The Sensible Diet

On Friday 17th April 2009 you could attend a one day course at Aston University on drug metabolism.

Drug metabolism exerts a powerful influence on drug action - from complete failure of a drug’s effectiveness to life-threatening toxicity. This course focuses on the aims, responses and processes of human drug biotransformation systems. As a result, it will assist health care professionals - particularly new prescribers (e.g. nurses, podiatrists or optometrists) to develop their drug therapy practices.

It’s hosted by Prof Michael Coleman, who combines academia with being cool and witty in equal measure.

This is more common than you think, although superglue is the usual culprit.

Paula Griffin, 29, squirted the hazardous liquid into her right eye by mistake after waking up with blurred vision.

Her eye was glued shut for eight hours and was only prised open again when doctors cut off her lashes.

Miss Griffin was warned she could have lost her sight forever and is still waiting to be told if there is any lasting damage.

The accident happened when she woke up and reached for a bottle of eyedrops in a bathroom cupboard.

But in her confused state she grabbed an identical-sized bottle of nail glue that was next to it.

Miss Griffin is worried about being seen as a dumb blonde, but she finds herself in the company of an Abbot of a Thai monastery - who further compounded his error by putting thinners in his eyes to try and rectify the problem. The earliest case of superglue-eyedrop confusion seems to have occurred in 1982. One publication (including management advice) describes finding 14 cases in 12 months at one emergency clinic.

Getting into the newspapers, if that rate of occurrence is typical, is a real achievement.

John Rentoul has been running an occasional series based on headlines to which the answer is “no”. These include:

He’s the outcast bishop who denies the Holocaust - yet has been welcomed back by the Pope. But are Bishop Williamson’s repugnant views the result of a festering grudge against Marks & Spencer?

No.

Is This Atlantis?

No.

And today’s

Is Gordon Brown Insane?

No.

John suggests that the accusation of madness when you are in disagreement with a politician is “a standard refuge of the over-expressive commentator”, but it’s far more common than that.

Norman recently posted about the news that ministers would be reviewing whether PSA testing was sensible on the basis of a study reported in the media, with a further update by a reader here. His link takes you to an article by Sarah Boseley in the Guardian. Unlike some other papers, she at least notes the down side of screening:

the trial also threw up the very real risks of being wrongly identified as at risk and having unnecessary and potentiually damaging treatment. A total of 5,990 prostate cancers were detected in the screening group and 4,307 in the control group.

The rate of overdiagnosis – defined as diagnosis in men who would not have clinical symptoms during their lifetime – was as high as 50% among those who were screened.

Ben Goldacre, in The Guardian, takes the media to task for their poor, and selective, reporting in this case.

all around the world, people were saying something completely different, on the same day, about the very same academic publication: Prostate Cancer Screening May Not Reduce Deaths said the Washington Post. Studies cast doubt on leading prostate cancer test said USA Today. PSA testing may not save your life, after all said Scientific American. Prostate cancer blood test does little to decrease death rate said the Sydney Morning Herald. And so on.

Why would the American and the Australian journalists say something completely different to the British ones, about the very same evidence?

Firstly, our journalists were simply confused. Not a single newspaper managed to clearly explain the risks and benefits of screening in the trial they were writing about. It’s very simple: the study took over 160,000 men between the ages of 55 and 69 and randomly assigned them either to get PSA screening, or to be left alone. The differences were marginal. Yes, there were 20% fewer deaths in the screening group. What does that mean in terms of real people, in real numbers you can understand, not percentages?
[...]
But it gets worse. British journalists also deliberately ignored one whole half of the research, and I’ll confess I’ve slightly lost my sense of humour over this. There were in fact two large studies on PSA testing published in the New England Journal on the 18th of March 2009, not one. They were both published on the same day, in the same journal, they are side by side on the same contents page. British journalists discussed only one of them: the one that said PSA screening does reduce deaths.

The study they ignored was huge too: it took over 75,000 men and randomly assigned them to either a screening programme, or no screening. It found no difference in death rates between the two groups at all, and in case you think it was a close thing, in fact, there was a non-significant trend towards more deaths in the screening group. Not one UK newspaper mentioned this trial.

Ben’s case against the media, and argument that a group of dispersed experts and commentators on the internet can counter and compete with such misinformation, is persuasive. However, while I think informed citzen and scientific comment on blogs and other electronic media can act as Policeman and a corrective check on the media, I’m not convinced such groups are currently as powerful, in terms of engaging with the public more generally, as a front page headline in the media.

Jeremy Laurence draws attention to the news that Prof David Salisbury, Director of Immunisation at the Department of Health, has decided to sue the One Click Group - the group who used homophobic attacks on Brian Deer.

I fear this episode is symptomatic of a wider problem. The fault, if Salisbury has one, is not in what he says but how he says it. The tone in a recent Radio 4 ‘Today’ interview, as measles cases hit a new high, was hectoring, with a note of irritation. “I think it’s irrational [refusing the vaccine]. I think it’s putting children’s lives at risk. I can see no shred of benefit,” he said. Is he becoming exasperated? That would not be surprising, but this is not the way to reassure parents anxious about their children’s safety

Whatever the pros and cons of David Salisbury’s legal action against the One Click Group, it should be noted that the Independent cannot be trusted as experts on what is reassuring to parents. In the past few days they have run three stories on vaccines that are on a par with the worst of the Daily Mail’s scaremongering over MMR vaccine. The first one was a front page story on Meningitis C vaccine, which I criticised in this post. The second story was a follow-up to the original Meningitis C vaccine story. I wrote a letter to The Independent about this story - which was not published.

Dear Editor,

The Independentreported on the 27th of February 2009 that doctors in the UK had been asked to trace all babies who had been injected with a meningitis C vaccine, which was also called a ‘tainted jab’. In fact, there is no evidence that any meningitis C vaccine distributed in the UK was contaminated with Staphylococcus aureus; it passed all normal sterility testing. Additionally, there appears to be no evidence that the Department of Health has asked doctors to trace any children, for the very good reason that there is no evidence of any safety risk to UK children. Could The Independent confirm whether this claim is true or just an excuse to provide an exciting headline? Ten years of media misreporting of the MMR-autism hoax, with its detrimental effect on public health, has apparently not been enough to make journalists reflect on their propensity to scaremonger when it comes to vaccine safety.

I have not received any information back from the The Independent to verify their claim that children were being traced.

Whatever the failings of the Department of Health over the years in communicating with the public, they are dwarfed by the huge tottering pile of deliberate misinformation thrown out by the media, with no regard to public safety, over the years.

The third story from The Independent concerning vaccines I will cover later today.