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Gary Schwitzer offers critiques of health and medical journalism in hopes of improving the quality of coverage.
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The unhealthy state of medical journalism
Study takes American media to task for coverage of new treatments
By Deane Morrison
May 28, 2008
News stories about health and medical treatments often omit critical information such as the costs, harms, and benefits of new treatments; the quality of the evidence; the existence of other treatment options; and potential conflicts of interest by sources used in the stories, according to a University of Minnesota-led study. In a review of 500 health news stories that ran in the U.S. media over 22 months, Gary Schwitzer, an associate professor of journalism, and several colleagues identified the failure to discuss the cost of new treatments as the most common fault. The study is published online in the Public Library of Science (PloS)/Medicine. "At a time when 16 percent of the Gross Domestic Product goes to health care, it's unforgivable that more than 75 percent of health journalism articles in 500 stories over two years by 60 news organizations failed to adequately discuss cost," Schwitzer says. The study reviewed stories in 50 major U.S. media that included a claim of efficacy or safety in a health care product or procedure. The three reviewers--Schwitzer plus two others drawn from medicine, health services research, public health, or journalism--rated each story according to 10 criteria and reached consensus before publishing their final evaluations on the project Web site. They found that besides cost, stories about medical research often failed to give all the numbers necessary to put the findings about risks, benefits, and the scope of medical conditions in context. For example, ABC's "Good Morning America" reported that breast cancer patients with relatively low blood levels of vitamin D were 94 percent more likely to have their cancer spread and 73 percent more likely to die than those with high levels of vitamin D. But nothing was said about the absolute risk of cancer spread or death. The reviewers also took the story to task for raising needless alarms through "disease mongering"--in this case, implying, without evidence, that taking supplements of vitamin D3 could reduce breast cancer risk or improve outcomes. The result was that the piece, according to the reviewers, "invites anxiety on the part of women who are not taking the supplements."
Poor coverage is happening "at a time when we're [also] getting some of the best health journalism we've ever seen," says Schwitzer. "But the valleys between the peaks may undo a lot of the good by driving consumers to demand unproven therapies."And while it mentioned that taking too high a dose of vitamin D can be harmful, the story mentioned sunlight as another source of the vitamin but omitted any mention of the dangers of excessive sun exposure. In a second example, "ABC World News" reported that a new test for prostate cancer showed improved accuracy. It stated that the test, developed by Johns Hopkins researchers, gave "false positive" results only three percent of the time. Yet it made no mention of how often the test accurately detected the presence of the cancer. Further, the reviewers faulted the story for not mentioning that screening for prostate cancer is controversial regardless of method because "it isn't yet clear if screening saves lives." And the story didn't disclose "what was abundantly clear even in a Johns Hopkins news release: the principal investigator receives a share of the royalties received on sales of the test. He is also a paid consultant to the manufacturer of the test." In the PLoS article, Schwitzer notes that these problems with health journalism occur at a time when many newsrooms have cut medical and health reporting positions following a drop in profits. "Those cutbacks may be the reason why only 35 percent of stories we evaluated were rated satisfactory on the criterion of whether the reporter had discussed the study methodology and the quality of the evidence, issues that only a trained health journalist could be expected to understand," he says. But, he adds, a lack of resources doesn't excuse poor coverage. The reviewers found substandard coverage in some of the top media while sometimes giving high scores to less prominent outlets. Poor coverage is happening "at a time when we're [also] getting some of the best health journalism we've ever seen," says Schwitzer. "But the valleys between the peaks may undo a lot of the good by driving consumers to demand unproven therapies." Schwitzer e-mails reviews of all stories to the journalists who wrote them and says the responses have been overwhelmingly favorable. Discussions of all the stories in the study can be found by visiting Schwitzer's Web page referenced above. He hopes that visiting it will help interested readers become smarter news and health care consumers. "We get feedback from people saying, 'I've never had anybody explain things to me like this before,'" he says. "We encourage consumers to register [at the Web site], weigh in, and talk to journalists and to us."