Med Health

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   • Do NOT publish a suicide note or detailed narrative.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").

Output Format

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〕

Examples

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

Gotchas

• WHO 自殺報導守則不可選擇遵守: 不報導方法、地點、遺書;必附求助專線(1925);違反導致 copycat 效應(Werther Effect)之文件風險。這是法律 + 倫理 + 公衛的三重義務,不是新聞美學選擇。
• 絕對風險不伴相對風險才是報導失敗: 「某藥物將 X 病死亡風險降低 50%」若不說明基礎風險(例如 1000 人中 4 人 → 2 人),讀者高估臨床意義。必須兩項並列,或都不列。
• 預印本 (preprint) 是非同儕評審版本: medRxiv / bioRxiv 的論文尚未經 peer review,在描述時必須明確標註「未經同儕評審」。發稿前應檢驗是否已正式發表在期刊。
• 單一研究 ≠ 醫學共識: 即使 Lancet 刊登,一篇論文不足以宣稱「科學證明」。需meta-analysis / 多中心驗證或醫學會聲明。LLM 傾向誇大單一研究的通用性。
• NNT 的臨床意義直覺優於百分比: 「需治療 500 人才有 1 人受益」 vs 「療效提升 0.2%」——同一結果,直觀度差異極大。優先用 NNT;若無法計算則注明。
• 製藥/醫療機構資助須在引述時點明: 研究由廠商贊助、醫師兼任產業顧問、醫院銷售新技術——這些利益衝突不揭露等同隱瞞。放在第一次引述該來源時,不要藏在尾註。
• 患者故事去識別化不等於「模糊化」: 「一名 60 歲男性患者 A」≠ 「患者 X 是成功病例」;前者遵守個資法 §72,後者若細節足夠仍可追蹤(就醫時間+地點+罕見疾病組合)。審核時逐項檢驗。
• 疫情数据更新快,引用需註明日期: 「確診人數 X」不標明「截至 4 月 29 日」會在重新整理後過時或誤導。時間戳必要。
• 「治癒率」/ 「完治」/ 「成功率」各有定義: 無定冠詞引用會混淆:是 5 年存活率?完全緩解?部分緩解?必須明確定義或引用原始文件。

References

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

Limitations

• Does not verify against live clinical trial databases or medical journals. This skill flags claims that need verification; it does not query ClinicalTrials.gov, PubMed, or Cochrane. Editor/user must verify or supply.
• Jurisdictional scope: legal references (PDPA, 醫療法, 醫療廣告法) reflect Taiwan law. For US (HIPAA), EU (GDPR), UK, HK, or PRC contexts, principles still apply but substitution required.
• WHO Suicide Reporting Guidelines apply globally, but enforcement and consequence differ by jurisdiction. Always apply these guidelines regardless of country of publication.
• Statistical literacy: judges poll quality, p-hacking risk, effect-size interpretation — partially covered in references/medical_evidence_reading.md, but for deep methodological critique use stat-hypothesis-testing or grad-survey-design.
• Not a substitute for legal review. Health-news pieces with named patients, drug/treatment criticism, or regulatory disputes should have attorney review before publication.
• Does not generate original reporting. If supplied material is insufficient or contradictory, this skill flags gaps — it will not source additional interviews or find additional studies.