Jane McCredie: A scary beat-up

“ ‘MIRACLE’ drugs put thousands at risk,” trumpeted a recent front-page headline in a Sydney newspaper.

“Thousands of Australians could be taken off cholesterol-lowering medications because of mounting evidence they increase the risk of diabetes and dementia,” the Sydney Morning Herald article began.

The rest of the story about US Food and Drug Administration’s changes to safety labelling for statins actually was quite accurate, but most readers probably didn’t get beyond the scary words in the headline and first paragraph.

For the record, the US regulator did not warn about dementia, but acknowledged potential cognitive effects (generally non-serious and reversible), as well as reports of increased blood sugar and HbA1c levels in people using the drugs.

“FDA continues to believe that the cardiovascular benefits of statins outweigh these small increased risks,” the regulator said.

So how did such a mild warning turn into a raft of media stories — the Herald was just one of many — that caused consternation in patients and may have prompted some to discontinue essential medication?

I’d put it down to a process journalists sometimes call “sexing up” — a relatively dull story that might have been happy pottering around on page seven is turned into a page-one lead by the addition of conflict, dramatic language and, where possible, a good dose of fear.

“Thousands at risk”, “mounting evidence”, “dementia” and “diabetes” did that job in the Herald story. And, somehow, describing a medication as a “miracle drug” makes it seem so much worse when it’s shown to have side effects.

The journalist in this case went on to interview a range of experts and provide a balanced discussion of risks and benefits — even including numbers needed to treat (150 to prevent a major cardiac event) and harm (500 for each new case of diabetes).

But much of that quality reporting was undermined by the sensationalist headline and opening paragraph, which may not actually have been the journalist’s responsibility. Reporters don’t write their own headlines and strange things can happen to articles once an editor decides they’re going on the front page.

In the highly competitive world of the news media, these sorts of distortions are all too common among news outlets.

Associate Professor David Sullivan, a lipid specialist at Sydney’s Royal Prince Alfred Hospital, described reporting of the US move as “rather alarmist” and in some cases “almost a bit mischievous”.

“It really casts a doubt in [the patient’s] mind and undermines the trust in the therapeutic relationship with their doctors”, he told Radio National’s Health Report.

“The case is made in this FDA announcement that people should not stop taking statins … but really that message isn’t delivered to the general public.”

Perhaps the regulator could have done more to get that message across, but it’s always difficult to prevent sensationalist reporting when safety concerns are raised about drugs that are as widely prescribed as statins.

The irony is that these kinds of news articles probably pose a greater risk to patients than any drug — people frightened into discontinuing statins may go on to have a major cardiac event as a result.

Imagine if we could label media reports with a number needed to harm as we do drugs.

Jane McCredie is a Sydney-based science and medicine writer.

Posted 12 March 2012