Tuesday, February 08, 2005

Journalistic Reforms

Last year, there was a bit of a shake-up in the medical journal business.  It had come to light that journals were guilty of selective publication: the practice of giving preference to articles that show a large effect of a new treatment.  The solution was to require researchers to register clinical trials in advance.  I've already discussed this in some detail, so I won't rehash it now.  A matter of greater significance is the question of selective reporting by the general news media.  The latest issue of The Economist has an article about the recent scandals in which the Bush Administration has been caught paying journalists:
MOST policy issues are genuinely tough. But just occasionally, something comes along that is as straightforward as it looks. Is it a good idea for a government to look as if it is paying bribes to journalists? Or for a government to put out fake news reports? No and no. And George Bush, at least, gets it. “I expect my cabinet secretaries to make sure that practice doesn't go forward,” he says. “There needs to be a nice, independent relationship between the White House and the press.”

Yet the past month has brought a slew of stories of government departments stomping all over that bright line. The most recent is the case of Michael McManus, a syndicated columnist. He got $10,000 from the Department of Health and Human Services (HHS) for helping train marriage counselors. Before that it was Maggie Gallagher, another syndicated columnist: $21,500 from HHS for helping draft brochures promoting marriage. Before that came the biggest pay-off so far: $241,000 from the Department of Education to a talk-show host called Armstrong Williams to help promote Mr Bush's No Child Left Behind Act.
But this isn't a post about the unethical practices of our government, and I am not going to criticize our news media, either.  Rather, I am going to suggest some reforms that might make our news media more credible and trustworthy.  These are not new ideas.  They are ideas that already have been implemented by medical journals.

First, news media should publish a log of all requests for interviews, and all investigations undertaken.  If politicians are not making themselves available to the media, that fact should be published somewhere.  This is comparable to what the International Committee of Medical Journal Editors have decided is proper for medical journals. 

Second, if an interview is granted under certain conditions, those conditions should be noted in the article.  For example, if a politician grants an interview with the understanding that certain questions will not be asked, then the reader should be informed of that fact.  Clearly, if a medical journal reports on a study, then the conditions of that study must be made clear.  Regular journalists should do the same.

Third, potential sources of bias must be disclosed.  This seems obvious, but it not practiced routinely.  We all seem to expect that news articles will be written without bias, yet to do so probably is beyond the ability of the human mind.  Plus, sometimes persons with biases are the ones who are in the best position to do the reporting.  To see how this is practiced in medical journals, look at the end of a recent article in the Journal of the American Medical Association:
Financial Disclosures: Under separate licensing agreements between the Johns Hopkins University and Guilford Pharmaceuticals Inc and the Johns Hopkins University and Angiotech Pharmaceuticals Inc, Dr Brem is entitled to a share of royalty received by the university on sales of products described in this article. Dr Brem owns Guilford Pharmaceuticals stock, which is subject to certain restrictions under university policy. Dr Brem is also a paid consultant to Guilford Pharmaceuticals. The terms of this arrangement are being managed by the Johns Hopkins University in accordance with its conflict-of-interest policies. No other authors reported financial dislosures.

Funding/Support: Dr Parney is an Accelerate Brain Cancer Cure (ABC2) Foundation fellow. The GO Project was supported by unrestricted educational grants from Aventis Pharma and Guilford Pharmaceuticals to the Center for Outcomes Research, University of Massachusetts Medical School. This study was also supported in part by NIH/NCI grant PO1 CA13525 to the University of California, San Francisco.

Role of the Sponsors: The funding organizations had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript.
Note that one of the authors stands to profit from the sales of products described in the article.  That, obviously, could be a source of bias.  But the article has to do with management of brain tumors, which is an important topic.  Since, Dr. Brem knows a lot about this, and what he knows could save lives, the Journal went ahead and published the article despite the bias.  It would not be reasonable to withhold potentially life-saving information, because of a possible bias; nor would it be proper to publish the information without alerting readers to the possible bias. 

I think it is unreasonable for the general public to insist that reports be unbiased, since that probably is impossible in most cases.  Rather, we should insist on routine publication of all sources of bias.  This might not have been practical twenty years ago, but now that it is simple to put information on the Internet, there is no practical reason not to do so.