ASCO 2018: How a major medical meeting uses embargoes to shape the news, and what the consequences may be

Michael Joyce is a writer-producer with and tweets as @mlmjoyce

ASCO 2018Later today the American Society of Clinical Oncology (ASCO) will hold a virtual “presscast” giving journalists a sneak preview into a handful of “new, high-impact studies” that will be presented at their annual meeting two weeks from now.

Just six out of 2,500 abstracts were selected for the preview.

“Many medical meetings do this and I’ll have to say I think ASCO does a fairly good job of this Herculean task,” said Len Lichtenfeld, MD, a Deputy Chief Medical Officer at the American Cancer Society.

Len Lichtenfeld, MD

“But there are problems with less savvy journalists writing articles based on abstracts that haven’t even been presented yet.

“This is incomplete information that hasn’t been vetted or peer-reviewed. Most journalists — and the public — don’t know the limitations of these highly promoted data. They don’t know the context of how these results fit into the larger cancer picture. Not only are the abstract results usually skewed toward highlighting benefits, but they often generate more interest from investors than they do from the medical community. Not infrequently the stories based on these early, embargoed abstracts will be imbalanced.”

A potential for harm

Lichtenfeld — like other doctors I spoke with in researching this topic — points out that promoting what is essentially pre-reporting on preliminary, pre-published findings is worrisome.

“I’ll often have people coming to me for my expert opinion on these pre-published abstracts, but I have to tell them I can’t thoughtfully comment without the full picture. The meeting presentation hasn’t even occurred and the data are often proprietary. This not only puts commenting experts in a difficult position, but it can be potentially harmful to patients who are understandably eager for new treatments. On the one hand, they can be enticed by new treatments where the harms aren’t yet fully known or disclosed; on the other, they may be diverted away from choosing established treatments that have been shown to be effective.”

Who benefits here?

Vince Kiernan, PhD

If, indeed, there is a potential for harm then it raises the question of who stands to benefit from what really amounts to pre-pre-coverage? That is, media coverage not just before the preliminary data is presented at a meeting, but also coverage long before it’s deemed worthy of publication.

“It’s almost a rhetorical question isn’t it?” said Vince Kiernan, PhD of the Catholic University of America in Washington, D.C.. Kiernan has a special interest in science journalism embargoes (ie. an agreement that exists between journalists and those in control of the research findings, which the media won’t publish until an agreed-upon date, as with today’s embargo by ASCO).

“In this case both the organizers of the conference and the scientists gain prestige. People will see all the attention and think: ‘This must be an important discovery or an important conference’.”

But proponents of such embargoes argue the heads up helps journalists to be more accurate; they’ll have more time to seek out expert opinions and do in-depth research.

“I don’t buy that,” said Kiernan. “Journalists have habituated to embargoes. They simply yoke journalists into a pack, and that usually results in homogenous coverage. Do they really have freedom of action? Are they really free when the timing and the content are selected for them?”

And Kiernan said he has other concerns.

“Our culture has this folklore of the ‘marketplace of ideas.’ That journalists are competing with one another to get the story out quickly, accurately, and all in the public interest. But that isn’t really true is it? Medical meetings, journals, and institutions can use embargoes to shape journalist’s behavior — and their stories —  to serve their ends, not necessarily the interests of the public.”

More consequences

In short, medical conferences like ASCO’s that do this are cherry-picking content they consider newsworthy; essentially dictating when journalists can publish their stories, and topping it off by providing incomplete, preliminary, and often skewed results with little to no context. Also, when journalists write as a pack — about the same topic, at the same time — it tends to amplify the seeming importance of those findings, even though they may not be any more likely than previous studies to reflect the “true” answer to the research question.

Seesawing news coverage of topics like coffee — good for your one week, bad for you the next — is a predictable consequence of this system, according to journalist Ivan Oransky, founder of the Embargo Watch blog. Writing in Vox he noted:

It warps the public’s understanding of how science works. One new study can’t overturn the consensus in the field. And in many cases, the newest study is just the one most likely to be disproven in the future. Readers can often learn more from the history of a scientific question than they can from just the latest stab at answering that question.

This sentiment is echoed by Adam Cifu, MD, an internist at the University of Chicago. Cifu specializes in evidence-based medicine and has written a book about what happens when research findings are adopted prematurely, only to be reversed when ineffectiveness — or harms — become impossible to ignore.

Adam Cifu MD

“I actually don’t think that abstracts published at meetings do a whole lot to influence actual care. And I’d be pretty concerned about a doctor who changes their practice based on a meeting abstract. I tend to react to these abstracts with a, ‘I find this interesting but I’ll wait to read the actual published research before considering making practice changes.'”

So what’s the rush? Why the pre-pre-publishing of preliminary data? I asked Cifu: Is it because it might give doctors a jump on important findings that could save lives?

“In my entire career I have never read any article that would have changed someone’s life had I read it a couple of weeks earlier.”

Putting these concerns to the test

Over the next few days you’ll likely be coming across news stories generated by today’s ASCO presscast. We’ll take a look at some of them. And we’ll cover another flood of stories once the meeting is underway June 1-5 in Chicago.

We invite you to join us as we follow these stories closely to see just how reporters handle them.

Will the coverage be cautious? Will it be balanced? Or will reporters parrot what is spoon-fed to them?

ASCO is an important meeting with usually about 30,000-40,000 cancer specialists in attendance. As we wrote last year it serves as a barometer for many things … “a shortlist would include emerging technologies, politics, research funding, and the big money that big companies invest in their intense marketing and public relations campaigns.”

I would add to that list it also serves as a barometer for how such meetings influence media coverage. This week we’ll put that to the test.

Addendum (May 18th, 2018):

To read our first follow-up story of these embargoed abstracts, see this article by Mary Chris Jaklevic:

‘ASCO pumps up a one-sided view of lung cancer screening: Here’s what most of the coverage missed’

More coverage of ASCO’s 2018 annual meeting:

As world’s largest cancer conference gets underway, keep these three tweets in mind

Are the clinical trial results for breast cancer drug taselisib ‘incredibly exciting’ or ‘disappointing’?

A hyped news release gets revised at ASCO: Did it lead to improved coverage from journalists?

Questions about a ‘simple blood test’ to screen for cancer prompt revealing answer: It’s complicated

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