Rounding up some of the latest health coverage
Filed under: Government, Health care reform, Health journalism, Hot Health Headline, Public health
With good topics for the blog flooding in and a short holiday week to get them all posted, I’m taking a shortcut to point you toward some interesting stories:
ProPublica: What Health Care Reform Means for the underinsured
Rapidly rising premiums have forced them to increase their deductible every year, and now they have a policy with a $5,000 deductible per illness per year.
Steve Lopez in the Los Angeles Times: A doctor is flummoxed by the costs when he becomes the patient
As a physician, he’s well aware that emergency room treatment is very expensive. But knowing the true cost of the limited supplies and labor required to treat such a minor wound, he found the experience more than a little disturbing.
Trevor Butterworth in Forbes.com: Why mall Santas do need the H1N1 vaccine, featuring AHCJ board member Maryn McKenna’s take on how well the media has covered H1N1.
McKenna gives the media a “gentleman’s C” for its coverage of swine flu, but believes it has been getting better in the past few months.
AHCJ member Elaine Schattner, M.D., in the Huffington Post: Mammography: A Not-So-Fatalistic View
I’m a medical oncologist and breast cancer survivor who holds a highly informed and intensely personal perspective on the subject. In my view, the press is getting and giving the wrong message on mammography. There are significant flaws in recent analyses that have escaped most headlines.
Times crafts strong reminder of screening’s dangers
Sarah-Kate Templeton, in The Times of London, tells the story of one victim of medical screening and overtreatment, wrapping that story in the larger debate about unnecessary medical screening and finally caps it all off with the news of a “Making Sense of Screening” guide, produced for the charity Sense About Science by a group of British scientists and doctors.
Templeton’s story provides a forceful reminder of the dangers of some early screening and aggressive treatment, all in the words of a 56-year-old math teacher who was diagnosed with a dormant form of breast cancer, and whose doctors recommended radical treatment.
The National Health Service has had to rewrite its advice to include warnings about potential harm caused by the screening process “after research showed that thousands of women have been misled into having unnecessary surgery.”
Scans at LA hospital spewed 8x normal radiation
Filed under: Government, Hospitals, Hot Health Headline
On Oct. 8, the FDA issued an alert recommending hospitals review CT scan radiation levels after dangerous doses were detected at an unnamed hospital. The Los Angeles Times‘ Alan Zarembo took over from there, finding that serious radiation overdoses at Los Angeles’ Cedars-Sinai hospital had prompted the warning.
Zarembo followed up with a series of stories on the radiation and its aftermath:
Cedars-Sinai investigated for significant radiation overdoses of 206 patients
Zarembo leads with a summary of what exactly went down at Cedars-Sinai:
More than 200 patients at Cedars-Sinai Medical Center were inappropriately exposed to high doses of radiation from CT brain scans used to diagnose strokes, hospital officials told The Times on Friday.
About 40% of the patients lost patches of hair as a result of the overdoses, a hospital spokesman said.
Even so, the overdoses went undetected for 18 months as patients received eight times the dose normally delivered in the procedure, raising questions about why it took Cedars-Sinai so long to notice that something was wrong.
Class action filed for Cedars radiation patients
Zarembo checks with experts who say the class-action suit filed on behalf of victims has little chance of success because it’s difficult to prove damages, especially since they may not develop for years.
Cedars-Sinai head expresses regret for radiation overdoses
A quick-hit story in which the hospital details exactly what they’ve done to ensure it doesn’t happen again.
4 patients say Cedars-Sinai did not tell them they had received a radiation overdose
Zarembo tracked down patients who said that, while they were contacted by the hospital concerning hair loss, they weren’t informed of radiation overdose or potential cancer risk.
Hospital error leads to radiation overdoses
Zarembo writes that the problem has been traced to a CT scanner reset in early 2008.
Cedars-Sinai radiation overdoses went unseen at several points
In one of the most remarkable moments, Zarembo writes that, before every single scan, technicians were shown a screen indicating, among many other things, the unusually high radiation level. The error was in plain sight the entire time.
Beginning in February 2008, each time a patient at Cedars-Sinai Medical Center received a CT brain perfusion scan– a state-of-the-art procedure used to diagnose strokes – the dose displayed would have been eight times higher than normal. No standard medical imaging procedure would use so much radiation, which one expert said is on par with the levels used to blast tumors.
Somebody should have noticed. But nobody did – everybody trusted the machines.
Related
The New York Times‘ Walt Bogdanich added a broader perspective on the story, adding an additional case and subtly weaving it into the debate about the dangers of medical screening.
Cancer society’s messages on screening conflict
Filed under: Conflicts of interest, Hot Health Headline, Public health
The New York Times‘ Gina Kolata reports that the American Cancer Society, a longtime defender of early detection and cancer screening, is planning to release an online message next year “to emphasize that screening for breast and prostate cancer and certain other cancers can come with a real risk of overtreating many small cancers while missing cancers that are deadly.”
“We don’t want people to panic,” said Dr. Otis Brawley, chief medical officer of the cancer society. “But I’m admitting that American medicine has overpromised when it comes to screening. The advantages to screening have been exaggerated.”
The ACS’ change of heart on breast and prostate screening was inspired, in part, by a recent analysis published in JAMA.
In it, researchers report a 40 percent increase in breast cancer diagnoses and a near doubling of early stage cancers, but just a 10 percent decline in cancers that have spread beyond the breast to the lymph nodes or elsewhere in the body. With prostate cancer, the situation is similar, the researchers report.
In an interesting side note, Kolata includes a quote from Colin Begg, a biostatistician at Memorial Sloan-Kettering Cancer Center in New York, that shows a different perspective on media coverage of the screening debate.
“I am concerned that the complex view of a changing landscape will be distilled by the public into yet another ‘screening does not work’ headline,” Begg said. “The fact that population screening is no panacea does not mean that it is useless,” he added.
Kolata’s story was published on Tuesday. On Wednesday, the ACS released a statement from Brawley in which he says the organization stands by its screening recommendations. In the statement, Brawley says ACS “stands by its recommendation that women age 40 and over should receive annual mammography” and that its recommendation that men consult with their doctors to “make an informed decision about whether or not prostate cancer early detection testing is right for them. ”
The LA Times‘ Booster Shots blog has more, as does NPR’s health blog.
Schwitzer: One-sided push for screening wrong
On his Schwitzer health news blog, University of Minnesota journalism professor, HealthNewsReview.org editor and AHCJ member Gary Schwitzer reminds journalists – in particular, CNN’s Howard Kurtz and Larry King – that even when you’re talking to prostate cancer survivors about screening for the disease, it’s “wrong to use a network television platform to give one-sided advice to an entire population of men without giving balancing information on harms.”
Reminding journalists that PSA screening might not always be a good thing, Schwitzer quotes the U.S. Preventative Services Task Force:
Potential harms from PSA screening include additional medical visits, adverse effects of prostate biopsies, anxiety, and overdiagnosis (the identification of prostate cancer that would never have caused symptoms in the patient’s lifetime, leading to unnecessary treatment and associated adverse effects). Much uncertainty surrounds which cases of prostate cancer require treatment and whether earlier detection leads to improvements in duration or quality of life.
Organization: Teen breast tests wasteful, harmful
Jeff Baillon of KMSP in Minnesota’s Twin Cities reports that the National Breast Cancer Coalition (a nonprofit grassroots advocacy and fundraising organization) opposes Sen. Amy Klobuchar and Rep. Debbie Wasserman Schultz’s proposed education program pushing for breast cancer screening in girls as young as 15.
The coalition’s president called the bill a “waste of taxpayer dollars,” saying that it could actually “harm young women,” Baillon reported.
In the piece, oncologist Barry Kramer, who leads the Office of Disease Prevention at the National Institutes of Health, sayys there is no evidence that early screening is beneficial to young women, and some that it may even harm them through unnecessary biopsies that may then impede detection later in life when the risks are much higher.
Related
- Experts question early breast cancer screening push
- Cancer Screening: The Clash between Intuition and Science
Kramer, who spoke at Health Journalism 2008, made this presentation on the panel “Lies, damned lies and medical statistics: How to interpret the evidence” at Health Journalism 2008.
Experts: Benefits of cancer screenings overinflated
In Reader’s Digest, Shannon Brownlee reports that while the American Cancer Society and federal government still push regular cancer screenings, “a growing group of scientific heretics - published in highly respected medical journals, working at some of the most august institutions - strongly believe that it’s time to rethink our whole approach.”
(Some researchers) say that yearly mammograms are not nearly as effective at reducing the risk of dying of breast cancer as most women think, and that mammography leads many women to get unnecessary treatment - especially those diagnosed with DCIS [ductal carcinoma in situ]. The problem is bigger than just mammography: They say the prostate-specific antigen (PSA) test may do men more harm than good if they don’t already have symptoms of prostate cancer. And they have similarly grim things to say about other widely used cancer screening tests.
Experts that Brownlee interviewed say that screening catches tumors that would never cause major problems but not so effective at catching the more deadly, fast-growing kinds of cancer. Only a small percentage of all cancers that occur are fatal, and some cancers disappear on their own, Brownlee reports.
Brownlee also answers reader questions directly and has talked to AHCJ about her book, Overtreated.
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Health Journalism 2010, AHCJ's annual conference, features a world-class program with story ideas, sources, stronger reporting skills, chances to meet newsmakers and network with other journalists.
- 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
- Shortened Lives: How location, lifestyle affect health
- Covering a complex story for the long haul
- Aging in the 21st Century: Presentations and tip sheets
- AHCJ calls for better information from Joint Commission Web site
