Parikh examines media’s role in vaccine-autism link
In his latest dispatch, Salon.com contributor and pediatrician Rahul Parikih describes the media as the willing enablers of the decade of hysteria brought about by what he describes as “Dr. Andrew Wakefield’s now infamous study linking the MMR vaccine to autism.” Parikh starts by describing exactly how Wakefield artfully manipulated the media from the beginning:
The anti-vaccine hysteria, after all, began like so many other big stories: with a press conference. That’s where Andrew Wakefield first staked his claim that the MMR vaccine caused autism, according to Paul Offit’s book, “Autism’s False Prophets.” Wakefield wasn’t flanked by doctors or hospital officials but by P.R. folks he had hired himself. “One case of [autism] is too many,” he said. “It’s a moral issue for me, and I can’t support the continued use of [the MMR vaccine] until this issue has been resolved.”
The problem, of course, is that a news conference loads a gun that the media usually pulls the trigger on: Headlines like “Ban Three-in-One Jab, Doctors Urge” started rolling off the presses. While measles made a tragic resurgence, few reporters attempted to scrutinize Wakefield or his audacious claim.
Finger successfully pointed, Parikh then goes on to analyze, with the help of AHCJ member Gary Schwitzer, exactly how the media was duped. He finds that it comes down to the fact that science is pretty complicated stuff, while the news cycle is not.
Frankly, progress in science and medicine occurs much more slowly than the news cycle can tolerate. “Science,” says Schwitzer, “is like a slow winding stream. It has ebbs and flows, and twists and changes in its path that, if you don’t follow, can fool you. But too many reporters, unfortunately, like to dip their toe in the water, run back and report about it without following that river to where it leads.”
Parikh also blames the reporters’ technique of adding “balance” to a story by including opposing opinions that may come from discredited fringe elements, but adds that it’s not entirely the media’s fault.
The Lancet, one of the world’s most well-known medical publications, played an enormous role here, showing us how medical journals are at risk for their own kinds of malpractice. Offit’s “False Prophets” details how Richard Horton, then the journal’s editor in chief, seemed enamored of the notion of publishing something muckraking. As Offit writes, “By ignoring the criticisms of several reviewers, the warnings of an accompanying editorial, Wakefield’s history of holding press conferences, a British press primed for controversy, and a public distrustful of pubic health officials, Richard Horton allowed the public to question the safety of a vaccine based on flimsy, irreproducible data. The loss of the public trust that followed was entirely predictable.”
Parikh ends his piece on a positive note, praising Brian Deer’s investigations into Wakefield’s research in The Sunday Times (of London).
Radiation oncologists request more regulation
The New York Times’ Walt Bogdanich reviewed the American Society for Radiation Oncology’s new six-point plan, most of which seem to be a response to Bogdanich’s series (Part 1 | Part 2) on serious radiation errors. As a whole, Bogdanich writes, the plan seems to signal a push for more standardized, consistent and universal regulation of radiation treatment in the United States.
The group’s six-part plan includes creating a database of errors, enhancing accreditation programs, improving training, working with patient support organizations to help patients and caregivers better communicate with their radiation oncologist, further development of a compliance program for technologies from different manufacturers and providing expertise and support to policymakers to pass an act requiring national standards.
Related
Philly VA botched 92 of 116 cancer treatments
Philly VA doc defends himself before Congress
Scans at LA hospital spewed 8x normal radiation
Patient 2.0 empowers patients, worries doctors
Filed under: Health data, Hospitals, Hot Health Headline
Writing for Time, Bonnie Rochman digs into the ramifications of patients sharing information and tips online, an “empowerment movement” she calls “Patient 2.0.” In the piece, she profiles the newly created Society for Participatory Medicine, which “encourages patients to learn as much as they can about their health and also helps doctors support patients on this data-intensive quest,” as well as PatientsLikeMe.com, a free service which makes its money by selling anonymized patient information.
One private-sector initiative already has about 50,000 patients inputting their symptoms and treatment regimens and updating details of their disease progression. Wonder how others are coping with your particular ailment? PatientsLikeMe.com spells it out via color-coded charts and graphs. “When you need help, privacy is a terrible thing,” says Jamie Heywood, who co-founded PatientsLikeMe in 2004 before his brother died of Lou Gehrig’s disease, or ALS.
Rochman demonstrated the strength of PatientsLikeMe in an anecdote in which data from the site’s users allowed administrators to reach clear conclusions about the effectiveness of lithium in the treatment of ALS six months ahead the formal clinical trials that were testing the same thing.
While medical professionals like those at the Society for Participatory Medicine have embraced the patient power movement, “plenty of doctors are worried about the quality of the information that is being assessed as well as patients’ ability to understand it,” Rochman wrote. A few have taken it upon themselves to fill the gaps, banding together to weigh in on the effectiveness of certain off-label treatments via Twitter, and to produce patient seminars on the reasons for clinical trials and the efficacy of various treatments.
NCHS: Patient 2.0 most popular use of health tech by far
The National Center for Health Statistics recently (Feb. 2) released statistics for the first half of 2009 on “Health Information Technology Use Among Men and Women Aged 18-64.” The stats show that “searching for health information online” is still the only use of health information technology embraced by a majority of American adults.
The numbers:
- From January through June 2009, 51% of adults aged 18-64 had used the Internet to look up health information during the past 12 months.
- Over 3% of adults aged 18-64 had used an online chat group to learn about health topics in the past 12 months.
- Among adults aged 18-64, women were more likely than men to look up health information on the Internet (58.0% versus 43.4%) and were also more likely to use online chat groups to learn about health topics (4.1% versus 2.5%).
- From January through June 2009, almost 5% of adults aged 18-64 had communicated with a health care provider by e-mail in the past 12 months.
- During the first 6 months of 2009, 6% of adults aged 18-64 requested a refill of a prescription on the Internet, and almost 3% had made an appointment with a health care provider in the past 12 months using the Internet.
- Among adults aged 18¬64, women were more likely than men to request a prescription refill on the Internet (6.6% versus 5.3%), make an appointment using the Internet (3.5% versus 1.8%), and communicate with a health care provider over e-mail (5.6% versus 4.2%).
Attention focuses on football’s neurological effects
Friday Night Lights author Buzz Bissinger, writing in Time, looks at two things he claims are being overlooked during the most recent uproar over football injuries: High school athletes and spinal injuries. Bissinger has strong opinions and two anecdotes, one of which includes a source who said that roughly two Texas high school football players suffer catastrophic spinal injuries each year.
Bissinger praises Alan Schwarz’ work on concussions at The New York Times, but openly doubts whether the advances Schwarz is helping force at the professional level will ever translate to high school.
I know the focus will not trickle down to where it is needed most: the high school level. Research has shown that young players are far more susceptible than older ones to serious injuries. …
There should be an ambulance at every high school game. There should be trainers. But don’t bet on it, as school districts cry a lack of money. Kids will continue to suffer serious head injuries. Kids will continue to become paralyzed because they never learned how to properly tackle, with their heads up. The game’s violence will continue because that’s exactly why we like it, our gladiatorial lust still intact 16 centuries after the Romans. The bigger the hit, the greater the roar.
Not a new concern
In an Op-Ed piece in The New York Times, Deborah Blum, a professor of science journalism at the University of Wisconsin, writes about a warning published in The Journal of the American Medical Association that said the medical profession can no longer ignore that “There is a very definite brain injury due to single or repeated blows on the head or jaw which cause multiple concussion hemorrhages” in a report about professional athletes.”
But what really makes the research and its conclusions so interesting is its timing: it appeared in The Journal of the American Medical Association on Oct. 13, 1928. This raises the question – at least for me – as to why we are announcing the athlete concussion-dementia link as a new, and still somewhat debatable, issue some 80 years later.
House Judiciary forum
Watch a video webcast of the Feb. 1 “House Judiciary Committee Forum on Head Injuries and Other Sports Injuries in Youth, High School, College and Professional Football,” or read about Republican’s reluctance to hold said forum in Houston.
Dan Rather report
Dan Rather’s latest investigative effort was a far-reaching look at concussions and football, with emphasis on both the high school and professional games. He frames it as part of the pre-Super Bowl concussion awareness push (PDF Transcript).
ESPN to air ‘Head Games’
ESPN reporter Greg Garber, on “Outside the Lines,” will look at the issue of concussions and the NFL at 8 a.m. ET on Sunday. Harold Donald Carson, a former linebacker and inductee into the Pro Football Hall of Fame, “has become one of the leading spokesmen for the NFL’s retired players. Passionate and eloquent, he is in some ways the league’s conscience on the subject.”
Carson, who played 13 seasons for the New York Giants, estimates he suffered about a dozen concussions during his career, but none of them were documented. While he believes concussions among former football players will escalate into an epidemic, Dr. Joseph Maroon, the Steelers’ neurosurgeon for nearly three decades and a member of the NFL’s concussion committee for the past three years, disputes that:
“Because we know that there are millions of high school kids, college kids, youth leagues, as well as other who play football annually, I think we are not seeing the epidemic at that level people are speculating about,” Maroon said.
Related
- Advanced MRI reveals damage in brains of retired NFL football players
- Tim Tebow’s head fuels concussion debate
- Technology in play to help make football safer
- Brain damage caused by football is cumulative
- ‘Playing through’ concussions is damaging
FDA warns against promoting unapproved drugs
Filed under: Health journalism, Hot Health Headline
The New York Times‘ Natasha Singer looked into the FDA’s recent warning of prominent cosmetic doctor Leslie Baumann (bio) for the promotion of an unapproved drug, based on comments she made about Botox-like Dysport (she was an investigator in a trial of the treatment) in outlets such as Allure, Elle and the Today Show. Singer also considered the chilling effect this warning might have on other clinical investigators upon which the media has traditionally relied.
Now, some industry experts say the F.D.A. warning may curb the media enthusiasm of certain cosmetic doctors who until now have provided scoops about coming medical products — or have talked up the latest unapproved cosmetic uses for drugs and devices that the agency had approved only for other purposes.
“It’s a wake-up call,” said Nancy Behrman, owner of Behrman Communications, a public relations firm in Manhattan. Her firm has represented cosmetic medical companies as well as doctors. “The whole business has spiraled out of control, and we need to step back and slow it down.”
FDA representatives say that there’s a line between scientific discussion and drug promotion, and that investigators are welcome to talk to the media as long as they don’t cross it.
Thomas W. Abrams, director of the agency’s Division of Drug Marketing, Advertising and Communications, said that investigators were free to have scientific conversations about investigational drugs with their peers and with journalists. But an investigator should not promote any unapproved prescription drug — or an unapproved use of an already approved drug — as being safe or effective if the agency has not yet deemed it to be so, he said.
Singer also talks to another of the media’s favorite doctors, dermatologist Fredric S. Brandt, who said that, in future discussions with media he would take care to offer only scientific facts on unapproved drugs, and leave his opinions and recommendations out of the discussion.
VA works toward improving care for female vets
Acknowledging that female veterans have gotten short shrift at VA hospitals, some are now working to improve the services and experience women receive, according to NPR’s Erin Toner.
For example, the Clement J. Zablocki VA Medical Center in Milwaukee now has a women’s clinic and one manager there says the hospital is working to change the culture.
Toner also reports that a bill pending in Congress would “authorize a study of women who’ve served in Iraq and Afghanistan to find out how the wars have affected their physical, mental and reproductive health.
“The bill also would require a review of the barriers women face in accessing VA health care.”
NPR also includes a map of how many female veterans are in each state.
Related
During a 2008 panel on veterans’ health presented by the San Francisco Bay Area Chapter of AHCJ, Tia Christopher described her difficulties getting the help she needed as a Navy veteran who survived military sexual trauma and has PTSD. She expressed concern for female vets, whose experiences and health issues are significantly different from those of male soldiers and are largely underreported.
Listen to Christopher and the other panelists talk about the health care challenges facing vetereans.
‘Salami slicing’ yields many articles from one trial
Filed under: Health journalism, Hot Health Headline
As discussed by Toronto Star’s Stuart Laidlaw and Pharmalot’s Ed Silverman, the journal Psychotherapy and Psychosomatics recently drew attention to the practice of publishing multiple journal articles from the results of one clinical trial in a study they titled “A Case Study of Salami Slicing: Pooled Analyses of Duloxetine for Depression” (PDF). Duloxetine, for the record, is an Eli Lilly drug better known as Cymbalta.
Salami slicing is well known (and disliked) by top-flight journal editors who, Laidlaw said, often require authors to “declare if any part of the underlying research has been – or soon will be – published elsewhere.” Still, the researchers behind the Psychotherapy and Psychosomatics paper found it remains widespread, at least in the case of Cymbalta.
The authors speculate that the practice is propelled by two key factors: researchers who want to increase their exposure and publication counts and pharmaceutical manufacturers who want to “widely disseminate” the results of positive studies and create an artificially inflated base of scholarly support for their products.
Researchers defend the practice as cost-effective, saying that medical trials can be prohibitively expensive, and salami slicing is one way to extract as much research as possible from one trial. Additionally, they say that trials are intentionally designed to be sliced, and that there are often multiple separate issues that each warrant their own manuscript.
Laidlaw also found at least one researcher who took issue with the semantics of the practice’s sensation-friendly label.
“I would be careful of anything that’s given a folksy name,” says Dr. Ralph Meyer, director of the National Cancer Institute of Canada’s Clinical Trials Group at Queen’s University.
Calif. maternal death on rise, according to report
Filed under: Government, Hot Health Headline, Public health
Citing investigators who wrote a yet-to-be-released report, Nathanael Johnson of California Watch reports that the “mortality rate of California women who die from causes directly related to pregnancy has nearly tripled in the past decade.”
The state’s Department of Public Health has held the report without releasing it for the past seven months, according to Johnson.
In a Sentinel Event Alert sent to hospitals nationwide last month, the Joint Commission advised doctors to be aware of medical conditions that contribute to maternal death, including pre-pregnancy obesity, diabetes and high blood pressure. Johnson writes that the alert may signal that the problem is national.
The California report was presented to the American College of Obstetricians and Gynecologists in 2007 - to gasps from the audience, Johnson reports.
The state of California has yet to share the report with the public. Researchers say that, after reviewing the report in 2008, officials in the Department of Public Health asked for technical clarifications. Revisions were complete and approved in the first half of 2009, according to [Shabbir Ahmad, the scientist in California’s Department of Public Health who organized the statewide review].
Academics: Media added to reform confusion
Filed under: Health care reform, Health data, Hot Health Headline, Member news
Health News Florida’s Carol Gentry talked to journalism professors at three major Florida universities about the effect of media coverage on public perception of health care reform. The trio suggested that the media muddied the issue by focusing coverage on the political horse-race aspects while neglecting to invest the time necessary to fully explain the proposed legislation’s finer details.
In a column for AHCJ, Trudy Lieberman, the organization’s immediate past president has discussed some of the same shortcomings of health reform coverage. The academics say this is nothing new – many of the same issues surfaced during Clinton’s health reform push in the early ’90s, but say today’s fragmented media environment and 24-hour news cycle have certainly exacerbated matters.
[Kim Walsh-Childers, University of Florida journalism professor] said many Americans get their information from talk radio or blogs, “which are far less likely to provide balanced, complete information than are traditional news outlets, especially newspapers.”
“Even those who read newspapers may be getting far more information about the political strategies (of) the various stakeholders … than they are about what those proposals actually would mean for the average family,” Walsh-Childers continued.
Walsh-Childers praised NPR and The New York Times for their more thoughtful reform coverage, and said layoffs of experienced health reporters had likely weakened coverage at many outlets.
Gentry also cited surveys conducted by the Kaiser Family Foundation which found that peoples’ opinions of reform changed when they were better informed of the bills’ actual components.
Surveyors found that while a majority said they were opposed to the legislation, support grew markedly when survey participants found out the major parts of the plan.
Three-fourths became more favorable when they heard about tax credits for small businesses and two-thirds liked what they heard about health exchanges, constraints on health insurers and plugging the Medicare prescription-drug “doughnut hole.”
Related
More columns by Lieberman about coverage of health reform:
- Putting a human face on McCain, Obama health plans
- Look for opportunities to localize the debate on national health reform
- If candidates won’t focus on aging issues, journalists better
- Candidates’ health reform language needs closer scrutiny, definition
- Journalists must do better to inform, educate public
Transmitter tracks health-care workers’ washing
Despite constant reminders and a high-level of industrywide awareness, studies indicate that less than half of American health care workers wash their hands as frequently as they ought to. This contributes to the health-care-associated infections that kill tens of thousands annually. Now, NPR’s Gigi Douban reports, one Alabama hospital has resorted to high-tech monitoring devices to keep tabs on the handwashing practices of its employees.
Workers wear a special wireless transmitter, from which, Douban writes, “the hospital can tell when she entered a patient’s room, whether she washed her hands and whether she washed again on the way out. The information is sent to hospital officials, including the CEO.”
“If they’re habitually not complying, we can send them an e-mail or send them a text message, something that goes to them personally,” says Harvey Nix, CEO of Proventix, the company that developed the monitoring system at Baptist Princeton.
According to Douban, the CDC is currently investigating the effects of the technology upon the behavior of health workers.
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The latest volume in AHCJ's ongoing Slim Guide series gives a head start to journalists who want to pursue stories about one of the most vulnerable populations – nursing home residents.
- Addressing the growing demand for kidneys
- Ethics in hard times: Panel for science and health journalists
- Compromised care: What reporters learned about felons in nursing homes
- Experts say tuberculosis poses a nearly silent threat
- Childhood obesity: Experts discuss strategies, solutions journalists should cover
- Mark your calendar now for Health Journalism 2010!
- Directory of freelance health journalists now available
- New resource: Easier-to-use Nursing Home Compare data
- Resources for covering H1N1 flu, pandemics and preparedness
- Online tools for creating multimedia: easy, accessible, and inexpensive