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More pro-screening bias by some journalists

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There’s a saying about the some of the problems with screening tests: How much disease you find may be a matter of how hard you look.

Recently, I have evidence that how many problematic news stories on screening tests you find is only a matter of how hard you look.

I won’t repeat episodes I’ve already written about on this blog. Just click on the screening category – http://blog.lib.umn.edu/schwitz/healthnews/cat_screening.html – to see the past evidence. But here are some new examples.

1. Tom Burton, in the Wall Street Journal this week, had an article under the headline, “Three Tests May Foil Artery-Disease Deaths.??? He wrote: “Three simple tests that can potentially save thousands of lives from strokes, aneurysms or other arterial problems are getting a big endorsement today. …As of today, the Society for Vascular Surgery, representing the nation’s 2,400 vascular surgeons, is for the first time recommending these three tests to screen for artery disease in many people 55 years old and over.???

But the only professional perspectives he included were from vascular surgeons. He could have easily included a perspective such as the one I elicited from Dartmouth’s Dr. Gil Welch, in response to the story: “Screen many, to find the few –while many others get labeled at risk in the process. And thus many will be treated “wrong”, have an immediate operation for which the risks exceed the benefit. To see the full effects, you need to randomize. And there has been no randomized trial showing its net effect.???

This story was reported by a veteran, Pulitzer-winning journalist at one of the newspapers whose health coverage I respect the most. Yet he reported a one-sided story with a clear pro-screening emphasis.

2. CNN’s Elizabeth Cohen last week had a story in which she listed an entire litany of screening test recommendations for women – many of them unsupported by the best medical evidence. Perhaps the most glaring was this: “At 40 … women need to start having mammograms every year.??? Are she and CNN totally unaware of the controversy over mammography in the 40s, fired anew most recently by the American College of Physicians just two weeks ago? Her statement – as if fact – is simply not supported by the ACP or the U.S. Preventive Services Task Force, perhaps the most balanced, unbiased source on such questions.

3. Georgia Public Radio last week aired a special report, “Breast Cancer in the African American Community.??? On the air they stated, “Typically every woman should start having mammograms at age 40.???

On their website, they stated: “The American Cancer Society recommends that every woman over 40 have a regular screening mammogram.???

It is another example of journalists appearing to be oblivious to the contrary recommendations of other learned bodies of experts in this country.

What accounts for this apparent pro-screening bias seen in some stories? I’m going to continue to track these practices and try to investigate journalists’ rationale.

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Comments

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Kevin B. O'Reilly

April 23, 2007 at 12:08 pm

Interesting. Health care journalists should understand all of the larger risks of Type II errors with any screening.
That said, it seems that simple questioning could have avoided these mistakes. For example:
(1) Why would someone not want to get this screening?
(2) What are the risks of the screening?
(3) What is the evidence to support the screening?
(4) Who opposes doing this screening routinely? Why?
Shouldn’t those questions have yielded the leads the reporters could have then used to do less one-sided reporting? Are these basic questions not being asked, or are they not answered honestly?