One of two talks I gave at Cancer Research in the Media: The NCI’s 2nd Annual Inter-American Workshop for Scientific Journalism

1. Covering Cancer Treatment:
Tricks of the Trade
Ivan Oransky, MD
Executive Editor, Reuters Health
Cancer Research in the Media
Inter-American Workshop for Scientific Journalism
Guadalajara, Mexico
November 8, 2011

2. 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?

3. From Covering Medical Research, Schwitzer/AHCJ

4. Just Say No
Sometimes, it’s better not to cover something.
But if you must…

5. 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

6. Who Could Benefit?
• How many people have the disease?
• Keep potential disease-mongering in mind

7. How Effective is the Treatment?
• Adding months, or years?
• Preventing complications? How many?
• Always remember to quantify results, not just
“patients improved”

8. 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

9. Who Dropped Out?
• Why did they leave the trial?
• Intention to treat analysis

10. 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.

11. Who Has an Interest?
• Disclose conflicts
• PharmedOut.org
• Dollars For Docs series
http://projects.propublica.org/docdollars/

12. 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?

13. Don’t Rely Only on Study Authors
• Find outside sources. Here’s how:

14. Use Anecdotes Carefully
• Is the story representative?
• Does the source of the story have any conflicts?
• More on this at today’s panel session

15. 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”

16. 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

17. 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

18. Number Needed To Treat
• Same concept as number needed to screen
• Can be calculated from absolute risk:
– 100/absolute risk difference (as a percentage)

19. Keep Yourself Honest
• Use HealthNewsReview.org

20. Acknowledgement/Contact
• Nancy Lapid, Reuters Health
ivan-oransky@erols.com
Twitter: @ivanoransky