital administrators, pharmaceutical companies, and government officials, will not be allowed to access the digital records.
Strong protections against corporate and government abuse
The Health Information Portability and Accountability act, commonly known as HIPPA, already protects patients’ privacy rights, dictating who
can and cannot access health information. And the law mandating EHRs actually strengthened privacy protection.
“The new law includes many provisions to prevent breaches of privacy, such as a provision to notify patients when their records have been
accessed,” said David Blumenthal, National Coordinator for Health Information Technology at Health and Human Services. There are also
increased penalties for breaching privacy. "Depending upon the type of violation, fines can reach up to $1.5 million per privacy violation," he
said.
Recent laws have also added business associates of medical providers to the list of those who can be penalized for a breach of privacy said
Szemraj said. That means that medical providers cannot share information with any company with which they do business, including
pharmaceutical and health companies, for any purpose.
Fear that the government might use the information to control medical practices and health are also groundless. The law specifically prevents
government officials from accessing the information contained in EHRs for any reason.
About the source: This document was prepared by FactCheck, a nonpartisan, nonprofit "consumer advocate" for voters that aims to reduce the
level of deception and confusion in U.S. politics. Since it launched in 2003, FactCheck.org has received numerous honors for its work from
such news outlets including TIME magazine and PC Magazine. Most recently, it received the 2009 Clarion Award for presidential election
coverage the previous year, and, in both 2008 and 2010, it received Webby awards from the International Academy of Digital Arts and Sciences
for being the best Politics site (the Webbys have been called the “Oscars of the Internet”).
Kelly Garrett <garrett.258@osu.edu> 24