New England Journal of Medicine editorial on health care journalism

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Susan Dentzer, editor-in-chief of Health Affairs and health policy analyst for the PBS NewsHour with Jim Lehrer has a commentary in this week’s New England Journal of Medicine, “Communicating Medical News — Pitfalls of Health Care Journalism.” Excerpt:

“In my view, we in the news media have a responsibility to hold ourselves to higher standards if there is any chance that doctors and patients will act on the basis of our reporting. We are not clinicians, but we must be more than carnival barkers; we must be credible health communicators more interested in conveying clear, actionable health information to the public than carrying out our other agendas. There is strong evidence that many journalists agree — and in particular, consider themselves poorly trained to understand medical studies and statistics.5 But not only should our profession demand better training of health journalists, it should also require that health stories, rather than being rendered in black and white, use all the grays on the palette to paint a comprehensive picture of inevitably complex realties. Journalists could start by imposing on their work a “prudent reader or viewer” test: On the basis of my news account, what would a prudent person do or assume about a given medical intervention, and did I therefore succeed in delivering the best public health message possible?

Although the primary responsibility for improving health-related journalism must lie with journalists, clinicians and researchers can help. When interviewed by journalists about a news development, such as a new study, they should offer to discuss the broader context, point reporters to any similar or contradictory studies, refer journalists to credible colleagues with differing perspectives, and mention any study limitations or caveats about the results, as well as any potential or real conflicts of interest among the study authors. It will take many expert hands to ensure that the health news the public reads really is fit to print.”

Let’s not lose sight of the fact that medical journals like the New England Journal of Medicine also play a role in this picture. As Trudy Lieberman points out on the Scientific American website,

“…much of daily health reporting these days is based on findings reported in medical journals. They, too, have come under criticism recently for failing to disclose authors’ potential conflicts of interest, such as their ties to companies that paid for the research (those caveats are becoming more transparent). But journals usually publish “good” news — a phenomenon detailed in several studies this year that showed how rarely pharmaceutical companies publish studies with negative findings.

The journals, Lieberman notes, have same interest as the mainstream media. “They want to build an audience and hope because the American healthcare system is built on hope and money.”

Unfortunately, neither the NEJM essay nor the Scientific American article mention the project, which, for almost 3 years has given daily evaluations and grades of health news coverage – e-mailing journalists to help them improve. Interestingly, one of the commenters to the Scientific American article did refer readers to as a “great learning resource for those who want to develop their critical thinking in this important area.”

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January 2, 2009 at 7:39 am

It was sort of sad that they didn’t mention your project. Dentzer cautioned against carnival barking in favor of more nuance, and then used the ezetimibe anecdote to prove her point, worrying that sensational coverage of that drug’s lack of evidence might cause people to discontinue using it prematurely. Given the huge controversy swirling around that trial (a letter from Steve Nissen in the very same edition of the journal took Peto et al to task for downplaying cancer risk in the trials), did I just hear someone bark?

Adrienne Larocque

January 6, 2009 at 8:40 pm

I just discovered and signed up for e-mails. It’s great for helping average people think critically about news reporting on one of the most important topics imaginable – their health. Keep up the good work!


January 7, 2009 at 6:42 am

All this sounds like a recipe for disaster. Seems like morals and ethics have been completely and utterly thrown by the wayside.