JAMA: Media Shortcomings in Reportage of ENHANCE Study

Ignored by the media radar nearly altogether* is a recent JAMA editorial, in which Northwestern physicians Philip Greenland and Donald Lloyd-Jones chastised the press for its off-target reportage of the ENHANCE study results in January and February.

In a editorial section titled, "Lesson 2: The News Media Must Be Sure to Get the Facts Straight," the authors cited the media's mischaracterization of the study's primary outcome, which had no bearing on the prevention of clinical events (eg, MI or stroke), was not "negative" (but instead, was not statistically significant), and did not assess "fatty plaque" (but instead, used intima-media thickness as a surrogate marker for atherosclerosis).

Adding confusion to misinformation in press reports, quoted medical experts "appeared to be unaware of the actual results of the study," the authors wrote, and some reporters (eg, John Carey for Business Week) wrongly and grossly generalized the ENHANCE results to undermine the benefits of cholesterol lowering altogether (see citation here). The authors also pointed an admonishing finger in the direction of NYT op-ed columnist Gary Taubes:

In this case, the news media apparently fanned a lot of the frenzy and then seemed to stand back, unable to clear up the confusion or in some instances, added to the confusion [see NYT op-ed piece here]. It is difficult to understand how such a study could mushroom in importance to the point that 50 years of serious and logical research has been damaged and defamed for no good purpose.

Greenland and Lloyd-Jones cautioned medical experts to refrain from commenting to the press until all relevant study data are available (fat chance). They also noted that attempts by the American Heart Association and the American College of Cardiology to allay confusion backfired, given that these organizations have commerical relationships with pharma. Despite the authors' belief that the AHA and ACC can make independent, science-based recommendations, they advised that "[t]hese organizations must distance themselves from industry support to retain their credibility with physicians and health consumers."

*The JAMA editorial was covered on February 28 by heartwire.