In lots of little ways, this AP piece exemplifies the difference between very good and outstanding health reporting. Compared with the solid effort from Reuters, the AP’s take was just a little more thorough in its evaluation of the evidence and its implications for readers. Some examples:
The AP did require about 100 more words to deliver these details, and we realize that space is always a concern. Sometimes it does take a little more space to thoroughly address all of our criteria.
Current evidence is unclear as to whether vitamin supplements help prevent chronic diseases, and they’ve been shown to cause harm in some cases. That’s why, with the exception of people suffering from a vitamin deficiency, most of us are advised to get our vitamins from food instead of supplements. The current consensus, however, is based on studies that typically used high doses of a single vitamin. The low-dose multivitamin used here doesn’t seem to cause the same problems seen in other research, and may even offer a benefit for men similar to those in this study. That’s good news, of course, but it’s hard to get too excited considering the very small size of the reduction, which is barely outside of the range that would be considered statistical noise. It’s the kind of finding that could easily be reversed when the next study comes around–and readers should be warned accordingly.
Not applicable. Most people know that multivitamins are inexpensive.
The story was very cautious in its framing of the results, quoting a researcher who called the effect “very mild” and who said he wasn’t sure it’s significant enough to recommend to anyone. The story also took the time to explain exactly what the benefit looked like in absolute terms: “After about 11 years, there were 2,669 new cancers, and some people had cancer more than once. For every 1,000 men per year in the study, there were 17 cancers among multivitamin users and more than 18 among those taking the placebo pills. That worked out to an 8% lower risk of developing cancer in the vitamin group.” The competing Reuters coverage didn’t provide these details.
The story states that side effects were similar between vitamin and placebo group participants, with the exception of their being more rashes among vitamin users. The story also touches on potential harms from dietary supplements in general (e.g. they are minimally regulated and not subject to strict testing for purity) and for specific groups (e.g. people on blood thinners or with cancer, whose vitamin use might interfere with their treatment).
The story provides a solid explanation of where this study fits in the hierarchy of vitamin research. It explains how the study differs from previous trials that looked at the effects of individual vitamins in higher doses. It also differentiates the new research from previous observational studies of vitamin users, which “can’t give firm conclusions.”
No disease-mongering. The story is clear that the results apply to older, relatively healthy men who don’t smoke.
We hear from an expert who wan’t involved with the study, and we receive a complete description of the study’s funding sources. The story notes that while NIH paid for most of the study, Pfizer supplied the pills. That’s a detail we didn’t hear about in the competing Reuters piece.
The story says that multivitamins are “less effective than a good diet, exercise and not smoking, each of which can lower cancer risk by 20% to 30%, cancer experts say.” We’ll call this good enough for a satisfactory, but we do quibble with the story’s broad assertions regarding the effectiveness of these lifestyle recommendations. With the exception of smoking cessation, which is certainly effective for preventing cancer, it’s never been conclusively proven that dietary changes or exercise can reduce cancer risk. In fact, recent research suggests that fruits and vegetables — long thought to be strong cancer fighters — actually have little or no effect on cancer risk. Obesity is emerging as the main diet-related culprit when it comes to cancer, something the story could have been more precise about.
The availability of multivitamins is not in question.
The story is clear about where this study stands in context with previous research.
It’s clear that this story wasn’t based on a press release.