mcgovern award lecture - american medical writers association
DESCRIPTION
The McGovern Award is given by the American Medical Writers Association for "preeminent contributions to medical communications." It was presented at the AMWA annual conference, in Memphis, October 9, 2014.TRANSCRIPT
![Page 1: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/1.jpg)
Too Much Of The Wrong Kind
Of Health News
Gary SchwitzerPublisher, HealthNewsReview.org
Adjunct Assoc. Prof., School of Public Health, University of Minnesota
![Page 2: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/2.jpg)
![Page 3: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/3.jpg)
![Page 4: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/4.jpg)
![Page 5: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/5.jpg)
Our criteria: Does the story explain…
• What’s the total cost?
• How often do benefits occur?
• How often do harms occur?
• How strong is the evidence?
• Are there alternative choices?
• Is the condition exaggerated?
• Is this really a new approach?
• Is it available?
• Who’s promoting this?
• Do they have a financial conflict of interest?
69%
66%
65%
61%
57%
Percent unsatisfactory after 1,889 story reviews – 7 years
![Page 6: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/6.jpg)
![Page 7: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/7.jpg)
Most common flaws
• Conveying a certainty that doesn’t exist– Exaggerating effect size– Using causal language to describe observational
studies– Failing to explain limitations of surrogate
markers/endpoints– Single source stories with no independent
perspective– Failing to independently analyze quality of evidence
![Page 8: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/8.jpg)
“Good journalism has a subtle feature of reticence. We don’t publish everything we hear. We filter. We curate. The goal of the traditional journalist is to create a reputation for accuracy, fairness, relevance and timeliness, and this requires the willingness to not publish things that are unlikely to be true. … There’s nothing at stake here except the survival of credible journalism.”
- Joel AchenbachWashington Post
![Page 9: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/9.jpg)
![Page 10: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/10.jpg)
Daily Drumbeat of Dreck
![Page 11: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/11.jpg)
After mouse experiment with 5 successful results!
![Page 12: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/12.jpg)
![Page 13: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/13.jpg)
![Page 14: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/14.jpg)
![Page 15: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/15.jpg)
How did this…..
….become this?
![Page 16: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/16.jpg)
And all of this…. 327,000 results on a Google search!
![Page 17: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/17.jpg)
A university news release played a role
![Page 18: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/18.jpg)
![Page 19: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/19.jpg)
2013: The year we “cured” cancer – three times !
“Breaking Through Cancer’s Shield” - Oct 2013
![Page 20: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/20.jpg)
èèè
![Page 21: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/21.jpg)
“Boston Children’s Hospital could be on the verge of curing type 1 diabetes. Seriously. This huge news, which was announced today on their blog.”
![Page 22: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/22.jpg)
![Page 23: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/23.jpg)
JOSH BILLINGS (PEN NAME OF HUMORIST HENRY WHEELER SHAW, 1818 – 1885)
“The trouble with people
is not that they don't know, but
that they know so much that ain't so. …
I honestly believe it is better to know nothing that to know what ain’t so.”
![Page 24: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/24.jpg)
Journal of Incidentalomas
Journal of Experimental EfficacyJournal of Preclinical Self-Importance
Journal of Surrogate Markers Only
![Page 25: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/25.jpg)
September 2012
Positive “spin” was identified in about half of press releases and news stories. The main factor associated with “spin” in press releases was the presence of “spin” in the journal article abstract conclusion.
In other words, a direct link from published study news release news story.
Who thinks about the reader, the consumer, the patient…at the end of this food chain?
![Page 26: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/26.jpg)
Mayo’s Dr. Victor Montori to a journal club:
“Beware spin: composite endpoints, surrogate markers, subgroup analyses, inadequate comparators (too much or too little of an effective alternative or placebo when an effective alternative exists). Above all, avoid the intro/discussion sections which is where most of the interpretational spin is introduced.”
But many journalists – who feed off a steady diet of journal studies in order to meet their story quotas and click rates – have no idea what any of these terms mean.
![Page 27: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/27.jpg)
Dr. Richard Lehman has published reviews of journal articles for 8 years on BMJ website
“I too was once a conclusion-of-the-abstract reader, and was quite smug that I had even got that far. It took me some years to become aware of perhaps the most important principle of critical reading: never believe the stated bottom line without confirming it from the data. And beware of the limitations of the data.”
![Page 28: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/28.jpg)
Dr. Lehman reminds us:
350 years ago the Royal Society of London for Improving Natural Knowledge used as its motto,
Nullius in verba
Rough translation:
“Don’t take anyone’s word for it.”
We still have much to learn from those notable 17th century skeptics.
![Page 29: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/29.jpg)
“Bad science is no excuse for bad journalism.”
![Page 30: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/30.jpg)
Pharma says that for every 5,000 compounds in pre-clinical testing, only 5 make it to human trials. And of those, only 1 will get FDA approval.
But we keep seeing stories like:
– The Toronto Star: “New breast cancer drug heralded as breakthrough” (Phase 2 study)
– CNN: “Stem cell medical breakthrough?” (Phase 1 study)
– Medscape: ‘Truly Remarkable’ Response with Combination for Melanoma (Phase I study – 37 people followed 12 weeks)
Another estimate: only 8% of new drugs in Phase I studies ever get approved
![Page 31: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/31.jpg)
“BREAKTHROUGH” on all 3 main TV networks on a Phase I study
Note that all 3 practice “question mark journalism” – which allows you to say anything, followed by ?
![Page 32: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/32.jpg)
Cover story “breakthrough”
16 words: “moving into the testing phase”
![Page 33: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/33.jpg)
Stenography, not journalism
Reported on Phase 2 breast cancer drug study – directly from a Pfizer news release – which didn’t include any data.
But the story lifted a glowing quote from the company news release:
“The study suggests ‘the potential to transform the standard of care,’ said Mace Rothenberg, Pfizer Oncology's chief medical officer. ‘This is encouraging information for these women.’ “
No data. No independent perspective. Free publicity on results no one will see for two more months when they are presented at a meeting.
But Reuters and AP also reported on the Pfizer news release. Those stories were picked up by Huffington Post, ABC, Charlotte Observer, Boston Herald, Idaho Statesman, Washington Times, Bradenton Herald, Fort Worth Star Telegram, Myrtle Beach Sun News, Philly.com, others
![Page 34: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/34.jpg)
Why does any of this matter?
• Because we are often mired in an ugly, uninformed public dialogue about health care
![Page 35: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/35.jpg)
Message from a researcher who promotes mammography benefit
to a researcher whose work questions benefit
“May the faces of the thousands of women who have died, and will continue to die, prematurely because of you, continue to haunt you in your dreams, and in your nightmares.”
![Page 36: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/36.jpg)
The management of
• The CEO said the US Preventive Services Task Force “condemns tens of thousands of men to die this year and every year going forward…”
• The COO said that Dr. Otis Brawley, chief medical officer of the American Cancer Society “has killed more men by giving them an excuse to not be tested.”
![Page 37: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/37.jpg)
When an FDA advisory committee in 2011 recommended against Avastin for breast cancer
The VP of the National Breast Cancer Coalition - a breast cancer survivor - told the panel the data don’t show that the drug extends the lives of breast cancer patients, but do show it increases risk of harm, especially risk of hemorrhages.• Next, a woman got up to give her public presentation and
started by saying, “I am disgusted to have to speak after that woman.” Her statement was met with applause.
• One woman yelled, “What a patient representative! You better hope your breast cancer doesn’t come back. You’re an embarrassment to all cancer survivors. ”
![Page 38: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/38.jpg)
Respected patient advocate Musa Mayer said:
“As a patient rep for the FDA’s Oncologic Drugs Advisory Committee, I, too have been publicly reviled for making evidence-based decisions that I felt would benefit the larger population of patients. Some of us have had to grow accustomed to receiving hate mail, hurled epithets intended to shame us, and even threats from those who claim to speak on behalf of patients.”
![Page 39: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/39.jpg)
Journalism has an agenda-setting responsibility on issues like this
But the story of the forces behind this wretched public dialogue on screening and on evidence-based medicine is largely untold.
• Are the lobbying forces of special interests so powerful?
• Are journalists afraid, unaware, don’t consider it newsworthy?
• Any one of these possibilities is unacceptable.
![Page 40: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/40.jpg)
Journalists could help people understand
• In health care, newer isn’t always better…more isn’t always better…less can be more.
• Bad things happen when we re-define normal states of health as illness requiring treatment
• There are tradeoffs involved in any health care decision: something you stand to gain but also something you stand to lose.
![Page 41: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/41.jpg)
![Page 42: McGovern Award Lecture - American Medical Writers Association](https://reader031.vdocuments.mx/reader031/viewer/2022013101/557cf56ad8b42a57118b48af/html5/thumbnails/42.jpg)
St. Augustine & Jerry Garcia
“Hope has two beautiful daughters. Their names are anger and courage; anger at the way things are, and courage to see that they do not remain the way they are.”
“Somebody has to do something, and it's just incredibly pathetic that it has to be us.”