Here are two headlines on the same New England Journal of Medicine article this week, on a study from Johns Hopkins.

The local paper – the Baltimore Sun – had the cheerleading headline: “Hopkins study supports use of CT scan of heart.”

The Wall Street Journal, on the other hand, had a quite different headline: “Heart scans sometimes fail to identify blockages, study finds.”

Granted, the Baltimore story had some strong caution, such as this quote:

“I think [the study] is overly optimistic about CT angiography,” said Dr. Steven E. Nissen, a cardiologist at the Cleveland Clinic. “In the real world, as opposed to in a carefully designed study, CT angiography does not perform as well as was reported in this study.”

But the headline sets reader expectations of what is to follow. We think the WSJ outshined the Sun on this one.

All over the country, daily journalists working on newspapers or on radio or TV are now also being asked to publish blogs – often without any additional pay for the additional work.

But I recently discovered a case where a reporter pressured to do a blog had that blog censored by a TV news director because he didn’t like what was in the blog.

The reporter – a TV health reporter – posted two entries about some questionable (I would call them unethical) practices in TV news. One referred to the practice of medical centers buying air time within newscasts and having the message appear as news. The posting asked blog visitors:

“What do you think of commercials for local health care behemoths that look like news? … Are you able to tell they are clearly commercials?”

The other blog entry was about subscription services that provide health news for stations to fill their newscasts. The reporter, whose station often uses such a service, wrote on the blog:

“I’ve noticed a lot of the subscription reports have to do with research. And not that I have anything against research — in fact, I think it’s a very important part of medical advancement — but I believe the mass media need to be very careful about highlighting investigational procedures, products, and techniques. …I worry sometimes these packages peddle false hope, or at least, premature hope.

What do you think of these subscription pieces? Can you tell when it’s something I’ve written versus a (subscription) piece? Do you think stations should even subscribe to (such) services?”

Without being told in advance, the reporter noticed that the blog entries had been deleted. The news director then called the reporter on the carpet and said that “He didn’t think it was right to ask viewers what they thought about something management had already decided to do.”

The reporter no longer blogs on the station website. That reporter asks if other reporters have had similar experiences, stating “it’s about reporters everywhere having viewpoints about what their own industry does, and not being able to express their views without fear of reprisal.”

Please weigh in if you know of other such in-house censorship of the free flow of ideas. In an era of transparency, there are apparently some editorial decisions that some news managers – at least this one – don’t want to shine a light on. That may be the best evidence there is for why the practices in question should be re-assessed.

Adverse experiences early in life can lead to minor childhood behavior problems, which can grow into serious acts of teen violence, as per new research. This “cascading effect” of repeated negative incidents and behaviors is the focus of an article in the November/December edition of the journal Child Development…….

Associate Professor of Neuroscience and Ophthalmology at LSU Health Sciences Center New Orleans, is the lead author of a paper identifying, for the first time, a specific function of a fragment of ribonucleic acid (RNA), once believed to be no more than a byproduct, in regulating inflammation and the development of Alzheimer’s disease. The paper, An NF-kB-sensitive micro RNA-146a-mediated inflammatory circuit in Alzheimer’s disease and in stressed human brain cells, would be reported in the November 14, 2008 issue of The Journal of Biological Chemistry…….

Four in five Americans support the idea of a nationwide study to investigate the interactions of genes, environment and lifestyle, and three in five say they would be willing to take part in such a study, as per a survey released recently. The research was conducted by the Genetics and Public Policy Center at Johns Hopkins University with funding from the National Human Genome Research Institute (NHGRI) of the National Institutes of Health (NIH)……..

Paul Levy. President and CEO of Beth Israel Deaconess Medical Center in Boston, blogs about keeping up with the Joneses in the medical arms race. He wrote:

“Many months ago, I wrote about the da Vinci Robot Surgical System and expressed doubts about whether there was evidence to support the clinical efficacy of this equipment, as opposed to the marketing efficacy of the company selling it. Well, the time has come to graciously say, “Uncle!”

Without making any representations about the relative clinical value of this robotic system versus manual laparoscopic surgery, I am writing to let you know we have decided to buy one for our hospital.

Why? Well, in simple terms, because virtually all the academic medical centers and many community hospitals in the Boston area have bought one. Patients who are otherwise loyal to our hospital and our doctors are transferring their surgical treatments to other places.

Prospective residents who are trying to decide where to have their surgical training look upon our lack of the robot as a deficit in our education program. Prospective physician recruits feel likewise. And, these factors are now spreading beyond urology into the field of gynecological surgery. So as a matter of good business planning, concern for the quality of our training program, and to continue to attract and retain the best possible doctors, the decision was made for us.

So there you have it. This is an illustrative story of the health care system in which we operate.”

Researchers have long known that women’s preferences for masculine men change throughout their menstrual cycles. A new study from Indiana University’s Kinsey Institute is the first to demonstrate differences in brain activity as women considered masculinized and feminized male faces and whether the person was a potential sexual partner……..

“Anemic.” That’s what the Wall Street Journal Health Blog calls the fact that health news made up 3.6% of all the news content analyzed by the Kaiser Family Foundation and the Pew Research Center’s Project for Excellence in Journalism over an 18-month period ending in June.

One data point I locked into is this:

Despite ongoing debates about the future of our health care aystem, health did not become a dominant part of the 2008 primary campaign narrative. Looking at all of the presidential campaign coverage over the first six months in 2008, health-focused stories made up less than 1% of the coverage.

While the analysis ended in June, I’ll go further and predict that a systematic analysis of the June – November period would show that health policy coverage didn’t improve any.

The report concludes:

“Given the small portion of national news information that is dedicated to the health care system, it may be difficult for the public to become fully knowledgeable about the state of our system and potential changes under debate.”

See the full report here.

Earlier this year, when I published our data on our first two years’ experience on the HealthNewsReview.org project, I thought that surely leading U.S. journalism publications such as Columbia Journalism Review or American Journalism Review would be interested in some kind of summary.

Wrong. Not a word of interest.

But internationally, journalism bloggers from several countries picked up on the story immediately. And now a German journalism magazine, Message: Internationale Zeitschrift für Journalismus, has republished the PLoS Medicine article.

I hope we can get an international discussion started – backed by the experiences of my colleagues on the Media Doctor Australia and Media Doctor Canada projects.

Our combined pool of news stories reviewed in the 3 countries now totals over 2,000 – a very clear picture which shows how many news stories across the globe fail to deliver important details on health news stories such as:

• How much is this going to cost?
• How small is the potential benefit?
• How large are the potential harms?

Mark Twain, a skeptic of the idea of free will, argues in his essay “What Is Man?” that humans do not command their minds or the opinions they form. “You did not form that [opinion],” a speaker identified as “old man” says in the essay. “Your [mental] machinery did it for youautomatically and instantly, without reflection or the need of it”……..