Medicine in the Media: 
The Challenge of Reporting on Medical Research

  Sunday, May 4, 2008

6:00–9:00 p.m.

7:30 p.m.

Welcome Reception Hanover Inn—The Terrace

Adventures in Disclosure: Conflicts of Interest in CT Screening for Lung Cancer
Paul Goldberg   

  Monday, May 5, 2008

7:30 a.m.

Breakfast

8:00–8:15 a.m.

Opening Remarks
Barry Kramer, Director, NIH Office of Medical Applications of Research  

8:15–9:00 a.m.

Orientation and a big picture look at medicine in the media
This session will review the goals of the course, outline some common problems researchers see when they read stories about health in the media, and discuss ways to do better. Steven Woloshin

9:00–10:00 a.m.

How big? Numbers in research
A major challenge for health journalists is understanding how big the main effect is in a given study. This session describes how health outcomes are counted and compared. The session will also provide a quick review of some basic terms used in health research and statistics. Gil Welch

10:00–10:15 a.m.

Break  

10:15 a.m.–12:30 p.m.

How sure? Basic research designs
No matter how big the numbers are, you still need to decide whether to believe them or not. Perhaps the most basic question to ask is whether or not the numbers came from a true experiment. This session focuses on the basic distinction between randomized trials and observational studies. Gil Welch  

12:30–1:30 p.m.

Lunch The Terrace  

1:30–2:45 p.m.

Using what you learned: Problems with numbers and some solutions
Understanding the numbers is one thing, but communicating them to your readers is another. This example-based, interactive session will highlight how numbers can be misleading (or just confusing) and offer practical guidance on how to report them clearly. Steven Woloshin

2:45–3:45 p.m.

Special Topic:  Disease mongering I
Healthcare providers and the public are under increasing pressure to accept expanded definitions of what constitutes disease. When this pressure does not serve patients’ interests, it has been labeled disease mongering. The primary interest served is the financial well-being of pharmaceutical and device manufacturers who stand to gain from expanded markets. In this session, we review the case of “restless legs syndrome” to explore how the media can unwittingly facilitate this process. Steven Woloshin & Lisa Schwartz  

3:45–4:00 p.m.

Break

4–5:30 p.m.

Special Topic: Disease mongering II
Susan Kelleher will report on her series, “Suddenly Sick,” an investigative series about disease mongering that she wrote for the Seattle Times. In the series Kelleher explores how subtle changes in disease definitions, entanglement between the pharmaceutical industry, researchers, policy makers and practitioners conspire to make everyone sick. Susan Kelleher

5:30–6:00 p.m.

Break  

6:00–6:30 p.m.

Bus to Dinner  

6:30–9:00 p.m.

Dinner The Simon Pearce Restaurant in the History Mill in Quechee, Vermont
In addition to an elegant dinner, we will be treated to a glassblowing demonstration, and there will be time to browse the retail store, which offers glass and pottery.

Overtreated
In keeping with the afternoon’s theme, Shannon Brownlee, Schwartz Senior Fellow at the New America Foundation, discusses her recently  released book, “Overtreated: Why Too Much Medicine is Making Americans Sicker and Poorer.”  

  Tuesday, May 6, 2008

7:30–8:00 a.m.

Breakfast

8:00–9:00 a.m.

How sure? The limited role of statistics
P values and 95% confidence intervals can be intimidating, but these are the basic measures that researchers use to express the role of chance and the precision of their findings. Being comfortable with these statistics can help journalists judge for themselves the value of study findings. In this session, these concepts will be explained clearly and concisely. Gil Welch

9:00–10:15 a.m.

Using what you learned: Highlighting cautions about observational studies
Because some exposures are harmful, much research cannot involve randomized trials and must rely on observational studies. A major problem with these studies is that they may be difficult or downright impossible to interpret correctly. This session will address the problem of confounding and how researchers typically deal with it.  Gary Taubes will provide practical advice on how journalists can effectively write about these kinds of studies, address the inherent problems with this research, and discuss the issue of whether they should learn to ignore it entirely. Lisa Schwartz & Gary Taubes  

10:15–10:30 a.m.

Break

10:30–11:45 a.m.

Using what you learned: More cautions (even for randomized trials)
Even with the best study designs, you need to understand basic study facts: what was measured, who participated in the study, and for how long. This session deals with the problems that arise in extrapolating from intermediate to clinical outcomes, from high- to lower-risk patients, and from short- to long-term results. Lisa Schwartz & Steven Woloshin

11:45–12:45 p.m.

Lunch  The Terrace

12:45 – 5:00 p.m.

Out & About—Choose a recreational or academic activity. 
Options include: a moderate hike, exploring downtown Hanover, a visit to a science museum, a computer lab session and a visit to the Dartmouth Hitchcock Medical Center. Transportation will be provided.

5:00–6:00 p.m.

Break/Tutorial
You may opt to relax back at the Inn, or work with members of the faculty in small groups to clarify or discuss any of the concepts covered in the course so far.  

6:00–7:30 p.m.

“Night at the Museum” Hood Museum of Art
No, Ben Stiller’s not coming. But we’ll enjoy a lovely dinner reception, tour the exhibits, and learn a thing or two.  

7:30–9:00 p.m.

Special Guest: Marcia Angell, author of “The Truth About Drug Companies: How They Deceive Us and What to Do About It,” and “Science on Trial: The Clash of Medical Evidence and the Law in the Breast Implant Case,” and former Editor-in-Chief of the New England Journal of Medicine.  

Wednesday, May 7, 2008

7:30–8:00 a.m.

Breakfast

8:00 – 9:30 p.m.

Special Topic: The logic of cancer screening
This session provides tools for journalists to critically assess unqualified endorsements of cancer screening tests and to distinguish between strength of opinion and strength of evidence. Barry Kramer    

9:30–10:30 a.m.

Too big?
One statistic often presented in research papers and news releases but quite prone to misinterpretation is the odds ratio. This session will provide guidance on understanding this tricky concept, and deciphering it for your audience. Steven Woloshin  

10:30–11:00 a.m.

 Break

11:00 a.m.–
12:15 p.m.

Garbage! When the news may not be fit to print
The cautions about some study designs are formidable—so much so that journalists might reconsider covering them at all. This session will highlight stories that might have been best left on the cutting room floor—for example, preliminary results (e.g., scientific meetings, animal studies), uncontrolled studies, and cost-effectiveness models. Steven Woloshin &  Lisa Schwartz

12:15–1:00 p.m.

Lunch The Terrace

1:00–1:45 p.m.

Guidance on Guidelines: Using clinical recommendations in reporting
Multiple organizations (professional medical societies, advocacy groups, government, and others) produce recommendations for clinical practice.  So whom do you trust, and why? Using a case study to guide the discussion, this talk will provide simple tools to help evaluate the quality of a given guideline. Jennifer Miller Croswell

1:45–2:30 p.m.

Using what you learned: You make the call! 
Practice in detecting statements that are exaggerated, overstated, or misleading.  Steven Woloshin, Lisa Schwartz & Gil Welch

2:30–3:45 p.m.

Special Topic:  Adiposity 101: Understanding why we get fat
As obesity and diabetes rates skyrocket, public health authorities, researchers, physicians and virtually everyone else involved insist on describing obesity and overweight as a disorder of overeating -- caused by excess calorie consumption and so cured or prevented by eating less and exercising more. It would be nice if true, but it's not the case. Gary Taubes reports on the lessons from his book “Good Calories, Bad Calories: Challenging the Conventional Wisdom on Diet, Weight Control, and Disease” and the possibility that fifty years of obesity research have led us farther from the truth, not closer.

Farewell!