OK, we're not #1.
But we're a busy little blog, as shown by the fact that this blog has just become the 5th most active blog out of 6,336 blogs with 15,465 authors hosted on the University of Minnesota Libraries.
What we rank 5th in is in the number of entries. Since September 2004, I've posted 866 entries on this site. And counting.......
There has been a lot of speculation about what happened to and what could have saved Tim Russert.
Some, like a Wall Street Journal piece, "A Visceral Fear: Unexpected Heart Attacks," bordered on disease-mongering. That story discussed:
"...experts who think wider use of coronary calcium CT scans could help spot more people at risk of soft-plaque blockages. The noninvasive procedure takes about 15 minutes and costs a few hundred dollars. But few insurers cover it because there is scant evidence that treating people on that basis saves lives.At a minimum, seeing a picture of the calcium lining their arteries can be a wake-up call for patients to take their coronary-artery disease seriously and to be diligent in taking medication, exercising and making other healthy lifestyle changes."
I'm sure there are such experts. But there are many other experts who do not support wider use of such scans. It's not just insurers who are reluctant. The story makes the procedure sound quick and inexpensive. But that is on the individual level. Who should be screened? Everyone over 40? The entire population?
Pictures - even those of the insides of our coronary arteries - don't tell the whole story. And neither did this piece.
From time to time, I've highlighted how the Integrity in Science Watch project of the Center for Science in the Public Interest tracks news coverage (or lack thereof) of conflicts of interest in medicine and science.
• Cheer to Andrew Pollack of the New York Times for disclosing that Eric L. Matteson, chairman of rheumatology at the Mayo Clinic, has consulted for many companies developing arthritis medication. Matteson is author of a recent study examining the link between various arthritis medications and cancer.• Jeer to Audrey Grayson of ABC News’ Medical Unit for failing to note that Michael J. Manos, head of the Pediatric Behavioral Health Center at the Cleveland Clinic’s Children’s Hospital, consulted and served on the speakers’ bureaus of Eli Lilly, McNeil Consumer and Specialty Pharmaceuticals, and Shire US. Manos was quoted supporting use of pharmaceuticals to treat Attention Deficit and Hyperactivity Disorder rather than St. Johns Wort.
• Cheer to Marilynn Marchione of the Associated Press for disclosing that Michael Gnat, a professor at the Medical University of Vienna, consults for Novartis, AstraZeneca, and other breast cancer drug makers. Earlier this month, Gnat announced results of his recent study showing Novartis’ bone drug, Zometa, can slow the spread of breast cancer.
Add the New York Daily News to my list of news organizations taking an unhealthy advocacy stance for screening tests.
A promotion in the paper screams out, "Get your free prostate cancer screening, courtesy of the Daily News":
Beginning on Father's Day, New York's hometown newspaper offers these free tests every year, because we believe we should help New Yorkers take care of themselves.So far more than 120,000 men have taken our free tests, and almost 10,000 have found that they need further action.
The screening is quick and easily performed.
Let's stop and break that down. More than 120,000 men have taken the free tests and almost 10,000 found they need further action? How many were false positives? How many faced further testing, treatment and anxiety that lead to nothing?
The screening is quick and easily performed? Does that mean that the decision about whether to have it should be quick and easy? Or should a man slow down and consider some of the cascading consequences of this "quick and easy blood test?"
Back to the newspaper promo:
The American Cancer Society recommends that men take the screenings from the age of 50, but high-risk males who include African American men and those with a family history of prostate cancer.
The Cancer Society may recommend that, but the group viewed as the "gold standard" in making preventive health recommendations, the U.S. Preventive Services Task Force, does not. USPSTF states:
The USPSTF found good evidence that PSA screening can detect early-stage prostate cancer but mixed and inconclusive evidence that early detection improves health outcomes. Screening is associated with important harms, including frequent false-positive results and unnecessary anxiety, biopsies, and potential complications of treatment of some cancers that may never have affected a patient's health. The USPSTF concludes that evidence is insufficient to determine whether the benefits outweigh the harms for a screened population.
Why, oh why, don't news organizations tell the other side of this story? Why don't they tell the evidence-based side of the story, instead of playing on peoples' fears to help sell newspapers?
Almost no mainstream news organizations reported on my paper, "How do US journalists cover treatments, tests, products and procedures? An evaluation of 500 stories," in last week's PLoS Medicine journal. 
That's probably not surprising. Why would you publish a story about an analysis that showed that you and your industry did a sub-par job in covering health news?
However, some journalists and top bloggers gave the study a good look.
Scott Hensley at the Wall Street Journal Health blog had some fun with it.
Maggie Mahar took a long look on her HealthBeat blog.
Minnesota Public Radio covered it on the air and online.
And, although I have no idea what they wrote, bloggers in France and Germany wrote something about our work. I hope it was helpful to those French and German surfers.
And I hope the dissemination of our results does some good in improving health journalism.
As we flip the calendar over from a very busy May into a sunny June, I want to reflect on the common themes in the blog entries of the past four days:
1. My PLoS Medicine article, “How Do US Journalists Cover Treatments, Tests, Products and Procedures? An Evaluation of 500 Stories.�
2. The Commonwealth Fund analysis on variations in child health care across the US.
3. Another "more care isn't always better care" study - this time in JAMA.
4. Consumer Reports releasing an online tool using Dartmouth Atlas data to allow you to look at aggressive vs. conservative care - comparing hospitals on this scale.
Connect the dots. Jack Wennberg's work rings through these themes.
Inexplicably widespread variations exist in the way health care is practiced in this country and more data comes in every day. More evidence also comes in every day that "more and newer isn't always better" in health care. And journalists are spending too much time on the "more" and the "newer" rather than on questions of evidence, costs, quality and access to care.
As a result, many consumers aren't getting much smarter at a time when some policymakers, employers and insurance company marketing folks push "consumer-driven health care" plans. Americans don't know what they're buying with the health care dollar and giving them more "skin in the game" doesn't make them smarter - only makes them hurt more - if they're not educated in the dots.
