Map of life expectancy at birth from Global Education Project.

Thursday, May 29, 2008

Another Open Door Crashed Through

Gary Schwitzer in PLoS Medicine:

  • The daily delivery of news stories about new treatments, tests, products, and procedures may have a profound—and perhaps harmful—impact on health care consumers.
  • A US Web site project, (, modeled after similar efforts in Australia and Canada, evaluates and grades health news coverage, notifying journalists of their grades.
  • After almost two years and 500 stories, the project has found that journalists usually fail to discuss costs, the quality of the evidence, the existence of alternative options, and the absolute magnitude of potential benefits and harms.

Most health "journalists" base their stories on press releases from researchers, drug companies, and medical device manufacturers. They are caught up in the heroic mythology of medicine, and get all breathless and excited about dramatic breakthroughs and world changing advances. The fact is that medicine advances incrementally, and the vast majority of what happens on the cutting edge offers a little bit of benefit, and a lot of side effects and risks, for a lot of cost. True breakthroughs that offer a big ratio of benefit to risk at reasonable cost don't happen very often, and they generally can be seen only in hindsight, as the result of the accumulation of a lot of pieces of knowledge and technique.

The polio vaccine, which suddenly and cheaply eliminated a great scourge, provided an enduring template for how the culture views medical research. That was more than 50 years ago and I can't think offhand of anything comparable that has happened since then. (Correct me if I'm wrong. Vaccines for measles, mumps and so on are nice, but those diseases didn't compare to polio in their impact.) But reporters are still seeing its ghost.

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