Tuesday, May 23, 2006

Can We Ever Believe Anything In The Mainstream Media?

Remember the recent story on how Americans are far, far more sick than the English?

Well - guess what? It's all false! First a recap of the original story:

If You've Got a Pulse, You're Sick


FOR a nation that spends more than any other on health, the United States certainly doesn't seem very healthy.

Many cancers are on the rise — prostate, breast, skin, thyroid. We're fatter than ever. As for diabetes, the number of people who say they have it has doubled in the last 10 years. Now a report says that the English — those smoking, candy-eating, fish-and-chips lovers — are actually healthier than Americans. And they spend half as much on health care.

The American-English comparison, published this month in The Journal of the American Medical Association, analyzed data from people's own reports of their health and also used some objective measures: a blood test for diabetes, using hemoglobin A1c, and blood tests for proteins associated with heart disease risk, fibrinogen and C-reactive.

Their blunt conclusion?

"Americans are much sicker than the English," wrote the investigators, led by Dr. Michael Marmot of University College Medical School in London.

Then the New York Times' re-examination of these 'facts':

It's hard to make cross-cultural comparisons — the populations may not be representative. But it can be even worse when the question involves health. Sometimes, the data that are needed just can't be found because what one country measures, another guesses.

Take obesity, for example. Dr. Jeffrey M. Friedman, an obesity researcher at Rockefeller University, once wondered how much thinner Europeans actually were. So he looked for nationally representative data that included actual measures of weight, not just what some groups of people said they weighed. The United States has such data, but not Europe, with the exception of England.

"You can't get those data," Dr. Friedman said. "They don't exist."

There is, however, one statistic that scientists say is fairly solid: life expectancy at birth. And in comparing the figures for the United States and Britain, it turns out they are almost identical: 77.6 years in Britain; 77.1 in the United States.

Then the truth about heart disease:

As for heart disease, 50 percent more Americans than Britons say they have it, and more say they have high blood pressure and high cholesterol. But when Dr. Marmot and his colleagues looked at actual measurements of blood pressure in British and American populations ages 40 to 70, there was no difference. And Americans had lower cholesterol than the British.

And cancer...

Here, men over 50 routinely get a blood test for prostate cancer, the P.S.A. test, when they have medical exams. It is so accepted that some doctors do not even tell the men they are doing the test. Here, free skin-screening clinics pop up every year and doctors advise people to have their skin examined regularly for cancer. Here, women get mammograms starting at age 40, and they get them every year thereafter. Here, even thyroid cancer screening is on the rise.

And while screening picks up cancers that would become deadly if left unnoticed, in many cases it also picks up tiny cancers that might have gone nowhere — people would have died with them, not of them. Autopsies have repeatedly found that people often have such cancers, but had they been found through screening and treated, people would have thought they'd been "cured."

That phenomenon, overdiagnosis, is a recognized consequence of increased screening, medical researchers say. A telltale sign is a cancer whose incidence rises but whose death rate does not budge.

The most recent example was with thyroid cancer. This month, in a paper in JAMA, Dr. Welch reported that the incidence of thyroid cancer in the United States had increased by 250 percent over the last two decades.

But the death rate from it remained the same.

Screening is much less common in Britain, Dr. Heath says. For example, she said, "we don't do P.S.A. screening for nonsymptomatic men, and we don't do skin screening."

So it turns out that the whole premise behind this report was... bogus. But now the readers of the New York Times know this. But what about the readers of the LA Times? Has our Times followed up on this new story?

Stay tuned...

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