From Drew Altman, PhD, president of the Kaiser Family Foundation. Read the entire column, but here's an excerpt:

With so much of the media now configured for instant news and the relentless pursuit of controversy, stoked by spin and manufactured news by partisans on both sides, the many great journalists in the news business working hard to inform the public face a big challenge in explaining the complex issues in health reform.

My appearance early this morning on the statewide Wisconsin Public Radio network can now be heard online (Real Player file).

The network asked me to talk about - and take calls from listeners about - my HealthNewsReview.org project.

I probably talked too much and didn't leave enough time for calls, but the ones we took on the air reflected an intelligence and a healthy skepticism that was refreshing.

In order to improve health journalism, we must learn from examples good and bad.

One of the worst we've seen in some time was published last week by the Des Moines Register.

Excerpts of our review:

A paid advertisement could not have been more promotional and less informative than this one-sided celebration of a type of chiropractic manipulation.

The story features the case of one man who suffered terrible pain from a nerve disorder called trigeminal neuralgia. Readers are told that he credits the treatment with preventing him from committing suicide by immediately ending terrible pain attacks that conventional medicines failed to control. The story quotes practitioners and announces an upcoming event they are hosting, but there are no independent voices nor any reference to independent sources of information on either the disorder or its treatments.

By trumpeting a highly emotional and extreme case, by failing to challenge the vague claims of practitioners promoting their services, and by ignoring independent sources of information, this story is the antithesis of solid medical journalism.

Thanks to Andrew Holtz for his role in this review.

CBS' Harry Smith.

CNN's Sanjay Gupta.

Some UK reporter.

Hasn't anyone from The Onion been stricken yet?

Stay tuned for next week's episode: "The cure for journalistic narcissism."

Great piece of local health policy journalism by the Dallas Morning News. Excerpts:

"There's a lot of money to be made in owning imaging machines," said Dr. Richard Strax, president of the Texas Radiological Society. "You can buy a relatively inexpensive second- or third-hand MRI machine for a few hundred thousand dollars and make millions on it."

"Today we can't even tell you how many MRI machines are in Texas, who owns them, what condition they're in and what quality of scans they're turning out," Ron Luke, health policy chairman of the Texas Association of Business, told state lawmakers this year. "That doesn't sound like we're very bright, does it?"

For three sessions, radiologists and doctors have fought in the Texas Legislature over the issue of self-referral. This year's legislation, backed by radiologists and business lobbyists, would have required licensing and accreditation of imaging machines, along with a year-long state study of the extent of self-referral by physicians. But it failed.

Proponents of the legislation say opponents are driven by financial motives. Imaging has become a "lifeline" for many doctors, said Dr. Cynthia Sherry, past president of the Texas Radiological Society.

"It's all about the money, OK? Those very doctors opposed to this are the ones participating in it," Sherry said.

An 1,800-word story on a vital health policy topic. Wow, do we need more like this. Ten gallon hats off to the Dallas Morning News.

If you have a mailbox, there's a good chance that you've received a letter from Peggy Fleming urging you to get some health screening scans to help prevent strokes.

I did - and I blogged about it six months ago.

Now Jeff Baillon of KMSP-TV in Minneapolis-St. Paul shows once again how TV news can do a good job of educating consumers on tough health care issues like the overselling of such screening tests.

This is an 8 1/2 minute report. Granted, this station has a one-hour newscast. But what a tribute to this news team to find the time and to make the investment to dig into health care claims as they have done.

(Disclosure: Baillon was a student in my health journalism seminar last Fall.)

MinnPost.com columnist David Brauer wonders why the Washington Post - and not a local news organization - asked tough questions about whether the Mayo Clinic is a replicable model for health care reform.

Presidents have said some whacky stuff - even on network TV.

But journalism organizations - rather than treating such appearances as "open mike" night - have an obligation to listen, to react, to ask tough questions.

So when former President Bill Clinton was interviewed on ABC's Good Morning America today, shouldn't we have expected some kind of challenge to his wild statement that - because of what's now known about breast cancer genetic variations - females "should be tested as soon as possible after they're born - young girls, for example, for breast cancer" - ???

And then Clinton went on to predict that someday we would go in for our annual checkup and "stand in a cone and our bodies will be scanned and now submicroscopic tumors will be picked up."

It is the identification of submicroscopic are-they-tumors-or-are-they-something-else abnormalities that already create confusion for patients and their physicians in screening of the prostate, breast, cervix and more.

I guess it was expecting too much to have Good Morning America reflect on any of this.

For the second time in a week (maybe it's happened more and we fortunately missed it), the New York Daily News has copied animal research stories in the London Daily Mail and spread the excitement about possible human uses across the ocean.

Yesterday, the NYDN touted "a new cream that promises instant anti-impotence with no side effects."

We're talking about a study in 10 rats.

Supposedly the cream "succeeded" in 9 of them, although how anti-impotence "success" was measured in rats was not described.

Even if this had been about 10 people we would have shrieked, as if we'd seen a mouse.

Last week, the NYDN headline was: "Coming soon! The mind-cleansing drug that helps you forget all your bad memories"

We weren't told what kind of animals nor how many benefited from this approach.

Maybe they were elephants, who supposedly never forget. Now THAT would be news!

I feel a promotional campaign underway for the trials of an implantable device to control high blood pressure that is resistant to drug therapy.

NBC did a breathless story on the device a few weeks ago.

And now the Des Moines Register published one that is strikingly similar to the NBC piece.

* No data on harms or benefits
* The closest thing to evidence was a single positive anecdote of patient success
* No independent perspective, only an interview with a single conflicted source
* No estimate of costs of this approach which could be considerable.

The South Dakota resident who sent me this clip wrote, simply, "Just...wow."

Keloland News Healthbeat reporter Kelli Grant is taking you to an appointment every man over 50 should schedule with their doctor.

That's an editorial/advocacy stance not backed up by evidence-based guidelines from many major medical and heatlh care organizations. And news stories aren't supposed to do that.

TV news prostate cancer awareness month promotions apparently try to do good.

But they miss the mark when they fail to tell men that The American Cancer Society, for example, does not support routine testing for prostate cancer at this time.

The "every man should" message discourages complete, balanced, informed decision-making. There shouldn't be an "every man should" message just as there shouldn't be an "every man shouldn't" message.

If TV can't take the time to explain these issues more completely, they shouldn't cover them at all.

The Los Angeles Times and the Wall Street Journal deserve credit for pointing out the limitations of some types of studies.

The Times reported on a study questioning whether the dietary supplement quercetin lived up to its hype that it might improve athletic performance. Key quote in the story:

The results were disappointing, said the lead author of the paper, Kirk Cureton, a kinesiologist at the University of Georgia in Athens. "Our hypothesis, based on previous studies in mice, was that we would see positive effects. But our findings are important because they suggest that results from the animal studies shouldn't be generalized to humans," Cureton said in a news release.

And the Journal wraps up eight recent studies, commenting, on one or another:

• Because it used a one-time survey, originally intended to track breast cancer, the study's researchers were unable to follow patients as their diagnoses changed over time, and thus couldn't conclude that obesity or abdominal fat definitively led to asthma.

• The study relied on parental reporting to determine when the infants reached these motor milestones. If enough parents deliberately or unintentionally avoided reporting delayed development, the findings could be skewed, the researchers said.

• The study was too small, the researchers said, to conclude whether immediate treatment of these patients prevented heart attacks, death, or other long-term adverse effects.

• The study was conducted on mice only. More research is required before such findings can be generalized to the management and erasure of human fears.

• The study also included white men, black men and black women, but the researchers found a strong association between PKNOX2 and multiple-drug addiction only for the 1,393 white women in the study, which has 3,627 subjects. They suggested, however, that different genes could play a similar role for these other subjects.

• The study didn't measure the years of experience, hours since sleeping, or any other characteristic of the surgeons, making it difficult to determine the underlying reasons for the after-hours patients' poor outcomes.

• The study excluded patients with high social anxiety, which is thought to increase the time required to process facial expressions and involve a different cognitive pathway, the researchers said.

• The study was small--just 275 subjects--and 40% of the patients dropped out before the end of the three-month study (most of them because their symptoms became worse during the trial).

Following my criticism of the BMJ last week for failing to point out the limitations of observational studies and failing to explain that association does not equal causation, it is refreshing to see journalism examples like these that show how it should be done.

At this point, just about 12 hours after the study was released, I find more than 140 stories online on the misleading "thick thighs protect against heart disease" theme promoted by a BMJ news release. Nary a mention in any of these about association versus causation - or about how an observational study like this has profound limitations. Ah, but they love the "thunder thighs" headlines! That's all that matters. To hell with public understanding.

Keep reading if you want to see some of the headline examples from around the world.

I like to see this. Maybe the competitive juices will generate some improvement in health news coverage.

A Los Angeles Times blog post - reporting on our announcement yesterday that HealthNewsReview.org won't do regular reviews of TV health news anymore - then compared the Times' scores with the TV networks.

Their lede:

Need more evidence that you should get your information about new developments in medicine from reliable news outlets such as the Los Angeles Times rather than from TV? We offer you the following.

And then they went on to post the scorecard:

Average TV networks' score: 2.1 stars out of 5 possible
Average LA Times score: 3.84 stars out of 5 possible

Let the healthy competition begin.

You won’t be seeing network TV health news stories show up in the reviews on this site any more – at least not in the way they’ve appeared in the past.  Reasons:

• This is just one part of an overall change we’ll be announcing soon - a change in the entire scope of which news organizations we will review.

• We can’t review everything.

• Reviewing the TV news segments is the most time-consuming part of our work because we transcribe the broadcasts ourselves.

• After 3.5 years and 228 network TV health segments reviewed, we can make the data-driven statement that many of the stories are bad and they’re not getting much better.

• Our last publisher’s note
http://www.healthnewsreview.org/blog/2009/08/network-tv-morning-health-news-segments-may-be-harmful-to-your-health.html
gave details on the embarrassing performance of the networks’ morning health news segments. 

Here is a breakdown of 3.5 years of daily reviews of ABC, CBS, NBC.

Other interesting facts:

Reviews of these networks’ stories made up 27% of the first 855 reviews we conducted.  (So it’s not like we didn’t give them a chance to improve!)

Of all of the stories we’ve reviewed by 60 news organizations in 3.5 years, there have been only 40 bottom-dwelling zero-star scores.  These three networks account for 27 of those – or a whopping 68% of the total!

Conversely, the networks’ meager two five-star stories make up less than 2% of the total of 108 five-star scores recorded by all news organizations combined in 3.5 years.

Get the picture?  This stuff is really bad. 

One network TV health news producer has told me not even to bother to e-mail him about our reviews because he’s not going to share them with the staff anyway.  He thinks it’s unfair that we apply the same 10 criteria to broadcast stories as we do to print stories.  But neither he nor anyone else has ever pointed out even one of our ten criteria that is NOT important in every health care story. 

So we will re-direct our efforts.

It’s not like we’ll ignore TV news.  We’ll still comment on what we see in Publisher Notes or in a soon-to-be-introduced blog on this site. 

We just won’t tie up a lot of time transcribing TV segments, and doing point-by-point critiques applying our ten standardized criteria – all with the intention of helping TV health news get better.

Some have said that one definition of crazy is doing the same thing over and over and expecting a different result.

If our critiques aren’t helping TV health news, it’s time to devote more attention to other news organizations where, perhaps, our constructive outreach efforts may do more good.

We urge TV health news decision-makers to realize how often they’re doing more harm than good with so many of their non-evidence-based, cheerleading promotions of treatments for wrinkles, weight loss, baldness, toenail fungus, etc.- and breathless enthusiasm for new devices and other “new stuff” in health care. 

When I see craziness going on at Town Hall meetings on health care,  I think about how this is a public whipped into a frenzy over believing they have the best health care system in the world - while the TV networks fuel that frenzy by seemingly curing everything almost every morning and night. 

Broadcast journalism pioneer Edward R. Murrow said about TV:  “This instrument can teach, it can illuminate; yes, and it can even inspire. But it can do so only to the extent that humans are determined to use it to those ends. Otherwise it is merely wires and lights in a box.”

Almost all of the TV stories we’ve reviewed in 3.5 years fail to teach, illuminate or inspire.

We’ll still be watching, hoping for change. . .

Announcement on HealthNewsReview.org today:

You won't be seeing network TV health news stories show up in the reviews on HealthNewsReview.org any more - at least not in the way they've appeared in the past. Reasons:

• This is just one part of an overall change we'll be announcing soon - a change in the entire scope of which news organizations we will review.

• We can't review everything.

• Reviewing the TV news segments is the most time-consuming part of our work because we transcribe the broadcasts ourselves.

• After 3.5 years and 228 network TV health segments reviewed, we can make the data-driven statement that many of the stories are bad and they're not getting much better.

• Our last publisher's note gave details on the embarrassing performance of the networks' morning health news segments.

Here is a breakdown of 3.5 years of daily reviews of ABC, CBS, NBC.

Other interesting facts:

Reviews of these networks' stories made up 27% of the first 855 reviews we conducted. (So it's not like we didn't give them a chance to improve!)

Of all of the stories we've reviewed by 60 news organizations in 3.5 years, there have been only 40 bottom-dwelling zero-star scores. These three networks account for 27 of those - or a whopping 68% of the total!

Conversely, the networks' meager two five-star stories make up less than 2% of the total of 108 five-star scores recorded by all news organizations combined in 3.5 years.

Get the picture? This stuff is really bad.

One network TV health news producer has told me not even to bother to e-mail him about our reviews because he's not going to share them with the staff anyway. He thinks it's unfair that we apply the same 10 criteria to broadcast stories as we do to print stories. But neither he nor anyone else has ever pointed out even one of our ten criteria that is NOT important in every health care story.

So we will re-direct our efforts.

It's not like we'll ignore TV news. We'll still comment on what we see in Publisher Notes or in a soon-to-be-introduced blog on this site.

We just won't tie up a lot of time transcribing TV segments, and doing point-by-point critiques applying our ten standardized criteria - all with the intention of helping TV health news get better.

Some have said that one definition of crazy is doing the same thing over and over and expecting a different result.

If our critiques aren't helping TV health news, it's time to devote more attention to other news organizations where, perhaps, our constructive outreach efforts may do more good.

We urge TV health news decision-makers to realize how often they're doing more harm than good with so many of their non-evidence-based, cheerleading promotions of treatments for wrinkles, weight loss, baldness, toenail fungus, etc.- and breathless enthusiasm for new devices and other "new stuff" in health care.

When I see craziness going on at Town Hall meetings on health care, I think about how this is a public whipped into a frenzy over believing they have the best health care system in the world - while the TV networks fuel that frenzy by seemingly curing everything almost every morning and night.

Broadcast journalism pioneer Edward R. Murrow said about TV: "This instrument can teach, it can illuminate; yes, and it can even inspire. But it can do so only to the extent that humans are determined to use it to those ends. Otherwise it is merely wires and lights in a box."

Almost all of the TV stories we've reviewed in 3.5 years fail to teach, illuminate or inspire.

We'll still be watching, hoping for change. . .

On the very day that we announced that HealthNewsReview.org would no longer systematically review network TV health news stories, we were provided two fresh examples - both on ABC - of the sorry state of many network TV health news efforts.

Reporting on the two studies in the Journal of the National Cancer Institute that raised important questions about both prostate cancer screening and breast cancer screening (at least the role of clinical breast exams), ABC still managed to end up with strong statements of endorsement - DESPITE the evidence on which they just reported.

On ABC's World News Tonight, reporter Dan Harris turned to a New York urologist for his only expert interview on the prostate issue. He didn't interview the authors of the study. Nor Dr. Otis Brawley of the American Cancer Society who wrote a powerful accompanying editorial. He only turned to a urologist, who makes his living off of diagnosing and treating prostate cancer.

Harris asked the urologist: "Seeing this study, one is tempted to conclude that you should stay away from early screening. Is that the right conclusion to reach?"

The urologist responded: "That's absolutely the wrong conclusion to reach. ...You should be screened because if you had cancer you'd want to know about it."

Harris' conclusion: "Bottomline: doctors we spoke with today said you should still go for early screening but you should know that these tests are not foolproof."

Harris said they spoke with "doctors" (plural). Viewers should ask: which doctors? Who were they? Were they all urologists? Why didn't you have the authors appear (one of whom is a urologist)? We only heard from one urologist.

Then, on ABC's Good Morning America this morning, medical contributor Dr. Marie Savard reviewed the two studies. Savard wrapped up her discussion with anchor Diane Sawyer by emphasizing that the digital rectal exam (one prostate screening option) "is still important."

Savard: "Men you still need to appear every year and get checked."

Diane Sawyer "You'd rather have a false positive than something missed."

Savard's opinion and Sawyer's rhetoric clash with the recommendations of major scientific and medical organizations, which don't differentiate between PSA tests and digital rectal exams.

On the American Cancer Society website are these statements:

Neither the PSA test nor the DRE is 100% accurate. Abnormal results of these tests don't always mean that cancer is present, and normal results don't always mean that there is no cancer. Uncertain or false test results could cause confusion and anxiety. Some men might have a prostate biopsy (which carries its own small risks, along with discomfort) when cancer is not present, while others might get a false sense of security from normal test results when cancer is actually present.

No major scientific or medical organizations, including the American Cancer Society (ACS), American Urological Association (AUA), US Preventive Services Task Force (USPSTF), American College of Physicians (ACP), National Cancer Institute (NCI), American Academy of Family Physicians (AAFP), and American College of Preventive Medicine (ACPM) support routine testing for prostate cancer at this time.

Over and over and over I have written about how many news organizations stick to the pro-screening message despite the best and latest evidence.

ABC News has done it again - twice - in different programs.

There were opportunities here to drive home the importance of shared decision-making, to explain the uncertainties, to show how there isn't one best choice for all people. But despite the fact that they reported on the studies - mostly accurately - they still left viewers with strong screening endorsements at the end of both programs.

That's advocacy, not journalism.