When the Public Media Confuses You …

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Let’s begin with two video clips.

When Fox and CNN cover the same topic in the same tone, the conclusion appears solid. However, here’s the puzzle: if Avandia is so dangerous, why is the FDA divided in pulling it off?

The answer is simple: available evidence is mixed. For example, Nissen’s meta-analyses at NEJM were seriously challenged in both medical and statistical literature and the way of interpreting significance was heavily criticized. As new evidence emerges, proper assessment requires further effort. That’s why another committee meeting was just held but the opinion was still divided.

The extreme one-sidedness of these video clips is striking. They have drawn a well-settled conclusion for a highly controversial issue, not only misleading lay consumers, but also doing harm to the FDA’s reputation (not committed to public health) and fairness (potentially driving towards overly safety-conservative decisions).

This is not the only case of media’s failure regarding accurate health information. A recent study shows the worrisome quality of the news coverage on the warning of the suicidal risk with pediatric antidepressant use, which largely misses several key messages (importance of monitoring, etc.).

Public media is generally more trusted than manufacture’s commercial, but the latter alone is rigorously regulated (e.g., by DDMAC). All stakeholders (e.g., PhRMA/DIA/FDA) should urge the Congress/state legislators to regulate public media to ensure balanced healthcare information (constitutional as exceptions to the First Amendment). This is not only beneficial to the public, but also rewarding to responsible media (examples set by the following).

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3 Responses to “When the Public Media Confuses You …”

  1. kwl4 Says:

    As a family physician and health care journalist, I have mixed feelings about your proposal to increase oversight / regulation of health care journalist. First, who will serve as the arbiter of whether or not a health-related story is “fair and balanced”? That person (or persons) will be subject to intense lobbying from industry, patient advocacy groups, etc. and, unless rendered immune from political maneuvering (like the Federal Reserve) will have a hard time remaining objective and keeping his or her job. Also, there can be considerable scientific disagreement regarding an issue such as the safety of Avandia, which is one of many drugs used to treat diabetes and easily substituted for by its competitior, Actos, which has a less muddled safety record. Rather than threatening medical journalists with regulation that will have an uncertain effect on the “truthfulness” of news stories, I’d advocate making more people aware of independent organizations that evaluate the quality of these stories, such as http://www.healthnewsreview.org/

  2. snaurec Says:

    I think that the discussion regarding benefits and risks of Avandia (and any other drug for that matter) should be left to the experts in FDA. The interpretation of medical and statistical evidence is very complex and requires high level of expertise. The majority of conclusions regarding the safety of the drug are made after pre-marketing clinical trials are completed. Here, the patients receiving the drug are quite uniform with respect to age and their medical histories. The data from clinical trials are then submitted to the FDA and used by this agency to either approve or reject the drug. Some safety aspects of the drug emerge only after it is marketed and used by highly heterogeneous population of the patients. This additional safety data is used by drug makers to update the labels available to physicians and patients. FDA also carefully monitors safety of new drugs and is aware of adverse events reported by patients or physicians. One significant improvement in this area could be mandatory report of adverse events by physicians to the FDA. As of now, this reporting is voluntary and results in fluctuations in reporting, quite often influenced by the media.

    The media’s involvement and its extreme one-sidedness in the early stages of investigations just confuses the public and medical professionals. As a result, a panic is created; the patients switch from the drug in question and quite often may deprive themselves from the benefits of this medication.

  3. gingershu Says:

    I think the media should NOT be given a blank cheque that says it’s okay for them to report anything they want with impunity under the guise of freedom of the press. They should be held accountable when they misinform the public – especially when it is done in the process of catering to the interests of particular individuals, groups of persons or political parties. Sensationalism is another problem when the media feel they need to hijack the attention (and fears) of the public.

    The medical community also has a responsibility to talk to the media and communicate with them in a constructive, interactive manner. When the medical professional itself is divided on certain issues and clinical investigations seem to yield mixed, inconclusive results, the media should report this in an impartial, rational manner.

    A stark example of when the media becomes the mouthpiece of unscrupulous politicians is during the H1N1 scare last year. In Taiwan, TV stations affiliated with the opposition party spread rumor sand insinuations, via call-in talk shows, that the H1N1 vaccines are unsafe and have caused numerous deaths – clearly targetting the government’s vaccination program just because of different politican standings. Such irresponsible behavior continue to go unchecked in the name of “freedom of speech”.

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