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#Post#: 1505--------------------------------------------------
Immunotherapy and back--how the media handled 2016's big healthc
are stories
By: agate Date: December 30, 2016, 6:53 pm
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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
HTML http://fivethirtyeight.com/features/science-isnt-broken/#part1.
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.[/quote]
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