Don Berwick and the Institute for Healthcare Improvement have done important work in addressing health care quality issues. But they may have overstepped the boundaries of evidence with a recent study that drew a lot of news coverage, claiming that hospitals they worked with saved over 122,000 lives by cutting down on errors and improving care.

"The Numbers Guy" column by Carl Bialik in the Wall Street Journal says the studies warrant a second opinion. Bialik quotes Dr. Bob Wachter of UCSF, author and lecturer on medical errors: ""I don't think it saved 122,300." He added that, like in a political campaign, the health-care campaign used "statistics selectively to try to mobilize your base to do good. It's understandable. It's not good science."

Dr. Gil Welch of Dartmouth and the VA said, "I think there's been a tendency in the errors business to first overstate the size of the problem, and now, I'm afraid, to overstate the effect of interventions on the other side."

Read Bialik's full article. It does a good job of questioning claims and pointing out how well-intentioned advocates may be driven by passion more than by evidence, and how journalists can easily get sucked into the vortex. (Bialik points out how the Wall Street Journal reported the Berwick claims, along with the Associated Press, U.S. News & World Report and many other media.)

The Gannett Company has sold a 32-page issue of an insert entitled "USA Weekend HealthSmart" to drug company advertisers and to newspapers across the country. The New York Times reports that the insert appeared in 76 newspapers with an estimated circulation of 7.5 million.

I was one. I am no smarter for having scanned the section. I have, however, become familiar with many more drug ads thanks to this piece of fish-wrap. You can't call it news. There's lots of "advice." And then there are all the ads.

There is one four-page spread from Astra-Zeneca that could lead just about any reader to self-diagnose with bipolar disorder. The ads ask if there's ever been a period when you flew off the handle at little things...needed less sleep...felt irritable...were much more interested in sex than usual, etc. If so, the ad goes, you may need treatment for bipolar disorder. Gee, that's about 100% of us. What a nice market!

Sadly, this won't be the last of such bombardments. The Times reports: "Executives at USA Weekend initially considered the issue to be a test. But after seeing the results — more than 16 advertising pages, from marketers like AstraZeneca, Johnson & Johnson and Pfizer, bringing in more than $3 million in revenue... they are already looking at publishing HealthSmart again, perhaps as soon as the fourth quarter."

And the Times story suggests this is a sign of the health of U.S. newspapers. If this is healthy, I don't want to see sickness.

At least CNN doesn't discriminate based on gender when it gives screening test advice that clashes with evidence-based guidelines.

Back in February, CNN's Sanjay Gupta gave screening test recommendations to men at various ages. The advice flew in the face of unbiased, authoritative guidelines of the U.S. Preventive Services Task Force (USPSTF).

Then on Mother's Day weekend in May, CNN's Elizabeth Cohen gave women screening test advice that also conflicted with USPSTF recommendations.

See my full commentary on this topic.

To promote screening in groups for whom the evidence of benefit is not clear and for whom the evidence of some harm is significant is not good journalism. It is a form of advocacy journalism that is advocating the wrong things.

Dartmouth's Steve Woloshin and Lisa Schwartz have studied the pitfalls of news coverage based on scientific meetings. Their new work, in the Medical Journal of Australia, looked at print and broadcast news stories based on research reports at five major scientific meetings on heart disease, AIDS, cancer, neuroscience and radiology.

Results: "34% of the 187 stories did not mention study size, 18% did not mention study design (another 35% were so ambiguous that expert readers had to guess the design), and 40% did not quantify the main result. Only 6% of news stories about animal studies mentioned their limited relevance to human health; 21% of stories about small studies noted problems with the precision of the finding; 10% of stories about uncontrolled studies noted it was not possible to know if the outcome really related to the exposure; and 19% of stories about controlled but not randomised studies raised the possibility of confounding. Only 29% of the 142 news stories on intervention studies noted the possibility of any potential downside. Twelve stories mentioned a corresponding 'in press' medical journal article; two of the remaining 175 noted that findings were unpublished, might not have undergone peer review, or might change."

This is important work, pointing out that "the public may be misled about the validity and relevance of the science presented."

What ethical standards still exist at Time magazine? Or do they exist and they're just being ignored?

The Center for Science in the Public Interest points out that this week's Time magazine includes a column by Dr. Andrew Weil touting the benefits of fish oil supplements. CSPI says, "The column was sparked by a recent report in the Journal of the American Medical Association showing that fish oil supplements did not reduce the risk of serious abnormal heart rhythms. The article failed to disclose that Dr. Weil sells his own brand of fish oil supplements on his website.

I've pointed out other questionable advertising-related editorial practices at TIME in the past.

Let the reader - and the buyer - beware.

CNN has been giving viewers screening test advice that does not reflect the best medical evidence.

In my last Publisher's Note I pointed out how CNN's on-air advice conflicted with evidence-based guidelines when it advised men in their 40s, 50s and 60s about screening tests they should have. That segment was broadcast in February.

In May, on Mother's Day weekend, CNN did the same thing in promoting screening tests for women. At one point in the broadcast, CNN medical correspondent Elizabeth Cohen said, "So to be clear, don't wait to be sick to get tested. Starting in your 30s you should be getting regular heart health tests, thyroid tests and skin exams. That's in addition to your yearly gynecological testing." While she spoke, a graphic appeared on-screen reading:

I asked Michael Pignone, MD, MPH, Associate Professor of Medicine in the Division of General Internal Medicine at University of North Carolina - Chapel Hill to react to this on-air advice. Regarding the vague "heart health tests" recommendation, Pignone says, "If this means screening for hypertension and lipid disorders and smoking cessation, it is reasonable. But not electrocardiograms (ECGs) or other imaging studies." Unfortunately, CNN did not specify which heart health tests they were talking about, so viewers could easily have been misled.

What about the thyroid test recommendation? "This is not recommended for young women who don't have symptoms," says Pignone. He also says the "yearly skin exam" recommendation is controversial, lacking a strong evidence base.

While reporter Cohen's phrase, "your yearly gynecological testing," was vague, a graphic appeared on screen that specified "pelvic exam, pap smear." Pignone says there is good evidence for Pap smears to detect cervical cancer but no good evidence to support pelvic exams in women without symptoms. Younger women, he points out, may benefit from chlamydia screening. But as with the heart testing recommendation, CNN's vague advice was less complete than it should have been.

Later in the broadcast, CNN gave the following advice to another age group of women: "In their 40s women need to start having mammograms, and at 45 they need to have regular diabetes testing." The "need to" terminology is troubling. Mammograms probably have some benefit for women in their 40s but it is modest, according to Pignone, and screening in this age group leads to a high rate of false alarms. Diabetes screening in the general population of women this age is also controversial.

It appears that CNN is trying to help people with these screening test recommendations - in February for men of different ages and in May for women of different ages. But viewers need complete information on potential harms as well as potential benefits of such tests. To promote screening in groups for whom the evidence of benefit is not clear and for whom the evidence of some harm is significant is not good journalism. It is a form of advocacy journalism that is advocating the wrong things.

Consumers - and journalists - can be guided by the work of the U.S. Preventive Services Task Force, a group of medical experts convened by the federal government to conduct rigorous, impartial assessments of scientific evidence and develops recommendations for clinical preventive services.

I'll end with a line often attributed to Mark Twain. (But, in the spirit of this commentary, some question the accuracy of that attribution.)

"It ain't what people don't know that hurts them. It's what they know that ain't so."