Gaps in evidence drive shared decision-making movement (#ahcj09)
Shared decision making is of public interest - at least to anyone who thinks they might one day go to the doctor.
“This must be gratifying to Jack Wennberg,” panel moderator Gary Schwitzer, publisher of HealthNewsReview.org, mused at the end of the question and answer session following the panelists’ presentations.
“He couldn’t get his work published for 30 years. He was laughed at, considered a pariah. Finally, he had to publish in Science, which is not exactly a standard journal for variations in health care.” Using Medicare data, his Dartmouth Atlas of Health Care demonstrated striking variations in the kind of care patients receive - and the resulting costs - depending simply on where they live.
As it has been applied, Wennberg’s pioneering research revealed a large number of medical procedures where there is no clinical consensus as to the course of treatment. In response, there is movement to educate - and mandate - physicians to include their patients in the decision-making process.
AHCJ member Chris King, of the St. Louis American, writes about the shared decision-making panel.
Ombudsman explores nuances of science writing
Making sense of health reporting is not always easy, especially when clinical trials are concerned. Results may be interpreted in different ways to suit different views. Agendas of those involved may not always be evident. And sometimes, even expert sound bites oversimplify any murkiness. That was the takeaway from a recent column by Deborah Howell, The Washington Post ombudsman, who cited the recent debate over the results of a study of the widely used Crestor cholesterol fighter.
That particular study, known as Jupiter, highlighted the difficulties that can arise when weighing competing statistics. In this case, the debate was over relative risk versus absolute risk, two very different ways to measure whether Crestor can reduce the likelihood of a cardiovascular event compared with a placebo. Howell notes that media coverage was chastised for highlighting the measure touted by AstraZeneca, which sells Crestor and funded the research. Critics say that by describing drug as a blockbuster and emphasizing relative risk overstated the case in favor of the drugmaker. In fact, the Post’s own story was mentioned.
Her weekend essay raised the delicate and difficult balancing act that can occur when coverage requires a nuanced approach to often complicated data and concepts. In the end, she suggests something most health journalists, hopefully, know already - above and beyond anything else, look for and examine the evidence.
Just in case, here are some tip sheets:
- Evidence-based medical reporting: A brief primer
- Evidence-based medical reporting
- Understanding the scientific article
- Understanding medical publications
- What you need to know about risks, rates and ratios
- Medicine 101: Words, numbers and journals
- Lies, damned lies and medical statistics - how to interpret the evidence
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- What reporters should know about Alzheimer’s and related dementias
- Apply for fellowships to attend Health Journalism 2012
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- Transparency & medical errors: Public reporting of patient harm is a potent force
