TIME magazine this week has an article on what it calls "medicine's secret stat," NNT or number needed to treat. The magazine uses the example of a study that might show that statin drugs lower the risk of heart attacks by 30%.

"But that number is meaningless unless you take into account the percentage of men in both groups who have heart attacks in the first place. If those people represent only a tiny fraction of the two populations, an improvement of 30% isn't much--maybe one heart attack fewer in a group of thousands.

Since public-health officials want to save lives, they focus on the thousands and avoid the NNT. Since pharmaceutical companies are in business to sell drugs, they do the same. Those two forces have kept NNT from being a big part of medical education. We could all help change that by doing nothing more than asking for the number up front the next time we're handed a prescription."

But the TIME article didn't discuss how journalists could be and should be using NNT in their reporting.
That's why we put a little primer on the topic on our HealthNewsReview.org website. More consumers would understand the topic, and ask their doctors about it, if more journalists put the concept in more stories about research studies.

You may have heard about the 15-year old Florida girl who started hiccuping a month ago and hasn't stopped. If you watch the network morning shows, your chances of knowing about her are better.

What you may not know is the level of harassment applied to book guests like her. The St. Petersburg Times reports: "The competition for her story became so frenzied over the weekend that NBC's Today show changed Jennifer and her mother's New York hotel after another network's exhaustive attempts to get an interview.

Waiting for her were calls from the Ellen DeGeneres Show, and television stations from as far away as Canada and Britain."

Another chapter in the misplaced priorities of network news decision-makers.

Broadcasting & Cable magazine reports:

"The sponsorship of a PBS program on obesity by diet drug maker GlaxoSmithKline has one veteran noncom TV watcher a bit exercised, but PBS says it is by the book.

Jeff Chester, executive director of the Center for Digital Democracy, and a frequent critic of what he sees as the increasingly commercialization of noncommercial broadcasting, has written to PBS ombudsman Michael Getler to complain about what he sees as too lax sponsorship policies.

Glaxo is underwriting the April broadcast of 'Fat: What No One is Telling You' ...

'We note that funding comes in part from GlaxoSmithKline,' Chester wrote Getler. 'The drug giant just happens to have a recently approved for over-the-counter drug on the market-under the brand name Alli, that is for 'use by overweight adults along with a reduced calorie, low-fat diet.' ...

PBS program executives need to 'cut the fat' out of their sloppy review of what's appropriate for underwriting,' said Chester."

Getler responded on his PBS ombudsman blog: "My view is that Chester’s eagle-eye provides a continuing, very useful challenge to PBS, a challenge that I agree with even though I sympathize with PBS’s constant search for funding, the difficulty of finding sponsorships to bolster more traditional funding, and that fact that some funders simply have an interest in seeing subjects aired and are willing to take their chances on how the program will come out. But in this case, there is little doubt how a program about obesity is going to turn out. Even though GlaxoSmithKline came in late and, under PBS policy, has no say in any of the content, this kind of possible conflict can undermine credibility and, without knowing the financial details, doesn’t seem worth it. "

(GS note: Thanks to one of my blog readers for tipping me off to this controversy.)

Last week it was NBC's hype of a drug for restless leg syndrome.

This week it was NBC using some of its airtime to promote a new "laser hair comb" for baldness. You figure a network newscast has about 22 minutes for real news. It chose to give a chunk of that time to this. The video can be seen on the MSNBC site.

What's going on with the NBC newscast? Is it cheerleading-in-TV news month? Perhaps, given that we're in the midst of a ratings-sweeps period.

On the HealthNewsReview.org site, we wrote: "There is an underlying tone of disease-mongering whenever a national TV network uses some of its precious 22 minutes of airtime to promote an expensive new product to "treat" - or as the story says at one point, "cure" - baldness - a condition that is a normal part of aging for many men.

Anchor Brian Williams' comment - "..when you use the expression "potential cure for baldness" in this country, you're going to be a multimillionaire overnight..." - is more cheerleading than reporting. If this story had to be reported as one of the few stories of the day in a network newscast, it should have offered more evidence and context than boosterism."

One wonders what the 47-million Americans without health insurance would think if they saw a story like this on the network news.

Much of the coverage of the death of Anna Nicole Smith represented another low point in journalism.

CNN, which has billed itself as “the world’s most important network,� asked its senior medical correspondent, Dr. Sanjay Gupta, to comment on the death.

Wolf Blitzer introduced Gupta, saying, “Talk a little bit about what we know. A lot we don't know, Sanjay, about the cause of her death.�

Gupta led off saying, “There's a lot we don't know as well.�

Talk about a reason to stay tuned! But if you stayed tuned, you heard Gupta jumble together conjecture about “the heart as being the most likely culprit� – followed by “Why she would have heart problems? Not exactly sure.�

He continued: “Also lung problems. Could there have been some sort of a clot?... Could it have been some sort of medication problem?�

Blitzer and Gupta then speculated about the flu, about her weight problem, about her addiction to painkillers, about a diet plan called Trimspa, about ephedra – much of it followed up with the reminder, “Whether that had anything to do with this, we don't know as well.�

So there you have it: virtual autopsy from long distance via speculation, rumors, and no direct knowledge of anything.

I am disappointed that Vioxx, Viagra, and the Virus of the West Nile were never mentioned.

As Blitzer introduced CNN anchor Jack Cafferty for another segment, Cafferty said: “Is Anna Nicole Smith still dead, Wolf?�

BLITZER: “Yes, we're going to -- updating our viewers coming up shortly on...�

CAFFERTY: “I can't wait for that.�

A San Antonio Express-News columnist reminds us that we're in the middle of the February TV ratings or sweeps period. And she laments the hype, including that of health news. Excerpt:

"Oh no, I woke with a headache. Boy, do I feel tired! Does that mean I'm at risk for a stroke?

It's February sweeps — a fact I almost forgot because of the many other biggies of the month: the Super Bowl, the many awards shows, such as the upcoming Grammys and Oscars."

I'd like to hear from anyone else around the country about their favorite TV sweeps pieces this month.

A Vancouver Sun story is a good example of an imbalanced story that fails to address health policy issues with context and completeness. The story reports on an advocacy group report and, in so doing, takes a flawed advocacy stance itself.

The story begins: "Cancer patients are increasingly having to pay for important new drugs administered in public hospitals, the latest symptom of Canada's inconsistent and often inadequate funding of cancer treatment, an advocacy group reported Monday."

The story says, "One breakthrough leukemia drug is paid for by just a single province, (British Columbia)." The story didn't explain what qualifies as a breakthrough.

Then the story dipped into the language that is usually used when cost-effectiveness decisions are made by government officials - "rationing." The story says, " 'Essentially, we will continue to ration life-saving cancer treatment, and some Canadians will live and some will die simply because of where they live,' said the report."

Late in the story, it finally disclosed that the advocacy group was financed largely by pharmaceutical companies.

The report also looked at the availability of PET (positron emission tomography) scans and mammograms for cancer patients, raising questions about what the report said was underuse of the two technologies.

But overuse of PET and other scanning technologies is generally a bigger concern than underuse. And who's to say that women aren't choosing to forego mammography after weighing the evidence? The story certainly didn't look into that possibility.

Journalists will not contribute to a meaningful discussion on health care reform if they take the party line of a pharma-funded advocacy group as gospel.

NBC News anchor Brian Williams delivered an awkward and unusual story lead-in last Wednesday, one which has touched off a firestorm of criticism of him even on his own blog.

Williams said, on the air: "If you watch this newscast with any frequency, then you've seen it - this ad playing behind me here on the screen - for a medication for something called restless leg syndrome. A lot of us had frankly never heard of the condition but we figured people must suffer terribly from it for there to be a medication to treat it. And so,motivated by a commercial by one of our own sponsors, we asked NBC News correspondent Josh Mankiewicz to do some checking. "

Mankiewicz’s story begins: “They show you the problem, and the solution. The syndrome, known commonly as RLS, affects millions and has been known to some for at least 60 years. But until recently, most people — even many physicians — had never heard of it. The drug company GlaxoSmithKline changed that.�

The story then quoted a doctor who said: "I'm not generally a big fan of direct-to-consumer TV ads. However, for this particular disorder, I think they've done a great service by spending most of the time identifying the problem." (You can read Williams' blog later to see what some viewers dug up about this "expert" source.)

The story went on to brag about Glaxo’s earnings from the drugs. And cited a single patient who said the drug “worked like a charm.�

The NBC hype didn’t end there. Brian Williams went on his blog to brag about the story.

But viewers went to the blog as well, many of them to criticize NBC and Williams, saying things like:

“Brian,
You said "We commissioned last night's story...."
And with whom did you commission that biased story?
(GlaxoSmithKline - the maker of the restless leg drug in the story)? I thought NBC was trying to cut commercials so we get more news. Does this integraded (sic) ad then count as news or advertising.�

Or

“This is only one of numerous examples of drug companies, trying to invent a disease or malady, or whatever, just to sell prescription drugs.�

OR

“it seemed to me the majority of writers were upset (as was I) about the blatant commercial you ran for for an advertiser�

OR

“Give anything a name, initials and a drug to "cure" it and you'll become a millionaire. Goes to show how gullible we have become in this country. And think about it, Brian, you're part of the problem/solution?�

OR

“This time you've really crossed the fine line between journalism and advertising, and you owe your viewers an explanation and an apology.�

Had NBC, Williams or Mankiewicz done even a little research, they would have found, free on the web, an article entitled, “Giving Legs to Restless Legs: A Case Study of How the Media Helps Make People Sick.� Which is just what NBC did with this egregious example of disease-mongering. I am at least comforted that an intelligent viewing audience is starting to catch on to such examples of shoddy journalism.

You get a half hour on an international news network to report on health news and you use it to:

1. Tell people if you want to avoid the flu, "try to avoid getting too close to sick people."

2. Feature a doctor who lost 70 pounds by using lots of hot sauce, even though you admit "it doesn't really have any science behind it."

3. Promote a "permanent" wrinkle filler, while minimizing evidence - and failing to quantify potential benefits or harms.

That's what CNN did this weekend with its "House Call With Dr. Sanjay Gupta" program.

The first two were just laughable. The last was more dangeous.

The story described "ArteFill, billed as the first permanent filler." It said "known side effects are minimal."

But it's easy to find the following on the FDA website:

Side effects of ArteFill® include:

* Lumpiness at injection area more than one month after injection
* Persistent swelling or redness
* Increased sensitivity
* Rash, itching more than 48 hours after injection

Let's let consumers decide if those sound "minimal" or not. The story never mentioned that one of the conditions of FDA approval last fall was that a five-year study for safety be done after approval, a clear sign that reviewers were not convinced that all the evidence on safety was yet in.

Meantime, the story profiled a woman who had the injections: "In less than 30 minutes, (she) was sold. She thought she looked fresh with, if anything, her wallet, not her face, showing fatigue."

Let's let consumers decide if this sounded like a news story or a commercial.