The mojo of open journalism, plus that itchy beta thing

DobbsandZimmer

Me (right) hypnotizing Carl Zimmer just before the Rebooting Science Journalism session at ScienceOnline 2010. It worked. Carl had planned to use his 5 minutes to just say, “We are DOOOMED.” Instead he talked about duck sex.

I’ve been meaning for two weeks now to post on ScienceOnline 2010 and the Rebooting Science Journalism session, in which I joined Ed Yong, John Timmer, and Carl Zimmer as “unpanelists.” Lest another frenzied week delay me further, here’s my addition to the #scio10 #reboot corpus.
Journalists-v-bloggers is (almost) dead
Many at the conference, and pretty much everyone in the Reboot session, agreed that the distinction between journalist and blogger would continue to fade — and that “good science journalism” would increasingly be defined as well-informed, well-crafted, transparent writing about science. (Transparent as in clear, yes — but especially as to declaration of possible conflicts of interest.)
Two kinds of stories: “Wow” versus “This smells kinda funny”
In my own 5 minutes (see way below), I drew a distinction between “wow” stories (about cool/new findings, theories, etc) and “something smells funny here” stories (of more investigative or critical nature). The former are often easily and well done by bloggers with good BS detectors; Ed Yong’s many excellent explanations of new or replicated findings are a prime example. This poses obvious competition to writers and pubs who rely heavily on such pieces.
The “Smells Funny” stories, however, may be more threatened by decline of paying venues if writers can’t find supplemental funding to support the extensive reporting these require. I’m split on that prospect. On one hand, the MSM and traditional science press have bankrolled some great examples of this sort of story — the numerous great stories the Times has done on conflicts of interest in pharma/psych research, for instance, as were the stories on the horrid conditions at Walter Reed. My own story on PTSD took many, many weeks of time and thousands of dollars of travel. Yet there are Smells Funny stories the MSM won’t touch and others it botches badly; perhaps new models will do as well or better in funding these.

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The Rise Of Marketing-Based Medicine (via Pharmalot)

The Rise Of Marketing-Based Medicine

64 Comments

By Ed Silverman // January 28th, 2010 // 7:57 am

money13You’ve heard of evidence-based medicine. Well, a new paper summarizes a panoply of practices employed over the past two decades or so – ghostwriting, suppressing or spinning data, disease mongering and managing side effect perceptions among docs – that the authors call marketing-based medicine. And they rely on internal documents from litigation – such as the much-publicized lawsuits over antipsychotics and antidepressants – to illustrate their point.

A stunning must-read from Ed Silverman on a must-read paper. The comments following Ed’s post are also rich.

I imagine there will be blowback and some vigorous challenges to the facts and stats in the paper. But the industry emails quoted are themselves devastating, and suggest how successfully the marketing forces within the industry won out over those who wanted to make drugs that clearly worked, rather than aggressively sell drugs that either didn’t work that well or worked for some but carried nasty side-effects that were downplayed.

Pharma, biotech, and medicine itself will be years digging out of the credibility hole this sort of thing put them in.

Posted via web from David Dobbs’s Somatic Marker

Hits of the week past

Hits of the week:
Savage Minds (with a spiffy website redesign) asks Why is there no Anthropology Journalism?
Jerry Coyne takes sharp exception to both a paper and a SciAm Mind Matters article by Paul Andrews and Andy Thomson arguing that depression might be an evolutionary adaptation. Dr. Pangloss punches back. (NB: 1. I was founding editor of Mind Matters, but no longer edit it, did not edit the Andrews/Thomson piece, and don’t know any of these people. 2. While my recent Atlantic article presented an argument for how a gene associated with depression (the so-called SERT gene) might be adaptive, this is not the same argument, at all, that Andrews and Thomson make — though it’s compatible with theirs.)
In a splendidly wrought post titled “A ‘Severe’ Warning for Psychiatry,” Neuroskeptic shows how the expansion of the depression diagnosis — which many argue was driven by pharma’s eagerness to expand the market for antidepressants — may have led to recent findings that antidepressants appear to work mainly for the more severe cases. Irony lives (though at great expense).
A while back I came close to writing a story on how the U.S. is in danger of falling behind both the EU and China in scientific productivity. Mooney & Kirshenbaum have a nice post — and an alarming graph — showing how rapidly China is gaining.
The Atlantic examines What Makes a Great Teacher, while John Hawks gapes at how hard it can be to fire even a really bad one. We don’t figure this out, we watch China and the EU pass us sooner rather than later.

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Chess computing as a metaphor for Pharma. Who knew?

Above: Kasparov after his first meeting with Deep Blue, in 1997, when he crushed DP. Later it wouldn’t go so well.

In a splendid article in the NY Review of books, former world chess champion Gary Kasparov ponders the limitations of technology as a means of playing chess truly well. When I hit this paragraph late in the article, it struck me that you could write much the same thing about pharma. From The Chess Master and the Computer – The New York Review of Books:

Like so much else in our technology-rich and innovation-poor modern world, chess computing has fallen prey to incrementalism and the demands of the market. Brute-force programs play the best chess, so why bother with anything else? Why waste time and money experimenting with new and innovative ideas when we already know what works? Such thinking should horrify anyone worthy of the name of scientist, but it seems, tragically, to be the norm. Our best minds have gone into financial engineering instead of real engineering, with catastrophic results for both sectors.

(via Instapaper)

Only in pharma, it would be “when we already know what sells.”

Posted via email from David Dobbs’s Somatic Marker

Why do antidepressants work only for the deeply depressed? A neuroskeptical look

Neuroskeptic ponders the growing evidence that antidepressants significantly best placebo only in the more (or most) depressed patients. His take is that:

antidepressants treat classical clinical depression, of the kind that psychiatrists in 1960 would have recognized. This is the kind of depression that they were originally used for, after all, because the first antidepressants arrived in 1953, and modern antidepressants like Prozac target the same neurotransmitter systems.

Yet in recent years “clinical depression” has become a much broader term. Many peopleattribute this to marketing on the part of pharmaceutical companies. Whatever the cause, it’s almost certain that many people are now being prescribed antidepressants for emotional and personal issues which wouldn’t have been considered medical illnesses until quite recently. Antidepressants also have a long history of use for other conditions, like OCD, but this is a separate issue.

There’s a chicken-egg puzzle in here, of course: Did the expansion of the Dx encourage the rise in Rx, or did the availability (and marketing of) the drugs encourage the expansion of the Dx? I suspect the latter.

Later: D’oh! Neuroskeptic’s post is at http://neuroskeptic.blogspot.com/2010/01/severe-warning-for-psychiatry.html. Thanks to ericbohlman for pinging me about the oversight. Apparently the hazards of blogging by iPhone are many.

Posted via email from David Dobbs’s Somatic Marker

Rice, alcohol, and really fast evolution in humans

In my “Atlantic article on the genetic roots of stable-versus-reactive temperaments, I noted that the key gene variants linked to these traits appeared to have developed over only the last 50,000-100,000 years — a short time in evolutionary time. That same idea is developed in Cochran and Harpending’s “The 10,000-year Explosion.” Here Razib at Gene Expression looks at polymorphisms that have developed over the last 10,000 years in response to agriculture.

Changes in human diet driven by cultural evolution seem to be at the root of many relatively recently emerged patterns of genetic variation. In particular, lactase persistence and varied production of amylase are two well known cases. Both of these new evolutionary genetic developments are responses to the shift toward carbohydrates over the last 10,000 years as mainstays of caloric intake.

via scienceblogs.com

Posted via web from David Dobbs’s Somatic Marker

Ezra Klein – America spends way, way, way more on health care

We don’t have a government-run system. But our system is so expensive that our government’s partial role is pricier than the whole of government-run systems.

via voices.washingtonpost.com

Absorb that: Our supposedly efficient supposedly free-market healthcare system costs us more in government spending alone than other countries spend on government-run systems.

Posted via web from David Dobbs’s Somatic Marker

NEJM study finds post-event morphine cuts combat PTSD rates in half

This is a pretty big deal if it holds up in future trials. One caveat I’ve not had time to check out is whether the morphine was often applied as part of an more robust medical response in general, which itself might reduce later PTSD symptoms. I hope the DOD soon follows up with another, larger study, for as Ben Carey notes, the has some substantial implications if indeed it holds up.

via nytimes.com:

In the new study, researchers at the Naval Health Research Center in San Diego reviewed detailed medical records of 696 troops who had been wounded in Iraq between 2004 and 2006, determining whether and when morphine was used in treatment. Military doctors used the drug for most serious injuries — generally in the first two hours after the injury — but sometimes administered others, like anti-anxiety medications

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Rebooting science journalism -mixed-metaphor notes on the upcoming yakfest

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Tomorrow I fly to North Carolina for the ScienceOnline 2010 conference, or unconference, where on Saturday I will sit down with Ed Yong, Carl Zimmer, John Timmer, and anyone else who squeezes into the room, to talk about rebooting science journalism. The obvious assumption behind the topic (if I can return to the titular metaphor) is that science journalism is such a mess that it needs not just cleaning up, but a wholesale restart. But “rebooting” is probably too mild a term for what most people think is needed; if we’re to stick with digital metaphors, I’d to say the assumption is more that we need an entirely new OS, not a restart of this one.
At this point, frankly, the shape of that discussion is as obscure to us as cloud-covered terrain. We’ll be discussing how to navigate terrain we can’t yet see, and carrying, with great unease, crappy maps that we know are based on questionable reports and outdated geography. “Here be dragons!” seems the only certain thing on them. And as Jay Rosen likes to point out, the title on the map — “science journalism” — is a term that, while it seemed to have a coherent definition five years ago, now seems more vague and inexact and arbitrary with each passing day.*`
So how to think or talk about this coherently?

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