Quality of health news reporting found lacking

Incomplete articles about new treatments can mislead patients and waste valuable time in the exam room, physicians say.

By Kevin B. O’Reilly — Posted May 9, 2011

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Articles in the most-read American news outlets usually fail to adequately discuss the pros and cons of new medical treatments, tests, products and procedures, according to an analysis of nearly 1,500 health stories from the last five years.

The finding is based on reviews done by a panel of more than 30 physicians, scientists, public health researchers, medical journalists and other experts affiliated with the website, which marked its fifth anniversary in April. Less than 30% of stories explicitly discussed the cost of new treatments, and only about one-third adequately covered their benefits and harms or addressed the quality of the medical evidence offered in their support.

"On most days, on most stories, we're giving a kid-in-the-candy-store view where we're making everything look terrific without noting the downside or noting the price tag," said Gary Schwitzer, a former TV news reporter and publisher of "And we wonder why we have a confused health care consumer population?"

Schwitzer, who headed CNN's medical news unit and was founding editor of the Mayo Clinic's patient website, started to encourage better reporting and help patients and physicians. The project is funded by the Boston-based Foundation for Informed Medical Decision Making, a nonprofit that develops materials to help patients and doctors evaluate treatment options.

"Our end game is not just the improvement of journalism, but improvement of the flow of information for consumers," Schwitzer said. "I'm extremely sensitive to the plight of the physician today who has to deal with patients coming in waving news articles that are a waste of both of their times." performs a valuable function, said Anthony G. Alessi, MD, a Norwich, Conn., neurologist and sports medicine specialist.

"There is a huge need for independent review, especially where the media's concerned," said Dr. Alessi, who hosts a weekly call-in radio show, "Healthy Rounds," on Hartford, Conn., radio station WTIC. "There are lots of things we debunk that are based on inadequate testing and marginal results that they are really touting to be a lot better. The media needs to review these darn things and not let these people do this infomercial thing."

Critical review

Twenty-one leading news outlets, such as USA Today, The New York Times and the websites of National Public Radio and CNN, are checked each weekday for articles that cover new medical treatments. Three of the panelists judge the story on how well it meets 10 criteria, such as disclosing expert sources' conflicts of interest and avoiding the use of a news release as the major information source. Stories are graded on a one- to five-star scale, with satisfaction of any two criteria worth one star. The reviews are emailed to the reporters who wrote the articles.

By this fall, Schwitzer and his colleagues hope to introduce a tool to let users see how news outlets' grades have fared over time. The site that inspired, Media Doctor Australia, already offers such a feature.

The reasons why journalists do not reliably deliver high-quality health reporting are myriad, Schwitzer said. Many reporters have little training on how to interpret medical research, face implicit pressure to sensationalize stories, work on short deadlines, have limited space and time for their articles, and devote only a portion of their workday to covering health care. But Schwitzer sees signs of hope.

About 50 journalists at an April meeting of health reporters told Schwitzer that they follow and refer to the site's criteria when researching and writing stories. The site's traffic has risen from about 1,000 unique daily visitors in 2009 to 5,000 in April. Also, the site recently added a 14-part tool kit to help journalists improve their reporting.

Misinformed medical journalism cannot only lead to fruitless discussions in the exam room, but can alarm patients unnecessarily. Several years ago, a patient of Minneapolis family physician Jon S. Hallberg, MD, became highly anxious because of an article he read in a men's magazine that described the conditions that could be uncovered by a full-body computed tomography scan.

"He was shaking like a leaf when he went to see me," said Dr. Hallberg, who contributes regularly as a medical expert on Minnesota Public Radio. "I had to talk him down. His health for a few weeks was worse just from reading a magazine article."

The American College of Radiology recommends against whole-body CTs for asymptomatic patients due to the unnecessary risk of false positives. Though physicians have the ability to access and understand the medical literature, the same is not true for patients, Schwitzer said.

"That's where the biggest harm occurs in the current state of medical journalism," he said. "It's essentially the only source of information the lay public has -- what they see in the media, in print, online and over the airwaves."

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Grading the news

The expert panel that critiques news articles for judges them on the following 10 criteria. According to the site, stories about new medical treatments, tests, products and procedures should:

  • Discuss the availability of the intervention, such as whether it has been approved by the Food and Drug Administration.
  • Cover the costs of the intervention and how that compares with other available treatments.
  • Steer clear of medicalizing minor problems or exaggerating the prevalence of a condition.
  • Explain the clinical evidence supporting the intervention and any research limitations.
  • Cover the likelihood and severity of potential harm associated with the intervention.
  • Explain what is novel about the intervention and how it differs from what is available.
  • Explain how the intervention benefits patients in quantitative terms such as the absolute risk reduction or the number of patients needed to treat.
  • Avoid relying on a news release as the major source of information.
  • Include independent experts and disclose sources' conflicts of interest.
  • Mention alternative methods of treating the condition and how effective they are in comparison.

Source: "About Us: Review Criteria," (link)

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External links

"Observations after 5 years and 1,500 stories on," Gary Schwitzer's HealthNewsReview Blog, April 18 (link)

"Comparison of our media sources," Media Doctor Australia (link)

"The State of Health Journalism in the U.S.," Kaiser Family Foundation, March 2009 (link)

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