Tag Archives: embargoes

Non-disclosure agreements and embargoes converge

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Some people unwind by watching birds. Or bays. Ivan Oransky, M.D., executive editor of Reuters Health and AHCJ’s treasurer, is different. He watches embargoes (And retractions). And it’s in his capacity as editor of the Embargo Watch blog that Oransky reports on how the press roll-out of the Wal-Mart/Humana drug plan demonstrates a convergence between non-disclosure agreements and embargoes.

Oransky obtained the text of the non-disclosure agreement, which appears to be a standard embargo agreement, with one exception. Reporters are banned from contacting any sources about the story until Oct. 1, though a seemingly contradictory provision allows them to approach sources who have agreed to the agreement — a more common embargo-style approach. Oransky is working his way through the public relations chain now, trying to find out why a non-disclosure agreement was used in place of an embargo, and why the conflicting provisions were inserted. He’ll update the post as soon as he finds out.

Until then, we’ll go with Oransky’s guess that the odd agreement was a careful end-run around regulators.

Until I get more clarification, I’ll guess that Humana decided to do this for fear of reprisals from CMS if CMS had any reason to think they were marketing the plan before today.

While the agreement seemed to have delayed most coverage for a few hours, at least, the story still got a substantial amount of attention, especially in the business press.

Policy lets many see study but restricts reporting

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

On his new blog, Embargo Watch, Ivan Oransky, M.D., writes about an embargo policy that restricts journalists from writing about papers even when they are widely available to doctors, medical schools and hospitals.

Oransky, who is treasurer of AHCJ’s board and executive editor of Reuters Health, has written about embargoes before for Covering Health and TheScientist.com, questioning whether embargoes are serving the public, the scientific journals or journalists.

In this case, The American Journal of Respiratory and Critical Care Medicine placed an embargo on a study it made available “through HighWire, a Stanford University service that many publishers use to make electronic versions of their journals available.”

This was a new one for me. Embargoed papers not being available to anyone but the press, sure. But available to many doctors — and anyone doctors showed them to — for two weeks before we could write about them?

Oransky discussed the policy with the director of communications and marketing at the American Thoracic Society, which publishes AJRCCM, and reports on the response from him as well as from other public relations professionals and reporters.

One particularly interesting comment points out that investors are likely seeing studies release on HighWire, perhaps giving some an unfair advantage financially.

Oransky: Medical study embargoes serve whom?

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

Embargoes, a fairly frequent topic of discussion on Covering Health, seem to bring out strong feelings in some people.

In one recent example allegedly involving embargoes, TheStreet.com’s Adam Feuerstein attempted to combat a rumor that the New England Journal of Medicine would be publishing an article about the experimental lung cancer drug seliciclib – a rumor that was seemingly driving up the stock price of Cyclacel Pharmaceuticals.

Feuerstein looked at his advance copy of NEJM and reported that no such article was coming out. He was immediately accused by a commenter on the story of having broken the NEJM’s embargo.

news-stand

Photo by Billingham via Flickr

As Reuters Health Executive Editor – and AHCJ board member – Ivan Oransky asked, “Is saying what’s NOT in an embargoed journal breaking the embargo?” Oransky concluded that it was not a case of breaking an embargo. The ensuing discussion on Twitter and in the comments on Feuerstein’s article is interesting. For the record, the NEJM apparently sided with Feuerstein, according to a commenter on the story.

Today, Oransky weighs in on the wider topic of who is served by embargoes on medical studies:

Two weekends ago, at ScienceOnline2010, I heard an interesting thing about embargoes. Connie St. Louis, who directs the science journalism masters’ program at City University, London, told an audience that one of the reasons for embargoes on scientific journal studies is that with more eyeballs on the study before publication, it’s more likely researchers will catch flaws in papers, which can then be pulled.

In other words, just as the FDA requires drug companies to monitor drug side effects in large populations once a drug is approved, in what’s called post-marketing surveillance or phase 4 testing, because such side effects may not show up in relatively small trials, this is a sort of post-acceptance peer review. So if a reviewer doesn’t catch an error during the normal course of peer review, journals can use the embargo period as a backstop.

I hadn’t heard that before, and I consider myself fairly well-acquainted with the arguments for and against embargoes. But it reminded me again that for all the talk of embargoes serving the public by allowing reporters to write more-informed stories, there are serious questions about whether journals are the group that gains most from embargoes.

As it turned out, I was in the midst of another episode that reminded me of that. Last week, the Cochrane Library published their quarterly set of reviews. Among them was a review of whether opioid drugs, when used as prescribed, carried a high rate of addiction. Cochrane researchers found that they don’t. That’s not the biggest research finding ever, but when you run a health news wire service filled with dozens of stories a day, like I do, it’s something worth covering. Plus, opioid dependence remains a big issue, for celebrities and lawmakers alike.

That study was embargoed for 7 p.m. Eastern on the 19th. Around the same time I was reviewing it, the Annals of Internal Medicine press packet hit my desk. That packet — embargoed until 5 p.m. Eastern Monday the 18th — included a paper that said high doses of opioids, even if prescribed, increased the risk of overdose. Again, not the most shocking study ever, but researchers and advocates continue to debate whether these drugs, when used in prescribed doses, are dangerous.

I figured the best way to serve our readers would be a story that included both of these studies, both as context for the other. Trouble was, if I ran one based on the Annals study, I couldn’t mention the Cochrane review. And if I waited for the Cochrane review’s embargo to lift, a competitor might run the other story. (Yes, we think about these things.)

So I emailed Jennifer Beal, who runs media relations for the Cochrane Library’s publisher, Wiley, explaining the situation, and asking her if she would consider moving the embargo. She returned my message right away, saying politely that she couldn’t, and explaining why, in a message that I found thoughtful.

“We thought about it very carefully but felt that our guiding principle with embargoes is that we are giving media an opportunity to investigate a story fully without the pressure to publish immediately, so that the story is still ‘new’ on the day the research gets published, and is therefore available for public consumption,” she wrote. “If we were to agree to a moved embargo, it would mean that you…would be writing about a story where the research was not available for the public to read if they wish and make up their own minds.”

The opioid study, she noted, was “one of approximately 160 articles publishing on Wednesday; this is a big operation where the publication schedule is planned out a long way in advance, so it is not possible to move forward the publication date.” (In a long-planned move, Cochrane is now going monthly, which will distribute the reviews more evenly.)

Based on resource constraints, I decided we could only run one story on opioid addiction or overdose last week. We ended up running a story on the Annals study, which seemed a bit more newsworthy than the Cochrane review. As it turns out, a number of news organizations covered the Annals study — Seattle’s LocalHealthGuide ran an item, which the Seattle Times picked up; The Seattle Post-Intelligencer, and our competitors HealthDay and Bloomberg, among others. As far as I can tell, only a site called MedIndia ran a story by the Health Behavior News Service pegged to the Cochrane review.*

(I should say here that I’m a big fan of the Cochrane Library, access to which is an AHCJ benefit. Some have criticized them for rejecting everything other than randomized double-blinded controlled clinical trials, but I’d rather see more rigor than less, given how often hype and poor evidence tend to rule the day. So this isn’t really about a problem at Cochrane. It’s about how embargo policies, whether well-intentioned or not, often make me wonder whether they serve the public.)

So whom did this Cochrane embargo serve? I’d argue it didn’t serve the public, because we and others couldn’t include news of it in the story we did decide to run. You might even say it didn’t serve Cochrane either, since I’m guessing many of my colleagues decided not to run something on it for similar reasons. And their rationale for not moving the embargo at least had the public in mind.

The episode reminded me of the CDC-autism embargo fiasco last fall, in which the CDC and the journal Pediatrics refused to lift an embargo on autism rate data that many in the autism advocacy community had already reported on. To me, the Cochrane decision was more justifiable, even if I didn’t like it.

Many have questioned embargoes, notably Vincent Kiernan, in his 2006 book “Embargoed Science.” Kiernan makes a convincing argument that embargoes serve journals most, by giving reporters something to cover every month or every week. Nowadays, that’s even more true, I think, as I see an increase in papers embargoed just 1-2 days, rather than the typical 5-6.

Still, when you run a high-volume news service, as much as you’d like to, it’s not reasonable to reject all embargoes in favor of 100% enterprising reporting. Our clients would be very unhappy, and justifiably so. Instead, we can try to cover studies with as much skepticism and context as possible. But when I hear yet another reason why embargoes might help journals, as I did at ScienceOnline2010, I’m only encouraged more to challenge the idea that embargoes are there for the public, and at least force journals to defend how they handle them.

Ivan Oransky, M.D., is executive editor of Reuters Health and AHCJ treasurer. Follow him on Twitter, where he periodically gets into debates about embargoes, among other things.

*Update:

After this post was published, we heard from Lisa Esposito, editor of the Health Behavior News Service, who tells us that Medscape and Elsevier Global Medical News did cover the Cochrane opioid review.

Embargoes: Bloggers say WSJ policy has changed

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

PaidContent.org reports that several sources say The Wall Street Journal has changed its policy on accepting embargoes. A Journal spokesperson denies there has been a change but PaidContent.org says that, according to its sources, “the WSJ will accept embargoes for exclusives but not when other media outlets are involved unless the story is considered big enough.”

Most of the coverage and speculation on the issue revolves around technology news, with some writers saying the WSJ is following in the footsteps of TechCrunch, but health journalists have to be wondering what this means for the paper’s coverage of health and medical news.

Nick Ragone, a public relations executive in New York City, writes on his blog that “My source tells me that they won’t take any embargoed information without prior approval of a deputy managing editor. Which, from what I gather, means they won’t be taking them ever.”

Kyle Austin of RaceTalkBlog says his sources at the WSJ tell him it’s not a big change “that they are only interested in embargoed data that other folks don’t have access to:

“We can still work on advanced stuff with a certain publication data[sic]* in mind, but we can’t accept an embargo that ties our hands to a particular time, particularly one that isn’t exclusive.”

*We’re assuming that “data” in the above quote should be “date.”

So, anyone at the Journal care to comment below and let us know how they will be handling medical coverage if this is true?