Media effects in the use of pseudoscience: A systematic literature review (1900–2022)

Abstract

Pseudoscience is not a fringe issue in society; it influences decisions on health or finances. Although there is not robust data on pseudoscience usage, most national studies estimate that it is used by 10% of the population. It is also not a fringe issue in research. This systematic literature review aims to analyse the existing body of research on this topic, with a primary focus on media and communication. The review is restricted to three databases (Web of Science Core Collection, Scopus and B-on), and data collection ended in 2022. From the analysis of 12,531 articles, it is shown that interest in pseudoscience exploded this century, mainly in health (75% of the sample), and that health and economic costs are a main issue regarding these practices. In media and communication (172 articles), the interest has been limited. Media effects are unexplored, highlighting a need to better understand how pseudoscience is communicated and used.

1. Introduction

The weight of disinformation in scientific research and, above all, in society, as exemplified by the new age revival or anti-vaccine movements, mirrors a more transversal phenomenon: the growing presence of anti-science voices in the public space (now extended to social media), greater access to pseudoscientific practices, as well as a quiver of scientific literacy and knowledge among the population. For example, in four years (2021 to 2025), a survey of the European Union about science showed that there are more people getting scientific facts wrong, mainly when the issues are conspiracy theories (European Union, 2025).

Is it that common though? Yes, data indicates that it is. Although information and research on the prevalence and use of pseudoscientific practices are rare (and now more than a decade old), existing data shows a dangerous trend. Most studies found that the usage rate is at least 10%, demonstrating in the most recent research (Barbadoro et al., 2011; Carvalho et al., 2012; Shmueli et al., 2011; Thomson et al., 2014), which consists of national or regional studies, that this is a significant issue for society. Also, most of the studies analyse only some specific pseudoscientific practices.

The promotion of pseudoscience affects the quality of information and, consequently, can increase the effects of adhering to such practices, leading to costs for individual health (Thomson et al., 2014) and public health (Walji et al., 2004; Spinks and Hollingsworth, 2009), but also economic (Kong et al., 2022) and even political costs (Szynkiewicz, 2020).

Research into pseudoscience is increasingly pressing, but there is no clear profile of its current consumers. Lack of data on the use of pseudoscience practices, users’ profiles and means of receiving information about pseudoscience results in a profound lack of knowledge about the roots of these practices, their usage and the stimuli for resorting to pseudoscience.

Previous studies have revealed some trends and many doubts on this matter. Women tend to adhere more to these practices, as do people with higher levels of education and higher salaries (Barbadoro et al., 2011; Cano-Orón et al., 2019; Fjaer et al., 2020; Shmueli et al., 2011). However, with regard to schooling and economic status, conflicting data can be found (Conboy et al., 2007; Lobera and Rogero-García, 2020; Thomson et al., 2014). A characteristic that seems to be more consensual is its use by people with chronic long-term illnesses (Goldner, 2006; Walsh et al., 2010).

Motivations to pursue these practices vary, from the search for new solutions (therapeutic ones, mainly) to dissatisfaction with medical treatment, the appeal of patient-centred medicine or interest in feeling like ‘the disease manager’ (Cano-Orón et al., 2019; Conboy et al., 2007; Lobera and Rogero-García, 2020; Thomas and Coleman, 2004; Thomson et al., 2014; Walsh et al., 2010).

Lobera and Rogero-García (2020) identify the media as one of the main channels to promote pseudoscience. Given the lack of literature on the promotion of pseudoscientific practices, studying reception practices is therefore relevant to understanding the role of media and how they influence society. Without reception studies, it will be harder to have a comprehensive view of this phenomenon and how it comes into people's lives—and this makes public policies and scientific literacy more fragile.

The absence of clinical prescription, diagnosis or obligatory scientific recommendations, which characterizes pseudoscience, also makes it more urgent to study the weight of media and communication in this field (Walji et al., 2004), particularly on how these practices are received by the population through TV promotion, social-media ads or authority figures—like physicians, such as ‘Dr Oz’ in the United States (Korownyk et al., 2014).

1.1 Defining the concept of pseudoscience

Based on the already published definitions of ‘pseudoscience’ (Bunge, 2011; Alonso-Marcos and Cortiñas-Rovira, 2014; Escobar-Jimenez, 2018; Fasce et al., 2020; Hansson, 2021), and which this review has allowed us to deepen, we have framed this concept within four pillars: 1) use of the scientific method as a form of validation, 2) an antiscientific or therapeutic framework, 3) refusal or denial of science, and 4) promotion as a product for help, treatment or response.

This discussion is not original. The debate stems from the opposite paradigm: what constitutes science? The contributions have come from philosophers such as Karl Popper (2005), Thomas S Kuhn (2021/1962) and Mario Bunge (2011), and there are differences between these authors, from Popper's principle of refutability (a more direct model) to Bunge's detailed cognitive fields (a set of 12 propositions to validate the presence of pseudoscience). Sometimes, as seen in this systematic literature review (SLR), there are different concepts used to describe pseudoscience practices, such as alternative therapies or complementary and alternative medicine, something that confounds and gives credibility to practices without scientific evidence. The lack of a clear and consensual definition of pseudoscience is also a problem when comparing data or discussing the phenomenon, for instance.

Within the scope of this SLR, we propose a definition, which we consider to be clear and comprehensive, of the identified pseudoscientific practices: we consider pseudoscience to be a set of practices, visions or ideas that have not been scientifically validated, which are presented as scientific and/or therapeutic, in a given scientific field.

2. Methodology

We did not identify any SLRs on pseudoscience within the parameters in which we conducted our research and particularly in the area of media and communication. In the course of the search, we identified vocabulary reviews (Murphy et al., 2003), reviews on specific practices, such as Tai Chi (Kong et al., 2016), or the use of these practices by the population, such as cancer patients (Horneber et al., 2012)—but nothing as comprehensive as the one we developed.

The use of an SLR is a valid option for evaluating research into pseudoscience, as it guarantees an approach characterized by predetermined objectives. It makes it possible to identify and summarize published work, as well as to analyse these publications in order to highlight their main research topics or any shortcomings (Jalali and Wohlin, 2012; Kitchenham, 2004). As Paul et al. (2021) point out, an SLR should be used when there is a ‘substantial body of work’ or ‘when no systematic literature review in the domain exists in recent years’ —two conditions that apply here.

In this SLR, we want to understand which dimensions have been studied, the main ideas resulting from that research, how pseudoscience has been defined and what methodologies have been used to understand this phenomenon.

3. Data and methods

Pre-analysis showed that, in addition to the concept of ‘pseudoscience’, which is central to this work, two other concepts—used as substitute terms in scientific articles—should be considered: ‘alternative and complementary medicines’ and ‘alternative therapies’. Although these terms are not equivalent, they are widely used across both the media and academic research, often interchangeably—even by practitioners. For example, in many studies—particularly in the United States—the term ‘alternative and complementary medicine’ is used, often following the definition proposed by the National Center for Complementary and Alternative Medicine (NCCAM), which describes pseudoscience as ‘unorthodox practices used along with conventional medicine’. In this regard, we follow Rowlands (2015), who argues that the concept of ‘alternative and complementary medicine’ is problematic, as it frames pseudoscientific practices as ‘medicine’, thereby granting credibility to practices that lack scientific support. Nevertheless, including these three terms allows us to obtain a broader sample and increases the likelihood of capturing a wider range of studies addressing pseudoscience.

This review follows the SPAR-4-SLR protocol proposed by Paul et al. (2021), which outlines three essential phases: 1) the collection phase, in which sources, research questions and data collection terms are defined; 2) the organization phase, when exclusion and inclusion criteria are applied and articles are classified according to the review's objectives; and 3) the evaluation phase, which is dedicated to analysing the corpus and assessing results against research questions and objectives. These phases serve as a guide for a rigorous SLR design, with adaptations to the objectives and research questions (Figure 1).

Figure 1.

SLR protocol based on SPAR-4-SLR (Paul et al., 2021).

3.1 Objectives and research questions

We set ourselves the following objectives: 1) to identify the main scientific areas that study ‘pseudoscience’; 2) to evaluate published research in the field of communication; 3) to learn about the definitions applied to pseudoscience in the field of communication; 4) to understand the main methodologies used in the study of pseudoscience in the field of communication; and 5) to identify research that studies the reception and effects of the media.

Five questions were defined to guide this SLR:

In what areas of research has pseudoscience been studied?

What topics has the scientific literature on communication studied when working with the concept of pseudoscience, particularly in the study of media reception and media effects?

How is pseudoscience defined in scientific literature in communication studies?

What methodologies have been used to study pseudoscience, alternative therapies and alternative and complementary medicine in communication studies?

Which populations have been studied in the field of communication studies?

3.2 Database selection

In order to cover the largest possible number of scientific publications, three comprehensive databases were selected: Web of Science Core Collection, Scopus and B-on. The descriptors ‘pseudoscience’, ‘complementary and alternative medicine’ and ‘alternative therapies’ were used in all three. Descriptors selection was motivated by a previous literature review, and descriptors in other languages were not used. To locate articles on these topics, the following search query was employed: ‘pseudoscience’ OR ‘complementary and alternative medicine’ OR ‘alternative therapies’.

3.3 Inclusion and exclusion criteria

Article collection was carried out in two phases. The first one went up to September 2022 (and with no minimum date limit) and 10,364 articles were obtained from the Web of Science Core Collection database, 24,964 from Scopus and 43,574 from B-on. Another 23 ‘retracted’ items were identified when the articles were imported into Zotero—all from B-on. In a second step, collection went from September to December 2022 and 531 articles were added.

The first inclusion and exclusion criteria previously defined were applied in this process: 1) The concepts ‘pseudoscience’, ‘alternative therapies’ and/or ‘alternative and complementary medicines’ are included in the title, abstract or keywords. 2) It is a scientific article, a conference paper, a dissertation, a book/book chapter or an essay—in other words, results that did not match these criteria were no longer returned in the search. At the end, we had 79,433 articles.

Other exclusion and inclusion criteria—as defined in the protocol—were then applied. The language criterion excluded any articles written in a language other than Portuguese, English or Spanish. In a first phase, 1160 articles were removed. The articles were later manually checked with a superficial analysis (title, scientific journal, abstract and keywords) to ascertain the areas of study, and a further 849 articles were excluded on the basis of language.

The next step was duplicates identification, when 38,910 publications were removed and a further 1322 duplicate articles were found at a later stage. An additional exclusion criterion was the classification of articles as ‘grey’ literature, which led to the exclusion of 4457 articles. A further 442 texts from newspapers, magazines or communication agencies were excluded.

Another exclusion criterion was access to the article; that is, when the article could not be found or, in other cases, when access was not available or provided by authors. In total, 2579 articles were identified under this criterion. In the vast majority of these cases, titles indicated that they would have been in any case excluded because they did not include the SLR's core concepts.

When the concepts ‘pseudoscience’, ‘alternative therapies’ and/or ‘alternative and complementary medicines’ were applied with a meaning distinct from that which is implied by the adopted definition in this SLR, those articles were also excluded. Evaluation was conducted through a systematic review of titles and abstracts; whenever ambiguity persisted, the full text was thoroughly examined. In this context, 17,152 articles were excluded, as many referred to new alternative therapies in clinical trials, in the sense of innovative therapies—and did not address pseudoscience itself.

A further 29 articles were excluded due to the lack of peer review, as well as another three because they had been retracted.

After applying all the exclusion and inclusion criteria (Figure 2), 12,531 articles remained and constituted the review's first sample. It is important to emphasize that, at this stage, texts were not fully read, but rather the title, keywords and abstract. However, when in doubt, for example as to the centrality of the concept of pseudoscience, a more in-depth reading was carried out.

Figure 2.

Process of selection and exclusion of publications from the database.

A more detailed analysis was then carried out. The scientific articles were read in full and analysed according to the indicators defined in the analysis model (see pseudoscience conceptualization in the supplementary material). Scientific areas were classified according to the typology outlined in the Frascati Manual (OECD, 2015), with the appropriate field determined through an integrated assessment of the study's primary research focus, publication journal, keywords, and the authors’ areas of specialization.

At this stage, additional inclusion criteria were applied to create a second sample focused on communication articles: 1) the scientific article falls within the field of communication; 2) the concepts are developed throughout the scientific article, exploring the theme, the concept or its application. Applying these inclusion criteria meant that, of the 12,531 identified texts, there were 172 articles in the field of media and communication. The whole process is depicted in Figure 2. Focusing on the field of media and communication enables a more in-depth exploration of how pseudoscience has been studied within this domain.

4. Results

4.1 Scientific publication on pseudoscience

The mere number of 12,531 scientific articles that constitute the SLR's first sample allows us to understand that this is no niche subject. Pseudoscience research, whether about its nature or its practices, has a robust corpus of research, and that alone shows the need to engage in this area and study what is being done around it.

A more detailed analysis of the 12,531 scientific articles reveals that the area of health has an extraordinarily greater weight than any other area: three out of every four articles, or 75% of the database, were categorized as health articles (Table 1). This particular appetite for working on pseudoscience-related topics is not surprising. One of the hypotheses that might explain this predominance is the very intrusion of pseudoscience into the world of health, with potential treatments or even ‘cures’ using pseudoscientific techniques (Peng et al., 2022; Tekin et al., 2022). This also reinforces concerns about the dangers of pseudoscience practices for the population.

Table 1.

Publications identified in this SLR, classified by area according to the model of the Frascati Manual (OECD, 2015).

Area	Publications	Total (%)
Agricultural and veterinary sciences	65	0.52
Natural sciences	1256	10.02
Social sciences	1101	8.78
Engineering and technology	6	0.05
Humanities and the arts	423	3.38
Medical and health sciences	9453	75.44
Others	227	1.81
Total	12,531	100

Notably, the field of health emerges as a prominent focus in the study of pseudoscience. This can be attributed, upon closer examination, to the prevalence of research articles investigating the use of various pseudoscientific techniques in the treatment of specific diseases (Tekin et al., 2022; Xiang et al., 2021). Such prominence is further explained by the widespread application of pseudoscientific practices as therapies or interventions for particular health conditions, or by studies evaluating their efficacy, including homeopathy (Schyma, 2010), phytotherapy (Motti et al., 2018), naturopathy (Steel and Adams, 2011), hypnotherapy (Bennett et al., 2008) and reiki (Ferraresi et al., 2013).

Table 1 shows the discrepancy between health and other areas, highlighting the low weight of the natural sciences (10%) and social sciences (9%). It is possible to extrapolate some trends in the areas with the greatest predominance of scientific articles. In addition to health, there are other sub-areas that stand out (see areas classification in the supplementary material). The most notable is biology, which stands out with 951 publications, mainly due to research into medicinal plants and phytotherapy. This makes us realize that we need to keep an eye on work in this area. Chemistry also stands out for its research into pharmaceutical effects, for instance. These appear to be expanding areas to be monitored. As we can already note, social sciences and mechanisms of studying how pseudoscience evolves and disseminates are not really explored abundantly.

4.2 Pseudoscience as a recent trend

One of the great advantages of an SLR is that you can get a complete overview of published work. In this case, we can see that the weight of these studies increases decade after decade—the current decade only includes 2021 and 2022. Above all, there was a very significant increase at the turn of the millennium (Figure 3), when published articles jumped from hundreds to thousands of publications. In fact, the 1262 scientific articles published in just two years—2021 and 2022—show a growing trend in publications about pseudoscience in this decade (2021 to 2030). If the rate of publication continues, this decade could produce more than 10,000 scientific articles on pseudoscience. These numbers mark an unprecedented interest on this topic.

Figure 3.

Publications identified in this SLR, classified by decade (1900−2022).

The growth is notorious, but pseudoscientific practices are not a recent research subject. The article ‘Quackery and the politicians’ was published in the Journal of the American Medical Association (JAMA) in 1900, and an article from 1901, titled ‘Pseudoscience’, was found, but was excluded because it proved impossible to obtain. This long tradition in journals such as JAMA and the impact of unproven treatment techniques also justify the volume of work on pseudoscience in health.

There are two issues to consider in this collection. The first is the great difficulty in indexing publications during much of the twentieth century, which can lead to less representation. The second is the great volume of publications in the twenty-first century. Even so, the difference between publication figures in these decades is so great that we would argue that these conditions would hardly contribute to a view other than that of an increase in publication trends on pseudoscientific practices over time and an unequivocal growth in articles about this subject. The growth has been more noticeable since 2010, which may be the result of higher publication rates and an increase in the scientific community, but it may also reflect a greater significance of pseudoscience in society.

4.3 Journals that publish about pseudoscience

There is a huge diversity of journals that publish on pseudoscience, also due to the diversity of covered areas. This SLR identified 3167 journals with at least one relevant article published. Despite this dispersion, if we count journals in which there are at least 25 publications, there are only 42 left. Almost all of them focus on health, especially ‘alternative therapies’. In fact, the only journal that could be considered generalist and not related specifically to health is Plos One (40 articles).

If we look at the ‘top 10’ journals (see top 10 journals in the supplementary material), we realize that only one of them is not specifically dedicated to these practices—in this case, Medicine. All the others are dedicated to ‘alternative therapies’, ‘complementary therapies’ or, in two cases, ‘integrative medicine’. This ‘top 10’, which includes journals with more than 100 articles, represents 25% of all the articles in the SLR database. This is especially relevant since it shows a practice of publication in journals that are dedicated to these practices and, in most cases, are known as promoters of ‘alternative therapies’.

4.4 Pseudoscience in media and communication

The 1101 social sciences papers are surpassed only by health and natural sciences, emphasizing the weight of this area, which is not enormous, but is still significant. There are two sub-areas that stand out with at least 200 articles: education (271 publications) and psychology and cognitive sciences (286).

The media and communication sub-area has 172 publications (the SLR's second sample), many on disinformation (Claassen, 2021) and also on media and media production analysis (Cortiñas-Rovira and Salvador-Mata, 2022). The presence of disinformation has a significant weight and is clearly a relevant concept for understanding the phenomenon of pseudoscience, due to its very nature and definition, but also due to its strong presence in the media, as evidenced by recent research (Tsfati et al., 2020; West and Bergstrom, 2021; Broda and Strömbäck, 2024; Wagnsson, 2022; Altay et al., 2024).

Like all the other areas, the media and communication sub-area is also growing rapidly, particularly since 2018 (Figure 4). Here, there is no clear predominance of scientific journals in which these papers are published. For example, Complementary Therapies in Medicine has the most articles classified as media and communication, with only six articles (see media articles in the supplementary material).

Figure 4.

Publications identified in the sub-area of media and communication, classified by year.

As for the researchers who study pseudoscientific practices in media and communication, dispersion remains the main highlight, with the majority of the authors identified—374 authors in the 172 articles—signing only one publication each over this period (since the 1990s).

Even so, among the 38 authors who signed more than one publication, there are names that stand out, especially from Spain. The most prominent is Sergi Cortiñas-Rovira, from Pompeu Fabra University (Spain), who was one of the authors of seven of the 172 publications in this sub-area. Felipe Alonso Marcos and Eudald Escribà-Sales also published three articles while at Pompeu Fabra University, as did Bertran Salvador Mata, who authored two. All of these articles were co-authored by Sergi Cortiñas-Rovira, with the exception of one publication exclusively by Escribà-Sales (2014), which accounts for this author's relevance.

The University of Valencia also plays an important role. Lorena Cano-Orón was the most prolific during this period, with seven papers, but Carolina Moreno-Castro (with five publications), Vanessa Roger-Monzó (four), Myriam Martí-Sanchez (three) and Emilia H Lopera-Pareja (two) also authored several articles—in many of which several of these authors collaborated.

The strong Spanish presence comes through in what could be considered two schools of scientific research on pseudoscience, both closely aligned with the study of journalism and its role in covering pseudoscientific practices, showing the Spanish weight in these studies (Gutiérrez-Muñoz, 2007; Elías-Perez, 2013; Galán-Fajardo and Gil-Vazquéz, 2020). Not related to Spain, Jeremy Y Ng stands out with six articles on online information on pseudoscience, all published between 2020 and 2022—always focusing on health.

4.4.1 The definition of pseudoscience in media and communication

Among the 172 publications in the media and communication sub-area, there is a predominance of the English language (151). Only 19 of the articles are in Spanish, with one in Catalan and one in Portuguese—something that may also be explained by the absence of Portuguese or Spanish descriptors in the initial search. ¹

One of the aims of this SLR was to understand how ‘pseudoscience’ or, in other cases, ‘alternative therapies’ are defined. We were surprised by the lack of a clear definition: in 107 of the 172 papers, there is no definition. It was also found that more attention is paid to the definition of ‘alternative therapies’ or ‘complementary and alternative medicine’—a more consensual expression in the literature. Many articles use the definition of the NCCAM, which defines them as ‘unorthodox practices used along with conventional medicine’ (Sagaram et al., 2002, 672; Dunne and Phillips, 2010, 671; Ng et al., 2022, 2).

Rowlands (2015) emphasizes that the use of the term ‘complementary and alternative medicine’ is not to his liking, since describing this set of pseudoscientific practices as ‘medicine’ gives them a credibility that the scientific method does not. In fact, the use of terms such as ‘alternative therapies’ or ‘alternative medicines’ lends itself to confusion and to the attribution of unfounded confidence.

If we focus on the concept of pseudoscience, which is much more present in Spanish than in Anglo-Saxon literature, the simplest means is to describe it as the opposite of science or something that ‘dresses up’ as science but is not, as simplified by Cortiñas-Rovira and Darriba Zaragoza (2018) or Sánchez-Hernández and Marin (2019).

Escribà-Sales (2014, 74) adds that, when we mention pseudoscience, ‘we are referring to a set of practices and beliefs that are not supported by scientifically proven evidence, but which make every effort to appear scientific’. Plencner (2014, 6) seems to agree, when stating that ‘pseudoscience offers an illusion of understanding without effort and without doubt’. To this component, Plencner (2014) adds the dimensions of ‘explanation’, ‘control’ and ‘mystery’ as central to this system of practices and beliefs.

One of the most comprehensive and frequently cited definitions is by Alonso-Marcos and Cortinãs-Rovira (2014, 100), who defined pseudoscience in a set of six principles: ‘1) the set of practices that attempt to assume scientific status and method, 2) through the presentation of isolated, unproven and/or purely subjective results, 3) obtained in an uncritical, unsystematic and/or interested manner, 4) to create knowledge that cannot be accumulated or scientifically valid, 5) that operates in areas where science does not exist or where it has not offered satisfactory results and 6) that is generally skilful at managing the media and the emotions of the general public.’

Generally speaking, most of these articles choose to expand on the concept of ‘complementary and alternative medicines’, which from the outset includes a predisposition to accept these practices without scientific proof as an integral part—even if in a complementary or alternative way—of the health-care system. When referring to the concept of pseudoscience, the definition tends to be harsher, taking it as an adversary of science and scientists.

4.4.2 Methodologies to research pseudoscience

In the sub-area of media and communication, there is a predominance of content analysis—more specifically, in 80 publications. Quantitative content analysis was applied in the majority of these studies, although this may be due to the initial phase of describing websites dedicated to pseudoscientific practices (Molassiotis and Xu, 2004; Walji et al., 2005).

A large number of these publications focus on analysing the content of newspapers or magazines, as well as websites. The publications include examples of quantitative content analysis (Gray et al., 1998; Wexler et al., 2020; Nguyen et al., 2022) as well as qualitative analysis (Uusitalo et al., 2000; Bubela et al., 2008; Suau-Jiménez and Ivorra-Pérez, 2022), and studies using mixed content analysis (Mercurio and Eliott, 2011; Lavorgna and Rocco, 2017).

The analysis reveals the weight of research on university websites that explores online databases or selects the first 50 pages of a given search engine as a sample (Sagaram et al., 2002; Schmidt and Ernst, 2002; Walji et al., 2004; Molassiotis and Xu, 2004; Walji et al., 2005; Keshet, 2012; Owens et al., 2014). Available information on websites was a key issue at the beginning of the millennium.

Media content analysis, whether applied to newspapers or to more specialized magazines—such as women's magazines (Sesselberg et al., 2006; Branson, 2014; Martí-Sánchez and Roger-Monzó, 2020)—is also relevant. There are 25 studies on the prevalence of pseudoscientific practices in the media (Gray et al., 1998; Bubela et al., 2008; Rowlands, 2015; Cano-Orón and Lopera-Pareja, 2021; Lopera-Pareja and Cano-Orón, 2021; Cortiñas-Rovira and Salvador-Mata, 2022).

As for data-collection techniques, questionnaire surveys (physical or online) were used in 18 publications, as were in-depth interviews, also in 18 publications. Focus groups were applied in five papers. In recent years, the use of social networks as platforms for collecting and analysing data, through network analysis, has also grown steadily, especially using X (Cano-Orón and Moreno-Castro, 2017; Fonseca Rodrigues and Gomide, 2019; Ng et al., 2022).

As a research method, case study was particularly relevant (13 articles), especially in some recent research, such as the analysis of pseudoscience in the Netflix series ‘The Goop Lab Netflix with Gwyneth Paltrow’ (Galán-Fajardo and Gil-Vazquéz, 2020); justice and pseudoscience in court (Denault and Jupe, 2018; Denault et al., 2020); or even current affairs, such as the analysis of the anti-vaccine movement promotion (Foster, 2017).

4.4.3 The most investigated pseudoscientific practices

Even in the area of media and communication, the association of these publications with health is notable. Cancer is the main researched disease (10 out of the 172 media and communication publications). Although depression, arthritis and HIV are also mentioned (twice), only COVID-19 comes close to cancer (six articles).

When it comes to pseudoscientific practices, there are not such strong leaders. The so-called ‘medicinal plants’ feature in six publications and homeopathy in five, but all other practices—such as reiki, naturopathy or neurofeedback—are residual. In fact, it seems to be more common to investigate the presence of pseudoscientific practices generally.

Finally, although studies with populations are not common, some trends are identified. For example, there are several studies in which samples are made up of students (Tseng et al., 2013; Fasce and Picó, 2019; Lopera-Pareja and Moreno-Castro, 2020), something that could be explained in part by the ease of recruiting students at the universities with which the scientists are associated.

Another relevant fact is the participation of patients (Gibson, 2012; Ho et al., 2012; Agarwal, 2020; Nissen et al., 2020), particularly cancer patients (Broom and Tovey, 2008; Scarton et al., 2018). The study of patients with oncological diseases or even chronic diseases is common, due to the increased social and health risks that the use of these practices can entail. Kong et al. (2022) mention, in the case of oncological diseases, a risk of impoverishment and financial catastrophe in high-income countries due to the use of pseudoscience.

There are also several publications that focus on alternative therapy professionals (Agarwal, 2018; Nissen et al., 2020) or doctors (Keshet, 2012; Salvador-Mata and Cortiñas-Rovira, 2020; Nissen et al., 2020)—two other populations that have been studied in greater depth, which demonstrates the relevance of health in this context.

The data shows that, even if the main research area is media and communication, there is mostly a concern with health-related issues, which proves this area's relevance in the context of pseudoscience, but also means that other areas will be missing, such as the promotion of pseudoscientific practices, reception studies, acquisition of information or source credibility.

4.5 The literature lacks media effects studies

Three studies were identified that are focused on media effects (Tsai et al., 2012; Tseng et al., 2013; Schiele, 2020). It is a fragile minority among the 172 articles on media and communication.

Tsai et al. (2012) and Tseng et al. (2013) have a similar approach with the intention of studying the effects of television exposure on pseudoscience usage. Both teams have reached relevant conclusions. Tsai et al. (2012, 187) concluded that ‘exposure to pseudoscientific TV programs was the most crucial factor in predicting the citizens’ pseudoscientific beliefs’. In Tseng et al. (2013), we find similar outcomes.

In both studies, research is supported by critical theories. Tsai et al. (2012) highlight the ‘bandwagon’ effect as an important factor to consider, mainly when people deal with celebrities and TV hosts, but also their friends, as information sources. These authors also explored the framing effect (Schütz and Wiedemann, 2008), which is a central theory of media effects; for example, presenting a horoscope on TV as something valuable and credible frames audiences’ first impressions. Tsai et al. (2012) look at framing as a process of perception that influences ‘confirmation bias by means of family and/or by traditional religious beliefs during decision-making’, an approach that looks at the issue interpretation effects of framing. According to Lecheler and de Vreese (2018, 41), research can look into framing effects regarding issue interpretations, but also ‘cognitive responses, emotional reactions, attitudinal effects, and behaviors’. Despite this, framing effects are not hegemonic, although they can contribute to decision-making, since the influencing process is a multiple-way road (McQuail and Deuze, 2020).

It is important to note that ‘construction of reality’ theories, such as framing or agenda-setting, have been disputed by researchers. Cacciatore et al. (2015) proposed a shift towards ‘preference-based effects models’, which would include framing effects, but highlight personal choices, behaviours or prior beliefs—creating a mediated effects model, in which media and audiences play their own roles.

Tseng et al. (2013) surveyed university students and do not explore media effects theories so much, although the framing effect is subjacent to their work, with a similar perspective.

The preference-based effects paradigm is valuable when studying media and pseudoscience, since it allows the study of short-term media effects with the perspective that, for example, TV offers framing of homeopathy as something credible and harmless—and that can influence the audience, reinforcing beliefs, benefiting from familiar bubbles or other means of influence. Looking at long-term media effects, which are not truly explored in the studies we found, this also associates properly with the cultivation hypothesis of Gerbner and Gross (1973), which looked at media, particularly television, as the provider of a set of perceptions or beliefs that will shape how the audiences see the world. Once again, this hypothesis looks at direct effects, which is something to be cautiously considered, since media effects are not hegemonic and other means of influence, such as family, prior experiences, beliefs or peer feedback must be taken into account (McQuail and Deuze, 2020; Oliver and Krakowiak, 2009; Veldhuis et al., 2014).

Schiele (2020) discusses the legitimization of pseudoscience in the public sphere, assuming that the public's first contact with pseudoscientific practices occurs through mainstream media, even though research and discussion are not supported by media effects theories.

Currently, analysing the development of trust in science and scientists remains challenging. A recent study by Cologna et al. (2025) indicated, for instance, that widespread mistrust in scientists is not prevalent and that no country exhibits particularly low trust in scientific experts. This finding suggests that short-term attempts to undermine science through disinformation or politically motivated discrediting may have limited impact. Nevertheless, certain findings warrant attention: 43% of participants reported perceiving scientists as not honest, and 44% believed that scientists do not prioritize people's well-being.

The threat posed by pseudoscience to public trust can be understood through the strategic use of scientific-sounding arguments and terminology—such as labelling interventions as ‘therapies’—which can persuade individuals to accept and disseminate false claims, even among those who generally trust science (O’Brien et al., 2021). When amplified by media exposure, these effects may be further magnified. However, research on the specific media-related effects of pseudoscience remains scarce. Notable exceptions identified in this review, such as Tsai et al. (2012) and Tseng et al. (2013), demonstrate that media dissemination can indeed reinforce pseudoscientific beliefs and facilitate their persistence within the population.

There is room to make media effects studies on pseudoscience a relevant aspect of communication research. There is scarce research on how the population receives information on pseudoscientific practices and how media contribute to that process, in a negotiated perspective, acknowledging the impact of other sources such as family, friends, school or work environments (Oliver and Krakowiak, 2009; Veldhuis et al., 2014; Kleinnijenhuis et al., 2019; Valkenburg et al., 2016). Without data and research on this specific issue, we cannot confirm Schiele's (2020) critical view of the media as enablers of pseudoscience. Data would also be relevant to assess how cultivation theory could be helpful to explain how the media contribute—in the long run—to the use of pseudoscience or to its credibility. This would require longitudinal research.

5. Discussion and conclusions

5.1 Gaps in the literature

There were only two SLR identified that could relate to our analysis: one refers to online information on alternative therapies (Sharma et al., 2016), and the other one is doctor‒patient communication (Davies et al., 2022). None of these is clearly a SLR about pseudoscience through the lenses of media and communication. When literature on pseudoscience in the field of media and communication is analysed, three essential gaps can be highlighted: 1) little research on television, a relevant medium, particularly for older and potentially more vulnerable populations, 2) an almost exclusive focus on journalism, and 3) the lack of more comprehensive studies at an age level (i.e., not focusing just on students or young people, but also in a personal context, i.e., not just patients or professionals).

Trustworthiness and attention to voices perceived as representative (for example, TV presenters or guests) may also have greater effects in populations with lower literacy or lower criteria for defining evidence. Rodríguez-Ferreiro and Barberia (2021, 6) point out that ‘endorsement of unwarranted beliefs is associated with low evidence criteria, leading individuals to test fewer hypotheses before settling to one of them, hence showing a jump-to-conclusion bias’.

The study of television effects and the effects of entertainment on the adoption of pseudoscientific practices was not expressed in literature. Who receives information on pseudoscience practices and how is it received? These are two essential questions to understand the effect of television entertainment on the adoption of pseudoscientific practices, how it happens and through what mechanisms.

Although the presence of pseudoscientific practices is relevant on the news side, it would be particularly important to look at these practices through the lens of television entertainment and media effects. And it is important to look forward with media effects models that consider a mediated perspective—highlighting other contextual and individual variables. After all, the promotion of practices without scientific validity is a piece of disinformation with potential effects on public health, the economy and a more scientifically robust society.

5.2 limitations and recommendations

An SLR is a competent and useful tool for giving a comprehensive overview of an area but involves choices that may represent limitations. Applying a second technique (snowballing) could guarantee an even more complete database. The articles to which we did not have access, and which could add relevant information to research in this area, are also a limitation. Linguistic limitations should be acknowledged, since data collection was centred on Anglo-Saxon and Ibero-American research. The use of purely English descriptors is also a potential limitation, although we do not expect significant effects from this, since the inclusion of an abstract in English is common practice in publications in several languages, which means that a significant amount of publications in other languages would end up being included in the search results.

Systematic literature reviews provide a better understanding of how a given subject has been researched and—in this case—how to improve research on pseudoscience in the area of media and communication. From the above-mentioned gaps and limitations of this study, a few recommendations are listed for future research:

Better data on pseudoscience is needed. In order to understand the origins and implications of pseudoscientific practices, it is necessary to gather data that shows how it is used, by whom and why.

A move away from journalism is necessary. Most studies are focused on journalism, particularly printed media, but audiences mostly watch TV and, specifically in this media type, entertainment (Nielsen, 2025; Pew Research Center, 2024; European Commission, 2023; World Economic Forum, 2020). These should be the main focuses.

More diverse samples are needed. A lack of studies with elderly people, for example, creates gaps in knowledge about reception and media effects.

Collaboration is required. Pseudoscience is a multifactor problem with health, social and financial consequences, so looking at it strictly from a media and communication perspective might not be sufficient. We suggest that the work with health professionals (and their data) or with psychology researchers would produce a better comprehension.

To inquire people. Studying pseudoscience and what constitutes this broad concept is highly relevant, but it would also be interesting to know what the population's perception of pseudoscience is—what they think it is and what they consider not to be pseudoscience.

Media effects should be assessed. An evaluation of how people access pseudoscience information and of the role that media play in this process is necessary, in order to create better science and media literacy policies and to protect people from pseudoscientific practices.

Social media and artificial intelligence (AI) next. The role of social media and its impact as a stage for pseudoscience dissemination—cheap and easy—should be a focus of research and monitoring, as well as large language models and AI chatbots and their responses to questions about pseudoscience practices. These are actual and urgent areas in which communication studies can be impactful and alert for hypothetical deviations.

5.3 Conclusions

This SLR systematizes the study of pseudoscience in the field of media and communication and provides insight into research trends. Something that stands out is the predominance of health research. Although predictable, it is surprising in terms of its relevance: three out of four publications are in this area.

Publication growth on pseudoscience is noticeably higher in the twenty-first century, and it is not just a reflection of the ‘publish or perish’ era. In the two considered years (2021 and 2022), 1263 papers were published and, if the trend continues, there will be more than 10,000 publications in this decade (2021‒2030)—almost as many as from 1900 to 2022, which is the period analysed in this SLR.

This shows a particular attention to this area, which in the case of the media and communication has been poorer. The interest of media and communication researchers has been growing, especially since 2018, very much based on what we could consider the two most relevant ‘research schools’ on this topic: Barcelona and Valencia.

In addition to the pointed-out gaps, there is also a need to clearly define what pseudoscience and pseudoscientific practices are. The scarcity of studies into their uses and effects also stands out, given that the use of these practices can lead to the development of social, health or economic problems. For example, their use as a treatment or panacea can delay the resolution of a health problem (Thomson et al., 2014) or increase the impoverishment of the population (Spinks and Hollingsworth, 2009; Kong et al., 2022). It would be particularly interesting to study—with a qualitative approach—the way people (in general) define pseudoscience and how the concept is enunciated. Overall, more research on audiences is required: how information is being received, whom audiences trust and why. Only three studies have looked into reception studies and media effects to explore pseudoscientific practices (Tsai et al., 2012; Tseng et al., 2013; Schiele, 2020)

When we look to recent studies about trust in science and scientists (Algan et al., 2021; Chan, 2025; Cologna et al., 2025; European Union, 2025), this parameter remains high—this is an area where trust still exists. However, the threats are there. Disinformation and misinformation are at the top of these threats, and pseudoscience practices benefit from the dissemination of misinformation and can contribute to undermining trust in science.

Pseudoscience is a health problem, an economic problem and a literacy problem, but it is also a communication problem, in terms of how it is transmitted, how it is received and whose credibility counts.

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