Until recently, my formal education in statistics was largely Darryl Huff’s “How to Lie with Statistics” and, more recently, Marya Zilberberg's “Between the Lines” (reviewed here). I find that stats, with difficult concepts to retain, requires repetition. The difficulty is compounded by the overwhelming amount of information and difficulty keeping up with medical literature, let alone critically analyzing it.
That’s why, too often we rely on peer reviewers and journal editors to digest materials for us, and give us findings in a short abstract, rather than immersing ourselves in all the time-consuming and painful details.
So this week, I was excited to receive a late acceptance and be able to attend the Medicine in the Media course (aka #NIHMiM12), aptly subtitled “The Challenge of Reporting on Medical Research.” This intense course is sponsored by the NIH, The Dartmouth Institute for Health Policy and Clinical Practice and the Department of Veterans Affairs. It is very wise investment by NIH, as it helps train media to review findings critically and to report medical findings correctly, which is no easy feat.
The main instructors of the course were Drs. Steve Woloshin and Lisa Schwartz, from Dartmouth, where they teach and write about their “healthy skepticism” initiative. This program includes documenting exaggeration, overdiagnosis, and studies of effective risk communication.
While it will take me some time to absorb all the material presented in this intense immersion course, they have on-line aids outlining their approach to understanding studies, available online via the Journal of the National Cancer Institute's web site and Dartmouth's Healthy Skepticism program site.
I particularly like their systematic, standardized approach, illustrated by their summary of the value of CAT scans for lung cancer screening. It would be extraordinarily helpful to have this sort of uniform reporting of results. Of course, that would lead to a more literate, skeptical public, which is why it will probably never be adopted…way too costly to industries. (Their common sense, pragmatic approach reminds me of Elizabeth Warren’s plain speaking and efforts to have a strong Consumer Protection Agency). For example, they provide a clear glossary of numbers with examples of how to calculate risk, and much of the course had us go through worksheets using these calculations. They similarly provide guidance as to how to report the findings.
Similarly, critically analyzing reports was stressed by Gary Schwitzer. I like his systematic approach as well, though was a bit surprised at the extent of his negativity about cancer screening tests. More for me to review…His HealthNewsReview.org provides handy questions to ask and tips for understanding studies from the fine “Covering Medical Research.”
In addition to these sessions about understanding the numbers and interpreting what the results mean, a couple of the other sessions particularly stood out for me. Hilda Bastian, editor of PubMed Health, provided an important overview of systematic reviews of literature.
Dr. Barry Kramer, originator of this course and now Director of the Division of Cancer Prevention at the National Cancer Institute (NCI), gave an important talk on the hazards of cancer screening, well summarized by Hilda Bastian on Scientific American guest blogs.
A panel discussion, “Inside the kitchen with medical journal editors,” gave an enlightening perspective about what editors are looking for in submissions for publication and how they communicate with journalists.
Panelists were Drs. Barry Kramer, Trish Groves, deputy editor of the BMJ and editor-in-chief of BMJ-Open, and Phil Fontanarosa, of JAMA. It was amusing and impressive watching Scott Hensley both moderate and tweet the panel discussion.
To my surprise, the course was not only quite informative but was often entertaining. We were regaled with tales of travel by T.R. Reid, anecdotes from USA Today’s Liz Szabo, and dramatic readings from participants.
I hope to enlighten you further as I incorporate this week’s messages into my writing.
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Lisa Schwartz and Steve Woloshin/The Dartmouth Institute
cartoon Screening Drive-thru/courtesy Hilda Bastian