The need for independent perspectives in health care news stories: Breakthrough? Or caution?

Because this project has (at least temporarily) run out of funding, some stuff that I would normally assign for our criteria-driven systematic story reviews must, instead, be dealt with in some sweeping overview reactions on this blog.  That’s because I don’t have any budget to pay the terrific team that’s been dedicated to this site. Nonetheless, some of this stuff must be addressed in some way.

Breakthrough? Or simply a “nice advance”? It depends on how you frame the story, and whom you interview.

• The Medical News Today website published, “Breakthrough radioactive injection extends lives of prostate cancer patients.” There was no independent perspective, only quotes from the lead author of the paper in the New England Journal of Medicine. Maybe if the story had included an independent perspective, it wouldn’t have used the “breakthrough” terminology.

• By contrast, the New York Times Well blog published, “New Radiation Therapy Prolongs Prostate Cancer Survival.”  It offered this independent perspective from Dr. Robert Dreicer, a prostate cancer specialist and the chairman of the Cleveland Clinic’s department of solid tumor oncology, who was not involved in the new research:

“I think this is a big deal,” said Dr. Dreicer said. “It’s not a home run, but it’s a nice advance.”

Important tool?  Or “caution…pseudo-scientific…research doesn’t support this…will only increase costs”?

The Star-Ledger of New Jersey reported, “Brain wave scan, approved by FDA, could help detect ADHD.” There was no independent perspective in the story, only a quote from a doctor at one of the NJ hospitals involved in the study, saying “this should be an important tool for clinicians to use to help decide who may need more evaluation.”

There was no independent perspective in the Fox News online story, either, so nary a word of caution in it.

The New York Daily News picked up a story from a French news agency (Huh? Why?) that also had no independent perspective and not a word of caution about the approach.

Bloomberg’s story was pretty empty as well.

The New York Times story was headlined, “Brain Test to Diagnose ADHD is Approved.” There were two noteworthy items in the story:

“The results showed that the device helped doctors make a more accurate diagnosis than using traditional methods alone, the F.D.A. said.

An agency spokeswoman said it did not release the study’s data.

William E. Pelham, the director of the Center for Children and Families at Florida International University, which conducts research on the disorder and treats children who have it, was skeptical about the test. Traditional methods of diagnosing the disorder are relatively accurate, he said, and years of research on brain function have not added much to those methods. The NEBA device, he said, only supplements other types of tests and would serve only to increase the cost of diagnosis.”

The second sentence of that quote about not releasing the study’s data was important, and deserved more attention.  Why didn’t they release the data? What’s that all about? “Trust us?”

The independent expert’s skepticism was an important contribution to reader understanding.

But the Los Angeles Times story was better because it had a much stronger note of caution from an independent expert and gave that perspective more space:

“Frankly, I’m surprised,” said Sandra K. Loo, a clinical psychologist at UCLA who has researched brain waves among children with ADHD. “The current scientific research really doesn’t support using EEG as a diagnostic tool.”

Loo and other researchers recently published analyses of previous data and new data that showed many factors interfered with an accurate diagnosis based on the ratio of theta and beta waves. Among them were age, other mental disorders and the type of attention deficit disorder.

Loo, who reexamined 10 years of her own EEG readings, said, “I basically don’t find any differences between ADHD (children) and controls.” …

“We need to understand it more, what these measures actually represent,” Loo said. “It’s really still not well understood. I would caution people.”

ABC News – online – also delivered a big dose of skeptical independent perspective:

“I don’t know that this is going to help the situation at all,” said Rachel Klein, a professor of child and adolescent psychiatry at NYU Langone Medical Center. “I think it’s going to make people spend money needlessly.”

During a 15-minute test, the NEBA system measures and compares two kinds of brainwaves through electrodes on the scalp. Studies have found that kids with ADHD tend to have different brainwave ratios than those without the disorder, but Klein said there’s “nothing to suggest” the comparison works to diagnose individual children.

“When a child walks into the office, we already know there’s a problem. The issue is whether it’s ADHD or something else,” she said, noting that learning disabilities and certain mood disorders can share symptoms with ADHD. “We have no idea whether [the makers of NEBA] have been able to discriminate ADHD from something else.” …

Klein fears that busy GPs might buy into the NEBA system, which generates a readout of brainwave activity similar to the squiggly lines of a lie detector test, as a way to simplify a complex diagnosis.

“They can charge for it and it gives you a pseudo-scientific basis for the diagnosis – a piece of paper with little wiggles and you can say they’re not the wiggles you expect,” she said, adding that she hopes parents “understand the limitations of the test” and “realize they don’t have to rely on commercial promotions.”

Meantime, you can almost feel the marketing machine firing up in the background to start pushing the technology.  And the news organizations that simply passed along cheerleading for the new approach without doing any independent vetting simpy helped fuel that marketing.

Finally, as we try to wrap up the week, see Faye Flam’s piece on the Knight Science Journalism Tracker, “City of False Hope? News Stories Promise ‘Keys’ to Curing Cancer and Obesity.”

Reminder:  We offer a list of industry-independent experts on our site to assist journalists in their story development.

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