Investigative Reporting on Medical Science: What Does It Take to Break through the Commercial Spin? '... It Is Almost Impossible to Get the Story Right When the Fundamentally Commercial Goals for Which the Study Has Been Done Are Covered Up with So Much Industry-Sponsored Expertise.'

By Abramson, John | Nieman Reports, Spring 2009 | Go to article overview

Investigative Reporting on Medical Science: What Does It Take to Break through the Commercial Spin? '... It Is Almost Impossible to Get the Story Right When the Fundamentally Commercial Goals for Which the Study Has Been Done Are Covered Up with So Much Industry-Sponsored Expertise.'


Abramson, John, Nieman Reports


When it comes to real-time reporting on medical science, journalists (as well as many experts and even medical journals) have been largely relegated to the role of cheerleading for the industry, unable to fulfill their rightful role as critical investigators providing a balanced view. The most recent example is the reporting of the JUPITER trial, which purported to show that people with normal cholesterol but elevated C-reactive protein levels benefit from being treated with the statin drug, Crestor.

My award for the most accurate coverage of this story goes hands down to ersatz (though some--surely including himself--would say uber-)journalist Stephen Colbert, who described the study as "a great breakthrough in the battle to find things to prescribe to people who don't need them." The rest of the coverage trailed far behind.

The Reporting Trail

About a week before reports of the JUPITER trial blanketed the media, a staff writer for a major newspaper sought my comments on the still embargoed New England Journal of Medicine (NEJM) article about the study. The authors reported that treatment of people with normal cholesterol but elevated levels of inflammation (as measured by a C-reactive protein test) with the statin drug Crestor reduced the risk of heart attack by 54 percent, serious cardiovascular complications in toto by 47 percent, and death by 20 percent. The article concluded that:

   ... the rates of a first major
   cardiovascular event and death
   from any cause were significantly
   reduced among the participants
   who received [Crestor] as compared
   with those who received
   placebo.

Clearly this story was going to have enormous impact on preventive medical care. I asked the writer if I could share the embargoed NEJM article with my colleague Jim Wright, who holds a medical and doctorate degree and is the managing director of the Therapeutics Initiative at The University of British Columbia, arguably one of the best centers for critical drug research in the world. Jim and I reviewed the NEJM article individually and together and arrived at a very different overall impression of the import of the study's actual findings. We then presented our analysis to the journalist in a conference call.

[ILLUSTRATION OMITTED]

Yes, there were significantly fewer serious cardiovascular events in the people treated with Crestor. But in terms of the actual benefit, 170 people had to be treated for a year to prevent one event at a cost of $270,000 for the Crestor alone. This dollar figure did not include the cost of screening many more people with a C-reactive protein test and the extra doctor visits and lab work to make sure there were no adverse effects of treatment with Crestor.

Nonetheless, fewer people with cardiovascular disease meant fewer people requiring expensive treatment and therefore savings, right? Wrong: The more important finding--which got short shrift in the NEJM article and none in the media coverage that followed--was that there was no difference in the overall rate of serious illnesses (called "serious adverse events") that occurred in the Crestor and placebo groups. In other words, there weren't fewer sick people requiring hospital treatment in the Crestor group (they just had different kinds of serious illness), and therefore the savings realized on less cardiovascular care would be used taking care of other illnesses.

There was also the finding that more people taking Crestor developed diabetes, which would not have been included in the "serious adverse event" category because rarely does an adult who develops diabetes require hospitalization.

The 20 percent lower death rate among people treated with Crestor was certainly noteworthy. However, a closer look showed that 400 people had to be treated with Crestor for a year to prevent one death, at a cost of about $580,000 for the drugs alone, not including all of the blood tests and doctor visits that would be necessary to treat all 400 people with Crestor. …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Investigative Reporting on Medical Science: What Does It Take to Break through the Commercial Spin? '... It Is Almost Impossible to Get the Story Right When the Fundamentally Commercial Goals for Which the Study Has Been Done Are Covered Up with So Much Industry-Sponsored Expertise.'
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.