We can’t do a Five Star Friday feature today because we didn’t have any five-star reviews to shine a light on.
In fact, this week, after publishing 128 systematic criteria-driven news story reviews so far this year, we gave our first zero-star score of the year to a Washington Post diet story. We don’t like doing that at all. We wish it would never happen. Our reviewers called it “enthusiastically superficial.”
So, instead, we’ll point out some other items that caught our eye.
In the US, Leonore Tiefer, PhD, is tracking news coverage of flibanserin.
Also in Australia, our old friend Ray Moynihan wrote in The Saturday Paper, “Disease definitions linked to pharmaceutical companies: Connections between drug companies and panels that define diseases raise questions about who is considered ill and how drug markets are expanded.”
CNN is promoting an upcoming CNN Film, “Glen Campbell…I’ll Be Me,” about “a music legend fights Alzheimer’s disease on his unforgettable farewell tour. (Prominently sponsored by the Eli Lilly drug company.) Atop a longer online story sits an attractive 18-photo slide show entitled, “The MIND diet prevents memory loss and may prevent Alzheimer’s.”
The slide show is attractive, but substance is another matter. Christine Stencel, who works in health communications/media relations for PCORI – the Patient Centered Outcomes Research Institute – Tweeted to CNN in response:
“I’m all for urging healthy diet, but w/such great promises (Alz prevention) comes need for super-great evidence.”
@cnnhealth I’m all for urging healthy diet, but w/ such great promises (Alz prevention) comes need for super-great evidence.
— Christine Stencel (@CStencel) June 23, 2015
We recently reviewed a CBS News piece on the MIND diet and gave it a low two-star score. Excerpt:
“The story focuses on the specific elements of the diet without critically appraising the research itself, and helping readers understand the limits of observational studies. Additionally, the story does not raise the issue that only relative risks were reported in the study, not absolute risk of Alzheimer’s, making the impact of the diet appear greater than it is.”
When I saw that the Philadelphia Inquirer re-published a news release from the Mayo Clinic, entitled, “Meditate on this: Mindfulness can improve well-being,” I immediately thought of Timothy Caulfield’s recent piece, “Be mindful, but not mindless,” in the journal Policy Options.
Caulfield holds the Canada Research Chair in Health Law and Policy at the University of Alberta, and is the author of “Is Gwyneth Paltrow Wrong about Everything? When Celebrity Culture and Science Clash.”
Kaiser Health News published an interesting Q & A with Dr. Michael LeFevre, whose term as chair of the US Preventive Services Task Force recently ended. Read, “Controversies Made Preventive Services Panel Stronger, Says Retired Leader.”
Finally, read the editorial by Ben Goldacre and Carl Heneghan in The BMJ – “How medicine is broken, and how we can fix it.” Excerpts:
“We briefly examine six domains where the academy could call for simple practical improvements that would address legitimate concerns.
Publication bias—We conduct trials to detect modest differences, and spend vast amounts of money specifically to exclude bias, yet we allow that bias to flood back in through selective publication….
Independent trials—A recent cohort study found that 97% of head to head trials sponsored by industry give results that favour the sponsor’s drug. Doctors and patients are right to want independent trials. On statins and oseltamivir, there are two clear opportunities, and here we declare our own conflicts. With colleagues, one of us (CH) first proposed a trial of oseltamivir in a pandemic in 2009; the other (BG) first proposed a trial of statins examining side effects over a year ago. In both cases we could have the answer by now.
Cost of trials—Replication will be possible only if the cost of conducting trials is radically reduced. Much of this cost is driven by disproportionate regulation around trials of routinely used treatments….
Better evidence—Treatments are routinely approved after trials with only surrogate outcomes. Drugs are then extensively promoted, at the moment of approval, when evidence on real world outcomes is paradoxically at its weakest. We could encourage better evidence by, for example, compelling companies to follow-up all phase III trial participants until real world benefits emerge, considering routine randomisation for newly approved drugs when benefits are unclear, and bartering with either patent extension or choice of the start date for market exclusivity. These suggestions would come at minimal cost and deliver more comprehensive data on treatment effects.
Shared decision making—Concern over statins has recently been reawakened by the introduction of a financial incentive for general practitioners to prescribe the drugs to low risk patients. This is ill judged because patients’ informed choices vary widely. An incentive to prescribe a treatment that many adequately informed patients do not want undermines informed decision making and inflicts avoidable reputational harm on the profession. If instead we incentivise shared decision making then—for the same financial outlay—best practice will be recognised, rewarded, and laid down in the everyday templates of what doctors do.
Declare conflicts of interest—Declaration of conflicts of interest is currently chaotic, inconsistent, and incomplete.