February 4, 2013
Sound Medicine radio program profiles work of HealthNewsReview.org
This public radio program in Indiana interviewed me in response to the paper by John Ioannidis and colleagues in JAMA, “Empirical Evaluation of Very Large Treatment Effects of Medical Interventions.”
A few of the points I tried to make:
- Oftentimes, if it sounds too good to be true, it probably is.
- Journalists sometimes treat studies as slam-dunk, cast in concrete, Moses coming down from the mountaintop with the new 10 commandments of “this is the way clinical practice is going to be changed and this is the way you should change your individual decision-making.”
- In seven years of work on HealthNewsReview.org, and after reviewing 1,860 stories, we’ve seen a clear pattern of exaggerating/emphasizing of benefits and minimizing/ignoring of harms.
- That pattern does not set us up for having a high quality public discussion about health care in this country.
- We try to convey to news organizations: We know it’s not malicious and that you don’t intentionally wake up and decide to screw up and hurt people but that’s what you are doing. There is harm in conveying stories that exaggerate benefits and minimize/ignore harms and fail to evaluate quality of evidence.
- Instead, we often are washed over by a tsunami of dreck in daily health news about studies.
- We’re trying to train the public to look on evidence-based medicine as rational rather than as rationing – which is the way many media messages have framed their thinking.
- I especially liked how the Ioannidis paper referred to “laboratory-defined efficacy.” Excerpt from the paper:
- “Trials with very large effects are more likely than other trials to pertain to laboratory-defined efficacy. Laboratory measurements have made randomized trials more efficient and very large effects may be easier to obtain. However, the relevance of laboratory end points as surrogates of hard clinical outcomes has long been contested.”
- Similarly, some media organizations (like one TV station in my metropolitan area) promote “Know Your Numbers” campaigns – numbers that may not translate into clinical endpoints that really matter in our lives.
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