A friend sent me a notice found on the Bulldog Reporter website, which is designed to help public relations people pitch their stories to journalists.

The item was entitled, "AP Radio Welcomes News and Information Related to Healthcare, Eldercare." It appears to be a clear invitation to PR people to send audio clips along with news releases because that might improve their chances of getting their message on the air.

The notice read: "Include audio in your release. New technology allows AP Radio to put more natural sound into news reports, and this allows for new PR opportunities. "Provide bits and pieces of your news release in audio," AP Radio news general manager Thomas Callahan suggests. "Everyone sends printed releases, but attaching an MP3 with excerpts might attract attention."

It is surprising to see such an open invitation from a journalism organization to PR people, especially given the myriad concerns raised in recent months about the dissemination of video news releases in TV news. How will listeners know which audio clips and which stories came from the work of independent journalism, and which came from a source hawking a product or some other vested interest?

By the way, the notice bragged that AP's radio division serves more than 4,300 stations with text, audio and/or web content, reaching more than 1 billion people around the world who see or hear an AP story every day. And now that may be more than 1 billion people every day who hear unfiltered PR hype.

The Boston Globe offers a good look at how peer review of medical research by medical journals is not perfect.

In the Globe: "Now, after a study that sent reverberations through the medical profession by finding that almost one-third of top research articles have been either contradicted or seriously questioned, some specialists are calling for radical changes in the system."

The Globe says it is difficult to discover what goes wrong in peer review when it does go wrong, largey because "peer reviewers are unpaid, anonymous, and unaccountable. Moreover, their reviews are kept confidential, making it impossible to know the parameters of the reviews."

The take-home message for journalists and consumers is: if you're going to treat each journal article as gospel, you're putting your faith in a flawed process.

Unbelievable.

The Pittsburgh Post-Gazette reports that a KDKA-TV medical "reporter," who is a physician, was "peddling Joint Formula 88 joint pain relief cream ($21.90) on QVC." Worse, if it can get worse, is that the cream is his product.

Did anyone talk to this guy about journalism ethics before hiring him?

I just spoke to a group of California journalists about the entanglement of conflicts of interest in the dissemination of health news and information. My recurrent message to them is what I would tell this "M.D.-reporter" -- YOU HAVE TO DECIDE WHETHER YOU'RE GOING TO BE A JOURNALIST OR A PR-ADVERTISING PERSON. You can't do both.

Add this egregious example to the long list of commercialism and conflict of interest incidents in journalism which I previously reported.

Often I criticize health news coverage in this blog. Today, I praise a reporter for nailing a story.

Andre Picard of the Toronto Globe and Mail hit a home run with his story, "Be Skeptical About the Herceptin Hype."

Herceptin is a drug intended for certain types of breast cancer. Picard writes:

"The most eye-popping claim is that, for this select group, the drug cuts the risk of recurrence by half. In clinical trials, women who took Herceptin along with a standard chemotherapy drug saw their risk of recurrence fall 52 per cent, compared to women who received chemo alone. That is an impressive relative risk reduction.

But what matters in the real world is absolute (not relative) risk reduction. Practically speaking, 15 per cent of women taking Herceptin and chemo had a recurrence of breast cancer within four years of diagnosis, compared to 33 per cent of women who took chemo alone. That is an absolute risk reduction of 18 per cent.

Nobody wants a recurrence, but what matters ultimately is survival. Herceptin, according to the studies, cut the death rate by one-third. That sounds impressive, but relative risk reductions always do. In reality, the difference in the death rate between the Herceptin and non-Herceptin groups was 2 per cent after three years, and 4 per cent after four years.

Based on those numbers, can we honestly say that Herceptin is an essential lifesaving drug?"

If more reporters knew the difference between relative and absolute risk, and reported the difference, we'd have a lot less hype in health news coverage.

Suddenly lung cancer is a hot topic in newsrooms. Peter Jenning dies one day. The next day Christopher Reeve's widow announces she has lung cancer. So it is understandable that some well-intentioned "disease awareness" efforts would come forward.

But journalists should employ facts and full disclosure when giving attention to such disease awareness campaigns. (The "Selling Sickness" book by Moynihan and Cassels gives many reasons why.)

CNN gave several minutes of airtime yesterday to a founder of the group, Women Against Lung Cancer. The network never revealed that the group receives financial support from the drug industry -- from makers of lung cancer drugs. But CNN also allowed the guest to talk about "studies looking at special spiral CAT scans of the chest so that we can pick up tiny nodules, hopefully before they have a chance to get into the bloodstream and spread." What neither the guest nor CNN disclosed is that many scientists don't think there is proof that such scans prevent premature death. And many see risks in such screening, even the possibility that they do more harm than good when scans lead to unnecessary followup testing that carries its own risk. That's why they're doing the studies. It's not a slam dunk that benefits will outweigh risks.

Those would have been balanced facts to present. Not just the promise of early diagnosis discussed during the emotional reaction to two celebrities' diagnoses.

When you hear about "disease awareness" campaigns, always look for facts in context and full disclosure.

I just finished reading an important new book, "Selling Sickness: How The World's Biggest Pharmaceutical Companies Are Turning Us All Into Patients," by Ray Moynihan and Alan Cassels.

It documents disease-mongering, how drug companies foster the creation of medical conditions to create markets for their pills, the marketing of fear, the "medicalization" of normal states of health, the hidden agendas of "disease-awareness campaigns," problems with drug company relationships with celebrity spokespersons and patient advocacy groups, and other issues about which most consumers don't have a clue.

As one skeptic says in the book, "We're changing the experience of what it means to be human."

It also points to numerous instances of what the authors call "sycophantic media coverage" and an "indictment of the flaccid culture of much medical reporting."

I highly recommend the book.

This is becoming a recurring theme: journalists working in news rooms while also doing paid public relations work.

A Minneapolis-St. Paul TV anchor did it.

A Nashville TV reporter did it. (Although she called me yesterday to explain that she's not doing it anymore.)

And now Detroit Medical Center announced that it has named a former WDIV-TV anchorman to be its communication director, "providing guidance on media issues and serving as a principal spokesperson" for the medical center. That's fine. But in the next breath, it's revealed that the anchorman also has a long-term agreement with WDIV-TV to produce periodic in-depth documentaries for this Detroit-based NBC affiliate.

How does the audience know which hat the anchor/PR man is wearing at which times?

As critics said at the time of the Minneapolis incident cited above, journalists who cross these lines between journalism and public relations raise warning flags. Questions of credibility, conflict of interest (real or perceived), and truthfulness arise when you're being paid by someone to make them look good in the media -- at the same time you're supposedly being an independent, objective journalist in other venues.

ABC World News Tonight broadcast a story last night, a portion of which is captured on their website, about patients' own stem cells used to build new blood vessels.

It is interesting clinical research, but the story offered only breathlessly optimistic projections -- no caveats, warnings, unknowns or uncertainties. An excerpt: "Results in more than 100 patients show that, within just three months after the stem cell injections, patients see a significant improvement in blood flow to the heart. The heart muscle itself actually doubles its ability to squeeze or contract.

The short-term results (3 months) send up one red flag. Another is the use of what are called surrogate endpoints. In other words, rather than reporting that people lived longer (which of course would be a pretty empty projection after only 3 months), they reported a different marker or endpoint to measure "success." That is, blood flow to the heart.

But the coup de grâce comes with the next line of the story: "Researchers say these adult stem cells might help tens of millions of heart patients each year."

Or, the story could be just as true to the facts and conclude, "Maybe not." The science behind this work holds great potential. It doesn't need hyping of short-term research measuring only surrogate endpoints that extrapolates these early findings to tens of millions of people.