Health News Review: Press releases, and health-care costs.
Last week, Gary Schwitzer‘s excellent Health News Review gave a moderately favorable three-out-of-five stars to a story by HealthDay on a case report of a single patient whose blood pressure was lowered by deep brain stimulation.
Schwitzer’s panel of experts rated the story satisfactory on several grounds, while criticizing it for not being clear enough on the potential harms and benefits of the technique, in which a probe is inserted deep into the brain to deliver an electrical pulse.
While I have the utmost respect for Schwitzer’s work at Health News Review and at his own blog, I had an issue or two with this particular post.
The review notes that the HealthDay story quoted two experts not involved with the study, “so we can be sure it wasn’t based on a news release.” While I agree that quoting outsiders is critically important, this story was, in fact, largely based on a press release. Indeed there is no indication that Maureen Salamon, the reporter who wrote it, talked to the researcher who did the study.
Take a look at the HealthDay story and the press release from the American Academy of Neurology. They’re not identical, but they are similar. And the author of the study, Nikunj K. Patel, is referred to only by way of a paraphrase from the news release.
Despite its three stars, this is not an example of good, or even moderately good, reporting.
And while we’re on the subject of Health News Review, I’d like to raise a question I’ve been meaning to ask Schwitzer. One of the criteria on which stories are judged is whether the story discusses the costs of the treatment under discussion. For established clinical procedures, it is of course important to mention the cost. But for experimental procedures in very early stages of development, it’s often the case that no price has yet been set. Prices are set by business people based on such things as their assessments of demand and competition. And that usually doesn’t happen–and can’t happen–until a product or procedure is nearly ready to go on sale.
Health News Review says HealthDay’s failure to discuss costs was “not satisfactory,” and it refers to a 2008 Chicago Tribune blog post in which “the cost of DBS [deep brain stimulation] was estimated at $150,000 or more per patient.” That blog post offers no source for the $150,000 figure, and it is about the use of deep brain stimulation for other conditions. The truth is, nobody knows what deep brain stimulation for high blood pressure would cost–how many treatments would be needed, how often it would succeed, and whether it would be covered by insurance. All of those things will affect the price–if this treatment ever comes on the market.
A better recommendation, in my view, would be for stories on such highly experimental procedures (this one is actually pre-experimental) to note that costs cannot yet be determined, but that such procedures are often very expensive when they arrive on the market. And such stories might note the cost of a particular procedure using deep brain stimulation for something else. But let’s not take unattributed facts from old blog posts just so we can put a meaningless dollar figure in a story.
All of which is to say, I rate Health News Review as highly satisfactory, with five stars out of five. Schwitzer and his team are not perfect, but they’re awfully good. And I hope they will take this post in the spirit of constructive criticism.
Because I don’t want to get on Schwitzer’s wrong side. He’s got true grit. And, for all I know, a six-shooter on his hip.
- Paul Raeburn
January 31st, 2011 at 5:20 pm
Paul,
I love Rooster Cogburn but wish you’d posted The Big Lebowski’s – er – Jeff Bridges’ picture instead.
Thanks for the nice words. And thanks for your thoughtful comments – definitely not just shooting from the hip.
And I agree with your critique of our critique on all counts. It’s rare that anyone thinks we were too soft on a review. I’ll lose your “true grit” compliment and confidence if this happens often.
Your recommendation on how the costs criterion could/should have been handled in our review matches how we usually write such analyses in such cases. Our wording and our rationale weren’t the best this time.
I remember momentarily balking when one of our reviewers wrote “we can be sure it wasn’t based on a news release” but then let it go. I would say that in this case we can neither be sure nor unsure that it was based solely or largely on a news release, but that, as you point out, it looks suspicious.
I’d chalk both of those up to sub-par editing by yours truly. I’m the only one who works on the project anywhere close to full time and I was traveling at the time. Thanks for keeping us on our toes.
Thanks also for noting at the end of your post that this is a team effort. Too often, I fear that journalists may think these are just my rants or praises. There are almost always 3 reviewers on each story – from a team of about 30 (all listed here: http://www.healthnewsreview.org/who-we-are.php). Each grades the story using our ten criteria (listed here: http://www.healthnewsreview.org/review-criteria.php). It’s a mix of journalists, physicians and people trained in how to evaluate evidence.
Gary Schwitzer
Publisher
http://www.HealthNewsReview.org
February 1st, 2011 at 2:26 pm
Gary,
We’re all aiming at the same thing–trying to help our readers (and ourselves) get a little better at what we do. I value the discussion.
And my regrets for the Rooster Cogburn reference. From now, when anyone asks about you, I will reply: The dude abides.