March 24th, 2011 by GarySchwitzer in Opinion
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Maggie Mahar’s Health Beat blog tipped me off about a Bloomberg opinion piece by an Oregon urologist that begins by stating:
“The decision to opt for medical care that relies on the most costly technology is often based on blind faith that newer, elaborate and expensive must be better.”
Later, he focuses specifically on robotic surgery devices:
“They are costly and require significant re-training for surgeons. Yet consumers hungrily seek out surgeons versed in their use. If a surgeon recommends an older, less expensive technology, many patients will shop for a surgeon willing to use the newest and costliest devices, even if the added benefits are unproven and the risks may be greater.
Hospitals do nothing to discourage this and engage in the kind of tawdry marketing more familiar on late-night infomercials by using patient testimonials. “I cannot believe how quickly I recovered,” a vigorous-looking patient is quoted as saying.
As a surgeon I have to ask: Where is the data? Was the recovery any quicker than in a procedure done without a robot? Would another surgical approach have served the patient as well? And cost a lot less?
…
We are all keepers of the health-care system treasury. In making treatment choices, physicians and patients alike would do well to ask: “If I were paying for this out of my own pocket would I choose this treatment, or am I just being wowed by the cool factor at someone else’s expense?”
In the first decade of practice I was enthralled with the amazing new technology. Moving into my second decade I hope to temper some of that enthusiasm with a bit of good old-fashioned fiscal responsibility.”
It should be noted that the urologist/author discloses in the editorial that he is is founder of a medical device company with its own surgical system.
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
March 18th, 2011 by GarySchwitzer in News, Opinion
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A new post on the Embargo Watch blog, “The power of the press release: A tale of two fish oil-chemotherapy studies,” addresses an issue that had me running around in circles for hours last week.
Some news organizations were reporting on a paper in the journal Cancer, reporting that it had been published in that day’s online edition.
But it hadn’t been – not when the stories were published.
Instead, all I could find was a study by the same authors on the same topic that had been published in the same journal two weeks prior.
What apparently happened, as Embargo Watch surmises as well, is that many journalists simply covered what was in the journal’s news release – not what had already been published two weeks prior – which was a more impressive article. And they rushed to publish before the new study had even been posted online – all over a very short-term study in a small number of people. Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
March 14th, 2011 by GarySchwitzer in News, Research
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Here we go again. Headlines across America blaring lines like, “Coffee may reduce stroke risk.”
It was a big study, but an observational study. Not a trial. Not an experiment. And, as we say so many times on this website that you could almost join along with the chorus, observational studies have inherent limitations that should always be mentioned in stories. They can’t prove cause and effect. They can show a strong statistical association, but they can’t prove cause and effect. So you can’t prove benefit or risk reduction. And stories should say that.
USA Today, for example, did not explain that in its story. Nor did it include any of the limitations that were included in, for example, a HealthDay story, which stated:
“The problem with this type of study is that there are too many factors unaccounted for and association does not prove causality, said Dr. Larry B. Goldstein, director of the Duke Stroke Center at Duke University Medical Center.
“Subjects were asked about their past coffee consumption in a questionnaire and then followed over time. There is no way to know if they changed their behavior,” Goldstein said.
And, he noted, there was no control for medication use or other potential but unmeasured factors.
“The study is restricted to a Scandinavian population, and it is not clear, even if there is a relationship, that it would be present in more diverse populations. I think that it can be concluded, at least in this population, that there was not an increased risk of stroke among coffee drinkers,” he said.”
When you don’t explain the limitations of observational studies — and/or when you imply that cause and effect has been established — you lose credibility with some readers. And you should. Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
March 8th, 2011 by GarySchwitzer in News, Opinion, Research
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We’re delighted to see that USA Today, Reuters, and WebMD were among the news organizations that included what an editorial writer said about an observational study linking ibuprofen use with fewer cases of Parkinson’s disease. All three news organizations used some version of what editorial writer Dr. James Bower of the Mayo Clinic wrote or said:
“Whenever in epidemiology you find an association, that does not mean causation.”
“An association does not prove causation.”
“There could be other explanations for the ibuprofen-Parkinson’s connection.”
Kudos to those news organizations. And some praise goes to the journal Neurology for publishing Dr. Bower’s editorial to accompany the study. His piece is entitled, “Is the answer for Parkinson disease already in the medicine cabinet? Unfortunately not.”
And unfortunately not all news organizations got that message. Because many don’t read the journals, so they certainly never get to the editorials. Instead, they rewrite quick hits off a wire service story. As a result, we end up with some of the following:
A FoxNews.com story was particularly deaf to Bower’s caveat, stating: “That bottle of ibuprofen in your medicine cabinet is more powerful than you may think.”
A CBSNews.com story never addressed the observational study limitation, instead whimsically writing: “Pop a pill to prevent Parkinson’s disease? A new study says it’s possible, and the pill in question isn’t some experimental marvel that’s still years away from drugstore shelves. It’s plain old ibuprofen.” Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
March 2nd, 2011 by GarySchwitzer in Better Health Network, Opinion
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Dr. Barron Lerner has written a book about breast cancer: “The Breast Cancer Wars: Hope, Fear, and the Pursuit of a Cure in Twentieth-Century America.” And he’s written a book about celebrity patients: “When Illness Goes Public: Celebrity Patients and How We Look at Medicine.” He wed the two topics in a blog post on the New York Times health blog entitled “Suzanne Somers, Cancer Expert.” Excerpts:
“Earlier this week, NBC’s “Dateline” devoted an entire hour on Sunday evening to allow the actress Suzanne Somers to express her rather unconventional beliefs about cancer.
It is not the first time a major media outlet has given air time to Ms. Somers, whose journey into the medical realm has been featured on a variety of news programs, talk shows and entertainment channels. A few years ago, Oprah Winfrey invited Ms. Somers on her show to share the secrets behind her youthful appearance — a complex regimen of unregulated hormone creams and some 60 vitamins and supplements.
But is it entirely outrageous that respected media organizations continue to give the “Three’s Company” sitcom star a platform to dispense medical advice? Not really, in a world in which celebrities have become among the most recognizable spokespeople — and sometimes experts — about various diseases.
…
…patients — especially those who want to explore every possible avenue — have the right to know that there are unorthodox cancer therapies that some people believe are helpful.
But not without several caveats, and that is where Ms. Somers, and many of those in the media who discuss her books and views, have failed. Ms. Somers says she is promoting hope, but false hope benefits no one.
Many people with end-stage cancer are, understandably, desperate, and thus potentially vulnerable to a sales pitch — even an expensive one. But here is a case when an informed patient may truly be a wiser patient. Perhaps if doctors were more willing to address the fact that these nontraditional treatments exist, and share what we do and don’t know about their effectiveness, an actress like Ms. Somers would have less influence, and science would override celebrity.”
There’s been quite an online response to Dr. Lerner’s blog post. One reader wrote, succinctly:
“From Thigh Master to Snake Oil.”
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
