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National Institutes of Health
NLM Director’s Comments Transcript
Towards More Thoughtful Health
Greetings from the National Library of Medicine and MedlinePlus.gov
Regards to all our listeners!
I'm Rob Logan, Ph.D. senior staff National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.
I’m Rob Logan, Ph.D., senior staff, U.S. National Library of Medicine, for Donald Lindberg, M.D, the Director of the National Library of Medicine.
Here is what’s new this week in MedlinePlus.
It takes skepticism and skill to be a thoughtful health reporter, said two veteran medical journalists and an often-quoted physician in separate sessions at the recent Association of Health Care Journalists meeting in Denver, CO.
Gary Schwitzer, publisher of HealthNewsReview.org and Ivan Oransky M.D., global editorial director of MedPage, told 200 journalists they need to understand and be more skeptical of research based on surrogate measures - especially when researchers imply the findings are linked to broader health outcomes that the immediate study did not assess.
For example, Schwitzer noted research about medications that reduce high blood cholesterol may be important, but sometimes the findings are depicted by researchers as linked to a more fundamental medical outcome – a reduced risk of heart disease and heart attacks.
While Schwitzer acknowledged it is important for journalists to report the broader implications of research findings, he explained health reporters should be more skeptical when the findings of a surrogate study are interpreted as possible evidence of a risk reduction for other diseases or conditions.
In addition, Schwitzer said more health journalists should explain whether research findings are derived from an early or advanced phase of a clinical trial. Schwitzer added health journalists should avoid reporting primarily based on one attributed source. He told about 200 of his peers (and we quote) ‘single source stories are (journalistic) malpractice’ (end of quote).
Similarly, Dr. Oransky warned health journalists not to rely on press releases as a foundation for health news stories. Instead, Oransky asked health reporters to derive research information from the original published article.
Returning to Schwitzer’s prior suggestion to carefully distinguish between immediate research findings and their implications, Oransky, a physician and news editor, urged health journalists to read the section within a refereed journal article where researchers detail a study’s limitations. Oransky added the limitations of the findings often are insightful and they rarely are included in the press release about a study.
Oransky and Schwitzer also suggested their peers report the degree of quantitative sophistication that undergirds a study’s findings. Oransky reminded the audience systematic reviews, comparative effectiveness research, and meta-analyses represent the most rigorous statistical evidence, while individual studies often are less empirically comprehensive or authoritative.
In a separate luncheon address, Paul Offit M.D., University of Pennsylvania School of Medicine, chided some recent attempts to balance news stories about vaccine safety. He told a packed ballroom of health reporters (and we quote) ‘You tell two sides of the story when only one side is supported by evidence’ (end of quote).
With good humor, Dr. Offit provided some examples where interviewees questioned the safety of an unapproved meningitis B vaccine used by several U.S. college campuses to thwart a prior outbreak of meningitis B.
Offit explained Princeton, the U. of California-Santa Barbara, and other universities recently used an imported vaccine to prevent the campus spread of meningitis B. He said an imported vaccine was needed because the U.S. Food and Drug Administration (FDA) has not approved a meningitis B vaccine for use in the U.S.
While Offit noted it was appropriate to report the recommended vaccine was not approved by the FDA, he emphasized the news sources critical of the vaccine had little to no evidence to raise concerns and frighten students and their families. Conversely, Offit (a pediatrician who advocated the vaccine’s use) said both he and the vaccine’s defenders provided comprehensive clinical evidence about the medication’s effectiveness and dearth of side effects.
At minimum, Offit said the reporting about the meningitis B vaccine should have noted the abundance of clinical evidence and scientific principles that buttressed claims about its safety and efficacy compared to the scarcity of evidence available to its critics.
Offit added a balancing of stories (without insights about evidence) causes harm when the impending risk to patients and the public is inaction. He noted some recent deaths from meningitis B on college campuses were preventable and cases may have occurred because some students were uneasy about the safety of an unapproved vaccine.
Full disclosure: I spoke at the Association of Health Care Journalists (AHCJ) meeting about using NLM’s consumer health websites. AHCJ also annually selects six journalists to spend four days at NLM to learn how to better use MedlinePlus as well as some of our other health information services. I look forward to hosting the AHCJ-NLM Journalism Fellowship program that occurs in the early fall.
Otherwise, even if you are not a medical journalist or health care provider, MedlinePlus.gov provides a convenient gateway to help you understand medical research, which is available in the understanding medical research health topic page.
For example, the National Institutes of Health provides a website that explains the occasional differences between news headlines and actual health risks within the ‘start here’ section of MedlinePlus.gov’s understanding medical research health topic page. A consumer guide to reading and gleaning useful information from medical research papers is provided in the ‘overviews’ section of MedlinePlus.gov’s understanding medical research health topic page.
You can sign up to receive updates about understanding medical research as they become available on MedlinePlus.gov.
To find MedlinePlus.gov’s understanding medical research health topic page type ‘understanding medical research’ in the search box on MedlinePlus.gov’s home page, then, click on ‘understanding medical research (National Library of Medicine).’ MedlinePlus.gov also has a health topic page on evaluating health information.
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It was nice to be with you. I look forward to meeting you here next week.