Friday, May 9, 2014

Gary Schwitzer, writing in JAMA Internal Medicine -- in an article that has been moved out in front of the paywall --- freely accessible for 6 months -- summarizes the work of a team of reviewers from who evaluated the reporting by US news organizations on new medical treatments, tests, products, and procedures between 2006 and 2013.  The results:

After reviewing 1889 stories (approximately 43% newspaper articles, 30% wire or news services stories, 15% online pieces [including those by broadcast and magazine companies], and 12% network television stories), the reviewers graded most stories unsatisfactory on 5 of 10 review criteria: costs, benefits, harms, quality of the evidence, and comparison of the new approach with alternatives. Drugs, medical devices, and other interventions were usually portrayed positively; potential harms were minimized, and costs were ignored. 

Here were the standards applied during this seven-year period:

Ten review criteria were used to assess each news story reviewed. The review criteria addressed whether the story (1) adequately discussed the costs of the intervention; (2) adequately quantified the benefits of the intervention; (3) adequately quantified the harms of the intervention; (4) evaluated the quality of the evidence; (5) widened the diagnostic boundaries of illness and promoted public awareness of these widened boundaries, which may expand the market for treatments, a practice that has been termed disease mongering; (6) quoted independent sources and identified the conflicts of interest of sources; (7) compared the new approach with existing alternatives; (8) established the availability of the intervention; (9) established whether the approach was truly novel; and (10) appeared to rely solely or largely on a news release as the source of information.

The one type of mistake that I have seen all too often is described in the article as "the tyranny of the anecdote."  Gary explains: 

Stories may include positive patient anecdotes but omit trial dropouts, adherence problems, patient dissatisfaction, or treatment alternatives. In one example, 4 major US news sources used the same “breakthrough” patient anecdote of one man’s reported improvement from a heart failure stem cell experiment. This example illustrates another common problem: patient anecdotes provided by public relations representatives for medical centers or industry that put an overly positive spin on an intervention. 

How perfectly these stories coincide with the anecdotes used by firms and hospitals in promoting their products or services.  How much more so when the reporter works in a small or medium size community whose hospital has decided to buy into a firm's technology. It becomes quite evident that the journalist is often taken in by the jingoism of the hospital and "finds" the anecdotes that support the joint marketing campaign of the suppplier and the hospital.   Gary suggests that "fawning coverage of new technologies" is the result:

Journalists often do not question the proliferation of expensive technologies, such as proton beam radiation machines and robotic surgical systems. The use of new technologies can increase the costs of medical care but may not improve care.

Gary suggests:

Our findings can help journalists improve their news stories and help physicians and the public better understand the strengths and weaknesses of news media coverage of medical and health topics. 

I hope so. These reporters, often younger men and women on the staff of newspapers, need to understand that their reports can have a substantial impact on the public perception of new medical devices, therapies, and hospitals.  They owe it to the public to be diligent and rigorous in their coverage. Are they up to the task?


Post a Comment

Blog Archive

Powered by Blogger.

Popular Posts