October 2009 Archives

It's a TV sweeps ratings period, and it's also breast cancer awareness month, so any boob could see this coming.

The Washington Post makes a big deal of the fact that DC station WJLA is making an even bigger deal about:

"...breaking TV's unspoken taboo by showing two women fully exposed on its late-afternoon and evening newscasts."

...

WJLA acknowledges, however, that the timing of its stories may raise some eyebrows: The reports will air on the first two days of TV's traditional "sweeps" month, a period in which stations air their most eye-catching stories to boost ratings that are used to set advertising rates.

WJLA general manager Bill Lord said he had no qualms about the timing of the reports, or in promoting them beforehand. "People will say we're doing it just for ratings," he said. "But we're a commercial television station -- we're trying to get people to watch us. Yes, this is an attention-getting story, but it's also an important story."

Tell me that even this dramatic viewer warning about their online video isn't meant to titillate:

WJLA.png


But the Post story buries the real story, only deep in the story getting to the question of how newsworthy this really is:

"The effectiveness of self-exams as an early cancer-detection method, however, has been questioned in recent years. The National Breast Cancer Coalition says medical studies suggest that the exams are not useful and can lead to "elevated anxiety, more frequent physician visits and unnecessary biopsies of benign lumps."


The American Cancer Society says self-exams play only "a small role" in finding breast cancer. On its Web site, the society says "it's okay not to do [a self examination] or not to do it on a fixed schedule."

At least the Post touched on these issues. The WJLA report never did.

But good luck telling that to a TV news director in the middle of a ratings period.

And good luck trying to talk about evidence (or lack thereof) when a naked breast can give you the bump in the ratings you need so badly.

Now, will they do the same thing for testicular cancer?

In the circles I run in, there's been a buzz about an announcement first made last December about a "partnership" between the FDA and WebMD. Yesterday the two entities announced an expansion of that partnership "to provide increased access to FDA's consumer health information."

I can appreciate the FDA's interest in reaching the public more directly with its messages.

But WebMD has turned over its "channel" - some of it marked "news" - to a government agency. Should journalists "partner" with a government agency for news and information?

And they boast that "Since the launch, over 150,000 consumers have accessed the FDA destination on WebMD ... The FDA's consumer information is also available through WebMD the Magazine, distributed ten times a year and reaching an additional 11 million consumers with each issue."

And I would remind the FDA that, while there may not be any ads on the FDA pages of the WebMD site, users are just a link away from ads on WebMD material. I just visited and quickly found myself viewing ads for drugs for fibromyalgia, depression, coronary artery disease and others. Is that appropriate for the FDA?

Something doesn't feel right about this - for either party - or for the public.

Sandy Szwarc of the Junkfood Science blog looked at this in greater detail when the partnership was first announced in December.

Excerpt from Dr. Len Lichtenfeld's blog posting, criticizing both the JAMA article and the NYT article this week that raised questions about screening.

"This was an opinion piece, not original research. It reiterated arguments that have been made before, and are certainly valid. But they represent the thoughts of several respected scientists, but not all who are involved in trying to reduce the burden of cancer in this country and throughout the world.


And while we may agree with the comments about prostate cancer, we do not agree with the negativistic comments about breast cancer. As noted in the New York Times article, when the public gets a mixed message it takes that as a reason not to move forward with the most effective breast cancer screening modality we have available today. ...

The sad part is that the women in this country may only read the New York Times, and leave it at that. They will miss the nuances of the experts' arguments. They will not read the conclusions of the JAMA study, and if they do they probably won't have the working knowledge that would put it in context.

Hopefully they won't miss the nuances that could impact their lives. That would be a tragedy. But such is the risk of living in a sound bite world."

Gina Kolata had her article in the Times - subject of my blog earlier today (below).

Later, the American Cancer Society issued this news release (Is it a retraction? Is it a correction? Is it 'we wish we hadn't said that to the NYT?' Is it "Gina Kolata got it wrong?' What is it?).

CBS News last night proclaimed the drug peramavir as a "lifesaving drug" for serious cases of H1N1 infection.

Lines from the story:

• "Experts caution its too early to see Peramivir as a miracle drug, but there's no doubting the drugs connection to some miraculous results."


• "Human clinical trials in the U.S. and Japan have called Peramivir safe and effective."

But not one shred of evidence was provided.

Instead, the story used the framing that the FDA was dragging its feet - as the website subheading read: "Doctors Say Intravenous Drug Peramivir Effective in Serious Cases; But It's in Trials and FDA Makes Few Exceptions"

Folks: it's the trials that determine benefits and harms. Not hyperbole about people being deprived of a wonder drug. Data - evidence - is what counts, and CBS didn't provide any in this story.

CBS 60 Minutes once again devoted a big chunk of prime time last night to an unproven idea - which is fine, if you're going to devote your show to such explorations of basic science all the time. But they don't. And it shows.

The subject was the pie-plates-and-radiowaves cancer experiment of inventor John Kanzius - which CBS has now profiled three different times - in April 2008, in July 2008, and now on October 18, 2009.

Correspondent Lesley Stahl exhibited some of the same breathless awe that she showed in previous segments, saying at one point, "we don't want to be in a position to hype this."

Too late, Lesley, you already have - with three segments in 18 months for something that isn't even in human trials.

I can only wonder what all the other cancer researchers watching think when they see such cheerleading for such little evidence.

A writer posted a query on the Association of Health Care Journalists (AHCJ) listserv last week asking for ideas about state-of-the-art but underused treatments.

Many of the responses were troubling. Some AHCJ members wrote in suggesting:

• MRI is far superior to mammograms for detecting breast cancer (leading another member to write in asking where was the evidence for that "superior" performance in lower mortality rates)
• robotic surgery for prostate cancer (ignoring a study published last week that tracked the runaway use of robotic surgery despite questions about evidence)
• cardiac CT for calcium scoring
• proton beam therapy

None of these can be considered underused given the questions of evidence with each of them.

But this is how some journalists responded when asked.

Thankfully, some voices of reason eventually chimed in on the listserv. Other writers called "state of the art" a marketing term and suggested that it be viewed as a red flag and that writers should "push back against editors who want us to write breathlessly about these gee-whiz procedures and techniques."

Yes, such push back against editors is important. But you can't blame editors for the ideas that writers bring to them. Given our experience on HealthNewsReview.org, where we've seen about 70% of stories fail to adequately discuss costs, benefits and harms of such new approaches, there still is huge problem of gullibility and gee-whiz-ness even in the rank and file of health care journalists.

Maggie Koerth-Baker's interview with me about HealthNewsReview.org- and how she connects it with her grandfather raising semi-feral chickens. !!!

HealthNewsReview.org review summary:

A 183-word story just can't do much. And this story didn't.


The NY paper clearly picked up the story from the BBC and passed along erroneous information about basic information such as where the study was published.

But at the heart of the story was the improper and inaccurate use of causal language from an observational study that can't establish causation, but only association. It is wrong when the story states, "The diet...has a positive effect on mood."

This kind of research news via briefs and pickups from other news organizations is a waste of time and space.

Dr. David Gorski writes:

The quantity of misinformation in that single six minute video is far beyond the scope of this article. .. I leave the dissection of this pièce de résistance of disingenuousness and misinformation as an exercise for readers (of his blog).

Andrew Wakefield, who has linked vaccines to autism, was given a new platform by CBS News now with new claims about the potential dangers from hepatitis B vaccine - based on research on 13 vaccinated monkeys.

The only other source cited was Wakefield's collaborator and co-author.

Here is how CBS summarized any past controversy:

The study became the centerpiece for an ongoing and nasty fight between vaccine safety advocates who embrace Wakefield's research and believe vaccines can be administered in a safer fashion, and public health and government officials who attack Wakefield and believe his ideas threaten international vaccination programs.

Notice the framing: vaccine safety advocates "embrace" his research while public health and government officials "attack" it.

Why would CBS not include any independent source to evaluate these claims from research in 13 monkeys? Why would they not mention the allegations from earlier this year that he falsified data in his 1998 study published in The Lancet, widely available online. Excerpt from one story:

10 of the paper's 13 authors -- not including Dr. Wakefield -- retracted the paper's conclusion that the MMR vaccine may cause autism.


Paul Offit, M.D., a pediatrician at Children's Hospital of Philadelphia, and a prominent critic of Dr. Wakefield, said the new allegations cannot really undermine the credibility of the MMR-autism theory because it had already been disproved.

A series of population-based studies have failed to find evidence that vaccines cause autism.

"I'm not sure what more people need to say than that this man and his theory are discredited," Dr. Offit said.

He said there was no longer a scientific controversy about the role of vaccines in autism.

At the same time, he said, the Times report is unlikely to change the minds of those who believe in the link.

"There is not one shred of his hypothesis that has held up," Dr. Offit said.

The ScienceInsider blog of Science magazine reports:

When the U.S. Army and its collaborators in Thailand announced at press conferences on 24 September that a large clinical trial of an AIDS vaccine had lowered the rate of new HIV infections by about one-third, researchers were surprised and encouraged. Although it was only a modest reduction, it was the first positive result from any AIDS vaccine trial.


Now some researchers who have seen more of the data in confidential briefings are complaining that a fuller analysis undermines even cautious claims of success, and they are raising questions about the way the results were announced.

See the Huffington Post investigative fund piece by Jeanne Lenzer and Shannon Brownlee, "Government Orders Columbia to Tell Patients 'True Nature' of Drug Study: Officials Say Research May Have Caused Harm to People Who Had Heart Surgery." Excerpts:

"....two-year medical study at Columbia that government regulators now say was carried out with ethical and regulatory mistakes and may have caused harm to some patients. The study was testing a commonly used intravenous surgical fluid that previous studies had shown could cause hemorrhaging at high doses. At least two patients in the study died shortly after receiving the fluid and more than two dozen others required transfusions, according to documents submitted to the federal government by the hospital and obtained by the Huffington Post Investigative Fund. ...


The issues raised by the Columbia study, which was indirectly funded by a pharmaceutical company, reflect the ongoing national debate over flaws in the system designed to protect people who participate in medical research. The federal oversight office has cited more than 40 hospitals and academic medical centers in the past two decades for falling short. The Columbia case stands out for the bitter controversy it has engendered for years inside the hospital, the courts and the federal government - reported here for the first time - and for the hospital's failure to contact patients even after federal investigators recommended it do so in 2003."

As I predicted yesterday, there has been nary a story on the US Preventive Services Task Force's new statement that the evidence isn't in yet on nine ways to look for signs of coronary heart disease in people without symptoms.

Journalists - many of whom sang the praises of at least two of those methods (the CRP test and coronary artery calcium CT scans) - either aren't aware or don't care about cautious, evidence-based recommendations from the USPSTF.

The only stories I've seen were by the Wall Street Journal health blog and by MedPage Today which did a
story and a blog posting.

On the MedPageToday blog, Peggy Peck wrote:

This is a setback for CRP believers, a group whose numbers swelled significantly when Paul Ridker reported last November that giving "healthy" adults who had hs-CRP of 2.0 mg/L or higher a potent statin for less than 2 years reduced "the rate of MI stroke, arterial revascularization, or cardiovascular death was 44% (P<0.00001)."


Those findings came from the JUPITER trial and when they were announced there were lots of pundits predicting that hs-CRP would become everyone's favorite test and that maybe it really was time to consider putting statins in the water.

Since last November churning out additional analyses from JUPITER has become something of a cottage industry and some weeks it is difficult to pick up a heart journal or attend a cardiology meeting without being confronted with yet another JUPITER result.

In my opinion it had gotten out-of-hand, so about a month ago I started telling every PR person so sent me the latest breathless JUPITER press release that "I am done with JUPITER."

But here I am, once again, strumming the JUPITER tune. There's no escaping it.

Well, there may no escaping it for journalists like Peck.

But almost every other journalist and news organization - so far - has found such news very easy to escape.

It seems to me that when previously highly-promoted approaches are judged to be not ready for prime time by an independent panel with no axe to grind, that's news.

A Madison, WI television station has offered to showcase doctors who pay for advertising as the top experts in their fields, according to the AP. Excerpt:

WKOW 27, an ABC affiliate, sent letters to doctors and clinic managers last month soliciting help to create "a local source for credible, consumer information on health specialties." The letter describing the "unique marketing initiative" didn't specify when the programming would run, which left some readers believing it would be on news shows.

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This page is an archive of entries from October 2009 listed from newest to oldest.

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