Author Topic: Immunotherapy and back--how the media handled 2016's big healthcare stories  (Read 79 times)

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Offline agate

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From MedPage Today, December 29, 2016 (emphasis added):

Quote
Immunotherapy and Back

Paul Raeburn looks at how the media handled 2016's big healthcare stories

by Paul Raeburn
Contributing Writer, MedPage Today


My favorite piece of media criticism in 2016 dealt not with hyping a questionable "cure" or failing to follow the money, but with the more arcane problem of p-hacking, or data mining. The critic described it this way: "P-hacking is very complicated, but it basically means collecting lots of variables and then playing with your data until you find something that counts as statistically significant but is probably meaningless."

Only the most stouthearted critic would attempt to explain this problem, which is complicated enough to sometimes fool scientists and the journal editors who publish them. (If you'd like to play along at home, Christie Aschwanden of fivethirtyeight.com has written a how-to guide that can turn you into a p-hacker in 15 minutes.) [The article can be seen here.

Who was this ambitious critic? Here's a hint: After he showed a series of quick cuts of study after study arguing on television for or against drinking a cup of coffee in the morning, he said, "Coffee today is like God in the Old Testament. It will either save you or kill you, depending on how much you believe in its magic powers."
The comedy should give it away: The ambitious critic was the comedian John Oliver, the host of "Last Week Tonight" on HBO. And the explanation of p-hacking -- and the questionable findings it can lead to -- were only part of a 19-minute segment in which he concluded, among other things, that "even the best designed studies can get flukish results."

With Oliver as inspiration, it's time to take a quick look back at a few of the big medical stories of 2016.

One of the most important stories dealt with a new study of the Alzheimer's drug solanezumab, which slowed progression of the disease, but not enough to be statistically significant. This is the flip side of what Oliver described. Instead of significant but meaningless results, here we get results that are claimed to be meaningful even if not significant. The day after the results were announced, Matthew Herper of Forbes led his story with, "Last night, Alzheimer's researchers held a celebration over their field's latest failure."

So how does one report this responsibly? Pam Belluck at The New York Times reported simply that the trial failed, "dealing a significant disappointment for patients." No gray areas there. Likewise at The Washington Post, which avoided the subtleties by apparently not covering the study, as far as I can tell from several searches. Damian Garde at STAT also reported that the trial was a failure, but he took time to note that several other similar drugs might yet succeed where this one failed.

The news was better for patients with primary progressive multiple sclerosis. A drug called ocrelizumab showed benefits and could become the first drug approved for this form of the illness. James Gallagher at the BBC News website wrote under a headline calling the study a "landmark," but he didn't back that up until the very end of the story, where he added a rather startling qualifier that did not make the headline. The drug, Gallagher wrote in his very last paragraph, weakens the immune system and "increases the risk of infection and cancer." Oh.

To take a broader look at 2016's most important stories, MedPage Today reporters asked experts in a wide variety of fields for their top picks. Among pediatricians, Zika virus and its association with devastating birth defects was far and away the top choice. Zika was heavily covered -- in part because of concern about its potential spread at the Olympics, and also because of the particularly shocking symptoms it produced in infants. And although the outbreak is less than a year old, the story has turned out to be more complicated than it first appeared to be.

Immunotherapy was the big story in cancer. It's been a big story -- or at least a promising approach -- for a few decades, but 2016 was the year when it began to make its mark. It was found effective in the treatment of non-small cell lung cancer and certain cases of breast cancer, and this success is spawning new clinical trials. Despite the good news, though, watch out for coverage that promises more than research can deliver.

Not all of the top stories were so high-tech. In health policy, doctors told MedPage Today that the top developments in 2016 were the promise to repeal Obamacare and the election of Donald Trump, which could ease the path to repeal. Two others were closely related -- concern about increasing healthcare costs and insurers leaving the Obamacare marketplaces. The exciting advances in the treatment of oncology and multiple sclerosis will likely have less effect on the population overall than these seemingly intractable issues relating to how we pay for the research advances once they reach the clinic. If that weren't bad enough, experts pointed to yet another problem: the exorbitant rise in the price of some pharmaceuticals. It's not clear how to solve that problem, but any solution likely would involve some kind of government intervention -- which might not be among the Trump administration's top priorities.

One thing is clear: The change in the political climate as we head into 2017 will likely require reporters, readers, and researchers to make extraordinary efforts to separate fact from fiction. It's a challenge -- and an opportunity.
MS Speaks--online for 12 years

SPMS, diagnosed 1980. Avonex 2001-2004. Copaxone 2007-2010.

 

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