Study: Good press releases contribute to good health journalism
Thanks to Gary Schwitzer for drawing attention to a study, published in BMJ, which analyzes the impact medical journal press releases have on actual press coverage of studies.
The authors begin with a somewhat gratifying hypothesis, writing that “Although it is easy to blame journalists for poor quality reporting, problems with coverage could begin with the journalists’ sources,” and positing that difficult-to-decipher studies and misleading press releases could lead to low-caliber health reporting.
They looked at 100 studies from five major journals, as well as a sample of 348 news stories based on those studies. In general they found that higher-quality press releases led to higher-quality coverage. Unfortunately, they also found that the inverse was true. Here’s an excerpt from the “Discussion” subheading (also highlighted by Schwitzer).
…Higher quality press releases issued by medical journals were associated with higher quality reporting in subsequent newspaper stories. In fact, the influence of press releases on subsequent newspaper stories was generally stronger than that of journal abstracts. Fundamental information such as absolute risks, harms, and limitations was more likely to be reported in newspaper stories when this information appeared in a medical journal press release than when it was missing from the press release or if no press release was issued. Furthermore, our data suggest that poor quality press releases were worse than no press release being issued: fundamental information was less likely to be reported in newspaper stories when it was missing from the press release than where no press release was issued at all.
Reporters looking for a Health News Review-style “how do I ensure my story clears their quality bar?” checklist can just scroll down to the “Quality Assessment” subheading. For the record, the metrics found there apply equally well to the PR professionals who write the releases.
Ohio’s hospital transparency law under fire
Filed under: Aging, Conflicts of interest, Europe, Government, Health care reform, Health data, Health journalism, Health policy, Hospitals, Hot Health Headline, Member news, Public records, Studies, Tools
Thanks are due to blogger and one-time hospital executive Paul Levy for drawing our attention to the Ohio hospital industry’s recent push to overturn much of the state’s recently passed transparency legislation.
The law required hospitals to post performance data, such as infection rates and patient satisfaction, on the Ohio Hospital Compare site.
According to Brandon Glenn’s report in the MedCity News, the hospital industry opposes the site, online since Jan. 1, 2010, because it serves the same purpose as the federal Hospital Compare site.
The OHA supports the new legislation… because it wants to remove “duplicative” reporting requirements on the state’s hospitals. Ohio hospitals already report the same data to a federal Hospital Compare website maintained for the public by the Centers for Medicare & Medicaid Services, said OHA spokeswoman Tiffany Himmelreich.
The new legislation “doesn’t reduce reporting. It just eliminates reporting the same information to two different places,” she said. “We don’t want the public to feel that this is taking a step backwards in terms of data availability.”
For their part, consumer advocates say website maintenance is not an onerous burden, and that the hospital association’s push is part of a larger, statewide antitransparency trend.
As an interesting side note, Glenn found the Ohio Hospital Compare site to be rendered inoperable by apparent bugs on an initial visit but discovered that, after his inquiries to the state health department, the site was put into working order.
Dallas reporters use AHRQ data to measure patient safety
Filed under: Health data, Health journalism, Public health, Public records, Tools
The Dallas Morning News continues its 19-month investigation into patient safety at UT Southwestern Medical Center and Parkland Memorial Hospital.
The project, “First, Do No Harm: An investigation of patient safety in Dallas hospitals,” is behind the website’s paywall but The Dallas Morning News has granted AHCJ members access. To find out how to access the stories, please click here and log in as an AHCJ member.
Among the latest reporting:
Dallas Morning News reporters Ryan McNeill and Daniel Lathrop took advantage of AHRQ’s Patient Safety Indicator (PSI) software, typically used internally by hospitals, to process 9 million publicly available patient records from Texas hospitals, all of which came from between
Parkland, the prominent local hospital that has earned scrutiny on numerous prior occasions, was just the most notable of a number of area hospitals that came up short (and generated headlines), but our interest lies more with the reporters’ investigative methodology as well as the path they’ve blazed for broader hospital quality reporting.
All their work was done in consultation with experts in the field, including academics, government officials and hospital administrators. An outside review indicated McNeill and Lathrop used the software properly, and their results were in line with a similar public analysis. But that’s not to say it was a simple process.
The newspaper spent six months analyzing nearly 9 million state hospital discharge records using Patient Safety Indicators, or PSI, software. This highly sophisticated system was designed for the federal government as a tool to measure potentially preventable complications among hospital patients.
The PSIs do not present a complete safety picture because they are based on administrative data — a summary of diagnoses, procedures and outcomes derived from patients’ medical charts, as opposed to a complete review of all medical records.
It’s not a perfect measure, but it’s one of the best available.
PSIs “reflect quality of care inside hospitals,” according to the Agency for Healthcare Research and Quality, a division of the U.S. Department of Health and Human Services. It released the PSI software in 2003 and periodically updates it, most recently in August. The News used that version for its final analysis.
The software analyzes the administrative data that nearly every hospital in Texas reports to the state. No patient-identifying information is included.
The results on 15 PSIs are statistically “risk-adjusted” because some hospitals treat a disproportionate share of unhealthy patients, who face a greater risk of potentially preventable complications. Rates from eight of the indicators are used to determine a hospital’s patient safety “composite score.”
The AHRQ has just started posting some PSI measures on Hospital Compare, and the Texas health department plans to follow suit in 2013, but reporters looking to get their hands on a broader swath of the data will still have to follow the Dallas duo’s do-it-yourself approach.
The reporters’ work drew criticism from the Texas Hospital Association, which said the methodology was “not intended for use in public reporting.” McNeill refutes its claims in a blog post. Daniel K. Podolsky, president of UT Southwestern Medical Center, also sent a letter criticizing the reporting. George Rodrigue, managing editor of The Dallas Morning News, published a point-by-point response to Podolsky’s letter.
Dartmouth Atlas report shows little improvement in readmissions
Filed under: Government, Health care reform, Health data, Hospitals, Public health, Tools
In the National Journal, Maggie Fox explains a new Dartmouth Atlas Project report (PDF) which demonstrates that, despite the looming implementation of penalties included in the Affordable Care Act and the existence of a simple, proven road map to improvement, most hospitals haven’t significantly cut down their readmission rates over the better part of the past decade.
“Only seven of the 94 academic medical centers we studied had statistically significant changes in 30-day readmission rates following medical discharge from 2004 to 2009,” [Dr. David Goodman's] team wrote.
According to Goodman, improving readmission rates is a simple matter of actively scheduling follow-up visits and implementing a team approach to care delivery. Unfortunately, he told Fox, making that work in a busy hospital appears to be easier said than done, even with significant federal penalties lurking just over the horizon.
The 2010 health-care reform law begins using a stick in one year, penalizing hospitals with higher-than-expected readmission rates for Medicare patients treated for heart failure, heart attack or pneumonia. Medicare payments could be cut by up to 1 percent in October 2012, 2 percent in 2013 and 3 percent in 2014.
In addition to the overall message of the report, it’s interesting to note that readmission rates were affected by the same regional variation which has provided such fertile ground for reporters covering other Dartmouth Atlas Project research.
The percent of patients landing back in the emergency room within 30 days of discharge after surgery varied from less than 12 percent in 2009 in Rapid City, South Dakota, to 19 percent in Kingsport, Tennessee and 18 percent in Newport, Rhode Island.
For an example of how to localize the information in the report, see this article by Stacey Singer in The Palm Beach Post. To learn more about readmission data from CMS, see this article by Charles Ornstein, AHCJ president and ProPublica senior reporter.
Pharma discloses free meals, ProPublica expands database
Filed under: Conflicts of interest, Government, Health care reform, Health data, Health journalism, Hot Health Headline, Member news, Pharmaceuticals, Public records, Tools
In his latest report, ProPublica senior reporter and AHCJ board president Charles Ornstein explains exactly how, since its founding last October, ProPublica’s Dollars for Docs database of pharma payments to physicians has mushroomed from 30,000 entries to more than half a million. They answer, he writes, has a lot to do with free meals and other perks that pharmaceutical companies are starting to publish ahead of strict federal disclosure regulations which will go into effect in 2013.
Pharmaceutical company representatives say the meals serve an important educational purpose, and they have adopted their own set of rules for such interactions.
A voluntary code of conduct adopted by the Pharmaceutical Researchers and Manufacturers of America says that “it is appropriate for occasional meals to be offered as a business courtesy” to doctors and members of their staffs attending information presentations by sales reps.
In such cases, the guidelines say, the presentations have to “provide scientific or educational value,” and the meals should be “modest” by local standards and not part of an entertainment or recreational event. Meals for spouses and take-out meals are not appropriate, the guide says.
To put it all into perspective, Ornstein demonstrates with numbers from Pfizer that, while the meal numbers have certainly increased the number of entries in their database, they haven’t had as significant an impact upon the overall dollar amounts in question.
Relatively, the meals didn’t add up to much money. Pfizer’s meals amounted to only $18 million last year, compared to $34 million for promotional speakers and $108 million for research.
As with previous installments, Ornstein, Tracy Weber and Dan Nguyen’s database work has spawned follow-up reports around the country. In fact, the response was such that Ornstein and Weber even took the step of re-nationalizing the localizations of their story, with the follow-up “News Reports Cite Drop in Physician Speaking Fees.” Below, I’ve linked to a few notable localizations and follow-up stories. If you’ve got another one to point out, add it in the comments.
- A Dozen Pharmas Make Payments to Physicians Public, Kathlyn Stone, About.com
- Drug firms disclose spending on meals, Liz Kowalcyzk, Boston Globe
- How To Find Out If Your Doctor And Drugmakers Are In A Relationship, Scott Hensley, NPR
Find health data at Childstats.gov, a clearinghouse for kid numbers
Filed under: Children, Government, Health data, Health journalism, Public records, Tools
Time to add another link to your “federal data clearinghouses” folder, if you haven’t already. Childstats.gov, published by the Federal Interagency Forum on Child and Family Statistics, synthesizes data from the CDC, NCHS, National Children’s Survey, AHRQ, Census and other specialized programs.
Photo by nasa hq photo via FlickrThe site is anchored by its annual report, “America’s Children: Key National Indicators of Well-Being,” and the easy-to-navigate nature of its databases seems to have already inspired some discussion on Twitter, particularly in relation to child homelessness.
Many of the data tools are simply links to general surveys (like AHRQ’s National Healthcare Cost and Utilization Project) that just happen to contain child-related information, but there are some more specifically relevant data sources, the best of which I’ve listed below.
- Data Resource Center for Child & Adolescent Health
- The National Children’s Study
- The National Center for Education Statistics
- Find Youth Info (findyouthinfo.gov)
- Census Child Care data
Minority population swells in nursing homes
Filed under: Aging, Health data, Hot Health Headline, Public health, Tools
In The Providence Journal, reporter and AHCJ board member Felice Freyer reports on the local effects of the national trend toward higher proportions of minority residents in nursing homes. In addition to the logistical concerns raised by this demographic shift, Freyer also explores what it says about health disparities and access to care in minority communities.
Freyer’s report is built on a Brown University study published in the July edition of Health Affairs. As you may know, free access to Health Affairs is one of the many benefits that come with your AHCJ membership.
… between 1999 and 2008, the number of Hispanics and Asians living in U.S. nursing homes grew by 54.9 percent and 54.1 percent, respectively, while the number of whites dropped 10.2 percent.
These numbers reflect the changing demographic profile of elderly people, whose ranks include growing numbers of blacks, Hispanics and Asians. But the researchers say their findings also raise questions about whether minority-group members have poorer access to assisted-living and community-based care. The question may be especially relevant as states such as Rhode Island strive to “rebalance” the long-term system to favor home-based care over institutional care.
Freyer’s story also includes data from Brown’s LTCfocus.org site, a handy tool for sorting and visualizing data related to long term care and nursing homes.
Two new resources for covering health reform
Filed under: Health care reform, Health journalism, Tools
There are two more resources to share with you from two of health journalisms’ ever-helpful friends, the Kaiser Family Foundation and the Alliance for Health Reform.
What questions do you have about health reform and how to cover it?
Joanne Kenen is AHCJ’s health reform topic leader. She is writing blog posts, tip sheets, articles and gathering resources to help our members cover the complex implementation of health reform. If you have questions or suggestions for future resources on the topic, please send them to joanne@healthjournalism.org.
Kaiser has started posting on its site a series called “Notes on Health Insurance and Reform. Written by Larry Levitt, senior vice president for special initiatives and senior adviser to the president at the Foundation, and Gary Claxton, vice president and director of the health care marketplace project.
They are both very good at tackling all those complicated regulatory and insurance issues that some of us may have just a few itsy bitsy questions about. The posts are short, and clear, very helpful. Two of the initial posts cover topics we’ve addressed here too on Covering Health (the high risk pool program and aspects of the exchanges). Here’s a link to the RSS feed, too.
The Alliance is adding another layer to its online sourcebook, updating the reference book pages with relevant local news stories from around the country. You can click on the sourcebook pages in the table of contents, choose a chapter (here’s the one on health reform) and you’ll see the local news stories on the right hand side of the website. Or you can sign up in the email alerts section of www.allhealth.org (which is how I get them) or naturally, there’s a Twitter feed. We’ll take a look from time to time at some of those local stories and see what lessons they hold for health care reporters elsewhere.
New life expectancy data can add context
to reporting on local health
A new data release today from the Institute for Health Metrics and Evaluation gives journalists some unique tools to help depict the health of a local population.
Emmanuela Gakidou, M.Sc., Ph.D., the director of education and training for IHME, told a Health Journalism 2010 audience that the institute was working on a project to show health information to the county level.
Just over a year later, the data allow the user to analyze life expectancy for every county in the United States and compare those numbers worldwide.
For example, the data could add context for a journalist following up on a tip from a speaker in an entirely different AHCJ event. In the recent Rural Health Journalism Workshop in St. Louis, Ellen Barnidge, Ph.D., M.P.H., of St. Louis University, discussed efforts in Missouri’s high-poverty Pemiscot County. A quick filter of the spreadsheet data shows men in that county share the same life expectancy – 68.5 – with Mauritius and Indonesia.
The data go back to 1987, allowing a journalist to look at changes over time as well for more than 3,000 counties.
Project researchers found that, while people in Japan, Canada and other nations are enjoying significant gains in life expectancy every year, most counties within the United States are falling behind.
The researchers, in collaboration with researchers at Imperial College London, found that between 2000 and 2007, more than 80 percent of counties fell in standing against the average of the 10 nations with the best life expectancies in the world, known as the international frontier.
Women have been especially affected. More than 850 counties in the U.S. have seen life expectancy remain static or go backwards for women since 1997.
The data also offers a breakdown of life expectancy by selected race – black and white – for each county.
The institute is an independent global research center at the University of Washington providing sound measurement of population health and the factors that determine health, as well as rigorous evaluation of health system and health program performance.
Study offers context for reporting on health insurance exchanges
Filed under: Health care reform, Health journalism, Studies, Tools
The first tip sheet I wrote about covering health reform was pegged to the one-year mark of the Affordable Care Act. One topic I addressed was the creation of state-based health insurance exchanges, or marketplaces. I won’t rehash that here – here’s the link to the brief – but I do want to point out a useful resource that became available just a few days after we posted that first guide.
What questions do you have about health reform and how to cover it?
Joanne Kenen is AHCJ’s health reform topic leader. She is writing blog posts, tip sheets, articles and gathering resources to help our members cover the complex implementation of health reform. If you have questions or suggestions for future resources on the topic, please send them to joanne@healthjournalism.org.
It’s an in-depth look at the two states that already do have exchanges – Utah and Massachusetts. Those states help illustrate the decisions, both practical and ideological, legislators and governors must make as to how active the exchange is going to be in shaping the local insurance market and the consumer experience.
Those exchanges are of course dramatically different – Massachusetts covers a couple of hundred thousand people, and Utah covers a couple of thousand. Massachusetts was the inspiration in many ways for the national health reform, while Utah is the model for states that want to do a lot less and rely a lot more on the free market. But the study by experts at the Georgetown University Health Policy Institute and the Center for Children and Families also found those two state exchanges also had a lot more overlap than is widely assumed.
For those of you who are writing your first story on exchanges, this report isn’t the place to start. For help with the basics, check out ideas from Sarah Kliff, a Politico health care reporter, and some background from Noam Levey, health policy reporter for the Los Angeles Times. And the Alliance for Health Reform had an event last year that explained the basics (this link includes a webcast, transcript and lots of other resources to help you get started.)
For those reporters who have been tracking the state debate over the size, shape and structure of the exchange, or following the initial phases of implementing the exchange, the Georgetown study should help provide some context for concepts that you may have heard of like “active purchaser” (an exchange that can be more discriminating about which insurers get to sell policies in the exchange and which don’t versus an “open market” (open to any health plan that wants to play.) Here’s a taste:
To many, the Massachusetts and Utah exchanges represent opposite points on a continuum of what exchanges can provide for consumers and small businesses. Yet the stereotype of Massachusetts’ exchange as an “active purchaser” and the Utah Exchange as the open market model is, in the words of one observer, “a false stereotype … perpetuated by … a media that likes simple contrasts.”
So be part of a media that goes beyond simplistic contrasts … dig in.
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New at HealthJournalism.org
- Data gives depth to investigation of patient safety
- What reporters should know about Alzheimer’s and related dementias
- Apply for fellowships to attend Health Journalism 2012
- AHCJ asks Supreme Court to permit broadcast of arguments in health reform case
- Tips for print, online journalists to embrace broadcast opportunities
- Numbers reveal how often, or how rarely, states check doctors’ disciplinary records
- How I did it: Falsified charts in nursing homes linked to patient care
- Access Denied: Looking at a lack of health care availability
- Transparency & medical errors: Public reporting of patient harm is a potent force
