HealthNewsReview.org summary of the CBS Early Show segment on blue dye, rats, and spinal cord injury:

The lasting value of this TV news segment on rats, candy and spinal cord injury may be that it allows us to coin a term for a chronic, pernicious condition long affecting health and medical journalism but not previously identified: Blue M&M Syndrome.

This condition may be diagnosed when a story on medical research has no reason to appear before a mainstream health audience absent some irresistibly funny/gross/wacky detail.

In this case it's the link between a chemical tested in rats with spinal cord injuries and blue M&Ms.

But Blue M&M Syndrome is present in many widely reported stories about scientific studies done on insects, worms, rodents or primates. They often involve mating, a specific food, an unpleasant secretion, or some easily anthropomorphizable behavior such as stress, aggression, napping, or gaining weight.

Studies like this are often scientifically significant, and should be reported for an audience of medical researchers and scientists. They are often cute or curious, allowing them to be reported in a wacky-news segment or a kicker.

But they should not be done straight-faced in a forum where consumers reasonably expect useful, pertinent health information. This is especially true when the studies involve a profoundly disabling medical condition.

What CBS has done is presented a story about spinal cord injury with no certain human application yet implied just the opposite.

The fact that the study was done on lab rats does not appear until 2 minutes into a 3-minute segment. Viewers are never told human applicability is uncertain. In fact, the correspondent said this (emphasis ours):

So again, more work will be occurring with this. This has to be given within hours of the injury, but it holds a lot of promise for the people who suffer from spinal cord injuries. It's not just the one injury that matters. It's the secondary injury that really gets people.

Last week the same news program did a segment, "Walk On: New Device Helps Paraplegics Walk Again," which as its title suggests falsely implies a medical device could make the disabled rise from their wheelchairs.

Now it's a story on how blue M&Ms can prevent permanent disability following spinal cord injuries.

Set aside the unfortunate coincidence that both stories offer similarly false hope to patients with the same serious physical disability.

The point is this journalism is beyond careless. It's beyond merely indulging trivia out of context to divert morning viewers.

This is reckless, veering toward malicious.

Thanks to Craig Stoltz for his thoughtful review of this story.

Watch CBS Videos Online

Journalist Maggie Mahar blogs:

"I fear that the way the media has been reporting on reform has played a significant role in shaping the public's perception of both the president and what some like to call "ObamaCare," personalizing the issue, as if reform were merely the president's favorite hobby-horse.

Begin with coverage of health care reform. In recent weeks, Media Matters has done an excellent job of tracking how "the media continues to spread conservative misinformation on health care reform." Here are just a few examples:

 "Despite clear progress, media declare health care reform nearing "life support"

 "On health care reform, networks highlight perceived setbacks far more than progress" July 22

 "Politico ignores contradictions in calls by "moderates" for lower costs, limits on public plan" July 20

 "CBS' Smith advanced falsehood that Dems are taxing small businesses to fund health bill" July 19

 "NY Times ignores House health bill's exemption protecting small businesses"

 "Wash. Post column cites inapplicable CBO assessment to claim public plan option has 'huge cost, minor benefit'" July 07

 "CNN.com joins Republican fear-mongering about Canadian-style health care" July 07

And here I'm not even including the over-the-top distortions of the truth that have become regular fare on Fox News, and in the pages of some decidedly conservative newspapers."

There's much more on her blog.

From last week's NPR program:

A segment entitled "Blame Canada," with the Canadian Broadcasting Corporation's Maureen Taylor explaining what health care is really like north of the border. Excerpt:

MIKE PESCA: What do Canadians make of how their health care system is being portrayed in the U.S. these days?

MAUREEN TAYLOR: I think we're actually saddened that you could use something that we find works so well, the Canadian health care system, to scare Americans into voting this down and being afraid to move forward with this.

And a segment called "The language of reform" with Frank Luntz, author and Republican wordsmith, who wrote a memo called "The Language of Healthcare 2009." He says his ten rules will help Republicans stop the "Washington takeover" of health care.

Just read the headlines:

Magic pill for spine injuries: blue M&Ms?
Rocky Mountain Independent

Blue Food Dye Treats Spinal Cord Injury?
Ivanhoe

M&M's, Gatorade May Hold Key To Treating Spinal Cord Injuries
WDIV-TV Detroit

Common, safe blue food dye may treat broken spines
Reuters

Perhaps the best because it emphasizes RATS in the headline:

Blue Dye Halts Worsening Paralysis in Animal Study U.S. News & World Report - (a HealthDay News story)

or

Blue Food Dye Helps Rats With Spinal Injuries-But Also Turns Them Blue
Discover Magazine

Perhaps the worst, because it actually puts the word "cure" in the headline:

Can blue M & Ms cure paralysis? Chicago Tribune

or

The Blue Dye in M&Ms Cures Spinal Injuries
Popular Science

Add to these the recent awful stories on paralysis and spinal cord rehab by ABC and CBS and you can only feel empathy for those suffering with these problems who are jerked around by sensational headlines and sometimes by the stories that follow.

Another example of fawning coverage of medical technology.

Another example of obsequious news on the DaVinci robotic surgical system, about which I've written earlier. (In fact, an earlier post just this week about the President playing with a robot at the Cleveland Clinic.)

A story in The Oklahoman reports on a university medical center's new DaVinci robotic surgical system for prostate cancer.

It failed to report on the limited evidence to support this approach. The U.S. Agency for Healthcare Research & Quality states that there hasn't been enough research to know how this approach compares with others.

It also failed to look at the apparent burgeoning medical arms race in Oklahoma City - just for prostate cancer much less anything else. One center is bragging about its latest generation robot. Another center is bragging about its even more expensive proton beam therapy.

Wouldn't that be a good story?

How local newspapers deal with issues of medical technology assessment, of community ascertainment of need, of resource allocation. of costs, of evidence is vital to public understanding of why we spend more than any other country on health care without the outcomes to show for it. Stories can educate or they can advertise. This one falls in the latter category.

(Hat tip to Craig Stoltz, from whom I borrowed the "wide-eyed new-technology-in-town" phrase, and who helped with the review of the story in question.)

This is one such example.

Our good friends at ABC's Good Morning America just keep coming up with new ways to brighten our mornings.

There's a very important study published in the July 27 Journal of Clinical Oncology. But iif you read different news stories - or at least their headlines - you'd never know they were all about the same study.

Perhaps the most clear story - and headline - came from Reuters Health.

Headline: Many prostate cancers grow too slowly to kill.

Excerpt:

A large 15-year study of men who had surgery for prostate cancer found only a small percentage died from cancer, adding to evidence that some men might be able to skip radical surgery to treat the often slow-growing tumors, U.S. researchers said on Monday.

The study of more than 12,600 men with prostate cancer who had their prostates removed found only 12 percent died from cancer 15 years later, even though some showed signs of having an aggressive type of cancer.

Many more men -- 38 percent -- died from causes other than cancer.

The study "shows a remarkably low risk of dying of prostate cancer within 15 years for treated men, and supports the concept that men with slow-growing cancers may not need immediate treatment," said Dr. Peter Scardino of Memorial Sloan-Kettering Cancer Center in New York, whose study appears in the Journal of Clinical Oncology.

U.S. News & World Report put this headline atop a HealthDay wire story:

Men Who Have Prostate Cancer Surgery Do Well

But study didn't determine value of any treatment vs. watchful waiting

But the Scottish Daily Record had the oddest headline:

Operation can give prostate cancer sufferers another 15 years, says research

As I write this I have not been able to find this story in the AP, the NY Times, the Wall Street Journal nor the Washington Post. Why not?

The Daily Dose on MSN tries to put our health news criteria to good use.

Hat tip to Erica Jorgensen, editor at MSN Health & Fitness.

I've written about Dr. Nancy Snyderman's form of health journalism many times.

But on Daily Kos today, JD Wolverton posts an open letter to Snyderman about what he calls her "fluffy health care news show."

In it he writes:

I'm disappointed with your take on health care reform and suppose you have come to your biases from your experiences as a physician. You need to look at health care from the perspective of someone earning the median income in the U.S. today, about $50,223 per year. ...

You don't quote peer reviewed sources for your opinions. You don't back up your assertions. Being an MD doesn't excuse you from citing sources....

Do us a favor. Do a real health care oriented show that does more than fluff pieces. ...

Honestly assess health care rationing in the U.S. Plenty of people talk about how health care rationing in the U.S. is done by insurance company bureaucrats and our ability to pay for our care - you should join us.

Say that there are long waiting periods for care in the U.S. - that disabled people who qualify for SSDI then have to wait 2 years (usually uninsured) before they can get onto Medicare. That's a heck of a waiting period, don't you think.

Do better. You don't have to be a wonk. Just be more honest than you are now.

(Hat tip to Pia Christensen.)

NPR explores an issue many others haven't, reporting that in "three critical months, PhRMA and its member companies spent $40 million lobbying Congress. That's more than $3 million each week."

So the Wall Street Journal publishes a story on "cankles" - chubby lower legs.

Well of course that's too much for morning TV shows to resist copying.

So ABC's Good Morning America airs a segment in which they at least acknowledge they're simply copying the WSJ.

The CBS Early Show had to join in the discussion of this vitally important public health concern as well.

But both the ABC and CBS segments featured the same woman and the same plastic surgeon!

Can't you just picture the limo driving them around Manhattan from network studio to network studio?

Now that's health journalism on the network TV morning health shows.

Former Washington Post health section editor Craig Stoltz, one of our reviewers on HealthNewsReview.org, called it "almost cruelly misleading" the way the CBS Early Show dealt with what it called a "new device helps paraplegics walk again."

Excerpts of the story review on HealthNewsReview.org:

This CBS Early Show segment on the three-year-old WalkAide medical device manages to put a check next to nearly every item on a list of Health Journalism Worst Practices.

1. It is full of loaded, technically incorrect language: new, revolutionary, miracle. The device is none of these. Twice the segment refers to the device as a "miracle in a box." It's not even in a box.

2. The segment makes two statements that are technically correct as worded but broadly misleading through implication:

It says the device is "a promising development in restoring full function" to people once confined to a wheelchair. [Reality: It can temporarily improve the gait of some patients with foot drop syndrome.]

It says it can "restore mobility to patients with multiple sclerosis, cerebral palsy and traumatic brain injuries." [Reality: It can improve the mobility of patients who are already mobile, and only a fraction of the patients with the conditions listed can be helped by it.]

3. The segment does not report on any research done on the device, or even indicate whether there is any. The evidence of effectiveness cited is a single anecdote.

4. The segment does not mention potential harms, contraindications or limitations. People with pacemakers can't use it; neither can pregnant women. One cannot wear it while driving.

5. While the segment celebrates the patient as a determined young woman who has earnestly undertaken eight years of rehab, it fails to make clear that she is [therefore] an outlier with untypical results.

6. No independent expert was interviewed to provide some perspective and reality check.

7. The whole "I had to snowboard again" conceit is just a foolish stage show, a clinically irrelevant fatuity. Indeed, the device cannot possibly function when the patient's feet are strapped into a snowboard.

All that said, the WalkAide appears to be a useful device for some people with foot drop--not new, not a revolution, not a miracle, but a device that can help improve the quality of life for some patients. It can help them walk more normally, perhaps reducing risk of falls, joint damage and muscle atrophy. It may help make their limbs healthier and stronger--though this has not been proven.

The WalkAide cannot help the paralyzed rise miraculously from their wheelchairs any more than a circus-tent preacher can. Yet the report implies this, almost cruelly misleading "the many Americans who have lost the ability to walk."

Why would a TV network, medical correspondent, producer and host do this in front of millions of people?

I am a one-man band. A mom-and-pop blogger minus the mom. Yet I've written four times since March 26 on the misguided EARLY Act supported by Senator Amy Klobuchar of Minnesota and Congresswoman Debbie Wasserman-Schultz of Florida.

• March 26

• June 19

• July 2

• July 13

Finally, this week, the Star Tribune, the biggest news organization in Minnesota, caught up with the story.

Where has the Strib been on this story? Among the smaller Minnesota news organizations that have already reported on the controversy are MinnPost.com and KMSP-TV. Yes, a TV station did a better job - sooner - than the state's biggest newspaper did.

(I will be pleased to run a correction if the Star Tribune reported on this earlier and I missed it. After all, I am merely a one-man band. A mom-and-pop blogger minus the mom.)

Reuters Health reports:

Preliminary results of cancer treatment studies presented at major cancer meetings should be viewed with caution, because the final results may wind up being quite different, new research shows.

Dr. Christopher M. Booth of Queen's University in Kingston, Ontario, and colleagues found that nearly two-thirds of abstracts presented at cancer meetings had small differences in numbers of patients, follow-up times, or results when compared with final reports of randomized clinical trials published in medical journals.

And for 10% of the presented abstracts they reviewed, researchers came to the opposite conclusion when the trial was actually published. This means study authors may have initially concluded that a treatment should be adopted, but switched to not recommending a therapy in a published report, or vice versa.

... (The author says) given the heavy media attention now given to research on cancer treatments, it's important for both patients and doctors to be aware of when a publicized finding is the final word -- and when it isn't.

(Hat tip to Ivan Oransky of Reuters.)

If you're going to cover an issue like spinal cord injury rehab, you're jerking the audience around when you use terms like "breakthrough." But the tenets of sound health journalism don't seem to apply at ABC's Good Morning America, where breakthroughs abound.

See the HealthNewsReview.org review of an ABC GMA story. Excerpt:

Without providing any evidence from the literature and relying solely on anecdotal information, this segment falsely raises hope, only adding further frustration and insult to injury.

Former Texas football coach Darrell Royal used to say "There are three things that can happen when you pass the ball and two of them are bad."

Today in the New York Times, the chairman of the United States Preventive Services Task Force is quoted: "There are five things that can happen as a result of screening tests, and four of them are bad."

Yet we continue to - if you'll pardon my cross-analogies - pass the ball all the time.

Natasha Singer presents a very thoughtful roundup of perspectives challenging the conventional wisdom on screening tests in the Times today. Excerpt:

Nearly every body part susceptible to cancer now has an advocacy group, politician or athlete with a public awareness campaign to promote routine screening tests -- even though it is well established that many of these exams offer little benefit for the general public.

An upshot of the decades-long war on cancer is the popular belief that healthy people should regularly examine their bodies or undergo screening because early detection saves lives. But in fact, except for a few types of cancer, routine screening has not been proven to reduce the death toll from cancer for people without specific symptoms or risk factors -- like a breast lump or a family history of cancer -- and could even lead to harm, many experts on health say.

Singer's article raises questions about:

"Don't forget to check your neck" thyroid cancer screening ad campaign.

Congresswoman Debbie Wasserman-Schultz's early breast cancer screening bill.

The American Urological Association's prostate cancer awareness campaign.

Mammograms (yes, mammograms).

Lung, ovarian, skin cancer screening.

For your own education, don't miss my blog entry yesterday questioning what we know even about colorectal cancer screening. (see next entry below)

We need far more journalism like this.

Let me state again - because I can feel the rabid, crusading, pro-screening forces ready to fill my inbox: This is NOT an anti-screening test message. It is a call for evidence. And there shouldn't be such such crusading pro-screening campaigns in the absence of evidence - or at least without a better public disclaimer about the lack of evidence.

If you're going to claim in a headline and in the body of the story that "Thousands of people with schizophrenia worldwide could have been saved if doctors had prescribed them the anti-psychotic drug clozapine," as an AP story did, you have an obligation to do a better job of explaining and justifying that statement.

Read our experts' review of the story on HealthNewsReview.org.

Christopher Martyn, associate editor of the BMJ, writes about (subscription required for full access) the response to Atul Gawande's "The Cost Conundrum" piece in The New Yorker and wonders "whether the problems of managing the nation's health are discussed in a different way in the US. Is the level of debate on a higher plane than it is in Britain? Or are there better mechanisms for transferring what is written in medical journals into formats that are more widely available and accessible?"

Because I spend a lot of time scrutinizing US health care and health policy news, I read on. Martyn writes:

It isn't that the UK media aren't interested in medicine and health. Many newspapers have regular sections devoted to these topics. The trouble is that much of it is low grade stuff intended to pass an idle moment rather than stimulate informed debate. Why don't the editors of serious dailies and weeklies emulate the New Yorker and commission some pieces tackling healthcare topics that matter? Instead of trivia about the illnesses of celebrities or whether feeding fish to your children makes them more intelligent, couldn't we have discussions about whether the National Institute for Health and Clinical Excellence is right to consider valuing quality adjusted life years (QALYs) differently at the end of life? Or why the (UK's National Health Service) finds it so hard to deliver health care to those who need it most? Or what we actually mean when we talk about inequalities in health?

It's always convenient to blame the media, but part of the fault may lie closer to home. Getting mainstream media coverage has become an important measure of success not only for researchers but for the institutions they work in, the bodies that fund them, and even medical journals. Courting media attention by issuing a press release when a paper is published substantially increases the chances of getting the findings on television or into the newspapers. But it also influences the way they are reported. Journalists working to a tight copy deadline don't have the time or ability to make their own critical appraisal of the research. Instead, they rely on the content of the press release, supplemented perhaps by a telephone conversation with the researcher. You might think the claims made by these press releases would be measured and unexaggerated. After all, even if they're written by university or funding agency press offices, they're presumably checked by the people who actually did the research. But you'd be wrong. A recent evaluation of press releases from academic centres found that a large percentage overstated the importance of the findings and failed to mention aspects of the study that limited the clinical relevance of the results.

If you agree that raising the standard of reporting of medical research and healthcare issues in the mainstream media would be worthwhile, issuing fewer and more accurate press releases might be a good place to start.

John Mack's background is in pharma marketing (and other things). Yet he joins the ranks of people who see problems with the Pfizer-funded journalism training being hosted by the National Press Foundation and promoted by the Society of Professional Journalists.

Read his blog entry on the issue.

In the past week we've seen three stories by major news organizations that failed to give adequate caveats about the limitations of animal research - and about how foolish it can be to make the leap to predictions of human efficacy based on animal research.

A story on congestive heart failure research in animals said the work:

* May revolutionize cardiac care;

* Could save and improve thousands of lives;

* Has vast potential.

A story on calorie-restriction in monkeys said:

* It was "groundbreaking";

* it "may be the key to a longer life with less disease";

* the findings were "a vindication for very extreme dieters."

And a story on caffeine and mice stated:

* "your morning cup of joe might help prevent memory loss due to
Alzheimer's Disease";

* "this is very important and very encouraging"

Nary a caveat in any of these stories about how something that seems so terrific in animal research often doesn't pan out when the approach is tried in humans.

One of the real benefits, I believe, in tracking health news coverage every day as I do is that you get a big picture of what an imbalanced view of research is often painted by news organizations across the country. You might think that nothing ever fails, nothing ever goes wrong, nothing ever has harms.

A simple line of caution about the boulevard of broken dreams of past animal research would help a great deal.

The CBS Evening News failed to emphasize the limitations of animal research when it called monkey calorie-restriction research "groundbreaking" - and that it "may be the key to a longer life with less disease."

The anchor lead-in called it "the research of restraint." We wish CBS had employed some restraint in the application of hyperbole.

See our review on HealthNewsReview.org.

Perhaps most notable was that the story failed to include the perspectives of any independent experts - who were likely to be critical. The NY Times had no problem reporting:

"Ultimately the results seem pretty inconclusive at this point," (Dr. Steven Austad, an expert on aging at the University of Texas Health Science Center) said. "I don't know why they didn't wait longer to publish."

Leonard Guarente, a biologist who studies aging at the Massachusetts Institute of Technology, also had reservations about the findings. "The survival data needs to be fleshed out a little bit more before we can say that caloric restriction extends life in primates," Dr. Guarente said.

The one source not involved in the research who was interviewed? A woman who wrote a book about extreme dieting. The story said that the findings were "a vindication for very extreme dieters" like her. Huh? Research in a couple of dozen monkeys is "vindication"? Getting such free network TV plugs for your book may be the only vindication involved.

An example of what appears to be happening more often - perhaps with the hyperlocal emphasis of many news organizations.

The Indianapolis Star reports on a story it claims could "revolutionize cardiac care" and "could save thousands of lives."

But for the new use in question, the procedure has only been done in animals. Even the promoter says human testing is a year away.

The story contained no discussion of evidence, of costs, of harms. Only anecdotes. There was an incomplete discussion of alternative options for the problem in question.

A reality check on a story like this: If the research came out of Ann Arbor or Columbus instead of Indianapolis, do you really think it would get this kind of play by the Indy paper?

Would it have been covered at all?

If not, why not? And then why is it worthy of such hyperlocal hyperbole just because it did involve an Indianapolis physician?

Howard Kurtz writes:

"The lead story in The Washington Post's Health section last week, on why some people seem immune to AIDS, focused in part on a top physician at Massachusetts General Hospital.

The work of researcher Bruce Walker, who runs the hospital's Partners AIDS Research Center, was first spotlighted in the third and fourth paragraphs. The article ended with a dutiful disclosure that it was condensed from one that had run in Proto, the magazine of, yes, Massachusetts General Hospital.

What gives? Health Editor Frances Stead Sellers, who obtained the piece without charge, says Proto is "one of the best biomedical magazines," that the article was by an established freelancer and that she was transparent about the story's origin. "The cure for a perceived conflict is disclosure. . . . I felt with this piece I was bringing something very interesting to readers," she says.

The magazine is produced by Time Inc. Content Solutions, where spokeswoman Carrie Jones says the hospital gets to review all copy and "to bask in the reflected glory" of a high-quality publication.

Sellers, who had run an earlier piece from Proto, says early-retirement buyouts at The Post have cut the weekly section's full-time staff from four to none, forcing her to rely heavily on freelancers. "If I had a whole bundle of reporters, I wouldn't be thinking of doing this," she says. "

Here's proof that local TV news can do a meaty job on a meaningful health policy issue. At a time when more local TV news becomes light, fluffy, "news you can use" that you really can't use, this effort is a refreshing and important use of airtime.

Jeff Baillon of Fox-9 TV news in Minneapolis-St. Paul put together a piece on US Senator Amy Klobuchar's (D-Minn.) support for "The EARLY Act," which Baillon reports, "would spend $9 million a year over five years on an educational campaign that would, among other things, encourage women as young as 15 years old to perform regular breast self exams in the hopes of catching the disease early."

But rather than go with the flow of what appears to be a noble cause, Baillon reported that there's no scientific evidence that screening young women in their teens and 20s does any good, and that it could actually do some harm.

MinnPost.com has also recently reported on the controversy surrounding the legislation.

I am not aware that the "big 3" of Minnesota news organizations - the Star Tribune, the Pioneer Press, or Minnesota Public Radio - have even touched the controversy. I will happily issue a correction if I simply missed anything they have done on the matter.

I know that two of the interviews Baillon used in this piece were captured when he attended a journalist workshop hosted by the National Institutes of Health last month. He paid his own way there. But he wanted to learn more about how to scrutinize claims in health care. This piece is good evidence of what he's learned. (Disclosure: Baillon was a student in my graduate health journalism seminar in Fall 2008. He got an A.)

With all of those aging prostates on Capitol Hill, one wonders how much money Washington, DC urologists make off of legislators' walnut-sized glands.

Here are two examples of the kind of public discussion through journalism that we need more often - and both focus on prostates.

David Leonhardt discusses prostate cancer as a litmus test for health care reform. Why prostate cancer? He explains:

Some doctors swear by one treatment, others by another. But no one really knows which is best. Rigorous research has been scant. Above all, no serious study has found that the high-technology treatments do better at keeping men healthy and alive. Most die of something else before prostate cancer becomes a problem.

"No therapy has been shown superior to another," an analysis by the RAND Corporation found. Dr. Michael Rawlins, the chairman of a British medical research institute, told me, "We're not sure how good any of these treatments are." When I asked Dr. Daniella Perlroth of Stanford University, who has studied the data, what she would recommend to a family member, she paused. Then she said, "Watchful waiting."

But if the treatments have roughly similar benefits, they have very different prices. Watchful waiting costs just a few thousand dollars, in follow-up doctor visits and tests. Surgery to remove the prostate gland costs about $23,000. A targeted form of radiation, known as I.M.R.T., runs $50,000. Proton radiation therapy often exceeds $100,000.

And in our current fee-for-service medical system -- in which doctors and hospitals are paid for how much care they provide, rather than how well they care for their patients -- you can probably guess which treatments are becoming more popular: the ones that cost a lot of money.

Use of I.M.R.T. rose tenfold from 2002 to 2006, according to unpublished RAND data. A new proton treatment center will open Wednesday in Oklahoma City, and others are being planned in Chicago, South Florida and elsewhere. The country is paying at least several billion more dollars for prostate treatment than is medically justified -- and the bill is rising rapidly.

You may never see this bill, but you're paying it. It has raised your health insurance premiums and left your employer with less money to give you a decent raise. The cost of prostate cancer care is one small reason that some companies have stopped offering health insurance. It is also one reason that medical costs are on a pace to make the federal government insolvent.

Meantime on MinnPost.com, Susan Perry writes about more doubts about prostate cancer screening:

On Father's Day last month, Sen. John Kerry, D-Mass., and radio shock jock Don Imus co-authored an op-ed for the Boston Globe in which they argued that men needed to be sure they received regular preventive screening check-ups for prostate cancer. Both men are prostate cancer survivors.

"Screening for prostate cancer is the only option," they wrote.

But therein lies a big, big problem -- and yet another medical controversy. Just a few days after that op-ed ran, a review article in the medical journal CA: A Cancer Journal for Clinicians reported that the PSA blood test, routinely used to screen for prostate cancer, saves few lives, wastes money and often leads to risky and unnecessary treatments.

An editorial that accompanied the review noted that not a single well-designed clinical trial has yet to show that PSA screening reduces the death risk from prostate cancer.

However, if you don't want to be discouraged about engaging the public in a discussion of the role of evidence in health care refom, don't read the comments attached to either piece.

Almost every day the CBS Early Show puts on light and fluffy "news you can use." This week they delivered news no one can use yet - because it was in mice. But they never delivered that punchline.

On HealthNewsReview.org, we said:

There's nothing wrong with reporting on animal research. But when you suddenly one day drop in animal research in a time slot used almost every day for consumer health news, and then fail to emphasize the limitations of animal research, you're not doing the audience a service. Is the CBS Early Show going to regularly report on basic research and animal research? Or just stories they think are cute because they involve coffee at a time when people are waking up? ...

The physician-reporter twice called the study results "very encouraging" - although the results of what actually happened to the mice was never adequately explained. And they're mice. The focus of the segment appeared to revolve around illustrating for viewers the amount of coffee they would need to consume to equal the amount given to the mice. All this, without ever once mentioning that results in mice do not guarantee similar benefit in humans.

The segment just flat failed to acknowledge the limitation that this was an experimental study in a mouse model of Alzheimer's disease and that human studies need to be done before a recommendation could be made for people.

Those are not my words, but those of Richard Horton, editor-in-chief of The Lancet - which operates a very strict embargo policy - speaking at the World Conference of Science Journalists last week.

Mark Peplow posted this summary:

"I'm Richard," he shouted, "I'm 47 and I've been addicted to embargoes for 14 years."

In a remarkable diatribe, delivered at top volume and with tongue only slightly in cheek, Horton explained that embargoes were all "about power and control - my power to control you, turning journalists into agents of propaganda."

Eyes ablaze, he continued, almost mocking the open-mouthed hacks in the audience: "Look at this story, don't you want it? Your rival wants it!" he cried. "But you've sold your soul to publicity masquerading as science."

Ultimately, getting rid of the embargo system would improve the quality of science journalism, he concluded, because it would force editors to employ reporters who actually knew what they were talking about, rather than simply being able to read and regurgitate a weekly press release at leisure.

The Politico.com story about the Washington Post "pay for access" proposal isn't astonishing to Merrill Goozner, who writes:

It's a long standing practice by one of the few sections of the news business that remains profitable -- the newsletter and trade journal business. There's also a vibrant conference sponsorship industry that sells exclusive access to top government officials.

For instance, a Texas-based outfit called Pharma Education Concepts, Ltd. is running one of its trademarked "Pharma Conferences" in Cambridge, Maryland in late-August. Dubbed "GMP By The Sea," the meeting brings top drug industry executives together with Food and Drug Administration officials to hear the latest thinking on globalization and the regulation of drug and biologic manufacturing processes. Featured speaker this year is Murray Lumpkin, deputy FDA commissioner for international and special programs. Pricetag: $1,495 a ticket.

In mid-June, a scrappy industry newsletter called FDAWebview filed a citizens petition with the FDA demanding journalistic access to this and any private meetings where FDA officials appear. Its editor couldn't afford the $1,495 needed to send a reporter to cover the GMP By The Sea meeting where Lumpkin, a public official, might say something newsworthy.

The real issue is what will be the ground rules for these Post-sponsored conferences. The public has the right to know what gets said in these meetings with its elected representatives and civil servants. I stand with FDAWebview. Any session where a top government official appears should be open to the news media, right on down to the lowliest blogger.

As always, thanks for the perspective, Gooz.

I think I got Susan Perry of MinnPost.com turned on to the controversy surrounding the bill co-sponsored by Sen. Amy Klobuchar and Rep. Debbie Wasserman-Schultz

Regardless of how she got inspired, Perry is now all over the story, adding a new posting today. She adds the fact that noted breast cancer author Dr. Susan Love opposes the legislation, adding her name to a long list of critics. Excerpt from the new posting:

One of the most contentious issues of the bill is its emphasis on breast self-exams for women under 40, despite research from large randomized trials that have shown such exams have no effect on either detecting breast cancer or influencing survival rates in women of any age.

And Christine Norton of the Minnesota Breast Cancer Coalition says in the new article:

"It's upsetting to me that the preponderance of evidence was not persuasive to stop the introduction of this legislation that would call for $45 million over a five-year period," says Norton. "I understand that that amount is 'decimal dust,' but to a taxpayer, it's significant, especially at this time when we're supposed to be focusing on health-care reform."

Politico.com has posted the response it got from the Washington Post.

The new posting reads:

The Washington Post has now responded to POLITICO's report this morning that the paper is arranging salons for lobbyists at the home of publisher Katharine Weymouth, events that would include Obama administration officials, members of Congress, and the staffers.

The solicitation -- with costs between $25,000 to $250,000 -- was listed on a flier that circulated to a lobbyist, who later passed it along to POLITICO.

Post spokesperson Kris Coratti has now sent the following statement to POLITICO:

The flier circulated this morning came out of a business division for conferences and events, and the newsroom was unaware of such communication. It went out before it was properly vetted, and this draft does not represent what the company's vision for these dinners are, which is meant to be an independent, policy-oriented event for newsmakers.

As written, the newsroom could not participate in an event like this.

We do believe there is an opportunity to have a conferences and events business, and that The Post should be leading these conversations in Washington, big or small, while maintaining journalistic integrity. The newsroom will participate where appropriate.

Wow. More assaults on the firewall between bean-counters and editorial. What would have happened if Politico.com hadn't reported this?

Mike Allen reports:

For $25,000 to $250,000, The Washington Post is offering lobbyists and association executives off-the-record, nonconfrontational access to "those powerful few" -- Obama administration officials, members of Congress, and the paper's own reporters and editors.

The astonishing offer is detailed in a flier circulated Wednesday to a health care lobbyist, who provided it to a reporter because the lobbyist said he feels it's a conflict for the paper to charge for access to, as the flier says, its "health care reporting and editorial staff."

The offer -- which essentially turns a news organization into a facilitator for private lobbyist-official encounters -- is a new sign of the lengths to which news organizations will go to find revenue at a time when most newspapers are struggling for survival.

Allen wrote at 8:04 EDT that he is waiting for a response from the Post.

If true, this is a devastating story.

The New York Times headline: "Bone-Growth Proteins Show Risk in New Study." Excerpt:

"Patients who received a bioengineered protein during spinal fusion procedures to correct neck pain had far more complications than patients who did not get it, according to a study released Tuesday.

The study, published Tuesday in The Journal of the American Medical Association, reinforces previous concerns about the use of the proteins in fusion procedures to treat upper spine, or cervical, pain. The substances studied, sold by either Medtronic or Stryker, are not federally approved for cervical procedures, although surgeons are free to use them for that purpose."

The Wall Street Journal headline: "Bone Proteins Costly In Surgery, Study Says." Excerpt:

"The findings contrast with previous studies, written by Medtronic consultants, in which authors concluded that cost savings over time could offset the initial cost of Infuse.

For instance, an article in 2002 by former Army surgeon David W. Polly Jr., now of the University of Minnesota, and colleagues said, "Preliminary results suggest that from a payer perspective, the upfront price of bone morphogenetic protein is likely to be entirely offset by reductions in the use of other medical resources. That is, bone morphogenetic protein appears to be cost neutral."

Dr. Polly, who last year received substantial consulting and speaking fees from Medtronic, didn't immediately respond to requests for comment."

The Star Tribune, serving the community where Medtronic and Dr. Polly are based, had what sounded like a local-business cheerleading headline, "Medtronic's Infuse a hit in growth of spine fusion."

But the story itself offered much more beef than the headline suggested.

Still, the Strib story seemed to swing back to what good news this could mean for Medtronic. Excerpt:

"JAMA's findings loom large for Medtronic, which sells the bioengineered product called Infuse used in spine fusion procedures. Since it was approved by the FDA in 2002, Infuse has proven to be a blockbuster device for the medical technology giant. Michigan-based Stryker Corp. makes a similar product, but Medtronic is by far the market leader.

While Medtronic doesn't break out figures for individual products, sales of biologics (including Infuse) have topped $3.6 billion in the past five years. Its spine division, which also markets devices used in spine surgery, is its second-largest with $3.4 billion in annual revenue."

And the Strib story never mentioned Dr. Polly right in their own backyard.

It's an important study and topic. Read all three stories if you get the chance.