behind the news

Telling the Whole Story

January 6, 2005

This morning over breakfasts of gummy oatmeal and dry, whole-grain toast, tens of thousands of health-conscious Americans learned that two new medical studies show that protein may be just as big a killer as cholesterol.

A Google search shows that versions of the story have already appeared in, or were mentioned by, more than 75 media outlets.

Many of the stories were similar to this one, written by Steve Sternberg of USA Today:

Two leading research groups independently reported today that lowering blood levels of a protein that promotes artery inflammation is just as important as reducing bad cholesterol for preventing heart attacks and strokes.

Their conclusions reflect a major shift away from the notion that bad cholesterol, or LDL, is the primary villain in heart disease. Levels of C-reactive protein (CRP) also must be reduced to halt the disease’s progression, researchers said.

Or, this article by Scott Allen of the Boston Globe.

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Most Americans have had their cholesterol levels tested, and more than 10 million take drugs called statins to reduce their levels of LDL, or “bad,” cholesterol. But relatively few primary care doctors routinely test patients’ blood concentration of C-reactive protein, the leading measure of inflammation.

“All of a sudden, we have a revolution,” Dr. Steven Nissen of the Cleveland Clinic told the Los Angeles Times’ Thomas H. Maugh II. Nissen directed one of the two studies. He added that if cardiologists routinely monitored levels of the C-reactive protein in patients at risk, “tens of thousands of lives” could be saved over the next few years.

“It’s really a big deal,” Nissen told Forbes.com.

Big deal for whom?

Good question in this day of hyped medical breakthroughs and — ultimately — medical misjudgments. Think Vioxx. Think anti-depressants for kids.

It’s certainly good news for the drug companies, which already earn $26 billion a year from those cholesterol-lowering drugs called statins, because statins also seem to reduce the levels of the protein called CRP.

As Gina Kolata writes today in her page-one New York Times story about the studies, if the research findings are correct, “a huge new market for the already popular statins could be opened among people whose cholesterol levels are normal but who have high levels of CRP.”

But that’s not what lifts Kolata above many of her colleagues and peers covering the same story. No, that would be her extra reporting, which enabled her to tell Times readers that the studies at issue were sponsored by Bristol Myers Squibb, maker of Pravachol, and Pfizer, maker of Lipitor, the two most popular statins. That is an important piece of information, mssing from too many stories, including those in the Globe and the Los Angeles Times.

But Kolata goes one giant step further in full disclosure, with this information: Dr. Paul Ridker, who headed the second study, at Boston’s Brigham and Women’s Hospital, “is also an inventor of a test for CRP that his institution licensed. He and his laboratory profit from the use of the test.” He and his laboratory will profit even more if CRP testing becomes routine, as the studies seem to indicate.

(That crucial financial interest also was reported in less detail by Delthia Ricks of Newsday and John Fauber of the Milwaukee Journal Sentinel.)

“That’s a key fact,” said Laurence M. Paul, executive director of the New York Times News Service. “I stopped reading [Kolata’s story] at that point.”

Kolata’s article was went out to subscribers of the Times’ wires in two versions, Paul told CJR Daily: the original, which local editors are free to revise, and a shortened version, offered as part of the “TimesExpress” service.

According to Paul: “In the full-length version, the passage about Dr. Ridker’s financial interest in the CRP test was included, but was in a block of text denoted as ‘optional trim’ material. In the shorter ‘TimesExpress’ version, that passage was not included,” and Paul is abashed and sorry about that. “We will be moving a corrective note on our wire this afternoon calling attention to this editing oversight and suggesting that client newspapers that used the story minus the qualifying passage may want to take corrective action themselves.”

Those client newspapers would include the Philadelphia Inquirer (registration required), the Houston Chronicle (registration required), and the International Herald Tribune (which is owned by the Times).

A simple fix, it seems. Let’s see how many clients take Paul’s advice.

–Susan Q. Stranahan

Susan Q. Stranahan wrote for CJR.