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Wednesday 28 August 2013

Getting the Statin Story Wrong: Physician-'Journalists' Must Do a Better Job

It’s not uncommon for me to wake up (in the Central time zone, where I live) and have a message from someone in the Eastern time zone already waiting for me, asking when I’m going to comment on some news story.

Recently I had one of those days.  The messenger was Charlie Ornstein of ProPublica, who’s also president of the Association of Health Care Journalists.

Before 9 a.m. Central time one recent day, he tweeted:

“Paging @garyschwitzer:  @CBSHealth: New wonder drug? Statins may have use beyond cholesterol.”
The CBS report in question was a live in-studio chit-chat with Dr. Holly Phillips, a “CBS News medical contributor.”

On the CBS website, the headline was: “New wonder drug? Statins may have use beyond cholesterol.”   A few quick observations:

1. That “may have” projection about statins is not new.  Drugmakers are in the business of constantly searching for new uses for old drugs.
2. And yes, statins are old drugs.  So why did the online and on-air stories refer to them as “new wonder drugs”?
3. Finally, the story was about a study.  The study only looked at statin harms/safety.  It didn’t look at benefits.  It didn’t even mention Alzheimer’s disease.  So, with no analysis of benefits, why did the online and on-air stories refer to them as “new wonder drugs”? And in the freeze-frame image from CBS, above, you’ll see that the subheadline is “THE BENEFITS OF STATINS.” That’s NOT what the study was about!
Dr. Phillips said:
“In addition to lowering cholesterol, statins lower inflammation in the body, particularly in the blood vessels,” said Phillips. “Inflammation is linked to a number of other diseases: Alzheimer’s disease, a number of forms of cancer, strokes. So by lowering that, we could theoretically lower many of these diseases.”

That’s a mighty big if.  And that’s NOT what the study in question was about.

So what was the story all about?

If it was about the study, it missed the mark, going way outside the boundaries of what was reported in the study.

If it was an attempt to promote statin use, it was journalistically unsound. The anchorman even asked Dr. Phillips what advice she gives her patients about statins.  You know what?  I don’t care what advice she gives her patients, and I don’t think CBS viewers should either. At that moment, she’s on the air as a journalist.  She shouldn’t be put in the position – or allow herself to be put in the position – of dispensing medical advice in this setting.

Finally, even in reporting on the supposed safety of statins, it’s important to clarify and delineate the population you’re talking about.  If you’re talking about using powerful drugs in healthy people for preventive reasons, you better be real clear about that.  And this study’s analysis of the statins-and-diabetes link is worth noting in that context.  But there are other safety concerns for statins in the primary prevention context as well.

So, there you go, Charlie.  Probably  predictable.  But so was the CBS story. And so are many health care stories by leading U.S. news media:

Of the almost 1,900 stories we’ve reviewed on HealthNewsReview.org in the past 7+ years, two-thirds fail to adequately quantify the potential benefits of the interventions they report on.


You can't blame all of this on poorly trained journalists.  This is an example where a physician-"journalist" on a big-time TV network didn't get it right. 


Graham

1 comment:

Lowcarb team member said...

Thanks for posting this Graham, Not only very interesting but confirming what I have suspected for some time. Not just about statins but about other drugs associated with diabetes, I daresay many other drugs too but I don't know anything about them, I always think of metformin in this "suspicious” class. I know many claim to benefit from it, I suspect it works mainly on weight loss which has never applied to me so I only have personal experience of the downside. Yet I take the maximum dose for cardiovascular protection apparently. Can't this protection be given at a lower dose no one knows or is prepared to risk lowering it.

From time to time we hear claims of metformin being almost a panacea, I’m afraid I tend to think of it as a drug in search of a disease this is because hype of this kind always makes me suspicious and is just based on a gut feeling. {Literally}

Of course statins is the classic it’s almost as if there are huge stockpiles of satins rapidly approaching the expiry date and new markets must be found.

On my last but one visit to the eye clinic {a fortnight ago} I was solemnly assured by a Dr that statins had been shown to prevent or alleviate maculopathy quite apart from their cholesterol -lowering properties. Having read the studies for myself I don't think that it is so clear-cut I think the consultant agreed with me. The claims or some of them may be true - I don't know. I am sure, however, that history is full of examples of this sort of thing all these "reliable reports " smack to me of attempts to turn base metal into gold.

There is nothing intrinsically wrong with searching for new uses for drugs, of course. Cynics like myself will, however be tempted to wonder if falling sales or potential new products waiting to be launched, are the real reason for this and not benefit to patients. It may even indicate a reluctance to withdraw products which may have fallen under suspicion.

Kath