The ShopTalk newsletter today describes the ugly TV news "shoving match" in Orlando over "the first report that a case of the swine flu was confirmed in Orlando." ShopTalk writes:

"Pity the poor viewers, who have to sort through all the hype and hysteria to find the facts."

Baltimore Sun TV critic David Zurawick writes:

"Dr. Sanjay Gupta, the CNN and CBS medical correspondent, was reporting from outside a hospital in Mexico City using such terms as "ground zero" and "chaos" to describe the situation.

Tuesday morning, on NBC's top-rated Today show, Dr. Nancy Snyderman, the show's health expert, was reporting "a couple of unconfirmed cases in New Jersey." ...

I can't imagine why Snyderman and Today were reporting unconfirmed cases. That seems to me one of the worst things a journalistic enterprise -- and Today is produced by NBC News -- should be doing. Wait for confirmation when reporting such data. ...

Even though Gupta is primarily known as the lead medical correspondent on CNN, he also works for CBS News, and I saw him Monday night on The CBS News with Katie Couric standing in front of a Mexico City hospital. He had his own mask -- down about his throat. Overly dramatic? Maybe.

I hated Gupta describing his location as "sort of ground zero" and reporting what he described as a lack of basic supplies for medical workers at the Mexican hospital as "sort of the chaos here," but he was the reporter on the ground. I just wish the language he used would have been prudent and less sensational."

Kudos to the Wall Street Journal, for including some perspective I've not seen anyone give quite this way:

"Many people assume a pandemic is a deadly scourge, but two of three flu pandemics that circled the globe in the 20th century were relatively mild. "Pandemics can range from being relatively mild to being extremely severe," said Keiji Fukuda, the World Health Organization's acting assistant director for health security and environment. "My own sense right now is it too early to make a call."

We're involved in another health journalism-related event on the University of Minnesota campus this week.

I don't watch much TV news anymore. As I wrote yesterday, I haven't watched ANY TV coverage of the flu story.

But Howard Kurtz has, and he writes today about some of the pitfalls of the "fever pitch" coverage as he calls it.

Only a comment because I've been asked: I've been favorably impressed by most of the flu news coverage I've read.

Haven't watched any TV coverage - generally a healthy habit.

Of course, if any readers have seen any examples they want to bring attention to, the forum is open.

The Knight Science Journalism Tracker offers a nice overview of news coverage.

Finished Tom Nesi’s book, “Poison Pills: The Untold Story of the Vioxx Drug Scandal.”

Chilling.

Sickening.

Everyone should read this story.

Another chapter has been written in the sorry series of unethical practices by local TV news operations in covering health news.

Al Tompkins of the Poynter Institute criticizes the Radio-Television News Directors Association and a local Maine TV station - and rightly so. Excerpt:

"I disagree with Radio-Television News Directors Association Chairman Ed Esposito's decision to allow WGME-TV to keep its Edward R. Murrow Award for a series of stories it produced about a medical team's work in China.

Maine Foundation for Cardiac Surgery paid for WGME's nine-day trip to Shanghai, which the Portland, Maine, station clearly disclosed at the beginning of each segment of its project, "The China Journey." The stories were well-told, and the photojournalism and editing was strong. ...

The station's heart was in the right place, but it should have put its wallet there too. Not doing so now gives stations nationwide an out when the boss comes knocking with a free trip to cover a worthwhile story."

Many stations may also make the claim that "their heart was in the right place" when they also accept medical industry money for sponsored segments that feature only the sponsors' experts - without disclosing that on the air.

RTNDA needs to wake up to how its own code of ethics - a strong document - is only a meaningless piece of paper if it isn't discussed and embraced by its members.

On Tompkins' site, the Maine news director responds: "The foundation NEVER tried to influence our coverage in any way."

They paid for the trip and got the coverage, didn't they? And that was coverage they would not have received if they didn't pay for the trip. To me, that's pretty clear influence.

Minnesotans, wake up from your winter doldrums and get your heads around health care reform issues.

Tomorrow (Friday April 24) - free documentary screening of Alex Gibney's film on Maggie Mahar's book , "Money-Driven Medicine."

Link to map of Murphy Hall location. Parking in Washington Avenue ramp two blocks east of this location.

Two more weak stories reviewed on HealthNewsReview.org:

• NBC Today show: Can you "recover" from autism?

Our review:
This story dangles hope of recovery in front of parents of children diagnosed with autism. Indeed, the word "hope" is invoked four times. However, the story provides no evidence to back up this hope.

• NY Daily News: Have a baby at new low, low price, says fertility doctor

Our review:
Is cheap really the whole story? This piece focuses on an infertility or subfertility treatment and promotes one doctor’s clinic in so doing. But cost, evidence, data are all weak points.

Another zero-star bottom-dweller for the CBS Early Show.

We now have three zero-star network morning show health segments reviewed on the home page of HealthNewsReview.org.

They're going for an 0-for-April.

Christopher Lane interviews journalist Philip Dawdy, who has written about the "astonishing" rise in the number of diagnoses of ADHD and bipolar disorder in teens and preschoolers.

Bloggers and Tweeters wrote about my presentations on 3 panels at the Association of Health Care Journalists conference in Seattle.

• On Washington state law encouraging shared decision-making.

• On the importance of covering costs in health care stories.

• Some folks followed my panel on "How To Report on Studies" on Twitter.

#ahcj09

It is not with any relish that HealthNewsReview.org publishes its worst review ever of a New York Times story.

Summary of our review:

"This story about a drug company's announcement of positive study results fails readers in every important way.

It portrays a "decisive" clinicial trial that shows a first-of-its-kind prostate cancer drug "prolonged the lives of men." It spins the tale of a determined company rewarded for its persistence against a slow-witted bureaucracy, whose earlier inaction led to the loss of "a lot of good men." It presents testimony of a cancer-stricken patient "looking into the abyss," seeking only "a chance." It anticipates the drug's approval, and documents Wall Street's instant validation of the study findings.

Not until paragraph eight does the story state that the company has not released the results, that the findings will not be discussed in public for two weeks, and that even then they will not have been peer-reviewed or published. It does not say that the results of this medical study were announced in a conference call to investors.

It recklessly, even perversely, suggests that the FDA's earlier inaction, combined with patient protests and what are now claimed to be positive results, constitute proof of efficacy.

It's hard to imagine why a story would delay and omit key information, imply efficacy had been demonstrated in the absense of evidence, or fail to balance all the positive views with those of a skeptic, or at least someone who urges prudence until the data are made public.

It is true that this story was originally published in the paper's business section. But all journalists share a common responsibility to the public when writing stories about diseases and treatments. In today's media environment, where a story's readers usually encounter it out of context of a "section," few readers will be "savvy" enough, if that is the word, to bring lower expectations of accuracy, balance and fairness to a story about what a drug can do for a deadly disease merely because it was originally written for the "business" section.

It's painful to imagine how families affected by advanced prostate cancer may respond to this article, and then to what they will subsequently learn. Even investors are badly served by such an unbalanced, incomplete story.

In any case, it is distressing to see such credulous, feeble, negligent journalism published anywhere in the New York Times."

Another terribly incomplete story on a morning segment on network TV.

It was about an osteoporosis drug now being looked at for poorly healing bone fractures.

CBS put a crawl under this story reading "Stem cells to build better bones." And then failed to mention stem cells even one time in the story.

They also had:

* No discussion of costs - which are significant.

* No discussion of evidence, which is limited.

* No discussion of the source of the information, but we can assume it was a recent study for which there was no control group to compare the results to. Furthermore, that study has not yet been published and the full results have not been reviewed by other experts. These are important caveats that the story should have mentioned.

Instead of data, the segment gushed calling it "godsend...really exciting...very important...could be lifesaving."

Complete story review on HealthNewsReview.org.

A posting on the WhatIfPost.com site - short for "What if America Had a Health Care System That Worked?" - discussed my recent report to the Kaiser Family Foundation on the state of US health journalism.

I'm on 3 panels at the Association of Health Care Journalists annual conference this week in Seattle.

Friday at 11 a.m.: Explaining costs in health care stories.

Friday at 3:15 pm: State legislation encouraging shared decision-making. Clinical, policy, legal views in one session.

Saturday at 2:30 p.m.: "How To Report on Studies" workshop. This session will mark the first time that the original publishers of the Australian, Canadian and US teams that have graded more than 2,000 health care stories will appear together on the same panel. It's Dr. David Henry - now in Toronto - who was the pioneer with the Media Doctor Australia website, Alan Cassels of the University of Victoria who started the Media Doctor Canada website, and me - publisher of the HealthNewsReview.org website. Should be fun.

Each year, timed to the Association of Health Care Journalists annual conference (which is this week in Seattle), TVWeek publishes a special issue on health journalism.

An index of this year's articles is available online.

In a little more than a week, 3 health segments on ABC's Good Morning America received pretty bad reviews from health care and journalism observers on HealthNewsReview.org. All 3 stories are currently on the site's home page.

The story, "Cutting Edge Nail Cure" got one of our rare, lowest, zero-star scores:

The advantages were unsubstantiated, the harms unstated and the effectiveness exaggerated. Network TV promoting an off-label use. Disease mongering at its worst. A new low. Stay tuned for lower.

The segment, "DNA tests replace Pap smear?" made a decent effort on an important topic, but, in the end, our reviewers felt:

This story gave lip service to an important new study, but fell far short on details. Didn’t quantify benefits or costs or discuss the possibly limited impact in developed countries.

And the segment, "New treatments for America's #1 killer," deserved this review:

Story on coronary calcium test fails to discuss evidence, cost, or problems with false positive tests. But it hypes the test and disease mongers – telling us it’s a wakeup call we all need. Not so.

Instead of starting your day with this kind of health news, you'd be better off going for a walk before work.

These are actual headlines from newspapers across the US on the DaVinci robotic surgical system:

• Robot doctor - surgery of tomorrow

• Da Vinci puts magical touch on the prostate

• Cancer survivors meet lifesaving surgical robot

• Robotic surgeon's hands never tremble

• Da Vinci is code for faster recovery

• Surgical Maestro

• DA VINCI ROBOT IS SURGERY WORK OF ART

• Hospital hopes robot surgery will lure patients

The last one is closest to the truth.

We reviewed another one today on HealthNewsReview.org.

It's hard to understand how so many stories could be so fawning, drooling over new technology, without discussing evidence of harms and benefits, which is limited.

As we said in our review of the latest story:

"(The story framed) the procedure like playing video games - "It's like shooting at space ships." Even though the surgeon interviewed said this, it would have been interesting to get a primary care doc's reaction to this comment. In fact, any independent source would have been appreciated.

Legitimate questions can and should be raised about any new medical technology. This story raised few, but let true-believer-surgeons promote their pet technology. One said he "loves his robot."

Even with prostate cancer, for which robotic systems have been used most often, the US Agency for Healthcare Research and Quality says there isn’t enough research yet to tell us how well robotic surgery works compared with other treatments."

The Tulsa World reports that the state of Oklahoma "is paying more than $3 million to an Oklahoma media company, Griffin Communications, to advertise a state (health) insurance program, and the company has promised to air television news stories on its Tulsa and Oklahoma City stations as part of the deal."

The story explains:

"Griffin employs former KWTV, channel 9, television reporter Angela Buckelew as the campaign's spokeswoman. She appears during news programming on both KOTV, channel 6, and channel 9 to talk about the Insure Oklahoma program.

The media spots aired as part of Griffin's marketing campaign blend seamlessly into the newscasts of KOTV and KWTV, with Buckelew acting as reporter and telling the individual stories of employees of small businesses who have benefited from the subsidized health insurance plan."

It's interesting to follow the online thread of reader comments, including these:

• TV news isn't very worthwhile anyway. Arrangements like this certainly won't make it better.
• What a pathetic corporation. If it's paid for, it should be labeled as a paid infomercial. Why would any self-respecting journalist work for this kind of an organization?
• This is an incredibly slippery slope.
• PAID content, person ACTING as REPORTER, blended into their NEWSCASTS........shameful

A drug company applies to expand its approval for a drug (Tykerb) for advanced breast cancer in the US and Europe. And the only source AP quotes in the story is an employee of the drugmaker. That is not sound journalism.

The story is one of the resounding majority (72%) of health news stories I’ve tracked in the past 3 years that failed to discuss the cost of the product being discussed.

But a woman on a breast cancer discussion board recently claimed:

“The drugs cost almost $6000 per month. I make only $1000 more per month than that. All my savings is wrapped up in real estate and I can't even sell a house right now to pay for these drugs. How can ANYONE afford these drugs if not covered by insurance?! If anyone has been on this treatment and the drugs have stopped working for them and you have an unused supply, I would appreciate hearing from you. Please don't throw these expensive drugs away. There are people out there who can use them!”

The story also gave an incomplete accounting of side effects and never quantified the benefits that the drug company put in its application for expanded approval.

Finally, the story failed to give the highly significant context that just last month the UK's National Institute for Health and Clinical Excellence (NICE) recommended that the drug "should not be used, except in the context of clinical trials, as it is not a cost effective use of resources."

HOW CAN ALL OF THIS BE LEFT OUT OF A NEWS STORY?

And before anyone counters, "This is meant to be a business story, not a health news story," let me just ask if business news readers don't deserve information on costs, from more than a single conflicted source, and context about steps one government agency has already taken to recommend against the drug.

Should Obama Get a PSA Test? On Prostate Cancer Screening and Comparative Effectiveness. That's the headline of Dr. Bernadine Healy's blog entry on the US News & World Report website.

I felt obliged to respond online with a comment in reaction. I wrote:

Dr. Healy writes: "Prostate cancer mortality rates have plummeted in the United States over the past 20 years, coinciding with the widespread use of PSAs. (No such drop has occurred in Europe, where PSA screening, by policy, is uncommon.) This suggests—though it certainly doesn't prove—that PSA screening saves lives."

However, if more silent cancers that never would have killed American men are now being found because of more American PSA testing, then by default, the mortality rate would plummet. You're now calling more things "cancer" – many of which wouldn't have killed a man anyway. Dr. Barry Kramer of the National Institutes of Health calls it a pseudo-epidemic. So Dr. Healy’s example certainly DOESN'T prove that PSA screening saves lives.

And the entire premise of the article about whether the President should get a PSA test - while provocative and probably meant to catch eyeballs - misses the conclusion most experts reached after the recent studies. When evidence raises so many questions about PSA screening, it becomes essential that a man discuss the potential benefits AND harms with his own caregiver. It's not an item up for debate by a magazine or by a urologist who won't even see the President.

Merrill Goozner, who headed the Integrity in Science Watch project at the Center for Science in the Public Interest for the past five years, has been axed by CSPI.

The good news is that he'll now have more time to devote to his terrific blog, GoozNews.com, for which, in the past, he had to cobble together an hour or two in the morning or an hour or two in the evening - or more - to fuel the blog. Or maybe he'll come up with a new initiative worth watching. He won't sit still - although he says a few rounds of golf will come first.

Gooz helped put health care conflict of interest on the public radar screen during his five years at CSPI. He has an eye and an intellect to hone in on troublesome tidbits that others may miss. We can't lose his regular contribution to journalism in whatever form that takes.

We wish him the best.

My Canadian friend and colleague Alan Cassels (along with two other colleagues) has published a new analysis warning "that private clinics selling high-tech services to screen healthy people for disease could be harming Canadians and placing an undue burden on the public health system. ...The results of the study found that there are prevalent misconceptions about the safety and regulation of CT and PET screening technologies."

He's also written a consumer guide, "To Screen Or Not To Screen, That is the Question," available at the same link above.

Alan is publisher of the Media Doctor Canada website - the Canadian counterpart to our HealthNewsReview.org project. Alan will join me and David Henry - the original publisher of the Media Doctor Australia website - in a panel at the Association of Health Care Journalists conference in Seattle in two weeks, where we will try to teach journalists about how to do a better job reporting on research and studies.

A radical approach, lacking in evidence on harms and benefits, gets bigtime coverage from a bigtime newspaper - the LA Times.

But, after all, it's based on the promoter's new book, so it must be legit.

See the story review on HealthNewsReview.org.

As if the TV networks' morning "news" programs don't give enough free pub to any author with an agent.