Society ‘snookered’ by research that isn’t new
Peggy Peck of MedPage Today found that research presented as new at the European Society of Cardiology’s annual meeting this weekend was actually published in July, despite the society’s requirement that information submitted for presentation must be new, unpublished data.
When asked by MedPage Today to point out the “news” in the Hot Line presentation, STAR lead investigator Bodo-Eckehard Strauer, MD, of the Heinrich Heine University of Düsseldorf, Germany, said the news was that bone marrow cell therapy significantly improved survival in patients with chronic cardiomyopathy, which he illustrated with a slide showing a Kaplan-Meier curve – the same graph that was published in the July issue of the European Journal of Heart Failure. Moreover, every data slide in Strauer’s presentation matched the tables in the published paper.
Following questions from MedPage Today, the organization acknowledged its error and has announced the researcher will not be allowed to present at its meetings for two years. Roberto Ferrari, M.D., president of the society, said the research had been accepted for presentation because they thought it had new data but that “We were snookered.”
AHCJ pushes for access to publicly funded research
Filed under: Government, Health data, Health journalism, Public records, Studies
The strong public interest in “direct, free and full text access to research articles” prompted the Association of Health Care Journalists to send comments to the House Oversight and Government Reform committee.
The letter [PDF] was in support of full-text access to the fruits of publicly-funded research to members of Congress considering H.R.5037 – Federal Research Public Access Act of 2009. One section of that bill would require researchers who receive funding from federal agencies to provide free online public access to final peer-reviewed manuscripts or published versions as soon as practicable, but not later than six months after publication in peer-reviewed journals.
While AHCJ did not take a position on the specifics of the bill, the group highlighted the strong public interest in “direct, free and full text access to research articles,” noting that for journalists to be able to provide readers and audiences with accurate and comprehensive reporting, they need to be able to see the full details of research reports, not merely the highlights contained in abstracts or news releases.
“The fundamental principle at issue is the public’s right to examine both the evidence produced by research studies and the methods employed by researchers. When the researchers are supported by taxpayers, the public’s claim is even stronger,” AHCJ’s statement read in part.
The statement took note of the concerns of some publishers who fear the mandate could cut into their income, while also pointing out that other publishers already provide free online access to the full text of research articles within six months of publication.
Related:
Bill would require public access to research
PTSD or personality disorder? It matters to soldiers
Filed under: Government, Health journalism, Health policy, Studies
The AP’s Anne Flaherty has put together a story that illuminates the Army’s refusal to admit that it could have misdiagnosed (and discharged) hundreds of soldiers who may have had PTSD or traumatic brain injury instead of a personality disorder. Keep in mind that a discharge for “personality disorder” means no veterans’ benefits and a lifetime of stigma. A diagnosis of PTSD or injury, on the other hand, means treatment will be covered by the government.
Photo by isafmedia via FlickrThe Army, for its part, has decided there’s nothing unusual about the following chain of events (taken from Flaherty’s story):
- The Army “discharged about a 1,000 soldiers a year between 2005 and 2007 for having a personality disorder.”
- In 2007, The Nation’s Joshua Kors writes a cover story exposing the Army’s apparent habit of diagnosing soldiers with a personality disorder instead of considering the possibility of PTSD or traumatic brain injury.
- Soon after, “the Defense Department changed its policy and began requiring a top-level review of each case to ensure post-traumatic stress or a brain injury wasn’t the underlying cause.”
- Sure enough, “the annual number of personality disorder cases dropped by 75 percent.”
- At the same time, the number of post-traumatic stress disorder cases has soared. By 2008, more than 14,000 soldiers had been diagnosed with PTSD — twice as many as two years before.
- Army officials “reviewed the paperwork of all deployed soldiers dismissed with a personality disorder between 2001 and 2006″ and said they “did not find evidence that soldiers with PTSD had been inappropriately discharged with personality disorder.”
Missouri data disclosure details infection fight
Filed under: Health data, Health journalism, Hospitals, Hot Health Headline, Public health, Public records, Studies, Tools
Missouri law requires hospitals to disclose infection rates for intensive care and certain surgeries. It doesn’t keep that data around for long, but St. Louis Post-Dispatch reporter Jim Doyle still managed to review data from 2005 to 2009.
Robots sanitize an ICU room by spraying hydrogen peroxide vapor into the air at St. John’s Mercy Medical Center.
He found that while numerous local hospitals lagged behind national infection rates, most were improving. A story that could have been a dire assessment of health care-associated infections instead became (mostly) a profile of local hospitals’ drive to cut down on the transmission of such infections. He doesn’t draw a clean line between the state’s monitoring and increased anti-infection efforts, but it’s tempting to read between the lines.
Doyle’s second installment continues the theme, discussing the aggressive, nonstop effort that is required to contain drug-resistant bacteria. Measures range from checklists to room-enveloping antibacterial vapors.
Missouri’s disclosure laws are an important step toward infection fighting, Doyle found, but their narrow definition allows hospitals some wiggle room and may miss serious systemic issues. Speaking of systemic issues, I highly recommend Doyle’s sidebar on why Missouri infection data is so hard to keep around.
Forum offers stats on well-being of elderly
Filed under: Government, Health data, Health journalism, Studies, Tools
AgingStats.gov is an often-overlooked federal clearinghouse of aging-related data from the Federal Interagency Forum on Age-Related Statistics. It focuses on summary reports.
Its latest effort, Older Americans 2010: Key Indicators of Well-Being (174-page PDF), summarizes 37 key indicators it believes are broadly relevant and easy to understand. By my count, 24 of those are explicitly health-related.
Everything is illustrated with an abundance of charts and maps, and an emphasis on bulleted summary and analysis helps keep things accessible. Those looking for a deeper dive into the summary numbers will want to head to the appendix.
As part of its health sections, the report contains seven “Health Status” indicators, including chronic health conditions, depressive symptoms, sensory impairments and oral health, and functional limitations.
One example:
It also includes eight “Health Risks and Behaviors” – things like diet, air quality, mammography and vaccinations – and nine “Health Care” indicators, including expenditures, prescription drugs and residential services.
The forum, which nobody seems to refer to by the acronym FIFARS, has been around since 1986. Participants include the Census Bureau, a number of Health and Human Services departments (AHRQ, CMS, NCHS and others), HUD, the Bureau of Labor Statistics, the Department of Veterans Affairs, the EPA, the Office of Management and Budget, and the Social Security Administration.
Thanks to AHCJ member Eileen Beal for suggesting this as a tool other members might find helpful.
Report looks at oil-spill fallout for children, families
As the gulf oil spill dragged on, coverage of its psychological and economic aftermath gained momentum. Now, Poynter’s Al Tompkins has spotlighted coverage of what is sure to be a flood of follow-up reports and post-mortems. Based on research conducted from July 19 through 25 (the well has been effectively capped since July 15), the National Center for Disaster Preparedness at Columbia University has released its “Impact on Children and Families of the Deepwater Horizon Oil Spill,” subtitled “Preliminary Findings of the Coastal Population Impact Study.”
Photo by kk+ via Flickr
As Tompkins points out, the study has already pulled in significant media coverage. Shaila Dewan’s story in The New York Times, for example, covered both specifics and context:
“There’s been a very overt effort by BP and the Coast Guard to project a sense that the crisis is over, but this is far from the case,” said Dr. Irwin Redlener, the director of the center and president of the Children’s Health Fund, a sponsor of the survey. “Our survey shows a persistent and overwhelming level of anxiety among families living near the coast, driven by both medical symptoms in their children as well as a substantial level of psychological stress.”
The survey included 1,200 coastal residents in Louisiana and Mississippi, most of whom live within 10 miles of the ocean.
One in five reported that their household income had dropped since the spill. Forty-three percent said they had been directly exposed to oil, either at beaches, on their property or in helping with the cleanup. Those who had been exposed were more than twice as likely to report that their children had developed physical or mental health problems since the spill. Also, families that had more concerns about their children’s mental health were more likely to report that they are considering moving.
Related
- For psyches, Gulf is Valdez on ‘fast forward’
- CDC says monitoring system finds no ill from spill
- Mental health impact of the BP spill multiplies
- Resources for reporting on health and the oil spill
- Assessing the Effects of the Gulf of Mexico Oil Spill on Human Health: A Summary of the June 2010 Workshop
- Tip sheet: reporting on the intersection of health, environment
- CDC Emergency Response and Preparedness
- A recent Dart Centre Europe panel looked at covering the human consequences of environmental disaster.
- Grief in the Gulf: Tanya Paperny writes about the challenge of reporting a slow-motion disaster.
- Dart Center resources for covering the Deepwater Horizon Spill
Health Journalism 2011 set for Philadelphia
Filed under: Health journalism, Member news, Studies
Put AHCJ’s annual conference on your calendar: April 14-17, 2011, in Philadelphia.
The program will include dozens of panels, field trips, newsmaker briefings, Freelance Pitchfest, world-class speakers, 2010 Awards for Excellence in Health Care Journalism luncheon and a number of other special events. Expect sessions on covering health care, health research, public health, health policy, consumer health and the business of health.
Local and national planning committees have begun gathering conference ideas for review. The organization has negotiated a a discounted hotel rate of $149 a night at the Sheraton Society Hill.
More details will be available in the weeks ahead, but set these days aside now for the best annual training event in health journalism.
Hearing on public access to research will be online
Filed under: Health data, Health journalism, Public records, Studies
Representatives of a number of medical- and publishing-related organizations will testify today at a hearing on “Public access to federally funded research” before the Information Policy, Census and National Archives Subcommittee of the U.S. House of Representatives’ Committee on Oversight and Government Reform.
You can catch the webcast of the hearing at 2 p.m. EDT. Update: It appears the hearing is not being webcast.
(Hat tip to the Electronic Frontier Foundation for the webcast link.)
Earlier
- Bill would require public access to research
- AHCJ: Proposal would be blow to public access
- Progress on open access issue not what it seems
Frugal Minnesota splurges on lower backs
Filed under: Health data, Health journalism, Health policy, Hospitals, Hot Health Headline, Public health, Studies, Tools
For physicians and patients, treating lower back pain is an exercise in restraint and patience. According to federal guidelines, such pain usually resolves itself within six weeks with minimum intervention, so it’s often a matter of resisting the temptation to order a $500 MRI within that time window. And in Minnesota, a state known for its health-care-related moderation, that temptation seems to be too much.
As the Christopher Snowbeck of the St. Paul Pioneer Press reports, Minnesota doctors are worse than the national average when it comes to giving lower back pain patients MRIs without exploring cheaper alternatives. And in the land of Lake Wobegon, being below average is a big deal. The conclusions come from Hospital Compare’s newly released 2008 outcomes data. To learn more about this data, check out AHCJ’s recent conference call on the subject.
For some help reading between the lines of Snowbeck’s story (and the Hospital Compare data), see Gary Schwizter’s recent blog post on the subject; he doesn’t mince words.
The story includes other excuses from local providers along the lines of “the data are outdated…we’ve changed…we’re better now…that can’t be right…it’s not us!” When have you ever seen a story on health care data that didn’t have these predictable reactions? It reminds me of The Tobacco Institute continually rejecting any new finding that showed new harms from smoking. When you don’t like the data, damn the data. For most of the history of medicine we had no outcomes data to show patterns of practice or what happens to people over time. Now that we’re starting to collect some such data, vested interests find that information is a menacing thing.
For more about treatment of back pain, particularly how much money is spent on it, see the just-released “Back Problems: Use and Expenditures for the U.S. Adult Population, 2007” (PDF) from the Agency for Healthcare Research and Quality.
How reform will affect America, group by group
Filed under: Health care reform, Health policy, Hot Health Headline, Studies
In Health Affairs (AHCJ members get free access), economist Joseph Newhouse considers how health care reform will affect four major groups. They’re summarized below.
- Uninsured or on Medicaid or CHIP (30 percent)
- Insured individually or through a small business (10 percent)
- Insured through a mid-size or large business (45 percent)
- Recipient of Medicare (15 percent)
Medicaid expansion and broader subsidies are “major gains.”
This group will undergo the most change, with the individual mandate expanding their ranks to as much as 50 million people (16 percent of Americans). Health reform should “repair” this now-broken sector of the market.
A wash, as an insurance tax is balanced out by a reduced need to cover uncompensated care for the uninsured.
Complicated. The doughnut hole will close, but future financing sources are murky. Newhouse goes pretty deep into just how murky.
His conclusion is relatively upbeat. Newhouse writes that while reform “addressed many issues in health care financing, it left many others unresolved.” The system will need to be revised and updated throughout the foreseeable future, Newhouse writes, and effective implementation will “require persistence for many years to come.”
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Spend a week at the CDC studying public health, meeting sources. Apply for the AHCJ-CDC Health Journalism Fellowships today!
- Reporting on the intersection of health, environment
- Tip sheet: Covering cuts to Medicare reimbursements
- Briefing: Reporting on health reform between now and 2014
- Covering high-risk insurance pools: Tips for reporters
- Health care reform has passed: What's next?
- Health and education: Covering these intersecting beats
- Reporting on the business of health care
- Health reporting resources for journalists on state and local government beats
