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Health News Coverage:
Just How Bad It Is, Why It Matters,
and What Doctors Can Do About It
Ivan Oransky, MD
Executive Edit...
Disclosures
I’m a full-time employee of Thomson Reuters, a provider of
news about health and other subjects
My wife is a f...
Dedication
Stanley Oransky, MD
May 16, 1941 – August 27, 2010
Just how bad is some health care journalism?
Front page story, May 3, 1998
"Judah is going to cure cancer in two years,'' ...
Just how bad … ?
Schwitzer G. How do U.S. journalists cover treatments, tests, products,
and procedures? An evaluation of 500 stories. PLoS...
207 stories
• 83 (40%) did not report benefits quantitatively
• 124 did, but
- 103 (83%) reported relative benefits only,
...
193 articles reporting at least one benefit or harm of a drug
100% mentioned at least one benefit
132 (68%) did not mentio...
193 articles reporting at least one benefit or harm of a drug
120 (62%) quotedat least one interviewee.
After exclusion of...
Wells: “Newspapers over-represent support for screening
mammography for ages 40 to 49”
Reports would have been improved by...
FDA message: Use of pediatric antidepressants is linked to a
risk of suicidality (as opposed to suicide itself)
• Reported...
Why It Matters:
Where do people find health information?
National Health Interview Survey:
Among blacks, Hispanics, and wh...
Why It Matters:
Where do people find health information?
Woodall ED et al. Sources of health information
Among Vietnamese ...
Survey of U.S. Latino adults
by the Pew Hispanic Center and the RWJ Foundation
• More than 25% lack a usual health care pr...
2010 Harris Poll
88% of adults have looked for health info online
81% of “Cyberchondriacs” looked online in last 30 days (...
In 1997 the South Wales Evening Post ran a “protracted campaign” on the
supposed dangers of measles-mumps-rubella (MMR) va...
Why It Matters:
Does media coverage make a difference?
(The $64,000 question)
Are medical experts like pots calling the ke...
Why is it so bad?
In a national survey of U.S. health and medical journalists:
• Nearly 70% had at least a bachelor’s degree
• 19% reported ...
Fewer reporters are doing more stories, broadcasts, and
blog posts
• Sites chasing a smaller number of advertising
dollars...
Barriers to improving medical journalism
• Lack of time, space and knowledge (the most common
obstacles)
• Competition for...
Many health reporters feel it’s hard to find independent
experts willing to assist journalists
They think editors need edu...
• Academic medical centers issue a mean of 49 press releases/year
• Among 200 randomly selected releases
– 87 (44%) promot...
What You Can Do
• Journals should make efforts to interest the press equally in
negative and positive studies
• Scientists...
• Develop relationships
– Answer calls
– Don’t just call when you have a paper published
– Send newsworthy items and ideas...
What You Can Do
Acknowledgements
My Twitter followers, especially Susannah Fox
(@SusannahFox) for references on media usage
Nancy Lapid of...
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Health News Coverage: Just How Bad It Is, Why It Matters, and What Doctors Can Do About It

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Grand Rounds, University of Wisconsin School of Medicine & Public Health, November 5, 2010

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Transcript of "Health News Coverage: Just How Bad It Is, Why It Matters, and What Doctors Can Do About It"

  1. 1. Health News Coverage: Just How Bad It Is, Why It Matters, and What Doctors Can Do About It Ivan Oransky, MD Executive Editor, Reuters Health Clinical Asst. Professor of Medicine, New York University Adjunct Asst. Professor, New York University Science, Health, and Environmental Reporting Program Grand Rounds University of Wisconsin School of Medicine and Public Health, Department of Medicine November 5, 2010
  2. 2. Disclosures I’m a full-time employee of Thomson Reuters, a provider of news about health and other subjects My wife is a full-time employee of CNN, a provider of news about health and other subjects
  3. 3. Dedication Stanley Oransky, MD May 16, 1941 – August 27, 2010
  4. 4. Just how bad is some health care journalism? Front page story, May 3, 1998 "Judah is going to cure cancer in two years,'' said Dr. James D. Watson, a Nobel laureate who directs the Cold Spring Harbor Laboratory, a cancer research center on Long Island.
  5. 5. Just how bad … ?
  6. 6. Schwitzer G. How do U.S. journalists cover treatments, tests, products, and procedures? An evaluation of 500 stories. PLoS Medicine 2008 doi:10.1371/journal.pmed.0050095 Just how bad … ?
  7. 7. 207 stories • 83 (40%) did not report benefits quantitatively • 124 did, but - 103 (83%) reported relative benefits only, - 3 (2%) absolute benefits only, - 18 (15%) both absolute and relative benefits • 98 (47%) mentioned potential harm to patients • 63 (30%) mentioned costs • 170 stories cited an expert or a scientific study - 85 (50%) cited at least one source with disclosed financial ties - 33 (39%) disclosed these ties Moynihan R et al. Coverage by the news media of the benefits and risks of medications. N Engl J Med 2000; 342:1645-1650 Just how bad … ?
  8. 8. 193 articles reporting at least one benefit or harm of a drug 100% mentioned at least one benefit 132 (68%) did not mentionside effects or harms 119 (62%) did not quantify benefits or harms – Of 510 mentions of benefits and harms, only 120 (24%) gave quantitative information – In 26% (31/120) the magnitude was presented in relative terms 37(19%) articles reported only surrogate benefits 7 (4%) mentioned contraindications 61 (32%) mentioned drug costs, 89 (46%) mentioned drug alternatives 30 (16%) mentioned nondrug options (such as exerciseor diet) Cassels A. Drugs in the news: an analysis of Canadian newspaper coverage of new prescription drugs. CMAJ, April 29, 2003; 168 (9) Just how bad … ?
  9. 9. 193 articles reporting at least one benefit or harm of a drug 120 (62%) quotedat least one interviewee. After exclusion of industry and government spokespeople, potential financial conflicts of interest were reported for only 5 of 164 interviewees (3%) Of 57 articles covering studies, only 15 (26%) included information on study funding Cassels A. Drugs in the news: an analysis of Canadian newspaper coverage of new prescription drugs. CMAJ, April 29, 2003; 168 (9) Just how bad … ?
  10. 10. Wells: “Newspapers over-represent support for screening mammography for ages 40 to 49” Reports would have been improved by • Identification of all sources for information cited • Less reliance on relatively few sources • Discussion of benefits in absolute terms Medical journalism may need standards similar to those used for reporting medical research Wells J. Newspaper reporting of screening mammography. Ann Intern Med 2001;35:1029-1037. Just how bad … ?
  11. 11. FDA message: Use of pediatric antidepressants is linked to a risk of suicidality (as opposed to suicide itself) • Reported correctly in the vast majority of news stories, BUT • Other key health messages in FDA warning often missing • News stories more likely to include anecdotes of children harmed versus children helped by antidepressants • Quoted experts more likely to emphasize benefits over risks Coverage grew increasingly neutral over time, conveyingneither the impression that the risks outweighed the benefits nor that benefits outweighed the risks Barry CL, Busch SH. News coverage of FDA warnings on pediatric antidepressant use and suicidality. Pediatrics 2010; 125:88-95. Just how bad … ?
  12. 12. Why It Matters: Where do people find health information? National Health Interview Survey: Among blacks, Hispanics, and whites, doctors and print media were consistently the two most frequent sources of information Meissner HI et al. How sources of health information relate to knowledge and use of cancer screening exams. J Comm Health 1992;17(3):153–165.
  13. 13. Why It Matters: Where do people find health information? Woodall ED et al. Sources of health information Among Vietnamese American Men,” Journal of Immigrant and Minority Health July 2006
  14. 14. Survey of U.S. Latino adults by the Pew Hispanic Center and the RWJ Foundation • More than 25% lack a usual health care provider • A similar proportion report obtaining no health care information from medical personnel in the past year • More than 80% report receiving health info from the media • 79% say they are acting on media information • “…the survey findings clearly demonstrate the power and potential of these alternative outlets to disseminate health information to the disparate segments of the Latino population.” Pew Hispanic Center, 2008: Hispanics and Health Care in the United States: Access, Information and Knowledge. Why It Matters: Where do people find health information?
  15. 15. 2010 Harris Poll 88% of adults have looked for health info online 81% of “Cyberchondriacs” looked online in last 30 days (mean, 6x/mo) • 17% looked for health info online ≥10 times in the last month Most are satisfied with their ability to find what they want online • Only 9% say they were somewhat (6%) or very (3%) unsuccessful • Only 8% think the info they found was unreliable 53% say they discussed online info with their doctors 51% looked for info online based on discussions with their doctors Why It Matters: Where do people find health information?
  16. 16. In 1997 the South Wales Evening Post ran a “protracted campaign” on the supposed dangers of measles-mumps-rubella (MMR) vaccinations • 5 front-page stories, • 3 opinion pieces • at least 18 other stories Immunization rates fell by 13.6% in the paper's circulation area, and 2.4% in the rest of Wales. Mason BW, Donnelly PD. Impact of a local newspaper campaign on the uptake of the measles mumps and rubella vaccine. J Epidemiol Community Health. 2000;54:473-74 Why It Matters: Where do people find health information?
  17. 17. Why It Matters: Does media coverage make a difference? (The $64,000 question) Are medical experts like pots calling the kettle black? "The reaction of the medical profession to evidence of damage to children was to claim coincidence," Edwards said. "We might as well say it was a coincidence that the take-up for MMR fell after we published our series of stories."
  18. 18. Why is it so bad?
  19. 19. In a national survey of U.S. health and medical journalists: • Nearly 70% had at least a bachelor’s degree • 19% reported having a master’s degree; • 4.5% had a doctorate; about 3% were M.D.s • Almost half had a degree in journalism • 13% had a degree in communications • 8% were ‘‘life sciences’’ majors Viswanath K et al: Occupational practices and the making of health news: A national survey of U.S. health and medical science journalists. Journal of Health Communication 2008; 13:759–777. Why is it so bad?
  20. 20. Fewer reporters are doing more stories, broadcasts, and blog posts • Sites chasing a smaller number of advertising dollars • Pressure to cover more and more, which places heavy reliance on journals and meetings Why is it so bad?
  21. 21. Barriers to improving medical journalism • Lack of time, space and knowledge (the most common obstacles) • Competition for space and audience • Difficulties with terminology • Problems finding and using sources • Problems with editors and commercialism Larrson A. Medical messages in the media--barriers and solutions to improving medical journalism. Health Expectations 2003;6:323-31. Why is it so bad?
  22. 22. Many health reporters feel it’s hard to find independent experts willing to assist journalists They think editors need education in critical appraisal of medical news Nearly all want short, reliable, up-to-date background information on various topics available on the Internet Most (79%) were interested in participating in a trial to evaluate strategies to overcome identified constraints Larrson A. Medical messages in the media--barriers and solutions to improving medical journalism. Health Expectations 2003;6:323-31. Why is it so bad?
  23. 23. • Academic medical centers issue a mean of 49 press releases/year • Among 200 randomly selected releases – 87 (44%) promoted animal or laboratory research, of which 64 (74%) explicitly claimed relevance to human health – Among 95 releases about clinical research, 22 (23%) omitted study size and 32 (34%) failed to quantify results – 113 releases promoted human research • 17% promoted randomized trials or meta-analyses • 40% reported on uncontrolled interventions, small samples (<30 participants), surrogate primary outcomes, or unpublished data—yet 58% lacked the relevant cautions Woloshin S et al. Press releases by academic medical centers: not so academic? Ann Intern Med 2009;150:613-618 Why is it so bad?
  24. 24. What You Can Do • Journals should make efforts to interest the press equally in negative and positive studies • Scientists should check all institutional press releases for accuracy and clarity • The health science community should promote contact with the media when confirmatory or non-confirmatory studies emerge in an area that has already been in the news • Medical journals should revise their policies so that scientists who explain a study to reporters do not jeopardize their chances of publishing their work Schuchman M. Medical scientists and health news reporting: a case of miscommunication. Ann Intern Med 1997;126:976-982
  25. 25. • Develop relationships – Answer calls – Don’t just call when you have a paper published – Send newsworthy items and ideas from other groups – Be an reporter’s back pocket expert • Help news offices write better press releases • Start your own blog • Don’t hype What You Can Do
  26. 26. What You Can Do
  27. 27. Acknowledgements My Twitter followers, especially Susannah Fox (@SusannahFox) for references on media usage Nancy Lapid of Reuters Health, for formatting my slides
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