reporting with numbers

Health and Medicine

Guidelines for reporting on medical interventions

1) Devote attention to both harms and benefits, even when the benefits are what’s “new.”

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A report notes that while clinical trials of a new Alzheimer’s drug were “promising,” “experts say they’ll want to do a deep dive on the details before they have a full understanding of the results.” The report also cites data from interviews with experts who worried about potential side-effects from the drug — including brain swelling, which occurred “in about 1 in 5 of participants.”

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Another report on this new drug states that it “proved effective in studies.” Referencing an official news release authored by the drug’s creator, the report goes on to state that the drug “reduced clinical decline compared to placebo by 27% at 18 months.”

DISCUSSION

News stories sometimes fail to discuss potential harms associated with medical interventions. Given our tendency to overestimate benefits and underestimate harms, it’s important to convey information on adverse side-effects and risks. The first report does so fairly effectively, but the second simply reprints material from that company’s own news release, and does so without scrutinizing its claims. Lapses like this can give audiences an overly optimistic understanding of new drugs, tests, products, or procedures, and thus contribute to higher health costs and worse health outcomes.

2) Discuss both relative and absolute benefits

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An article discussing a study about a new treatment for nightmare disorder talks about its impacts in terms of absolute benefits — that is, the number of people who benefited from the new treatment in comparison to existing treatments. Specifically, the article states that “within two weeks, people in the memory reactivation group went from an average of three nightmares per week to about 0.2 per week. The group on standard IRT also improved, but to a lesser degree – dropping from an average of just under three nightmares per week to one per week.”

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A report summarizing the same study notes only that the researchers observed a “fourfold reduction in nightmares over the basic therapy alone.” This conveys the relative benefit of the new procedure, but it says nothing about absolute benefits (i.e., how many people benefited from this new method compared to existing treatments).

DISCUSSION

Media coverage of medical interventions typically only discusses treatments and procedures in terms of their relative benefits — for example, “reduces death by 50%.” This information is important, but it could also be misleading. If one person out of 10 died after taking a drug for a disease that previously killed two out of 10, that’s a 50% reduction, and it makes a very big difference. But if one person in a million died after taking a drug for a disease that previously killed two people in a million, that’s ALSO a 50% reduction — even if it helps many fewer people. This is why it’s important to also talk about absolute benefits. Doing this will give a more complete picture of an intervention’s impact.

3) In addition to discussing risks and benefits, be sure to include data around other kinds of factors that might influence outcomes, such as costs, access, insurance coverage

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A news story on Wegovy (a weight loss drug) discusses not only its effectiveness, but also highlights data pertaining to affordability and accessibility. As the report states, Wegovy has “a monthly price of more than $1,600, and insurance coverage has been spotty.” The piece also informs readers that “Medicare currently excludes coverage of obesity drugs completely.”

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Another story about Wegovy shares the results of a 68-week clinical trial in which those treated with the new drug lost “15 percent of their initial weight–about 34 pounds.” The piece notes how “the treated teens reported improvements in their quality-of-life scores on physical comfort,” and concludes that Wegovy “could be a useful new tool for treating childhood obesity.” It does not include any information about the drug’s costs (or about how many insurance companies would cover these costs) nor how pricing might affect the extent to which it is actually useful as a new anti-obesity intervention.

DISCUSSION

Health is as much an economic and social matter as it is a strictly medical one. When reporting on the effects of a given medical intervention, strive to give audiences a bigger picture — one that includes not just risks and benefits, but also costs. Reporting only on the clinical outcomes associated with a new drug, test, or procedure can promote misconceptions about how much a given medical intervention can actually do.

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