Council for the Advancement of Science Writing

CASW Periscope

What’s going on with Newsweek’s health/medical news coverage? What you need to know.

HealthNewsReview.org - Tue, 12/12/2017 - 2:30pm

In the era of churnalism – churning out mass volumes of health/medical/science news every day – some news organizations seem to be simply going through the motions.

Newsweek lifted much of its “story” from The Guardian, in proclaiming a breakthrough in unpublished results from an early Phase I drug trial for Huntington’s Disease.

Recently, in 3 days’ time, we commented on 3 other Newsweek health news stories – all diet/nutrition stories.  We posted these on social media, but never put them on this blog, so here you go.  Looking for better from them in 2018 – or whenever.

November 7:  “Want to feel full? Eating two burgers is better for your health than ordering fries.” Newsweek didn’t lift from The Guardian this time, but, rather, from The Business Insider…the Harvard Health blog…and LiveScience.

On November 9, Newsweek published, “Why mushrooms may be the best food to help fight aging.”  I’m getting older just reading stories like this.

On November 8, Newsweek published, “Your vegetarian diet may be making you sad.” What’s sad is when a story contradicts itself, as this one did.

 

Categories: CASW Periscope

Storygram: Andrew Grant’s “At last, Voyager 1 slips into interstellar space”

CASW Showcase - Tue, 12/12/2017 - 9:05am

The Storygram series, in which professional writers annotate award-winning stories to illuminate what makes a great science story great, is a joint project of The Open Notebook and the Council for the Advancement of Science Writing. It is supported by a grant from the Gordon and Betty Moore Foundation. 

Andrew Grant is the online editor at Physics Today. His story below won the American Geophysical Union’s 2014 David Perlman Award for Excellence in Science Journalism. This annotation was done by Marguerite Holloway and students in the Columbia University Graduate School of Journalism’s M.A. Science Concentration: Tryggvi Adalbjornsson, Guia Baggi, Mariana Lenharo, Maya Miller, Greta Moran, Disha Shetty, and Elizabeth Whitman. It is co-published at The Open Notebook

Humankind has officially extended its reach to the space between the stars.In merely 12 words, Grant has managed not only to summarize the contents of the story—a classic notion of a good lede—but also to encapsulate the story’s significance. For millennia, the human race has been busy exploring its home planet. For decades, humans have explored the solar system. Now, a new age of exploration has begun—that of interstellar space. Also, look how beautifully this idea is framed within the structure of the sentence. By starting with the word “humankind” (relating immediately to us, the readers) and ending with “the stars” (denoting the ultimate frontier, of which we have dreamt since before the dawn of civilization), Grant emphasizes the story’s vast context. Voyager 1, this distant piece of metal, relates directly to one of the fundamental aspects of the human condition.

NASA’s Voyager 1 spacecraft exited the vast bubble of particlesThis vivid, familiar language helps the reader envision something not of our world. We may not know what’s out there at the edges of the solar system, but we know what a bubble looks like, and we can imagine one filled with some kind of particles that encircles the sun and planets on August 25, 2012, mission scientists report September 12 in Science. At the time, Voyager was about 18.2 billion kilometers from the sun, or nearly 122 times as far from the sun as Earth.Numbers can easily halt the flow of a story, but we usually feel better when a number carries with it a familiar point of reference. Although none of us have traveled to the sun, we have at least a hazy hunch of how long it would take to get there. Grant’s comparison is essential to our understanding the distance Voyager 1 has traveled. Also, “122 times as far from the sun as Earth” is a translation of a technical and opaque unit of measurement, the astronomical unit—the mean distance between the center of the earth and the center of the sun. In a big favor to us, Grant gives the measurement in common language, sparing us from having to stop reading to make sense of what an astronomical unit is.

AGU’S David Perlman Award for Excellence in Science Journalism This award recognizes excellence in science news reporting with a deadline of one week or less. This story was honored with an award in 2014.

“This is the beginning of a new era of exploration for us,” says Edward Stone of Caltech, who has headed the Voyager mission since 1972. “For the first time, we are exploring interstellar space.”After giving us the basic facts, Grant wisely goes straight to the source to confirm and expand on what was implied in the very first sentence of the article. He’s given us an authoritative voice to back up the dramatic claim that’s at the center of the account. Now, he can go on and tell us the whole story.

Confirmation of Voyager’s interstellar exploits came after determining that the probe is surrounded by a relatively dense fog of galactic particles rather than a thin mist of solar ones.It’s a lovely image. Even if you can’t really understand the difference between solar and galactic particles, this sentence gives you the idea that it must be similar to passing from a thin mist to a dense fog, and that the fundamental nature of the surrounding matter has changed. It was a tricky measurement that required patience, clever detective work and a heavy dose of luck.This sentence is simultaneously informative and engaging, giving the reader a realistic sense of how painstaking scientific determinations can be, while also creating a sense of narrative tension by casting such determinations as a blend of detective work and sheer chance. (Later in the story, Grant deftly revives the detective theme.)

NASA launched Voyager 1 and 2 in 1977 to explore the outer planets, but from the beginning Stone’s team hoped the probes would survive long enough to investigate the region of space where our star’s dominance finally wanes. The sun unleashes a flood of hot, charged particles called plasma that jets out in all directions.It’s easy to picture this “flood.” Grant’s pithy description makes understandable something that would require a lengthy technical detour to explain fully. The plasma forms a bubble called the heliosphere that is tens of billions of kilometers in diameter. Over the last decade, the solar plasma around Voyager 1 has thinnedThe language immediately makes the reader recall the thin mist described above, creating a consistent lexicon that exemplifies the careful construction of the story and that builds on readers’ growing understanding. as the spacecraft hurtles toward the edge of the bubble at more than 60,000 kilometers per hour. Astronomers have been waiting for Voyager to cross this boundary — the heliopause, where solar particles give way to even speedier particles ejected by other stars — and enter interstellar space.This sentence widens the lens to look beyond Voyager 1, providing a touch of historical context and a larger sense of what else is going on out there.

The first evidence that Voyager had reached that boundary appeared on July 28, 2012, when the number of solar particles measured by Voyager plummeted. But the particle count rebounded a few days later. Three similar dips and recoveries occurred in the following weeks until August 25, when solar particles disappeared for good (SN Online: 6/27/13). The solar particle measurement, combined with a surge in higher-energy particles from other stars, suggested that Voyager had exited the heliosphere and reached the promised land. Several well-publicized studies made that claim.In the previous paragraph, Grant built up great expectations for his readers about whether Voyager 1 would be able to cross the boundary of the heliosphere and suggested how exciting that would be. In this paragraph, that expectation is fulfilled—Voyager may well have reached “the promised land”—but only after several false alarms. Recounting those false alarms adds drama to the story.

Stone and his colleagues resisted that conclusion.This is the opposite of what the reader would expect after the previous paragraph, which left the impression that the case was all but closed. Reversing the reader’s expectation triggers curiosity: Why in the world was Stone so skeptical, even when his colleagues were convinced? They lacked evidence of what they thought would be the key signature of interstellar space: a shift in the direction of the magnetic field. Solar plasma produces a distinctive magnetic field because it all comes from the same source; scientists expected that the field would shift in interstellar space, where particles flit around in all directions. Despite the particle evidence that Voyager had departed the heliosphere, the magnetic field direction remained constant. “We felt we did not have the smoking gun to say that we had left the solar bubble,” Stone says.This quote echoes the idea of the mystery introduced above and nicely illustrates that research is usually not as simple as a “smoking gun.”

What the Voyager team needed was another independent measurement to confirm the story implied by the particle data. One option was to prove that Voyager was surrounded by cold, dense plasma from interstellar space rather than hot, wispy plasma from the sun.The descriptive yet simple terminology allows the reader to engage with dense and complex material and to understand the major differences between these two environments. Such a measurement would have been straightforward except that Voyager 1’s plasma instrument stopped working somewhere near Saturn 33 years ago.This last sentence packs a surprise, heightening our appreciation of the challenges the researchers face: How will they solve the mystery if critical equipment is offline? By revealing this detail here, Grant maintains narrative tension, pulling us along.

Donald Gurnett, a Voyager scientist at the University of Iowa, found a way to get the measurement anyway. Poring over data from another instrument on the spacecraft, Gurnett discovered that in April 2013 a blast wave from the sun, the same kind that can cause solar storms on Earth, had reached Voyager’s neck of the woods and jostled electrons in the surrounding plasma. It was the first such energetic solar shock in nine years. “In that sense we were lucky,” Stone says.This paragraph explains the work that led to the discovery, but avoids getting into the weeds. For example, the phrase “jostled electrons” brings to mind a clear image so Grant doesn’t have to get into the technical details. In just three sentences, Grant tells us about the work and luck involved in reaching the conclusion about the Voyager’s location. The phrase “neck of the woods” helps us connect with and conceptualize a faraway place and makes it feel familiar, even though it’s light-years away.

Gurnett then used the frequency of the electron vibrations to calculate that plasma surrounding Voyager 1 was about 50 times as dense as scientists would expect inside the heliosphere, a sign that the spacecraft had entered interstellar space.This sentence is a clear, concise explanation of the science supporting the main finding. Grant distills what was almost certainly a complex set of calculations down to the most fundamental result: “50 times as dense.” And he elegantly weaves the finding into the narrative, letting us watch over Gurnett’s shoulder as he performs this key analysis.

“The study very definitively shows that we’re in the interstellar medium,” says Gary Zank, a space physicist at the University of Alabama in Huntsville who was not involved in the research. “There’s no way of producing a density of that size within the heliosphere.”

Not everyone agrees, including a few holdouts on the Voyager team.Balance. By shining light on disagreement in the scientific community, Grant demonstrates that he knows the subject matter well. The phrase “including a few holdouts on the Voyager team” shows that he did not just go to outside researchers, but is aware of the inner workings of the team. This adds important nuance to the story and makes the reader trust Grant’s authority even more. George Gloeckler and Lennard Fisk, both from the University of Michigan in Ann Arbor, have written a paper demonstrating how plasma could become dense enough within the heliosphere to produce Gurnett’s measurement. “Gurnett definitely measured the density correctly,” Gloeckler says. “But I don’t believe you can say that what he measured is the interstellar plasma.”This quote makes clear that while Gloeckler and Fisk disagree with Gurnett, it is a question not of fact but of interpretation—and the researchers’ differing interpretations keep us engaged. Grant has folded the debate into the story, using it to build momentum, instead of centering the story on “disagreement.” This allows him to keep his focus on the specifics of the science, on the nature of evidence.

Barring a change in the magnetic field, Gloeckler believes the team should wait another two or three years for Voyager 2, which has a working instrument to measure the density and temperature of plasma, to reach a similar position in space.)) “Voyager 2 will experimentally answer this question,” he says. [highlight]“Why rush to conclusions now?”This latter part of Gloeckler’s quote is in accessible, conversational language, in keeping with the approachable tone that Grant has established.

Zank and many other astrophysicists say the evidence is overwhelming that Voyager 1 has crossed the heliopause, but they acknowledge that they have to determine why the magnetic field direction didn’t shift. At the same time, scientists are combing through more than a year’s worth of data Voyager 1 has collected since entering interstellar space. NASA estimates that Voyager 1 has enough plutonium fuel to keep all its instruments powered for another seven years, giving the probe plenty of time to measure an environment littered with particles that originated in distant stars and violent supernovas. “All this will give us considerable insight into what’s happening in the far reaches of the galaxy,” Zank says.Here, Grant zooms out from the focus on the narrow, black-and-white question of whether Voyager has exited the heliosphere and toward the potential for other insights that the spacecraft can offer in its final years.

For now, Stone and other scientists are excited about the robotic explorer’s accomplishment on August 25, 2012 — the same date, coincidentally, that the world lost its most famous human space explorer, Neil Armstrong.The first part of this final paragraph is cheery, and it also serves to remind the reader of the big picture—that no matter how scientists resolve the debate Grant has just described, the Voyager 1 mission has still achieved a great deal. Mentioning Neil Armstrong and his passing in this final phrase of the story strikes an awkward chord. It might have been better to end on the high note of the second-to-last paragraph.

You may read this story in its original format at Science News. A Q&A with writer Andrew Grant is at The Open Notebook. It was conducted by Marguerite Holloway and students in the Columbia University Graduate School of Journalism’s M.A. Science Concentration: Tryggvi Adalbjornsson, Guia Baggi, Mariana Lenharo, Maya Miller, Greta Moran, Disha Shetty, and Elizabeth Whitman.

The post Storygram: Andrew Grant’s “At last, Voyager 1 slips into interstellar space” appeared first on Showcase.

Categories: CASW Periscope

Storygram: Andrew Grant’s “At Last, Voyager 1 Slips into Interstellar Space”

The Open Notebook - Tue, 12/12/2017 - 8:45am
JPL-Caltech-NASA (Originally published in Science News.)

Voyager 1, launched in 1977. In a 2013 study, researchers reported that the spacecraft had crossed the border into interstellar space on Aug. 25, 2012.

 

The following story diagram—or Storygram—annotates an award-winning story to shed light on what makes some of the best science writing so outstanding. The Storygram series is a joint project of The Open Notebook and the Council for the Advancement of Science Writing. It is supported in part by a grant from the Gordon and Betty Moore FoundationThis Storygram is co-published at the CASW Showcase.

 

Andrew Grant’s 2013 Science News story “At Last, Voyager 1 Slips into Interstellar Space” is deceptive. It seems at first glance a straightforward, relatively short news story. But as my students and I began to look at it closely, focusing on one sentence at a time for our annotation, we realized just how much skill, authority, and knowledge are packed into this piece.

Writing clearly about space—about distances that are so great, as well as about proxies and environments so unfamiliar to ordinary experience—requires a particular dexterity. Grant needed to quickly explain enough of the challenging basic science underlying the story so that readers could understand the significance of the news and project themselves to the far reaches of the heliosphere, while simultaneously avoiding thickets of technical detail. He did that expertly, using accessible,​ familiar language to bring his readers confidently into unexplored terrain. Grant also needed to make clear that the claim was open-ended​,​ that although there was great excitement about Voyager 1 leaving the heliosphere, some researchers remained unconvinced. In our view, Grant’s piece did an excellent job of creating momentum around the question: How do we know Voyager 1 has reached interstellar space? By juxtaposing various particle counts with scientists’ uncertainty about those measurements and their interpretation, he developed a narrative tension that led readers to want to continue reading with the hope that the scientists would solve what remained, to some, a mystery.

In 2014, Grant wrote a follow-up story about the ongoing debate, picking up on and developing issues first outlined in this story. As Voyager 1 enters its 41st year of travel, Grant’s explanations and his story remain as engaging and enlightening as they were when the piece first appeared.

Marguerite Holloway, with students in the Columbia University Graduate School of Journalism’s M.A. Science Concentration: Tryggvi Adalbjornsson, Guia Baggi, Mariana Lenharo, Maya Miller, Greta Moran, Disha Shetty, and Elizabeth Whitman

(more…)

Categories: CASW Periscope

Student journalists produce 52 reports from WCSJ2017

National Association of Science Writers - Tue, 12/12/2017 - 7:39am

Student science writers from around the world have created a set of 52 stories from the World Conference of Science Journalists 2017, spanning most of the meeting's sessions and creating a valuable reference archive for journalists in the U.S. and abroad.

Article type: World Conference of Science JournalistsArticle topic: NASW news
Categories: CASW Periscope

Temple University again greases the clickbait machine with canola oil study

HealthNewsReview.org - Fri, 12/08/2017 - 2:34pm

Scientists should be lauded for investigating health claims used to a market a product. But when preliminary findings are reported to the public without appropriate context, that’s a problem.

And it’s one that we’ve seen twice in the past six months at Temple University.

In June we criticized an overreaching university news release: “Temple study: Extra-virgin olive oil preserves memory & protects brain against Alzheimer’s.” The study, based on research in just 22 mice that had been bred to develop Alzheimer’s, didn’t show any connection between human brain health and olive oil. And it only belatedly mentioned the fact that the research was conducted in mice. But this did not deter several news outlets — including USA Today, Newsweek, the Atlanta Journal-Constitution, and Philadelphia Inquirer — from covering it anyway.

The study compared mice given a standard diet with mice given a standard diet plus a tablespoon of olive oil daily in terms of their performance on memory tests.

HealthNewsReview.org Deputy Managing Editor Joy Victory touched on some of the many problems with that study, and the resulting coverage, writing:

Stating the obvious, here, but genetically modified mice are a far, far cry from people. And just because you’re able to reduce amyloid buildup in those genetically modified mice, doesn’t mean you’ll be able to do the same thing in humans.

In fact, even drugs that apparently do a great job of getting rid of amyloid in thousands of actual humans don’t seem to have much effect on the symptoms of Alzheimer’s disease.

Six months later, you’d hope that whomever is responsible for this messaging might have rethought their approach. But no, they’re at it again, this time with a similarly shaky study using the same methodology to claim canola oil could be bad for the brain. Yesterday Temple issued this attention-grabbing news release: Canola oil linked to worsened memory & learning ability in Alzheimer’s.

Once again, the headline jumps way ahead of what the research actually shows.

Nevertheless, the clickbait machine is whirring again. We spotted these hastily reported stories:

Only the Inquirer warned readers about relying on a mouse study, stating in the second paragraph: “The results should be viewed with caution because what happens in mice often does not happen in people.” But that warning came only after baiting readers with the overreaching headline.

The Inquirer’s story also contains information that’s not in the news release and does serve to temper some of the hype. It reports that the senior investigator “considers the study a ‘red flag’ for canola oil users, though he would not tell people to stop eating it,” that he plans to experiment with different fats and doses “to see how much is needed to induce brain changes and whether changes are reversible,” and that he acknowledges not knowing why canola oil and olive oil might affect the brain differently.

Unfortunately, none of these news outlets sought comments from outside experts who could have added much-needed perspective. That’s one of several tips we offer in: “How to report on preliminary Alzheimer’s research results.” 

It’s good when researchers look into the health effects of products, like canola oil, that are promoted with industry-funded research. But this new study doesn’t say anything meaningful for consumers; it’s simply one more example of the overblown diet claims that drive public skepticism of the field of nutrition science.

Categories: CASW Periscope

Birth control pills & breast cancer risk: big study generates big differences in quality of news coverage

HealthNewsReview.org - Fri, 12/08/2017 - 11:45am

Are the newer birth control pills of the past few decades safer  — at least regarding breast cancer risk —  than older oral contraceptives?

It’s a question doctors have been eager to study for some time. And this week a Danish study published in the New England Journal of Medicine provides some important, albeit observational, data.

If you heard about the study in a news story, you may have read or heard very different take-home messages than what other news consumers received from other news sources.

Dozens of news organizations covered this study. Below, I compare the coverage of five of them. I wouldn’t label it “The Good, The Bad, and The Ugly,” per se.

How about “The Very Good, The Not-So-Bad, and The Pretty-Darn-Ugly”

The very good

The New York Times was one of the outlets that set a very high standard by making the following key points quite clear:

  • What makes the study novel is it is the first large-scale, prospective study (1.8 million women over about a decade) to address the breast cancer risk in newer hormonal contraceptives (which have lower hormone levels than older contraceptives).
  • It clearly established  that the absolute risk for breast cancer with the newer contraceptives “was small but measurable” (for every 100,000 women, hormonal contraceptive use accounts for about 13 additional cases of breast cancer a year).
  • Different delivery systems — like intrauterine (ie. IUD’s)  or implanted hormone delivery systems — carried equivalent risk to pills (Note: not all IUD’s contain hormones)
  • A reminder that contraceptive hormones — although long known to increase breast cancer risk — are also associated with a decreased risk of ovarian, endometrial, and possibly colorectal cancers.
  • The study had limitations: it didn’t take into account other factors that can affect breast cancer risk: breast feeding, drinking alcohol, and exercise.
  • It included an important caveat: breast cancer risk increases with age, and how long a woman is on hormonal therapy.

And New York Times reporter Roni Caryn Rabin was the only reporter I came across who noted that the study was funded by Novo Nordisk, the company that makes Vagifem, a topical estrogen marketed for menopausal symptoms. She also pointed out that two of the study authors, including the lead author, “have been employed by Novo Nordisk since the manuscript was accepted for publication.”

NBC News.com touched on most of the above points covered by the Times. They appropriately emphasized the “small risk” high up in the story and provided this important context as well:

“It’s a disappointment to doctors who had hoped that lower doses of hormones in both oral and non-pill contraceptives might be safer than older birth control pills. But they stress there is no need for most women to abandon birth control pills for fear of breast cancer.”

The not-so-bad

The Guardian also included many of the most important points. They also highlighted some other aspects of the Danish study that many women on birth control would be curious about. Most notably, how the length of time on hormones affects risk: “among women taking the pill for five years, the study suggests, there would be an extra one case for every 1,500 women.” But this increased risk gradually disappeared over a few years after stopping the pill.

The Guardian also included this important quote from Kevin McConway, a statistician at the Open University in England who specializes in risk communication in the media:

“Like most other studies on hormonal contraceptives and breast cancer risk, this one is observational, so it cannot proved conclusively that the hormonal contraception is definitely the cause of the increased risk.”

Although Bloomberg covered some important ground in their reporting, they probably warrant a demotion to “The Bad” based on two things. First, the headline:

“Those Newer Birth Control Pills Don’t Lower Cancer Risk”

Notice they didn’t write ‘breast cancer’? A potentially massive oversight for those who don’t go past the headline and rush off to tell their friends: “birth control pills cause cancer!”

Speaking of massive, check out their opening line:

“Hopes that different formulations would remove a longstanding danger to women are dashed by a new study. Newer birth control drugs developed to replace those tied to cancer risk were thought to improve safety for the women who took them. It turns out they didn’t, according to a massive new study”

It’s a misleading one-two punch without context. The headline’s misleading generic reference to cancer is followed by unwarranted “dashed hopes” in the body text. Only further down in the article do we learn the relative risk of “about one extra case of breast cancer among every 7,690 women taking the drugs.”

But the damage has already been done.

The pretty-darn-ugly

Newsweek wasted no time with this fear-mongering headline: “Breast Cancer: Birth Control May Increase Risk By Up to 38 Percent”

This is the relative risk after 10 years on hormonal contraception. As with the Bloomberg framing, it’s only toward the end of the article that we’re provided with the much less startling absolute numbers.

The ending hits readers with a bizarre twist. Rather than point out that hormones may play a protective role in ovarian, endometrial, and possibly colorectal cancer …Newsweek finishes with this:

“… birth control may actually be protective against cancer on the whole, despite this increased risk for one type”

I can’t imagine what a roller-coaster ride that is for readers to go from that threatening headline to such a hopeful (albeit, very misleading) closer.

We see this reporting roulette frequently.  The quality of information that readers end up with is a spin of the wheel. The spectrum — as in this case — can be alarmingly wide. In cases in which the topic is esoteric the impact of this on consumers could be argued to be negligible. But in the case of oral contraceptives we’re talking about roughly 10 million woman in the United States alone. The impact of misinformation on this scale can become a public health issue.

I was encouraged that most of the reporting on this study was solid. The odds were fairly good that interested readers would walk away empowered with relevant information.

For those with an unlucky spin, I find myself left with a nagging concern: do they realize their bad luck?

Categories: CASW Periscope

WCSJ Video Showcase: Wallpaper

CASW Showcase - Thu, 12/07/2017 - 10:13pm

The World Conference of Science Journalists (WCSJ) in San Francisco toasted award winners from around the world. To honor that, here is a video montage composed of excerpts from interviews with those winners. This was the opening video that was played on WCSJ’s opening day.

This video was produced by the American Institute of Physics. The awards showcase was co-sponsored by the American Chemical Society, Science Advances and AIP.

The post WCSJ Video Showcase: Wallpaper appeared first on Showcase.

Categories: CASW Periscope

WCSJ Video Showcase: Opener

CASW Showcase - Thu, 12/07/2017 - 8:28pm

The World Conference of Science Journalists (WCSJ) in San Francisco toasted award winners from around the world. To honor that, here is a video montage composed of excerpts from interviews with those winners. This was the opening video that was played on WCSJ’s opening day.

This video was produced by the American Institute of Physics. The awards showcase was co-sponsored by the American Chemical Society, Science Advances and AIP.

The post WCSJ Video Showcase: Opener appeared first on Showcase.

Categories: CASW Periscope

How to communicate about obesity without promoting stigma

HealthNewsReview.org - Thu, 12/07/2017 - 8:10am

It’s not hard to tell when the CDC has released updated information on obesity rates in America. A quick scan of Facebook or Twitter and you’ll likely see headlines like “10 Fattest States in America,” and “Americans are getting even Fatter.”

Examples of news images that promote obesity stigma.

The pictures published alongside these articles often show people with obesity, slovenly dressed and eating or carrying food. In this CBS News slideshow there’s a picture of a woman holding up a double-meat cheeseburger with the American flag in the background, while a Washington Times article shows a headless figure sitting on a bench eating. The text may be equally off-putting–a Los Angeles Times article started off by saying, “If you dread the prospect of hauling your lazy rear end to the gym…the extra weight you’ve been carrying around may be to blame.”

This matters: Judgmental and dehumanizing word and image choices promote stigma–as content analyses like these reveal. Research shows that a culture of prejudiced behavior toward people with obesity is not only linked with many negative outcomes like bullying and depression, it also makes it less likely that people who are overweight or obese will seek treatment–not just for losing weight, but for even basic preventive care. 

Fortunately, by being mindful of the following points, journalists can help advance public dialogue about obesity and weight loss without stigmatizing people.  

Avoid ‘headless’ imagery

An example of an image that does not promote stigma.

Not showing a person’s face implies there is something shameful about what they are doing or who they are–yet that’s often what we see in news coverage about obesity. Videos like this one, accompanying a recent CNN news story can perpetuate damaging stereotypes about people with obesity. The video starts off with a climbing number on the scale, followed by an image of a person lying in a hospital bed, yet another person eating, and a headless figure seated on a bench wearing a shirt that leaves most of the person’s stomach exposed. An LA Times video similarly portrays people with obesity from the neck down, and in social settings where they are often eating.

To help remedy this, the Rudd Center for Food Policy and Obesity at the University of Connecticut created two free image and video databases with over 400 images and 88 b-roll videos of adults and children with higher body weight engaging in varied activities such as reading and delivering work presentations. The Canadian Obesity Network also has a free image bank of non-stigmatizing imagery. 

Weight loss is not a simple equation

There’s a common assumption that to lose weight, people with obesity simply need to eat healthier and move more. In reality, it’s far more complex for many people–long work schedules, food deserts, and unsafe neighborhoods can all stymie efforts to eat better and get more more physical activity. So, when writing a news story on obesity, it’s important to acknowledge the challenges that people may face, or alternatively, the abundant tools they’ll need when trying to lose weight.

A New York Times article from last year did a good job of addressing some of the environmental challenges that people with obesity face when trying to lose weight, such cheap, unhealthy food served in large portions. Another article published in The Chicago Tribune acknowledged the tools that people need to support their weight loss efforts, like community-based programs and policies.

Use words wisely

With body positivity and “fat acceptance” social movements, activists are attempting to reclaim power over use of the word “fat.” However, it is still a controversial term that can be used in derogatory ways. Try to avoid value-laden language like “fat” and “weight problem” when describing obesity, and rely on scientific terms instead.

For example, instead of saying “morbidly obese,” refer to obesity based on its “classes” as outlined by the CDC and NIH. Class 1 obesity refers to someone with a BMI between 30 and 35, class 2 obesity refers to someone with a BMI between 35 and 40, and class 3 obesity refers to someone with a BMI of 40 or greater.

In determining what counts as value-laden language, consider whether the language in question could potentially demean or embarrass someone. If it could, ask whether that language is needed to communicate the article’s main point. A Washington Examiner article published earlier this year could have made the point that the global prevalence of obesity is rising without referring to “French fry loving Americans” and how “…American children and adults are leading the obesity parade.”

In this instance, this type of language only serves to mock and embarrass people with obesity, making it inappropriate and unnecessary.

Finally, consider the label you’re using to describe people with obesity. It would likely strike you as odd to see an article reference a “cancerous” or “diseased” person, yet, so often we refer to “obese persons” in news stories about people with obesity. Try to put the person before the condition.

Headlines set the tone

While the headline may be the last part of a news story to be written, it is the first thing that readers see. Consequently, it sets the tone for the rest of the article. A headline like “F as in Fat: Top 15 fattest US states” makes for a poor choice for a headline because it equates fat with a failing grade.

A better headline would be this one from The Chicago Tribune, “American obesity report: 1 in 3 adults are beyond overweight.” This headline meets many of the criteria discussed above by focusing on the report’s main findings, and avoiding controversial or value-laden language.

Finally, focus on findings, not feelings

When focusing on the facts, the findings from research studies are put front and center like in this CBS News article. While photo selection could have been better, the article itself describes the findings of two different obesity research reports without introducing unsupported opinions or value judgments about people with obesity.

Conversely, when focusing on feelings, stigma emerges. That was the case in a UK Telegraph article with this judgmental headline, “Fat but fit is a myth, and big is not beautiful so stop making excuses for obesity.” The story states that people with obesity lack the willpower and motivation needed to make healthy lifestyle choices, with the author primarily basing this on personal experience. 

“Life is complicated, and if any amount of guilt, shame, blame, or even desire were sufficient to help patients cultivate permanent, intentional, behavior changes, the world would be a much thinner place,” says HealthNewsReview.org contributor Dr. Yoni Freedhoff, MD, an assistant professor of family medicine at the University of Ottawa, and founder and medical director of the Bariatric Medical Institute, which focuses on non-surgical weight management. 

Categories: CASW Periscope

Cheese and heart disease: What you need to know

HealthNewsReview.org - Wed, 12/06/2017 - 4:33pm

It’s pretty indisputable that cheese is delicious. But could it also be good for you?

That’s the clickable headline of the day, based on this meta-analysis of past studies looking at the relationship between cheese and heart disease.

As with all observational research, there are some important caveats. Here are four worth keeping in mind:

 

Categories: CASW Periscope

Video game therapy for ADHD: News touts a ‘landmark’ study but nobody has seen it

HealthNewsReview.org - Wed, 12/06/2017 - 2:24pm

Remember when Pokémon Go was going to be the next big thing for depression and anxiety?

Those were heady days.

Of course you’d be hard-pressed to find many Pokémon hunters at the local PokéStop nowadays. And yet in the summer of 2016, we tracked all sorts of health claims related to the app, including one that was based on a “study” that didn’t even exist.

Monday’s reporting on a new video game that aims to become a treatment for Attention Deficit Hyperactivity Disorder (ADHD) brings to mind similar concerns about a phantom study.

To be clear, a study about this video game most certainly exists and it’s a randomized controlled trial (RCT). That’s the good news — and I share enthusiasm for a non-drug approach to ADHD that’s being tested rigorously by researchers.

A screenshot from the Akili video game.

The bad news is that nobody outside of the company sponsoring the research has seen the results of the study.

And yet some news outlets are reporting on those unseen results in a way that makes the product sound like it will be a big help for children with ADHD. We don’t have enough information to draw that conclusion.

As usual, it starts with a news release

What we do have is a company news release that reports the video game produced “a statistically significant improvement compared to an active control” on one measure of attention in children who used it.

But how big was that improvement actually? And will it translate to noticeable and meaningful benefits on children’s’ behavior and ability to learn? The news release doesn’t tell us. It says the full results are to be presented at an upcoming meeting.

Boston Business Journal didn’t need to see the data in order to declare the study a “landmark” in its headline.

Reuters poured on the accolades and informed us that the company developing the treatment, Akili, “now plans to file for regulatory approval with the U.S. Food and Drug Administration in the first half of 2018, paving the way for what would be the first such ‘digital’ prescription product.”

STAT‘s only quoted source was Alkili’s CEO, Eddie Martucci, who said: “We have something that looks and feels and is delivered through a video game, but when someone’s using it, they’re getting a direct physiological activation that will lead hopefully — and we have a nice glimpse of data now — to cognitive and general clinical improvement.”

Actually, though, readers haven’t had a glimpse of any of that data. Nor have external experts. We’re being asked to take the company CEO’s word that these data suggest “general clinical improvement.”

The trial data haven’t been presented, published, or peer-reviewed, something none of these outlets cautioned against in their coverage. Nor did they attempt to compensate for this by seeking out an independent perspective on the findings.

What an independent source might have said

We’ve seen worse examples of companies making data-free claims that were passed along unquestioningly by news outlets.

Susan Molchan, MD

And STAT does a nice job of providing important context when it warns, for example, “it remains to be seen whether clinicians and insurers will embrace [the video game].”

But incomplete reporting based on news releases is a recurring issue and it’s worth noting that there are remedies. In this case, had any of these outlets reached out to an independent source, they might have heard concerns similar to what psychiatrist and former NIH clinical researcher Susan Molchan, MD, told me.

She says the primary outcome touted in the news release appears to be “a simple computer-generated neuropsychological task” and that the FDA would likely want to see a much broader range of assessments — including “more general scales (clinical global impression scales) that…try to capture whether there is an overall general improvement in what is going on in someone’s life.” She adds that it is premature to describe these results as “paving the way” for an FDA-approved digital prescription product as Reuters puts it.

Alan Schroeder, MD

“There’s the question of ‘statistically significant’ as found here, vs clinically significant—does this make a difference in behavior in the classroom, which the scales try to get at, or ultimately grades? We have no idea,” Molchan says.

Alan Schroeder, MD, the associate chief for research in the division of pediatric hospital medicine at Lucile Packard Children’s Hospital Stanford, expressed enthusiasm for the research in general and said he was pleased to see a company investigating non-drug approaches to ADHD. But he also raised concerns about reporting on the findings before peer review and said there were questions about the results. For example, “while the choice of the control group is understandable, is it possible that that video game used in the control arm may have been counterproductive? It would have been interesting to see a 3rd comparator arm of ‘usual care.'”

‘A lot of work left to do’

A final concern brings us back to Pokémon Go and its ultimately fleeting health impact. The new study lasted just four weeks, and that’s not enough time to tell if this product is going to achieve lasting and meaningful benefits for children with ADHD.

“There is the question of whether the kids would need to keep playing the game, and how often, to sustain the response (if there is one that matters),” Molchan says.

People get bored with video games. Even one that’s engaging enough to become a global sensation may quickly lose favor.

It’s a perspective worth keeping in mind as we assess this exciting but uncertain new area of psychological research.

“It’s great that non-drug interventions are being tested in RCTs,” Molchan says, “but there’s a lot of work left to do.”

Categories: CASW Periscope

Mark Pendergrast: The Most Hated Man in America

National Association of Science Writers - Wed, 12/06/2017 - 11:14am

Allegations of sexual harassment or assault by powerful men generate daily news headlines. In Advance Copy, Mark Pendergrast discusses how he jumps into the fray with his newest book, The Most Hated Man in America: Jerry Sandusky and the Rush to Judgment. Pendergrast asks: Did false memories, uncritical reporting, and the lure of potential large financial settlements contribute to Sandusky’s conviction as a serial child molester? “Weigh the evidence,” Pendergrast urges. “Then form your own conclusions.”

Member blog name: Advance copy: NASW members give the backstory on their booksArticle topic: Science writing news
Categories: CASW Periscope

Sham surgeries: A tale of medical reversals & the role of the media

HealthNewsReview.org - Wed, 12/06/2017 - 7:00am

For many of us a “sham” is not a good thing. It conjures images of fraud and being duped.

But in the world of surgery (and other interventional procedures) a sham — or sham surgery, more precisely — can be a positive thing.

Last month was a good example as the publication of three separate studies — all using sham surgeries in their design — brought into question the benefits of two expensive and widely used treatments, as well as one very controversial treatment. Here are those studies:

  1. The ORBITA Trial  – showed that placing stents in blocked coronary arteries did not improve chest pain (angina) symptoms, exercise capacity, or quality of life in non-emergency patients
  2. ‘Liberation Treatment’ for MS – placing stents to increase blood drainage from the veins of the brain did not cure or improve multiple sclerosis (MS) symptoms
  3. Subacromial Decompression – using arthroscopy to remove bone and tissue in patients with shoulder impingement symptoms did not significantly improve their pain or function.
What is sham surgery?

If a patient gets better or worse from a surgery, how do you know if you can attribute either result to the targeted intervention (like placing a stent or removing some ‘abnormality’)? If they get worse couldn’t it be partly attributed to other risks of surgery … like anesthesia, infection, or post-operative complications? And if they get better couldn’t that be a placebo effect?

Evaluating a surgical intervention isn’t as straightforward as a drug study where you can compare the active medication to a sugar pill in order to tease out the true impact.

But with a sham surgery it is more straightforward. That’s because in a typical sham surgery study you randomize one group to get the full surgery (like in the ORBITA trial above, to have a stent placed). The sham group, on the other hand, goes through all the same preparation and surgical steps except for one … they don’t get the intervention being studied (ie. no stent placed). Neither the patients emerging from surgery, nor the doctors evaluating the outcomes of the patients, know who did — or did not — get the stents. The confounding contributions of bias, placebo effect, and surgical complications are nullified.

You now have a control: the sham group. And you’ve created a double-blind, randomized controlled trial (or, RCT, for short) — the gold standard of medical evidence.

The world of ‘medical reversals’

Why are these sham surgery studies so important? Let’s take the coronary stent and shoulder decompression studies first.

Before these studies were published last month, the interventions evaluated in both studies had been performed on millions of people, costing billions of dollars, and been accepted as routine procedures in certain clinical situations. If these new results are supported by future RCT’s (and yes, they are needed in all 3 cases above) then these costly (or lucrative, depending on your perspective) treatments may become discredited and abandoned.

These are called ‘medical reversals.’

Adam Cifu MD

In the case of coronary stents we’re talking about potentially debunking an established treatment that goes back nearly 40 years. That raises important questions. Not the least of which is: who should be held accountable when it takes decades to show that a widely implemented treatment may have been not just costing us quite a bit, but accomplishing very little?

“I think the burden of proof should be on those who created these interventions, popularized them, and stand to make money from them,” says Adam Cifu, MD, an internist at the University of Chicago who specializes in evidence-based medicine, and who — along with Vinay Prasad, MD — coined the term ‘medical reversal’ in the book Ending Medical Reversal: Improving Outcomes, Saving Lives .

“But instead the burden of proof falls to other researchers, many of them quite brave, who are left to prove that maybe these innovations don’t really work. Our very first obligation is to do no harm, but until these drawn out reversals occur the harms are huge. People could have been benefiting from other therapies. Sometimes these therapies — and stents are a good example — can cause direct harms. And finally, there’s the immeasurable cost of losing the faith, respect, and trust of our patients. I’ve experienced that and it’s very painful.”

There are critics who argue that sham surgery is unethical. They say a fake surgery is not in the best interest of the those in the control group; that is, that surgery should only be performed to benefit people. Furthermore, the surgery puts them at risk, and this violates one of the most hallowed tenets of medicine: first do no harm.

I asked Cifu what he thinks of critics who call sham surgeries unethical.

“Yes, there are risks to sham surgeries like any other surgeries,” says Cifu. “But think of the difference between putting a few people at minimal risk versus putting hundreds of thousands of people at more significant risk for many years to come.” He adds:

“We’re strangely uncomfortable with upfront costs in our culture. We’re talking about a little extra care, a little extra time, and a little extra money on the front end to make sure these treatments and interventions are safe. Why won’t we accept these costs, but we seem to accept decades of harms from not being careful in the first place?”

The case of orthopedics: the nuance and uncertainty of pain

An area of medicine that is particularly prone to both breakthrough hype and subsequent medical reversal is orthopedic surgery. As in the case of shoulder decompression listed above, other orthopedic procedures have come under fire because of sham surgery studies. These include injecting specialized cement to stabilize spine fractures caused by osteoporosis, as well as  arthroscopic knee surgery to fix wear-and-tear changes of the meniscus (the C-shaped cartilage that forms an important cushion inside the knee joint).

Julie Switzer, MD

I ask Dr. Julie Switzer, an orthopedic surgeon at the University of Minnesota, why that is.

“So often we are operating on the assumption that people’s pain can be explained by the abnormal findings we find on an x-ray or MRI,” says Switzer. “But we can’t always know that the things like arthritic changes, or unstable joints, or ligament tears that we can change with surgery are actually responsible for that pain.”

She also thinks there can be a powerful placebo effect with surgery when you can show a patient an abnormality on a scan (unlike depression, let’s say, where no such abnormality can be pinpointed), and couple that with an objective surgical procedure (unlike an antidepressant pill), that can be very convincing for patients. She adds:

“There’s a unique investment that patients feel with surgery that introduces optimism, expectation, and hope. A sense that the benefit will be much greater than simply taking a pill. And that the greater the risk you feel you are taking, the greater is your investment in the outcome.”

The curious case of Dr. Zamboni’s ‘liberation treatment’

One of the reversals listed above — the so-called ‘liberation treatment’ for MS — is instructive on many levels.

Dr. Paolo Zamboni — a vascular surgeon motivated by his own wife’s struggle with MS — developed a stenting procedure to improve venous drainage of the brain, which he felt was impaired in the majority of patients with the neurodegenerative disorder. He dubbed this mechanism “chronic cerebrospinal venous insufficiency (CCSVI)” and the procedure as “liberation treatment.”

A ‘liberation treatment’ rally, Edmonton, 2010

His preliminary data suggested improvement in as many as 3 out of 4 subjects after the procedure. This launched not just a frenzy of news coverage, but also a social media tidal wave driven by MS patients and MS patient advocacy foundations. Clinics popped up across the globe to offer the procedure. Canadians even demanded the national health care system cover the costs.

But gradually, as the burden of proof fell to other researchers, it became clear the procedure really didn’t work. But, as eloquently reported by Helen Branswell of STAT, the damage had been done:

“Millions of dollars were spent trying to see if Zamboni was correct. Untold research hours were diverted from other lines of MS inquiry. Previously collaborative relationships between doctors and patients, as well as patients and foundations set up to advocate for their needs, were damaged.”

Let me be clear here: I’m not blaming Zamboni for this. In fact, he should be applauded for following up his preliminary, unblinded 2009 study with the sham RCT study published two weeks ago, and concluding: “this procedure cannot be recommended for the treatment of patients with MS.”

But all the fallout does raise another question …

Where was the context from journalists?

As Branswell points out, some news outlets were riding the breakthrough bandwagon … along with a lot of vulnerable patients, a slew of advocacy groups, a wave of medical tourism, and a fair number of doctors.

Was this misguided ripple effect avoidable? Yes. Early critics of Zamboni’s 2009 study clearly pointed out the limitations: an unblinded study of just 65 patients with subjective endpoints and lack of sham control. Zamboni himself cautioned: “The results of this pilot study warrant a subsequent randomized control study.”

But in a time where believing can take the place of knowing, and breakthroughs make better copy than caveats, Zamboni’s ‘liberation treatment’ should serve as a cautionary tale for all of us who cover new therapies; especially for diseases light on treatments, but heavy in suffering. Quite a bit is at stake.

“It would be wonderful if the media wasn’t so smitten with new breakthroughs,” says internist Adam Cifu. “Because that makes them partially responsible for boosting these therapies before they’re adequately tested.”

“Some sort of ‘breakthrough’ care that is going to make us better is what all of us find exciting. It makes patients excited and hopeful. Doctors get excited that they can help. And the media gets excited about the clicks and ratings that come with the hype. That’s exacerbated by the pressure of adopting a new idea quickly without adequate testing. Unfortunately, it’s not terribly exciting to say ‘let’s slow down, be careful, and let’s make sure that before we release a treatment that it actually works.’ But that’s exactly what we need on the front end. “

As journalists this ‘front end’ is our responsibility. Whether it be in how we frame a news release or how cautious we are in approaching breaking news.  Awareness of this — as well as awareness that medical reversals are a necessary and inevitable part of medical progress — will go a long way toward helping us do what our parents recommended to many of us: Take your time and do it right the first time. Because if you don’t, it’s a lot harder to fix further down the road.

And, yes, people can get hurt.

Categories: CASW Periscope

Smithsonian’s imbalanced stem cell coverage: Will it help dodgy clinics lure desperate patients?

HealthNewsReview.org - Tue, 12/05/2017 - 11:33am

Smithsonian Magazine’s American Ingenuity Awards aim to celebrate the “cutting edge of American achievement” by recognizing innovators in a variety of fields.

But in its zeal to honor a groundbreaking stem cell researcher, the official journal of the Smithsonian Institution may have contributed to unbalanced media coverage that often leads desperate patients and their families to seek unproven stem cell treatments.

Gary Steinberg, in a scene from a video included with the Smithsonian Magazine story. The video did not discuss any of the potential risks or study limitations.

Among this year’s award winners was Gary Steinberg, M.D., chair of neurosurgery at Stanford University Medical School. A profile of Steinberg, A Neurosurgeon’s Remarkable Plan to Treat Stroke Victims with Stem Cells, ran this month in the magazine’s online science section.

The subhead reads: “Gary Steinberg defied convention when he began implanting living cells inside the brains of patients who had suffered from a stroke.”

While Steinberg’s experimental work has been lauded in the research community, his “plan” to treat stroke victims with stem cells doesn’t amount to a proven treatment. Readers of this story might not pick up on that point.

The story focuses mainly on one patient, Sonia Coontz, who suffered a debilitating stroke at age 31 but made a remarkable recovery after undergoing Steinberg’s experimental treatment in an early-stage clinical trial.

In the story, Steinberg calls her one of his “miracle patients.”

The article describes how after Steinberg drilled a hole in her head and injected stem cells, Coontz within hours regained the ability to raise her arm over her head:

“I just started crying,” she recalls. She tried her leg, and discovered she was able to lift and hold it up. “I felt like everything was dead: my arm my leg, my brain,” she says. “And I feel like it just woke up.”    

No proven therapies for stroke patients

There’s also no warning that this trial of just 18 patients wasn’t designed to prove the effectiveness of stem cell treatments for stroke, and that a large majority of stem cell trials don’t show a benefit.

This sort of premature gee-whiz coverage can raise expectations for stem cell treatments and drive patients to unregulated clinics that offer unproven and sometimes risky procedures, as HealthNewsReview.org has chronicled.

There are no proven therapies to restore brain cells that have died from a stroke, yet plenty of unscrupulous clinics offer what they say are simple and risk-free stem cell treatments for stroke patients. The hazards of such clinics was covered in a New York Times story, A cautionary tale of stem cell tourism. These types of clinics also are operating widely in the U.S., and you don’t need to be a tourist to find them, as we discussed in the blog post Strip mall stem cells.

Tim Caulfield, a law professor and research director of the Health Law Institute at the University of Alberta, said via email:

“Given the tremendous amount of hype surrounding stem cell research, researchers and the media need to be very careful how the science is represented. This is particularly so given the emergence of clinics marketing unproven therapies. A story like this can be used by clinics to push unproven therapies.”

Paul Knoepfler, PhD, a stem cell researcher at the University of California-Davis, said of numerous stem cell trials, most yield results that are “too preliminary to come to any conclusions.”

“Digging deeper and pointing out that there are many for-profit stem cell clinics selling the idea of stem cells for stroke and who engage in hype could have added another layer of nuance and context for readers that would have be useful too,” Knoepfler said via email.

‘We don’t know why she got better’

Feeding the hype is the word “miracle,” which is included in HealthNewsReview,org’s words you shouldn’t use in medical news.

“Calling his research participants ‘miracle patients’ will only fuel public expectations,” Caulfield said. He said “with this 31-year-old we don’t know why she got better, as I’m sure the researchers would acknowledge. … Perhaps, for her, this was the natural progression.”

Knoepfler said it doesn’t seem to make sense “that stem cells could noticeably help stroke patients with severe brain damage within hours or just a day of infusion. That sounds more like a placebo effect or some kind of unusual outcome that may not be seen more generally in a larger group of patients in a randomized controlled trial.”

What the article did well

Jeanne Loring, PhD, a professor at the Scripps Research Institute who has long criticized the proliferation of unregulated stem cell clinics, called Steinberg a “good scientist.”

“Any success is remarkable in this field,” Loring said. “There’s no other recourse for people with stroke.”

She lauds the article for acknowledging that Steinberg isn’t exactly sure why stem cells appeared to “jump-start” dormant circuits in the brain.

But she would have cautioned readers at the very top that sometimes what appear to be miracle cures aren’t.

“There’s a common problem, especially today, that they (readers) don’t read to the bottom of the page, and the bottom of the page is where the reality shows up,” she said.

A more robust study is needed to determine whether the treatment actually was effective, and to its credit, the Smithsonian story does mention that a larger study is planned.

But study limitations should have been mentioned

Still, Caulfield wishes the limitations of the initial study had been emphasized. Along with its small size, the study didn’t randomize patients to treatment or a placebo. It didn’t include a control group that didn’t get the treatment, and both patients and researchers were aware that the stem cell treatment was provided.

Smithsonian isn’t the first news outlet to cover this preliminary research, which was described in a 2016 Stanford news release that led to several news stories including one in Medical Daily that HealthNewsReview.org reviewed last year.

Neither Smithsonian nor Medical Daily warned that the study was inconclusive, even though Steinberg’s straightforward caution was right there in Stanford’s news release. “This was just a single trial, and a small one,” he’s quoted saying in the release. “It was designed primarily to test the procedure’s safety.”

Avoiding single-patient anecdotes, emphasizing study limitations, and steering clear of sensational language are among HealthNewsReview.org’s tips for journalists to combat stem cell hype.

This is one more reminder that every journalist writing about stem cell research — no matter what the context — should take a close look at those guideposts.

Categories: CASW Periscope

Spotting Shady Statistics

The Open Notebook - Tue, 12/05/2017 - 8:45am

 

Volkan Olmez/Unsplash (CC0)

 

When freelance science journalist Tara Haelle first started writing about medical studies, she admits she had no clue what she was doing. She quoted press releases and read only study abstracts—practices that make most science journalists cringe. But in the spring of 2012, Haelle attended a workshop run by health journalism veterans Gary Schwitzer and Ivan Oransky at the annual conference of the Association of Health Care Journalists (AHCJ) in Atlanta. The two watchdog powerhouses—Schwitzer spearheads Health News Review and Oransky, Retraction Watch—taught Haelle and the other attendees how to catch flaws in research studies. Haelle came away from the session a new journalist. “I was like, ‘Holy crap, I’ve been doing it wrong,’ ” she says.

For years after the workshop, Haelle put those new skills into practice, poring over research studies for hours and delving deep into the thicket of their methods and results sections. Now the AHCJ Medical Studies Core Topic leader, she regularly takes down overblown or shoddy science. Some of the issues Haelle calls out involve questionable practices like excessive data mining or cherry-picking subjects—activities that likely reflect increasing pressure on scientists to produce eye-catching results.

The problem, according to Haelle and others, is that this statistical fudging has grown harder to detect. Much of it is buried in the way data are sliced and diced after the fact or put through tortured analysis in a search for significant results. The good news is that science journalists can learn to catch many of these tricks without getting a degree in biostatistics, Haelle says. “You don’t have to be able to conduct your own regression analysis to be able to look for problems.”

As journalists comb through a study’s nuts and bolts—avoiding the temptation to skim through the dense prose of the methods and results sections—they should also look out for specific red flags.

Data Dredging

One of the more common ways researchers might try to tweak their results is by a practice known as p-hacking, which entails mining a dataset until you get a finding that passes the bar of statistical significance. This is determined by a p-value—a measure of how unexpected a finding is, if in fact a researcher’s hypothesis was wrong. (Most scientific fields consider a p-value of less than .05 statistically significant.)

P-hacking takes advantage of the flexibility researchers have to massage their data after it has already been collected, according to biostatistician Susan Wei at the University of Minnesota. In most research studies, researchers must make judgment calls about which of several analytical approaches to use, says Wei. She notes that you could give the same dataset to five statisticians, and each would come up with a different result. “Data analysis is not quite a science,” she says. “There’s a bit more art to it.” (more…)

Categories: CASW Periscope

Headline vs. study: The unbearable heaviness of false hope

HealthNewsReview.org - Mon, 12/04/2017 - 7:00am

Here’s a perfect storm.

Take several common diseases that affect millions of people —  like antibiotic-resistant infections, Alzheimer’s disease, major depression and bipolar disease —  and then write headlines about recent (or old!) studies on these illnesses that hint at hope.

But then, in the ensuing article, don’t give your readers evidence to support your hopeful headline.

What is that? Irresponsible? Unethical? Or just sloppy journalism?

Regardless of what you call it, it’s such a pervasive problem that we see it daily. Especially with news releases.

One of our primary motivations in regularly publishing “Headline vs Study” is to get reporters and PR writers to stop and ask themselves: Is this headline accurate or is it offering misinformation or — worse yet — false hope?

Here’s a look at some headlines going back to October 31st, many of which walk that fine line of offering false hope to some understandably vulnerable people.

News RELEASE report card: 6 of 13 (46%) headlines overstate evidence (we list three examples below)

Headline: Scientists make significant breakthrough on superbug-killing antibiotic teixobactin

Study: No human research = no “breakthrough.” Period.

Our review: “Only a fraction of a percent of experimental drugs that produce positive laboratory test results survive the hurdles of animal and human testing. Especially when the need is so great, as is the case with antibiotic resistant infections, news releases should not proclaim success prematurely.”

Headline: Using Radar to Make Breast Surgery Easier for Women

Study: There is no study here. It’s worth noting that the manufacturers of the radar device — called the ‘Savi Scout’ — got FDA approval for commercial sales three years ago, but were not required to conduct clinical trials to assess safety and efficacy. This is not an uncommon practice, and worrisome enough that we’ve written this primer: “Why ‘approved’ medical devices in the US may not be safe or effective.”

Our review: Theoretically, this is a promising technology that could save time, money, and patient discomfort when compared to the existing method for marking tumors … which involves placing a wire marker under ultrasound. But theoretically doesn’t cut it. More rigorous studies are needed. Until then, headlines which make promises without supporting evidence are premature.

Headline: Simple Electrocardiogram Can Determine Whether a Patient Has Major Depression or Bipolar Disorder, Study Finds

Study: The study measured heart rate variability and inflammatory biomarkers. It did not prove such parameters could predict these two common mental illnesses, as the headline suggests.

Our review: Using language such as “groundbreaking” or “major breakthrough in psychiatric and primary care practices” — and not backing it up with data — is reckless. Especially when discussing very preliminary findings (with significant limitations) related to two diseases that affect millions of people who are understandably eager for new information.

News STORY report card: 4 of 13 (30%) headlines overstate study evidence (we list two examples below)

Headline: Blood From Young People Safe and Just Might Help Alzheimer’s Patients

Study: The results of this small, observational “proof of concept” study ended up as an abstract at a meeting earlier this month. It has not not been peer-reviewed or published. The research question: Do these infusions improve the mental functioning of Alzheimer’s patients? The findings: They don’t.

Our review: “The study has less than a dozen participants. There was no measurable data …  its ‘conclusions’ are basically the observations/opinion of caregivers as to changes in these patients … the beginning of ‘real’ clinical trials is at least a year off and there’s no guarantee that they will take place.”

Headline: Blood Thinners May Also Protect Brains of A-Fib Patients

Study: An observational cohort study that cannot prove that anticoagulant use reduces the risk of dementia. [See our primer on the limitations of observational studies]

Our review: “The story uses inappropriate language throughout, including in the headline and lead sentence, to suggest a cause-and-effect relationship between anticoagulants and dementia.” Reviewers found this sentence …”New research suggests they [blood thinners] help prevent dementia as well as stroke” … to be completely unwarranted given the study design.

You can find more from our Headline vs. Study series HERE

Categories: CASW Periscope

HIV ‘cure’ based on one patient? Here’s what you need to know

HealthNewsReview.org - Fri, 12/01/2017 - 3:05pm

“Cure” is one of the seven words we think you should avoid in health care journalism.

Stories from The Guardian and other news outlets demonstrate why this term shouldn’t be thrown around carelessly.

Their blaring headlines today raise hope that a cancer drug could “cure” HIV infection — a global scourge affecting millions.

But this potential cure is based on results from just a single man whose reservoir of dormant HIV-infected cells went down after treatment with the cancer drug nivolumab.

Further down in the story we learn that this man has only been followed for about four months, and there’s no telling if his reservoir of infected cells might increase again.

We also learn that a second man with HIV saw no benefit from the drug.

Then the only quoted source who’s not affiliated with the study says that “talks of cure are premature.”

One thing we don’t learn from The Guardian story is this: three out of the seven study authors have received payments from Bristol Myers Squibb, which makes nivolumab.

Today is World AIDS Day, a day when the global community is urged to show support for people living with HIV.

Hyped headlines touting a possible cure based on one patient aren’t supportive of patients at all. They tease false hope that ultimately can hurt the people who are suffering.

Let’s be clear: this was an intriguing and possibly important observation about one man’s lab test results — the headlines should have stuck to that.

There will be plenty of time to praise a “cure” — if that’s what it turns out to be — once the evidence is in.

Categories: CASW Periscope

Entries for this year’s Science in Society Journalism Awards are open

National Association of Science Writers - Fri, 12/01/2017 - 2:00pm

Entries for the 2018 Science in Society Journalism Awards are open, and this year's contest features a new category. With cash prizes, no entry fees for members, and submissions open to members and non-members alike, we hope that you enter your best work from this year and encourage your colleagues to enter, too. Entries close Feb. 1, 2018.

Article type: Grants & awardsArticle topic: NASW newsScience in Society awards
Categories: CASW Periscope

Four health policy stories to watch in 2018

HealthNewsReview.org - Thu, 11/30/2017 - 11:55am

With Thanksgiving in the rear view mirror and the new year on the horizon, it’s not too soon to look forward to reporting on health care stories in 2018.

In the world of health policy, the fate of the Affordable Care Act and one of its key provisions – the individual mandate — will likely continue to dominate headlines for the foreseeable future. But that doesn’t mean it’s the only policy story worth paying attention to. If you’re looking for a fresh angle on a health policy story, we’ve got you covered: Check out Trudy Lieberman’s recent take on hospital stories, or read on to learn about four more health policy stories that are worth keeping tabs on in the coming year.

How policy is shaping the opioid epidemic

A lot of news coverage has been given to the opioid epidemic in America over the past few years, but relatively little of that reporting has examined policy-level interventions. German Lopez at Vox recently looked at one of the states that is taking the opioid epidemic seriously: Vermont. Lopez explored the successes and failures of the state, which legislated a “hub and spoke” model of addiction treatment in 2012. Five years later, Vermont has an overdose death rate that is lower than the regional and national average, and has shorter wait times for people to get into treatment. Lopez reported that the success of the Vermont program, which takes an integrative approach to care, is prompting other states including California and Washington to consider similar interventions. At a time when it can seem hard to find a fresh angle on the opioid crisis, the impacts of these new policies may be worth examining.

The biggest policy debate you haven’t heard of

There’s a war happening between two of the biggest players in the health care world: the pharmaceutical industry and the hospital industry. As David Pittman of Politico recently reported, they’re fighting tooth and nail over an obscure law, more than two decades old, which could substantially change the price of prescription drugs for hospitals in low-income communities. The 340B Drug Pricing Program, started in 1992, requires drug makers to give substantial discounts to hospitals and health clinics serving low-income populations. Yet now pharmaceutical companies (with the backing of the Trump administration), contend that hospitals are taking advantage of this program and pocketing extra cash.

In mid-November, the Centers for Medicare & Medicaid Services (CMS) issued a ruling in favor of the pharmaceutical companies, calling for substantially lower hospital reimbursements next year. But the fight isn’t over yet: hospital advocacy groups, including the American Hospital Association (AHA), have already filed an injunction against the ruling. Expect this legal battle to continue into the New Year, and follow it closely: this could have major impact on low-income communities across the country

Regulating CRISPR embryos

This past summer, I wrote about Shoukhrat Mitalipov, PhD and his team at Oregon Health and Science University, reportedly the first lab in America to use the CRISPR-Cas9 system to edit the genes of human embryos.(CRISPR is short for “Clustered Regularly Interspaced Short Palindromic Repeat.”) While human embryos have been genetically modified in China since 2015, Mitlipov and his team used a more precise method of human germline engineering to fix an embryonic mutation that can lead to hypertrophic cardiomyopathy, an inherited heart disease, later in life. Some scientists rejoiced at this feat of genetic manipulation, while others pointed out that US policy may be unequipped to deal with new advances in embryo editing. More than 20 countries around the world have an outright legal ban on human germline editing, while still others have suggested that bans be put in place. But the United States is a special case: although human embryo editing is regulated by the FDA and NIH, there is no law against it. Mitalipov’s breakthrough has caused some scientists to worry that without a policy change, editing of human embryos in America could get out of hand. Ethics aside, it will be interesting to watch if and how the United States decides to deal with this scientific advance, and whether or not the policies surrounding human embryo editing will change.

Will Amazon be the new pharmacy giant?

Let’s wrap things up with some juicy speculation. For the past few months, the Internet has been abuzz with reports that the online retail giant is going to shake up the pharmaceutical industry. Rumors started this past summer after Amazon acquired Whole Foods, and past employees have been quoted as saying that an expansion into the pharmacy business is likely. In addition, last month it was revealed that Amazon received approval for wholesale pharmacy licenses in at least 12 states.

The rumors may lead nowhere. But analysts say the online powerhouse has the potential to profoundly disrupt the current pharmacy system—possibly fostering more price competition on drugs. The mere threat of Amazon entering the arena caused drugstore stocks to fall at the end of October. There are several ways that Amazon could enter the pharmacy business, including as a mail-order pharmacy, as a pharmacy benefits manager, or a provider of specialized services to doctors. Although whether or not Amazon will join the pharmacy business is still up in the air, the implications of such a move make this a crucial health economy story to watch unfold in the coming months.

Do you have another tip for health policy stories to watch? Mention it below in the comments.

Categories: CASW Periscope

From ScienceWriters: Bringing PIO skills to Ethiopia

National Association of Science Writers - Thu, 11/30/2017 - 10:14am

In January, an invitation to speak at a public-health workshop in Ethiopia arrived in Emily Caldwell's email inbox. The presentation topic was vaguely described as "health communication." Caldwell was thrilled to accept.

Article type: ScienceWriters magazineArticle topic: Science writing news
Categories: CASW Periscope

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