Common themes in the Alzheimer's test stories & the Cancer Society screening ad

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Today on this site we’ve reviewed three stories that made claims about a new Alzheimer’s Disease test. Each was far less than what it could have been. Here are the reviews, for your convenience:

• New York Times story review
• WebMD story review
• Reuters story review.

Also today I blogged about my concerns over a new American Cancer Society ad campaign, “Screening is Seeing.”

It strikes me that there’s a common theme between what was missing in the Alzheimer’s test stories and what bothered me about the ACS screening ad.

One of our story reviewers, journalist Andrew Holtz, wrote to me after reviewing the three Alzheimer’s stories:

“One general comment is the responsibility of journalists to word stories in a way that avoids lazy assumptions that “it’s better to know.” Not only do the results of this study document how many false positives this test would produce if used in isolation. Identifying someone as having (or likely to develop) an untreatable condition is likely to create great mischief while providing a benefit in only very specific circumstances.”

Granted, the Cancer Society ad wasn’t about untreatable conditions. But it did promote the broad, vague “it’s better to know” concept, drumming that into consumers minds once again.

Holtz writes about “providing a benefit in only very specific circumstances.” Messages about screening also need to be specific – for specific audiences for whom the evidence is clear. Otherwise the messages may encourage screening in populations for whom the uncertainties mount, and for whom the potential harms may start to stack up with the potential benefits.

Sometimes you just need to step back, connect the dots, and see the firehose of “screen, screen, screen…test, test, test” messages that deluge the American public. And realize there has to be a better way.

Addendum 4:20 pm Central time 8/11: Mary Carmichael of Newsweek built on my criticism of the ACS ad campaign and improved on it by creating a mock counter-ad. Get the message, ACS?

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Comments (10)

Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.

Elaine Schattner, M.D.

August 12, 2010 at 7:43 am

Gary,
The Newsweek piece didn’t add to your story, it diminished it by frankly mocking the ACS and, perhaps at a deeper level, demeaning the work of pathologists, oncologists and other doctors who take care of patients who really do have cancer and need treatment.
All else aside, a genuine question for your group, I’d think, is whether the appropriate criteria for evaluating information in a newspaper article differ from those relevant to messages provided in an up-front charity campaign.

Marty

August 12, 2010 at 7:55 am

Thanks for posting these reviews. I’ve looked all over the Internet’s reporting of this story to see if anyone has caught the problem with the group that did not show any memory failure during the study. I even posted a question on the Alzheimer’s Reading Room and got slammed. The story does suggest there is SOME connection between the biomarkers and Alzheimer’s, but does not–as you point out–offer a 100% guarantee of accuracy. And the consequences of that could be devastating to some people.
Thanks again!

Gary Schwitzer

August 12, 2010 at 8:27 am

Elaine,
I didn’t create the Newsweek mock ad so it’s not my job to defend it. But since you posted your opinion, I’ll respond with mine. I see nothing in the ad that demeans the work of doctors as you charge. Perhaps you should communicate with Mary Carmichael of Newsweek so you can discuss this directly with her.
But let me address the question you raise for our group. “Our group” had nothing to do with my blog entry. My blog is my blog. No one tells me what to write in it. It is, in the nature of most blogs, a forum that allows for many opinions to be stated. I stated in my original post about the ACS ad that it was my opinion. You are confusing my blog with the systematic criteria-driven review of news stories on HealthNewsReview.org. But even though you confused the two, I’ll address your underlying question of “whether the appropriate criteria for evaluating information in a newspaper article differ from those relevant to messages provided in an up-front charity campaign.” Many observers have commented that the 10 criteria we apply to the review of news stories could be applied to any form of health care communication in the cacophony of health care messages that flood the American public every day. So even though we don’t apply the criteria to ad messages currently, why wouldn’t that be a legitimate pursuit?
Gary Schwitzer
Publisher

Mary Carmichael

August 12, 2010 at 11:18 am

Elaine,
I’m sorry you think my piece demeans the ACS. That’s certainly not the intention, as should be clear from the following sentences in the piece:
* “The original ad, which you can see below, is intended to raise funds for a laudable effort by the Centers for Disease Control, its National Breast and Cervical Cancer Early Detection Program. According to a press release for the ad campaign, the program is short of funding and can afford to help only about one in five women who are eligible for its services. The press release also notes that ‘the program has provided more than 9 million screening exams to more than 3 million women and diagnosed more than 40,000 cases of breast cancer and more than 2,000 cases of cervical cancer since it launched in 1990.’ This is powerful stuff.”
* “The ACS surely didn’t mean to promote misconceptions about cancer screening. The literature on its Web site offers pretty clear guidelines for who should get screened when.”
And from my “ad” itself:
* “CDC programs save lives though some screening tests that detect cancer early. Current funding for these isn’t enough.”
The ACS does wonderful, high-quality work. It deserves ads that are equally high-quality. It also deserves ads that are an accurate reflection of its views. Its new ad is neither of those things. We all agree that the ACS does not “support all screening programs blindly,” as you say in your comment on Gary’s other post. But these ads make it look like it does. That is the problem.
Perhaps your issue is with the fact that I actually made an ad, myself. I did that to illustrate how easy it is to come up with one that does not “support all screening programs blindly.” If I can do it in an hour on my creaky old home computer, I’m sure the very smart professionals who designed the ACS campaign could have done it too.
As for “pathologists, oncologists and other doctors who take care of patients who really do have cancer,” my husband is one, and I wouldn’t dream of demeaning any of them. I don’t think it demeans a field to point out that its tools are not perfect — which all responsible pathologists, oncologists, and other doctors would surely agree with — or to argue that the field needs more funding so it can design better ones.
Thanks, Mary

Hugo de Toronja

March 8, 2011 at 4:32 pm

Dr. Schattner,
I’m not a physician, but have kept company with quite a few, some of whom both teach and practice at institutions you would no doubt recognize and respect. I have, in other words, a better than your average layperson’s familiarity with medicine and its practice.
While I understand and sympathize with your concerns, I’d nonetheless stress that the general public is now drowning in a sea of misleading, inaccurate, and, all too often, quack-generated, “scientific” and “medical” information.
My physician friends, having already struggled for decades with their patients’ home-grown garden-variety misperceptions and evasions, now complain of having to reason against patient misperceptions and evasions that have been fortified, in fact justified, by the deluge of crack-pot “information” on the internet.
In such a difficult environment, the need for reliable science-based medical information is critical.
But — and this is the tricky part — it must be communicated with absolute clarity and accuracy.
The content, grammar, syntax, punctuation, and tone, of such messages must be scrutinized minutely, and criticized and reviewed with equal zeal.
Please understand that sincere efforts to sharpen and improve information disseminated, in whatever form, by organizations such as ACS only enhance their legitimacy and, in the long run, strengthen the authority and effectiveness of valuable physicians such as yourself.