Writing about medicine, health, public health, science, and the pharmaceutical industry

January 19th, 2006

Fraudulent oncology article in Lancet

From the New York Times:

Published: January 19, 2006
A large study concluding that anti-inflammatory drugs reduce the risk of oral cancer was based on fabricated data, according to The Lancet, the prominent British medical journal that published the report last year.

The principal author was Jon Sudbo, a cancer researcher at the Norwegian Radium Hospital in Oslo. He had four co-authors at M. D. Anderson Cancer Center in Houston and another at Weill Medical College of Cornell University in New York.

In the Lancet paper, Dr. Sudbo said he received financing from the National Cancer Institute in Bethesda, Md. The news agency Agence France-Presse said the amount was $10.5 million.

A spokeswoman for the institute said yesterday that she could not confirm it had provided the financing. She noted that $10 million was a minute slice of the agency’s budget.

Officials at the Norwegian Radium Hospital told The Lancet they had information that the data was manipulated, the journal’s editor, Richard Horton, wrote in its current issue.

Dr. Sudbo is away on sick leave, according to Agence France-Presse. His American co-authors declined to comment, but their institutions both said in statements that they were not involved in the Norwegian hospital’s investigation.

“We are still reeling from the shock,” said Dr. Leonard Zwelling, vice president for research at M. D. Anderson. “There is no worse feeling in the world” than for a researcher to learn that he has put his name to a paper with fabricated data, Dr. Zwelling said.

A special feature of epidemiological studies like Dr. Sudbo’s is that they involve large numbers of patients and are unlikely to be repeated by other laboratories. Replication is considered the most reliable test of scientific quality.

The data problems in the Lancet report were discovered by Camilla Stoltenberg of the Norwegian Institute of Public Health, who is responsible for the Cohort of Norway database from which Dr. Sudbo had said the data were drawn, according to a report in the journal Nature.

January 18th, 2006

Industry-Funded Poison

This article in the Village Voice is about mysterious, shadowy capitalists, mercury in canned tuna, and a PR guy who cries “personal freedom!” when he really means “more profit!” It’s interesting to see rival health communication and social marketing strategies in action.

“[The PR guy’s] latest campaign is to convince the public that fears about toxic levels of mercury in tuna are wildly overblown… environmental activists are upset about how so much mercury got into the food chain in the first place, and while they say they are trying to make people aware of what types of fish are less safe, many of them are also fighting for things like stricter controls on coal-burning power plants.”

January 12th, 2006

FDA: Looking at the Fine Print in Pharma Ads

Since many med writers produce patient inserts and similar copy, this might be interesting to some of you: The FDA has launched a new study to measure the amount of time people spend reading the brief summary in print drug ads. There will be 420 study participants, all either diagnosed with high cholesterol, obesity, asthma or allergies, or caregivers for someone with one of the conditions.

Subjects will see test ads on a computer. The speed at which they click the option to move to the next page of a test ad and two other ads will be measured. In addition, the tests will gauge comparative speeds between the main page and brief summary page and between the test ad and the other ads, the FDA said. The series of studies represents an effort to test some new approaches for presenting risk information to consumers, something the FDA suggests is overdue.

There’s more, and though I’m generally skeptical of the FDA’s ability to make positive changes in any direction, it would be great if this lead somewhere.

January 9th, 2006

Social Marketing in the Cause of Healthy Diets

Here’s a very interesting article on social marketing.

“It’s clear that the straightforward approach to changing Americans’ behavior will no longer work. Simply gathering the evidence, donning the white coat, warning the public and recommending a course of action won’t cut it… The fight to stamp out tobacco smoking in the United States has schooled social marketers in the techniques they will need to get Americans off the couch and away from the chips.”

January 9th, 2006

Lazy Reporting on Pfizer

The CJR Daily has a great post on last Thursday’s front page Wall Street Journal article about Pfizer. Having read the article in question, I agree with CJR Daily’s Mr. Colby that the WSJ article’s reporting is sub-par. It’s an interesting post, and the fact that access to the WSJ article is restricted to subscribers is luckily irrelevant to understanding the issues.

January 6th, 2006

Universal Symbols in Health Care Settings

Now this is interesting. The Robert Wood Johnson Foundation recently announced the results of a project in which they tested “28 universal health care symbols at hospitals in Atlanta, Boston, Grand [Island], Nebraska, and San Francisco. They have produced the Universal Symbols in Health Care Workbook, a ‘how to’ for hospital CEOs, administrators and other health care professionals.” They have “developed a universal symbol for every department in a hospital from women?s health care, to lab testing to intensive care.”

Looking at the actual symbols, I don’t know about the diabetes one, infectious disease, or internal medicine (looks more like radiology to me). And doesn’t the intensive care symbol really symbolize the whole hospital aside from ambulatory care? Interpretive services looks like the aliens are sending radio waves through the patient’s head. Oncology looks way too much like the symbol for something else - maybe the United Way? The actual radiology symbol looks like an X-ray of a fish.

Via On Social Marketing and Social Change.

January 6th, 2006

Statistical Flourishes

Mr. Barrowman has started off the new year with a cracking post about statistics, statisticians, and the complicated relationships both have with the public… among other things. There’s also a proposal from a commenter to rename the folks who play in that field “quantitative scientists.” Read it here.

January 6th, 2006

Organic Food in Consumer Reports

There’s an article about organic food in the forthcoming (February) issue of Consumer Reports. I’ve done a lot of research and writing in this area, and thought I would point out a couple things they got wrong. First, they throw figures around and cite studies with abandon, but readers are left to fend for themselves as far as tracking down the sources. If you’re going to write about health risks, you’ve got to back it up, not just mumble something about “studies show”.

Second, they talk about the higher cost of organics without mentioning that the cost of producing industrial food is subsidized by our tax dollars, and besides, I don’t know how they figure that organics are 50-100% more expensive. I’d like to see the data on that one, especially since the cost depends on the food item, where you live, where you’re shopping and the growing season. (For more on why organic food is expensive, see here)

Also, I think this quote from Grist Magazine is very appropriate to this discussion here to read the whole article):
“The U.S. spends less on food as a percentage of GDP than any nation in the world, probably than any nation since the rise of the nation-state. The cheap-food machine we’ve created — fuelled by our cheap-oil policy and underwritten by billions each year in commodity-agriculture subsidies — means that poor people can get almost limitless calories. Nourishment, however, is not part of the game.”

I am glad that Consumer Reports is offering organic foods as a viable option to a general audience, and glad they mention that the business-firsters are trying to erode the standards for organic labeling.

January 6th, 2006

Papers that Need Medical Writers

I think we need a new feature around here: dissecting papers that could have used a professional medical writer’s touch. For example, take a look at this Nutrition Journal paper called “Evaluating changeability to improve fruit and vegetable intake among school aged children”. The Methods section in the abstract contains some slightly bizarre wording:
“Steps for identifying changeable fruits and vegetables include (1) identifying a dietary database (2) defining geographic and (3) personal demographics that characterize the food environment and (4) determining which fruits and vegetables are likely to improve during an intervention. ” What? Defining geographic… what? Whose personal demographics? Arrrghhh!

Do they really mean that the fruits and vegetables are likely to improve or change? I think they mean that consumption of fruits and vegetables is likely to be increased. The paper goes on referring to changeable fruits and vegetables, and I keep imaging shape-shifting pears and carrots. Call in the professionals… this paper needs some serious revision.

December 29th, 2005

Consultant Ghostwriter Causing Controversy

A post at Effect Measure this week discusses the chromium/cancer/Zhang controversy from a slightly different perspective that adds the spectre of ghostwriting to the mix. Unethical authoring/publishing practices really make headlines. I think ghostwriters and the companies that hire them are treading dangerous ground. The word of the day is transparency.

[Edited to add this - thanks to B. W. for the tip]
If you are interested in seeing the documents behind the WSJ story, source of the Effect Measure post, they are posted at the Environmental Working Group website. Environmental Working Group obtained these documents from California OEHHA and gave them to the WSJ.

December 22nd, 2005

WHO Publishes Bird Flu Handbook for Journalists

Via Effect Measure, we learn that the WHO has produced a Handbook for Journalists about bird flu. Sounds like they did a mediocre job of it, but I guess it’s a starting place. It’s too bad that they didn’t get all the facts straight.

December 18th, 2005

Cleveland Clinic’s Ties to Industry

The NY Times has published a couple of articles recently about the Cleveland Clinic’s business practices — namely, how it raises money, how it conducts research, and how it deals with conflicts of interest. First, Ties to Industry Cloud a Clinic’s Mission from December 17. Next, Doctor Suggests Merck Trial May Have Led to Demotion, from December 10. Click quickly before the articles are locked into the pay archives. Use bugmenot.com if you need a login.

Thanks to M. P. for the links!

December 15th, 2005

Wall Street Journal Examines Use of Ghostwriters

At AMWA this year, I attended an open session called “Haunted Writing: Exorcising the Ghosts From Medical Education and Communication Company (MECC) and Pharma Publications.” I thought one of the panelists had the right idea when she said, let’s not use the term ghostwriters. Let’s call ourselves professional writers. I think the choice of term influences how we are perceived. It is seen as slightly shameful to use ghostwriters, but saying a professional writer helped with the manuscript is a lot more honorable-sounding.

Of course, all of that presumes that the writer is acknowledged, which doesn’t always happen. I am sometimes asked to work on peer-reviewed manuscripts without attribution - so far, it’s running about half and half as far as how often I am acknowledged. In my initial draft, I always include a statement of acknowledgement of my services - including it upfront is better than later asking for the credit, I think. If I don’t get it, I really think less of the client.

This was prompted by a post in the Daily Health Policy report about an article in the Dec. 13 Wall Street Journal (which is only available to subscribers) [edit: The Pittsburgh Post-Gazette has reprinted the whole article]. The article discusses the fact that many of the articles that are published in medical journals “under the bylines of prominent academics are actually written by ghostwriters”, and the use of ghostwriters is often unacknowledged.

Here’s a quote:
“It’s hard to say how widespread ghostwriting is. An analysis presented at a medical-journal conference in September found that just 10% of articles on studies sponsored by the drug industry that appeared in top medical journals disclosed help from a medical writer. Often the help isn’t disclosed. An informal poll of 71 freelance medical writers by the American Medical Writers Association found that 80% had written at least one manuscript that didn’t mention their contributions.”

Here is the AMWA position statement on writer acknowledgement.

December 12th, 2005

Drug Safety

Consumer Reports has published a strongly-written article about FDA, CDER, advertising, and drug safety (or lack thereof). I think the article avoids hysteria pretty well, compared to some similarly themed pieces I’ve read. I think the overall message — that the system is flawed — is quite valid.

December 7th, 2005

Tools for Journalists

Following up from my previous post, I do want to point out that I have a lot of sympathy for journalists, since I know the job can be very difficult (with little reward) sometimes.

Did you know that NewsU has free courses for journalists? Check out the one on Covering Water Quality, the one for improving your revising skills, and how to be a better listener.

NewsU is a Poynter Institute project. I’ve been a fan of the Poynter since Jim Romenesko’s MediaNews moved there in 1999. There are a lot of useful tools on the site, and the Romenesko weblog is a great source for news about news.

December 7th, 2005

How News Is Made

This article on how news is made may interest many readers, especially those who write for the media. The article focuses on one somewhat dodgy press release that turned into hundreds of news stories about retail sales during the weekend after Thanksgiving.

I think there are several lessons to be drawn from this illustration. First, some journalists really do nothing but regurgitate press releases. I think that’s well known. Second, as the writer says at the end, the Internet allows us to watch how news is made. This is both good and bad. In my opinion, those who are paying attention should be generally skeptical of what the news media is telling us. And those of us who are involved in writing the news (about science, medicine, or anything else) need to be more willing to look carefully at our sources.

December 6th, 2005

Away from Universal Coverage

Contrary to my previous hopeful post (regarding an editorial from the Boston Globe), now the NY Times would like you to know that employer-backed health care is here to stay, for lack of a better choice. (Wait, shouldn’t that read, “employer-backed health insurance”? Huh.)

December 2nd, 2005

Science in the web age

Science in the web age is an article about scientist-bloggers and, more generally, science in the digital age.

I thought this was interesting:
“The dynamic hierarchy of links and recommendations generated by blogs creates powerful collaborative filtering … this is not so different from BioMed Central’s Faculty of 1,000, a popular fee-based service that highlights biology papers according to recommendations from a subset of 1,000 scientists. But in the blogosphere, this service is free and could marshall input from a subset of 10,000 scientists or more.”

November 29th, 2005

Gimme an Rx!

Here’s an article from the NYTimes about something many of us have seen: wholesomely sexy drug reps. Heh.

Quote: “Anyone who has seen the parade of sales representatives through a doctor’s waiting room has probably noticed that they are frequently female and invariably good looking. Less recognized is the fact that a good many are recruited from the cheerleading ranks.”

Via a reader (Thanks, Meg!)

November 29th, 2005


I’m a little late on this story from a month ago, but it’s so interesting I had to post it. This is about the intersection of design and medicine with the innovative ClearRx prescription pill bottle. In a way, it’s a good thing I’m coming across this late - the comments are an added bonus to a well-written blog post at Design Observer.

Even better, I came across this story by following a link from The Eyes Have It by way of Eels in Vinegar — two new blogs I have promptly added to my blogroll. Serendipity!

November 29th, 2005

Toward Universal Coverage

This is a well-written opinion piece in the Boston Globe from a few days ago, discussing progress toward true national insurance.

As a corollary, here’s an encouraging article that holds out hope that the collapse of our current insurance system may be the only thing that can bring us to universal health care coverage. Hope springs eternal, I guess.

November 23rd, 2005

Nutriton Marketing

Without making a judgement on whether this is good or bad, I’d like to draw your attention to this little article on marketers targeting the chronically ill. Quote: “Aging baby boomers and rising rates of obesity, diabetes and other health conditions have marketers looking to chronic illness as the new must-reach demographic.”

November 22nd, 2005

Trials for Social Interventions

Following the lead of clinical researchers, people who do research on social problems like poverty are starting to use randomized trials for public health and social work.

November 18th, 2005

Science and Nature

There’s an editorial in today’s NY Times that starts by observing that November 18 is the 250th anniversary of the most powerful earthquake ever recorded on the East Coast: the Cape Ann, Massachusetts quake of 1755. After some discussion of the reactions of that era’s preachers and scientists to the quake and other acts of nature, there’s a great parallel drawn to today’s tussling between faith and science.

There is, the author writes, “a specific type of belief that consistently finds itself at odds with science, one that is not found merely in America and is not limited to Christianity. It is the specific brand of faith that devalues reason and confers the mantle of infallible, absolute authority upon a leader or a book. It is only the priests of these sects, as Jefferson said, who ‘dread the advance of science as witches do the approach of daylight.’”

November 16th, 2005

Citizen Journalism

PressThink: If I Didn’t Build it, They Wouldn’t Come: Citizen Journalism is Discovered (Alive) in Watertown, MA

This is an interesting article from PressThink, a media/journalism blog written by Jay Rosen, who teaches Journalism at New York University.

The article is written by Lisa Williams, a “citizen journalist” who produces H2otown, a local news blog in Watertown, Massachusetts. She talks about local news, newsgathering, the age of blogs, journalism in general, and a bunch of other provocative and interesting things. While this is only peripherally related to medical writing, it’s certainly food for thought for anyone who writes for traditional or new media.

November 16th, 2005

Dr. Zoe D. Katze, Ph.D., C.Ht., DAPA

The Credentialing Con is an article about a guy who managed to obtain a bunch of impressive-sounding credentials for his cat, Zoe.

I’ve been thinking about credentials quite a bit as I look at graduate programs for next fall. It’s important for me to be clear about my true goals and objectives. I also want to keep a sense of humor about how meaningless (in the grand scheme of things) letters after one’s name really are.

November 11th, 2005

Available Domain Name of the Week

This is not related to medical writing, but it is somewhat language-related (and fun for a Friday). The available domain name of the week.

November 9th, 2005

US Has Highest Health Care Costs and Highest Error Rates

Compared to other Western nations, the US has the highest error rates, most disorganized care and highest costs, according to a new survey published in the journal Health Affairs. We pay more and get less — I think it’s time for a single payor system.

By the way, did you catch the West Wing debate on Sunday? I thought the Santos character brought up some interesting points about the health care system, like the fact that Medicare has lower administrative costs than the private sector.

November 3rd, 2005

A PhD’s Perspective

If you work with PhD students, or are a PhD student, or are considering a PhD, you may be interested in the archive of articles by Phil Dee at Science’s Next Wave. There are also quite a few columns that are relevant to anyone involved with science or medical writing, especially writing for peer-reviewed journals.

November 3rd, 2005

Covering the Evolution vs. Intelligent Design Debate

Columbia Journalism Review has a thorough exploration of science writing and coverage of the evolution vs. intelligent design debate here. Their position — one that I completely agree with — is that, “…journalistic coverage that helps fan the flames of a nonexistent scientific controversy (and misrepresents what?s actually known) simply isn?t appropriate.”

I am reminded of what my professor explained in my Writing for the Media class: there is often a huge disconnect between journalists and their readers in a number of areas. Most journalists are much better educated, less religious, and more liberal than their readers. I think this may lead to overcompensation on the part of some writers, since “balance” and “fairness” are journalistic mantras.

November 3rd, 2005

Medblog Podcasts

Looking for podcasts related to medical topics? Check out the interviews with medical bloggers, as well as a lot of stuff about medical practice management, at SoundPractice.Net

November 3rd, 2005

Hilarious Journal Articles

I’ve been catching up on my blogroll today, and via this week’s Grand Rounds, I discovered an amusing diversion: Hilarious Journal Articles. The link takes you to Technorati’s archive page for all such tagged posts by the writer behind KidneyNotes.

I’m not very familiar with Technorati’s tagging system, but it looks potentially useful.

Here’s the archive of all the editions of Grand Rounds so far.

November 2nd, 2005

Made-to-Order PhRMA Novel

Okay, now this is interesting. A PhRMA executive hired a team of writers and bizarre PR people to write a novel about terrorists poisoning prescription drugs imported from Canada. Wow. You’ve got to read the whole article, it’s quite amusing.

November 2nd, 2005

Kraft’s PR Strategy

You may remember that the Kaiser Family Foundation issued a report (PDF) last year that linked advertising to childhood obesity.

Now Kraft has decided to stop advertising certain products to children under 12, in an attempt to forestall government regulation and avoid becoming a corporate villain. As a former Kraft executive VP, Michael Mudd, explained, “If the tobacco industry could go back 20 or 30 years, reform their marketing, disarm their critics, and sacrifice a couple of hundred million in profits, knowing what they know today, don’t you think they’d take that deal in a heartbeat?”
Via PR Watch.

Here’s the article from the Wall Street Journal (reprinted on another site).

November 2nd, 2005

Flu season explained

Confused about flu season? Effect Measure, a public health blog, explains flu season and current surveillance methods for flu.

October 27th, 2005

Spellcheck Artifacts

Language Log has an amusing entry today on artifacts of the spellchecker age. If you aren’t reading them regularly, I highly recommend you start. It’s a great blog for lovers of language.

October 25th, 2005

Why Most Published Research Findings Are False

Why Most Published Research Findings Are False. Thought-provoking stuff.

October 25th, 2005

Antibacterial Soaps and Antiviral Tissues

Antibacterial soaps are a bad idea - they may be contributing to the problem of resistant bacteria - and antiviral tissues are not much better than regular tissues (I prefer the kind with lotion). Via Medpundit.

October 25th, 2005

The coming pandemic

Preparing for a Pandemic, from Scientific American. An excellent analysis.

October 19th, 2005

Bad doctor

Dr. Gilbert Ross is a shill for the industry-funded American Council on Science and Health (ACSH) - the most aggressive debunker of research reports emanating from government and academia. He was convicted of defrauding Medicaid and had his medical license revoked in 1995. In other words, he’s not credible. But the media continues to quote him as an expert in their never-ending search for “balance” and “fairness”. He’s a fraud and a faker, and should be shunned. Read more in this Mother Jones article.

October 18th, 2005

Fill This Prescription

A good editorial from Scientific American. Quotes:
“As the only licensed gatekeepers of public access to legal medications, pharmacists have an implicit duty to dispense them as needed.”
“It is tempting to wonder how far the principle of denying medicines for ethical reasons could stretch. Could one who disapproves of homosexuality refuse antiretrovirals to an HIV-positive gay man? If suffering is good for the soul, can one refuse to give out pain medication? But the pharmacists are not really fighting for a broad entitlement to morally judge which prescriptions to fill. And it is unnecessary to play “Where will this stop?” on an issue that already threatens women’s vital reproductive rights.”

I agree with the conclusion that the best answer is probably to make the morning-after pill available without prescription.

October 12th, 2005

Sci Am’s Web Awards

Scientific American: Science & Technology Web Awards 2005. Twenty-five sites on science and technology. Seems like these would be good resources for teachers and communicators.

October 7th, 2005

Flawed grants process at ONDCP

Drug-Free Communities Grant Process Blasted as Political, ‘Flawed’.

I was already a little cynical about ONDCP, so this doesn’t surprise me.

September 22nd, 2005

Dangling Particles

If you follow only one link from this blog today, make it this one. It’s a great op-ed from the NY Times by a professor of physics at Harvard. The subject is science writing, and the theme is that the current state of scientific communication is less than optimal.

September 14th, 2005

School Lunches

Harlem School Introduces Children to Swiss Chard. I like to hear news like this - people doing innovative things with nutrition in schools, especially for lower-income populations. This is a great article from the NY Times.

September 14th, 2005

The Lancet Asks Corporate Parent to Divest Itself of Weapons Involvement

This is a really interesting post at PR Watch: Medical Journal Decries Parent’s Deadly Interest. Basically, the Lancet is a subsidiary of Reed Elsevier, which has another subsidiary that runs a weapons exhibition. The Lancet asked Reed Elsevier to divest itself of the exhibition company, and Reed Elsevier said no. The Lancet article is here. You will need a login to read that article, and bugmenot.com can provide one.

September 13th, 2005

Katrina Shows Need for EMRs

The chaos following Hurricane Katrina underscores the pressing need for electronic medical records (EMRs), according to this story. (reg. req., use bugmenot.com if you need a login)

September 12th, 2005

Clinical trial registration

I’m researching and writing an article on the new clinical trial registration policies of the top-tier peer-reviewed journals, as well as proposed legislation that would make registration and reporting of results mandatory.

I think there is very little public confidence in the validity of reported scientific results, and the main reason is the loss of control of medical research by objective, disinterested, and qualified physicians and scientists. I found this interesting quote from a NYTimes article from 2001 (can’t link - it’s in the archives):

“In the early 1990s, about 75 percent of the drug industry’s clinical research dollars went to universities. ? By 2000, just 34 percent went to academic institutions, while the rest went to investigators working under the direction of either a private research firm ? or a pharmaceutical company.”

More here. PhRMA’s policy statement is here.

September 9th, 2005

DIA Journal Articles on Training Medical Writers

I’m posting this here so I can find it later and read the three PDF articles in this issue from January-March, 2001: Drug Information Journal.

The articles are:
Training Medical Writers in Today’s Environment 1: The Integrated Medical Writer
2: Competencies as a Tool to Assess Medical Writers
3: How to Please a Medical Writer (I really want to read that one!)

September 9th, 2005

Interesting 6-Figure Jobs

Interesting six-figure jobs, including medical writing (at the end). This article is nine months old, but I hadn’t seen it. Pretty good forecast, if money.cnn.com is to be believed.