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Friday, May 30, 2008

Mainstream Health Coverage Unsatisfactory

I think it is very positive that this report is published, this is the main reason for the founding of Natural Health News.
By Michael Smith, North American Correspondent, MedPage Today
May 28, 2008
Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston.

MINNEAPOLIS, May 27 -- Most health coverage in the mainstream media fails to address the costs, harms, and benefits of medical products and procedures, according to the publisher of, a Web site that grades journalists.

The coverage also usually ignores the quality of the evidence and the existence of other options, said Gary Schwitzer, B.A., of the University of Minnesota School of Journalism, who worked for 30 years as consumer healthcare journalist in radio, television, interactive multimedia, and the Internet.

On the other hand, he wrote in the May issue of the online journal PLoS Medicine, 85% of the time the mainstream media put the true newness of a procedure or product into context.

The findings come from an examination of 500 stories during the first 22 months of the Web site, which started publishing evaluations of health news stories in April 2006. Schwitzer, an associate professor of journalism, is publisher of the Web site.

The 22 months of reviews are "the clearest picture yet available of how major newspapers, magazines, and television networks cover treatments, tests, products, and procedures," he said.

He and colleagues monitor the top 50 newspapers (in circulation) in the U.S., the Associated Press, the three leading newsweekly magazines (Time, Newsweek, and U.S. News & World Report) and the morning and evening newscasts of ABC, CBS, and NBC.

News stories were rated as satisfactory, unsatisfactory, or not applicable on a 10-point set of criteria by two independent reviewers, with Schwitzer voting to break ties. The Web site has a panel of 27 reviewers, many in academic medicine.

In a random sample of 30 stories, two independent reviewers agreed on the assessment 74% of the time, he reported.

Stories were rated on whether they:

* Discussed costs. Only 23% got a satisfactory rating.
* Quantified benefits. Only 28% were satisfactory.
* Quantified harms. Only 33% were satisfactory.
* Discussed existing alternate options. Only 38% were satisfactory.
* Sought independent sources and explored conflicts of interests in sources. Fifty-six percent were satisfactory on this count.
* Avoided "disease mongering" -- making common conditions like baldness into disease states. At 70%, most were satisfactory.
* Discussed quality of the evidence, including the strengths and weakness of study types. Only 35% were satisfactory.
* Established the true newness of the approach, where 85% did a satisfactory job.
* Discussed the availability of the new approach, important when reporting on investigational drugs and procedures. At 70%, most were satisfactory.
* Went beyond a news release, by seeking outside sources. Here, 65% were satisfactory.

The upshot is that health coverage often delivers "an imbalanced picture of health care interventions," Schwitzer said, at least partly because newsroom cutbacks have reduced the time and resources available for health coverage.

In a sidebar to the study, Schwitzer highlighted several stories he and colleagues rated unsatisfactory, including some from the heavyweights of the media world.

For instance, a 2006 story in the New York Times about the effect of resveratrol (a component of red wine) on mice failed to point out that results in mice often have little bearing on what happens in humans.

In another example, the Web site took NBC's Today Show to task for a story titled "Mini-Medical Miracles: Getting Rid of Wrinkles," which it called "a classic case of disease-mongering." The story was part of a series looking at "treatments" for such things as baldness, insomnia, and dandruff.

The Web site reports its reviews both to the public (at and directly to reporters and editors, Schwitzer said.

In an accompanying editorial, the journal's editors said the "alarming report card of the trouble with medical news stories is thus a wake-up call for all of us involved in disseminating health research."

The editorial said that researchers, journalists, and medical journals themselves are often complicit in over-hyping a story, but there are signs that matters are improving.

The journal cited coverage of the growing field of genetic research, which might seem a ripe field for sensationalism. Instead, an analysis of "627 newspaper articles on gene discoveries found that only 11% contained such hype," the editorial said.

The review Web site is a step in the direction of better health coverage, although "a small step," said freelance journalist Andrew Holtz, M.P.H., of Portland, Ore., who is past president of the Association of Health Care Journalists.

Holtz said some editors and reporters "will just blow it off" but a growing number "want to do better and are hungry for some guidance." The 10-point rating system offers that guidance, he said.

"How can you make progress if you don't measure?" he said.

The study was supported by the Foundation for Informed Medical Decision Making. Schwitzer reported no conflicts. One of the Web site's reviewers, Colin Nelson, has contributed articles to MedPage Today.

Primary source: PLoS Medicine
Source reference:
Schwitzer G. "How Do US Journalists Cover Treatments, Tests, Products, and Procedures? An Evaluation of 500 Stories." PLOS Med 2008; 5(5): e95. doi:10.1371/journal.pmed.0050095.

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