I was very sad and quite angry after watching a powerful video this weekend entitled “The Faces of Medical Error: From Tears to Transparency.” It’s the story of Michael Skolnik. His mother, Patty, gave me the video when I met her recently. Michael had what may have been unnecessary brain surgery in 2001 and died three years later.
The Skolniks worked on this video as part of an educational campaign on medical error, and they created an organization now named Citizens for Patient Safety. Here’s a trailer to the video:
You can also watch a Today Show segment that profiled the Skolniks from a few years ago:
While much of the message is about medical errors and malpractice, the Skolniks also promote a message of the “critical need for shared decision-making.” In fact, I met Patty at a shared decision-making conference.
If you haven’t heard Michael Skolnik’s story, you should. And if you’re like me, you’ll need a tissue box close by for the sadness, and something else to help with the ensuing anger.
Thanks to Patty Skolnik for sharing the story and the video with me.
One of the things that makes evaluating medical evidence difficult is knowing whether what’s being published actually reflects reality. Are the studies we read a good representation of scientific truth, or are they full of cherry-picked data that help sell drugs or skew policy decisions?
That question may sound like that of a paranoiac, but rest assured, it’s not. Researchers have worried about a “positive publication bias” for decades. The idea is that studies showing an effect of a particular drug or procedure are more likely to be published. In 2008, for example, a group of researchers published a New England Journal of Medicine study showing that nearly all — or 94 percent — of published studies of antidepressants used by the FDA to make approval decisions had positive results. But the researchers found that when the FDA included unpublished studies, only about half — or 51 percent — were positive.
A PLoS Medicine study published that same year found similar results for studies long after drugs were approved: Less than half — 43 percent — of studies used by the FDA to approve 90 drugs were published within five years of approval. It was those with positive results that were more likely in journals.
All of that can leave the impression that something may work better than it really does. And there is at least one powerful incentive for journals to publish positive studies: Drug and device makers are much more likely to buy reprints of such reports. Such reprints are highly lucrative for journals. Read more »
I’ve written a few times about Veneta Masson, a nurse practitioner who wrote in Health Affairs and the Washington Post about her decision to forego further mammograms despite the fact that she was in a higher-risk category.
Veneta is also a poet. She sent me a video animation of her poem “Reference Range,” which I’m pleased to share with you. I think the poem and the video are beautiful, touching on important issues of how meaningless numbers and scores may be, subject to misinterpretation. She writes:
Reuters Health reports that more than a quarter of Americans taking antidepressants have never been diagnosed with any of the conditions the drugs are typically used to treat, according to new research published in the Journal of Clinical Psychiatry. An excerpt:
“We cannot be sure that the risks and side effects of antidepressants are worth the benefit of taking them for people who do not meet criteria for major depression,” said Jina Pagura, a psychologist and currently a medical student at the University of Manitoba in Canada, who worked on the study.
“These individuals are likely approaching their physicians with concerns that may be related to depression, and could include symptoms like trouble sleeping, poor mood, difficulties in relationships, etc.,” she added in an e-mail to Reuters Health. “Although an antidepressant might help with these issues, the problems may also go away on their own with time, or might be more amenable to counseling or psychotherapy.”
I have gushed praise for the Milwaukee Journal Sentinel for a long time. (Disclosure: I cut my teeth in journalism as a Journal Company employee way back in 1973. No ties since 1976.) As a mid-market newspaper facing all of the same hurdles as other newspapers, it consistently demonstrates tenacity and creativity in tackling vital healthcare issues in this country. The latest: A project called “Empty Cradles: Confronting Our Infant Mortality Crisis.”
While there is a great health/medicine/science team in place at the Journal Sentinel, I believe that much of the credit goes to the top — to editor Marty Kaiser, who clearly understands that healthcare issues are among the most important his paper can report on in serving public needs. Kaiser writes:
“The Journal Sentinel today takes on an issue we have too long ignored — the death of children before their first birthday. Infant mortality is a crisis not just of public health, but of ethics and morality. The rate at which infants die in our city is unacceptable. In 2011 we will examine the problem and point to solutions.”
The project is off to a great start, taking a global picture and focusing it locally. Read more »
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I have gushed praise for the Milwaukee Journal Sentinel for a long time. (Disclosure: I cut my teeth in journalism as a Journal Company employee way back in 1973. No ties since 1976.) As a mid-market newspaper facing all of the same hurdles as other newspapers, it consistently demonstrates tenacity and creativity in tackling vital healthcare issues in this country. The latest: A project called “
