The Star Tribune newspaper finally - 10 days after I submitted it - published my op-ed piece countering a feature story entitled, How To Be A Screen Queen. I give the paper credit for publishing my response, although they edited my submission and did not share with me in advance what the final published version would be. This is more than a little troubling to me - since what was published was not what I submitted.

One thing they left out was the broader context of such media advocacy pieces crusading for screening tests in the absence of the best evidence, something I reported on in a piece entitled, "Unhealthy Advocacy: Journalists & Health Screening Tests."

I'm going to continue to track news coverage of health screening tests and will continue to report on the results on this blog and in whatever venue I can find.

I've blogged earlier about something being smelly about the ENHANCE trial, comparing the cholesterol drug Zetia plus Zocor versus Zocor alone.

This week, a commentary in the Journal of the American Medical Association addresses some of the stink. Excerpts:

The unusual release on January 14, 2008, in the news media and on a drug company Web site, of a portion of the Effect of Ezetimibe Plus Simvastatin Versus Simvastatin Alone on Atherosclerosis in the Carotid Artery (ENHANCE) trial data resulted in numerous articles and commentaries in the lay media. The availability of only fragmentary information created massive confusion and raised many more questions than answers for patients, physicians, pharmaceutical companies, and regulators. A full report of the ENHANCE trial in a peer-reviewed medical journal is not expected for months, and the first public presentation of the study's findings in a medical setting will not occur before late March 2008.

Lesson 1: Drug Trials Should Not Be Done for Marketing Purposes Only

Lesson 2: The News Media Must Be Sure to Get the Facts Straight. Errors in Reporting Can Cause Serious Damage, and Patients May Be Harmed or Become Distressed From the Resulting Confusion

Lesson 3: Leading Scientific, Patient-Oriented, and Disease-Oriented Organizations Must Scrupulously Avoid Conflict of Interest

Dallas TV critic Ed Bark writes the latest chapter of an ever-thicker and ever-sicker story about TV stations selling "news" time to hospitals that want to look good on the air.

As I've asked before, when is the Radio-Television News Directors Association going to step up and address this situation, which is addressed in its own code of ethics but apparently almost universally ignored? Excerpts of that code:

Professional electronic journalists should:

* Gather and report news without fear or favor, and vigorously resist undue influence from any outside forces, including advertisers, sources, story subjects, powerful individuals, and special interest groups.
* Resist those who would seek to buy or politically influence news content or who would seek to intimidate those who gather and disseminate the news.
* Determine news content solely through editorial judgment and not as the result of outside influence.
* Resist any self-interest or peer pressure that might erode journalistic duty and service to the public.
* Recognize that sponsorship of the news will not be used in any way to determine, restrict, or manipulate content.
* Refuse to allow the interests of ownership or management to influence news judgment and content inappropriately.

Ten days ago, the New York Times posted Tara Parker-Pope's column, "No Answers for Men With Prostate Cancer." It discussed the federal agency report that concluded that nobody can tell men with prostate cancer what type of treatment is most likely to save their lives - or that any treatment is better than doing nothing.

Many news organizations, when they post such columns online, now offer readers the chance to comment online. As of this morning, 141 people have sent in comments in 10 days. They are all visible following the story posted online. Ms. Parker-Pope has responded to a few of the comments online, but other user comments raise assertions, make claims, ask questions - all unanswered or unchallenged.

That's disturbing for a number of reasons, the biggest one that it lends the credence of the New York Times' website to some spurious information posted on their site in an unchallenged manner.

I would suggest that if the Times is going to moderate some of the discussion, then it should moderate all of the discussion. And I realize what a tough task that would be, with 141 messages in 10 days.

But this should not just be a marketing move - that offering a sense of "online community" is good for business. Journalism principles should enter into this as well. But right now it looks like the New York Times has invited a conversation, got one, and now doesn't know what to do with it.

And this trend is only going to deepen. Witness CNN's I-Report feature that invites citizen journalism: "What's happening where you are? Is news happening in front of your eyes? Pull out your camera and I-Report it for CNN."

Democratization of news? Or abdication of journalistic oversight responsibility? Read the 141 messages (probably more by the time you get there) on the Times article above and make a judgment about whether the "community" discussion was worthwhile or not.

It's interesting to see the different interpretations, emphases, and headlines of different news organizations on the same story.

The New York Times uses a headline, "Most Breast Cancer Sites Get It Right" over a story that begins:

The Internet is filled with unreliable health information and bogus claims. But sites dedicated to breast cancer information appear to have a high level of accuracy, a new study shows.

Texas researchers recently analyzed 343 Web pages, retrieved using search engines that consumers are likely to use when seeking information about breast cancer. The study, published online today in the medical journal Cancer, turned up 41 inaccurate statements on 18 of the Web sites, or an error rate of just 5.2 percent.

But that "just 5.2 percent" is the focus of the headline and the lead in a Reuters wire service story on the same study, but headlined, "Some breast cancer websites inaccurate." The story begins:

Five percent of breast cancer Web sites have mistakes, with those involving alternative or complementary medicine the most likely to be misleading, U.S. researchers reported on Monday.

So is an error rate of "only" 5% good - and worthy of headlines? Or is an error rate of 5% "bad" and worthy of the headline?

Probably the best judges are women with breast cancer.

A tip of the hat to KARE-11 TV (Minneapolis) reporter Rick Kupchella for the start of his ratings period series, "A Cure For Health Care?".

TV news across the country is a wasteland if you 're looking for serious health policy discussions. But in the past couple of years Kupchella has tackled some of the most complex health care reform issues and proved that local TV news can tackle these topics. He's once again proved that TV doesn't have to hide behind the excuses of "It's gotta be short" or "It's gotta be gee-whiz visually."

And he doesn't even cover health news fulltime.

Kudos to Kupchella for his personal commitment and for striving for excellence in serving local viewers.

Last week the NBC Today Show presented a series it called “Mini Medical Miracles.�

Were you waiting for news on cancer? Heart disease? Diabetes? Infectious diseases?

Sorry. What you got was baldness, insomnia, dandruff and wrinkles.

But NBC called the approaches “miracles� and “breakthroughs.� Man, that’s what we need is a good miracle for dandruff and wrinkles.

Anchor Matt Lauer led into the wrinkles story by asking “Could having a new laser treatment in your forties or fifties prevent you from ever needing a facelift?�

Who says that anyone needs a facelift? Facelifts are a matter of want, not need.

47-million uninsured is a matter of need.

Lauer and NBC medical editor Dr. Nancy Snyderman could barely contain their enthusiasm for the laser “treatment.�

(Snyderman:) “This is going to be in your doctor’s office soon.�

(Lauer:) “It’s interesting. And anything that keeps people away from the knife. I mean, that’s major surgery.�

(Snyderman:) “I think you can say to people, this is a preemptive strike and it’s taking care of your skin and you can avoid a real operation. There will be a lot of people, men and women, who will be interested.�

There was no discussion of evidence, no quantification of benefits or harms, no discussion of how long the approach has been tested nor in how many people.

On HealthNewsReview.org the story is one of only 10 of the first 500 stories reviewed that got a score of 0.

Oh, for the good ol’ Today Show days of Dave Garroway and J. Fred Muggs, the chimp.