STATS ARTICLES 2007

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New York Times Continues to Mislead on Avandia Risks

Why does the Times continue to ignore scientific criticism of Avandia’s critics?

Undoubtedly New York Times reporter Gardiner Harris knows how to report; and, it is reasonable to presume that his editors – who provide the six layers of editing that every Times article must endure -- recognize good reporting when they see it. The problem with Gardiner’s coverage of the various controversies surrounding the diabetes drug Avandia, however, is what he continues to leave out of the story.

In today’s article documenting new studies, which purport to show a risk of increased heart failure from the drug, Harris reports:

“The controversy began in May when The New England Journal of Medicine published a combined analysis of more than 40 studies of Avandia that found that it significantly raised the risks of heart attacks. The study attracted wide attention, but it was also criticized by the company and some on Capitol Hill as flawed.”

This echoed an earlier report by Harris on Avandia which noted that the New England Journal of Medicine and the author of the study Dr. Steve Nissen,

“were criticized by Republicans on Capitol Hill and others for rushing to print a study they said was flawed.”

Both characterizations make it seem as if there are scientists on one side pointing out the problems with the drug (and calling for changes in drug regulation as a consequence) and politicians on the other.

Now if you were a diabetic, where would you think the balance of truth lies? With the scientists of course!

Except that in this case, you’d be wrong. The original study’s methodology was heavily criticized by a series of independent analyses, articles and submissions by leading experts– and one would have to be a lousy reporter or willfully blind not to have taken cognizance of the growing body of literature pointing out why the original claim for a 43 percent increase in heart failure is unsupportable. For example:

Faster publication isn’t always better” – Nature Clinical Practice Cardiovascular Medicine (2007) 4, 345 doi:10.1038/ncpcardio0942

Expedited Literature Review – The Rosiglitazone Meta-Analysis” – Reviews in Cardiovascular Medicine (2007) Vol 8 no 2.

Submission to the House Committee on Oversight and Government Reform by Dr. Brian Strom, Chair and Professor of Biostatistics and Epidemiology and Professor of Medicine and Pharmacology at the University of Pennsylvania School of Medicine (link is to extracts).

Uncertain Effects of Rosiglitazone on the Risk for Myocardial Infarction and Cardiovascular Death– Annals of Internal Medicine. 2007, Vol 147, 8

All of these aren’t merely opining that the original study was flawed: they point out why, objectively, it was flawed.

(The two new studies mentioned in the Times news story, one of which is co-authored by Dr. Nissen, appear, at first glance, to suffer from similar methodological limitations in that they are meta-analyses, but we’ll reserve judgment on their rigor until closer examination. Harris does not quote any scientist on the weaknesses of the new data, only those who support their conclusions).

The Times failure – twice – to acknowledge rigorous, independent scientific criticism that challenges the statistical grounds for scare-mongering over Avandia is not merely bad journalism, but a huge disservice at a time when diabetes is growing as major public health problem.


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