STAT – who we often admire for their thoughtful and thorough journalism – had a busy and commendable week.
Earlier this week they published two excellent articles addressing timely and provocative topics. Though they weren’t the type of stories that are eligible to be systematically reviewed by our expert team, each of them is worthy of five stars in our book.
We did review an article by Reuters Health on bystander cardiopulmonary resuscitation (CPR) that our reviewers think is an important read.
In the Name of the Cleveland Clinic … Or Not?
On January 6, Dr. Daniel Neides (Director of the Cleveland Clinic Wellness Institute) published what has been deemed an “anti-vaccine rant” in his “Words on Wellness” column on cleveland.com (the web presence of The Plains Dealer, Ohio’s largest newspaper):
“Does the vaccine burden – as has been debated for years – cause autism? I don’t know and will not debate that here. What I will stand up and scream is that newborns without intact immune systems and detoxification systems are being over-burdened with PRESERVATIVES AND ADJUVANTS IN THE VACCINES. The adjuvants, like aluminum – used to stimulate the immune system to create antibodies – can be incredibly harmful to the developing nervous system. Some of the vaccines have helped reduce the incidence of childhood communicable diseases, like meningitis and pneumonia. That is great news. But not at the expense of neurologic diseases like autism and ADHD increasing at alarming rates.”
As reported by STAT (“Cleveland Clinic Reevaluating Alternative Medicine Offerings Amid Uproar Over Vaccine Rant”) the ensuing uproar from Dr. Neides comments — felt to be contrary to the institution’s stance on vaccines — prompted an apology, a mysterious temporary disappearance of the controversial column, and served to highlight two questionable practices that plague many academic medical centers, not just Cleveland Clinic. First, why do medical centers, supposedly rooted in evidence-based medicine, continue to operate and aggressively promote alternative medicine institutes not firmly based on peer-reviewed science? Secondly, why do so many reputable hospitals continue to make these embarrassing blunders in public relations where unvetted material goes out with their stamp — but not their stamp of approval?
“This feels similar, in my view, to our Maryland ‘ChocoMilkGate’ story last spring,” says Gary Schwitzer, publisher of HealthNewsReview.org. “There were no clear protocols in place for PR clearance of material. These institutions need clear processes, protocols and clearance procedures for everything that goes out under their name.”
Many deadline journalists (and I am one of them) want to go directly to health care experts without being bogged down by PR department gatekeepers. Schwitzer acknowledges that desire and says he is not advocating for more minders. He’s warning that institutions are courting trouble when they turn MD-researchers loose to promote themselves and their pet projects without putting clear processes in place. It’s also a cautionary tale for consumers that just because you see someone from [insert famous medical center here], doesn’t mean his or her statements reflect the policies of that institution, or are based on the best available evidence.
STAT followed this story with six in-depth articles over six days, including their most recent follow-up (“Cleveland Clinic CEO sends out warning to staff after doctor’s anti-vaccine column”) in which CEO Dr. Toby Cosgrove says “Whether we realize it or not, every caregiver is a representative of Cleveland Clinic. How we engage in our lives outside of work can be linked back to our health system … in our world of social media, where every message has the potential to cause confusion and controversy, we must be mindful that our personal views cannot be associated with Cleveland Clinic’s.”
The Art of Silencing Science
It almost reads like a Hollywood script. The setting is the “Wild West world of supplements.” The guy on the black horse is an ex-con pushing weight-loss and muscle-building pills (after being in prison for allegedly doing the same with ecstasy) of questionable efficacy and safety. And the guy on the white horse is a handsome, Harvard professor with serious science credentials who wants people to know that a commonly used ‘natural botanical product’ ain’t so natural and may be dangerous.
But there’s no shoot-out. Just a lawsuit.
And that’s where Rebecca Robbins (@rebeccadrobbins) starts her well-told story, “A supplement maker tried to silence this Harvard doctor — and put academic freedom on trial.”
The supplement in question is called BMPEA. It’s an amphetamine isomer frequently marketed as Acacia rigidula, a shrub native to Texas which can not be legally used as a supplement because it’s safety has not been established (in fact, BMPEA hasn’t been found in the plant). Dr. Pieter Cohen had tested 21 popular supplements containing this alleged ‘natural botanical product’, found about half had BMPEA, including 6 out of the 10 Hi-Tech weight-loss supplements included in the study. Hi-Tech Pharmaceuticals is owned by the guy on the black horse, Jared Wheat, who sued Cohen for $200 million and lost.
Robbins and STAT have been following the story since before Cohen won the defamation trial last November because the case “had momentous implications for the future of research into the safety of weight-loss and muscle-building pills; for the freedom of academics to speak out about matters of public health; and for our ability to learn what’s in the supplements on our kitchen counters.”
We’ve covered the roughly $30 billion supplement industry plenty of times at HealthNewsReview.org (Dr. Oz & supplements, Orrin Hatch & supplements, and brain-boosting supplements) and our take often boils down to two things. First, we as journalists need to do a better job of scrutinizing news on supplements because, quite frankly, the industry isn’t that well scrutinized. Which brings us to our second point: because supplements don’t get near the FDA scrutiny that prescription drugs do, the efficacy, safety, and drug interactions of most supplements are not well known. Perhaps that is because too many studies looking at supplements are observational only.
Five-Star Story on Bystander CPR
Finally, a quick shout-out to Reuters Health who, on Wednesday, published a summary of a Danish report on how bystander cardiopulmonary resuscitation (CPR) may boost survival odds:
Our reviewers appreciated how the data were succinctly and accurately presented, as well as mention of the limitations of the study.
The article was considered important in building understanding among the lay public about the benefits and limits of bystander CPR, but “could have been a bit more clear on how this was measured–that it was looking at correlations between bystander CPR and survival rates, and not a direct experiment where more factors can be controlled (such as making sure the CPR is administered correctly).”
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