December 2006 Archives

Two years ago, I wrote about how the Minneapolis Star Tribune had acted like a cheerleader on behalf of a local company whose product was a mesh-like sock to go around the heart in hopes of combating heart failure.

Over two straight days, the paper reported on the company's trial results with the sock. The stories did not have one comment from an independent medical source. But they did promote the company's "bullish" attitude about "the future of their unsual device as well as the company's prospects."

When the paper reported on a trial, in which the sock group was compared with a non-sock group of patients, the paper said the sock group scored better in "improvement" (not defined). There was no mention of complication rates. There was no discussion of whether the results were statistically significant, or whether they could have been due to chance.

The Wall Street Journal also reported on the sock study, but pointed out that the "sock didn't lead to a significant improvement in ejection fraction, the percent of blood that is pumped out of the left ventricle during a beat and a widely used measure of the strength of the heart."

The Star Tribune coverage felt naive and pro-local-business.

Last week, the cheerleading ended. The Star Tribune was forced to report, "The future of a New Brighton medical technology company remains unclear after a U.S. Food and Drug Administration panel ruled Friday that it may need to conduct a new clinical trial for the firm's sole product -- a unique device that treats heart failure. ...The company based its initial FDA application on a 300-patient trial. A similar study, if required by the regulatory agency, could cost Acorn an additional $20 million and take about three years to complete."

Journalists should review data and evidence and seek independent analysis of ideas in medicine, not local companies' bullish attitudes about their own products.

I teach my classes - even undergrads - that if I could change just one thing about the way in which research news is communicated to the public - for the sake of public understanding - it would be to include absolute risk/benefit data in each story or each message - not just relative risk/benefit data. On the HealthNewsReview.org website, we evaluate stories on whether they include absolute data. We also offer a brief primer on the topic. Failing to include absolute data may make the outcome seem much larger than it really is.

But even medical journals don't do a good job of demanding that absolute data be included in article submissions, according to a review in this week's BMJ. In it, Dartmouth/VA researchers looked at 222 articles over a year's time in six journals: Annals of Internal Medicine, BMJ, Journal of the American Medical Association, Journal of the National Cancer Institute, Lancet, and New England Journal of Medicine.

They found that 68% of articles failed to report the underlying absolute risks in the abstract of the article, and half of these didn't report absolute data anywhere in the article.

The authors' conclusion: "Absolute risks are often not easily accessible in articles reporting ratio measures and sometimes are missing altogether—this lack of accessibility can easily exaggerate readers' perceptions of benefit or harm."

The relative inaccessibility of absolute data is no excuse for journalists. If you're going to cover research news, you need to do it completely and correctly, and that includes getting at the absolute data - even if the journal article upon which you base your story doesn't include such data. Journalists should demand it from researchers they cover, just as journals should demand it from researchers submitting articles.

Competition among news organizations is a good thing. Readers and viewers already get far too many reports that are regurgitated in similar fashion from the same source.

But big media companies increasingly are going in the other direction: hiring big media names to serve two masters simultaneously.

The latest is CNN's Dr. Sanjay Gupta, who, according to Broadcasting & Cable magazine, will begin contributing up to 10 medical reports a year to the CBS Evening News.

OK, to whom does he give his best stuff? How would we know it's his best stuff? Is he saving a little extra for the CNN folks who gave him his break in TV news? Or does he save his "A" game for new viewers in his shot at one of the Big 3 audiences?

And CBS already has Dr. Jon LaPook, Katie Couric's doctor-friend. When might they hire a real medical journalist, rather than a doctor playing one on TV?

Scores on Eight Lung Cancer Screening Stories

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In the last Publisher’s Note, I wrote about our reviews of six stories by six different news organizations on a study published in the New England Journal of Medicine about CAT scan screening for lung cancer in smokers.

After that Note was published, we posted two more reviews of other stories on that study.

U.S. News & World Report – one star

NBC Nightly News – two stars

Overall, then, of the eight stories we reviewed on this topic:

* 6 of 8 failed to adequately discuss potential harms of such screening, which can include radiation exposure, needless anxiety after receiving a potentially false positive result and significant medical complications associated with biopsies.

* 6 of 8 stories failed to adequately address the availability of CAT scan machines that can be used for the lung cancer screening described.

* 4 of 8 stories failed to discuss the costs of such screening, which were discussed in the journal article upon which the stories were based. Estimates range from $200 to $1,000 per scan, so this is a significant issue that half the stories ignored.

* 5 of 8 stories relied on a single source (relying only on authors of the published study) and/or failed to present balanced, independent perspectives.
Each story was reviewed by three independent reviewers using the same evaluation criteria.

We will continue to look for such cross-media comparisons and hope you find the reviews helpful.

About this Archive

This page is an archive of entries from December 2006 listed from newest to oldest.

November 2006 is the previous archive.

January 2007 is the next archive.

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