Emergency Medicine Australasia, an Australia-based medical journal, has declared that it will no longer accept paid advertisements from pharmaceutical companies.
The journal’s editors announced their decision in an editorial, and we learned about it from Pharmalot’s Ed Silverman. In the editorial, the editors say they’re drawing a line in the sand and all but dare other publications to join them. Here’s Silverman with the how-and-why:
The ban followed discussions with other emergency medicine specialists, who worried aloud that advertised drugs were supported by evidence that was neither “of reasonable quality, nor independent.” There were cases of “dubious and unethical” research practices by pharma, including ghostwriting. And academics may face pressure to withhold negative research, which could “inflate views of the efficacy” of heavily promoted drugs.
For more, refer to this AAP story. In this case, the acronym refers to the Australian Associated Press, not the physician group. In Australia, medical journals are one of the only places where pharmaceutical advertising is legal.
In Croakey, Melissa Sweet explains a new study about coverage of avian flu by Australian media and how it demonstrates the benefits of using specialized beat reporters to cover health stories. The study approaches the coverage from a public health communication angle, and addresses head-on concerns that the media has been a menace to public health with its reckless disregard for actual evidence.
Among other things, it notes that reporters seem to be genuinely dedicated to honest and effective reporting, which often puts them at loggerheads with editors and producers, groups which must be cognizant of what the report euphemistically calls “economic and structural imperatives.”
See Sweet’s post for more details but here are some of the highlights:
- reporters shared the same concerns as health professionals about the depth, accuracy and social impact of their reporting.
- specialist health and medical reporters had much greater capacity to produce better quality health stories.
- specialist reporters had a significant gatekeeper role for letting stories in, and keeping them out, of the paper. As one newspaper medical reporter said:If all I’ve done all day long is keep three really crap stories out of the paper then I consider I’ve done a good day’s work. And sometimes that can be quite a lot of work if somebody higher up than me has got “themselves all ignited about something. Then there’s a lot of work to do to hose people down and to bring these things round.”
Croakey is, of course, the health blog of Crikey, an Australian online magazine based in Melbourne.
In another study of health journalism, just published in PLoS Medicine, researchers found that stories written by health journalists were “superior to those written by other groups.” This study also looked at stories from news organizations in Australia.
The researches point out that, given economic considerations, editors might be tempted to use stories from wire services, foreign media outlets or other news organizations for their health coverage, however, they caution that editors should choose carefully because AP achieved fairly high and consistent ratings, whereas AFP had significantly lower average scores.
When a country is holding up the United States as a model of progress on medical conflict of interest issues, you might suspect there are some serious systemic issues there. Such seems to be the case in Australia, based on Melissa Sweet’s recent post on the Croakey blog. At present, there’s little baseline research into industry funding and influence in Australia, though what little there is seems to indicate a situation similar to what we’ve found in the United States. The lack of research seems to stem from a lack of awareness and perhaps even indifference.
The catalyst for this post seems to be the Walkey Media Conference, a media industry confab sponsored by the national journalists’ union that generated a bit of controversy thanks to a sponsorship from Exxon Mobil.
Sweet found a University of Sydney seminar in July that was to look at conflicts of interest to be less than packed, and inferred that Aussie “academics seem to regard (COI) as irrelevant, tedious or confronting.” Furthermore, she wrote, “Australian universities are dragging the chain in dealing with their staff’s conflicts of interest, at least compared with institutions in the US.”
The post makes a strong, well-researched case for COI disclosure and serves as a sort of roundabout compliment to the dogged American journalists (we’re looking at you, John Fauber) who are creating mainstream awareness of conflicts of interest.
(Hat tip to Gary Schwitzer)
In what could be a preview of things to come in the Northern Hemisphere, Bloomberg’s Jason Gale writes that, while it’s usually not fatal, H1N1 could still pose a public health threat, based simply on the sheer amount of hospital space its victims will occupy. As H1N1 sufferers pack intensive care units, those with more dangerous ailments may find themselves waiting for much-needed care.
“The Northern Hemisphere medical care requirements for the next six months are a train wreck waiting to happen,” said Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy in Minneapolis. “In the fall, even if nothing else changes in terms of the virus’s severity and our preparedness, it’s going to be a real challenge.”
While planned vaccinations may mitigate the virus’ severity in the Northern Hemisphere, experts say public health organizations still must be prepared for a situation like that currently straining resources in Oceania. In particular, current numbers of mechanical lung ventilation machines may be inadequate.
While fewer than 0.5 percent of swine flu sufferers may need hospitalization, those who do can remain in intensive care for up to three weeks, occupying a bed that could be used for 15 heart bypass patients. Christchurch Hospital, the biggest on New Zealand’s South Island, postponed non-emergency procedures requiring an ICU stay such as heart bypass as flu patients — three-quarters needing mechanical ventilation — filled up the 12-bed unit and nine other hastily created intensive-care beds, according to Shaw.