Covering Cancer Treatments: Tricks of the Trade
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Transcript of Covering Cancer Treatments: Tricks of the Trade
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Covering Cancer Treatment:Tricks of the Trade
Ivan Oransky, MDExecutive Editor, Reuters Health
Cancer Research in the MediaInter-American Workshop for Scientific Journalism
Guadalajara, MexicoNovember 8, 2011
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How Good is the Study?• Keep yesterday’s criteria in mind:– Peer-reviewed?– Published? Where?
• Was it in humans?– It’s remarkable there are any mice left with
cancer, depression, or restless leg syndrome
• Size matters
• Was it well-designed?
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From Covering Medical Research, Schwitzer/AHCJ
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Just Say No
Sometimes, it’s better not to cover something. But if you must…
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What’s Your Angle?• Are you trying to help readers, listeners, and
viewers make better health care decisions?
• Covering a study because it has a good business angle, or it’s about a local project, is perfectly OK, but it doesn’t mean readers deserve less evidence and skepticism
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Who Could Benefit?• How many people have the disease?
• Keep potential disease-mongering in mind
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How Effective is the Treatment?• Adding months, or years?
• Preventing complications? How many?
• Always remember to quantify results, not just “patients improved”
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What Are The Side Effects?• Every treatment has them
• Where to look:– Go beyond press releases and abstracts– Look at tables, charts, and results sections
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Who Dropped Out?• Why did they leave the trial?
• Intention to treat analysis
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How Much Does it Cost?• If it’s ready to be the subject of a story, someone
has projected the likely cost and market. – At least ask.
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Who Has an Interest?• Disclose conflicts
• PharmedOut.org
• Dollars For Docs series http://projects.propublica.org/docdollars/
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Are There Alternatives?• Did the study compare the new treatment to
existing alternatives, or to placebo?
• What are the advantages and disadvantages (and costs) of those existing alternatives?
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Don’t Rely Only on Study Authors• Find outside sources. Here’s how:
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Use Anecdotes Carefully• Is the story representative?
• Does the source of the story have any conflicts?
• More on this at today’s panel session
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Watch Your Language• Lifestyle/diet – are they randomized controlled
trials, or just observational?
• If observational, make the language fit the evidence:
– YES: “tied,” “linked”
– NO: “reduces,” “causes”
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Absolute vs. Relative Risk• Consider the risk for blindness in a patient with
diabetes over a five-year period
• The risk for blindness is 2 in 100 (2%) in people who get the conventional treatment and 1 in 100 (1%) with a new drug
• The absolute difference is derived by subtracting the lower risk from the higher risk: 2% - 1% = 1%.
From Covering Medical Research, Schwitzer/AHCJ
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Absolute vs. Relative Risk• Expressed as an absolute difference, the new drug
reduces the five-year risk for blindness by 1%.
• The relative difference is the ratio of the two risks.
• Given the data above, the relative difference is:
1% ÷ 2% = 50%
• Expressed as a relative difference, the new drug cuts the risk of blindness in half.
From Covering Medical Research, Schwitzer/AHCJ
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Number Needed To Treat• Same concept as number needed to screen
• Can be calculated from absolute risk: – 100/absolute risk difference (as a percentage)
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Keep Yourself Honest
• Use HealthNewsReview.org