Thursday, May 09, 2002

Two stories this week coming out of "professional" news organizations have blown the facts completely.  Infuriating. First is the failure of U.S. media to characterize accurately the place of assasinated Dutch politician Pim Fortuyn in the broader landscape of European political thought.  [A failure well-covered in the blogosphere, largely thanks to Adam Curry -- read his piece, "The Big Lie" -- and picked up by Dave, John, and others.]  Because of his narrowly focussed comments about possible consequences of immigration on his country, and a political opponent's characterization of those comments as "right wing," Fortuyn has been lumped by most mainstream U.S. media in the same "right-wing fringe" pot as France's Le Pen and Austria's Heider.  Wrong, wrong, wrong. Now comes the Washington Post (among others) announcing breathlessly that Against Depression, a Sugar Pill Is Hard to Beat.  The headline strongly suggests that placebos are as effective as SSRI anti-depressants (of the Prozac/Zoloft/Paxil class) in improving mood and changing brain chemistry. This is a gross, and potentially quite dangerous, mis-reading of a particular study, and a gross misunderstanding of what the "placebo effect" is.  If any depressed patient decides, on the basis of this story, to abruptly discontinue taking antidepressant medication and subsequently commits suicide, we wouldn't be surprised to read of a wrongful-death suit against the Post. Of course, buried a third of the way into the article (well below "the fold"), the writer back-tracks enough to say, The confounding and controversial findings do not mean that antidepressants do not work.  But clinicians and researchers say the results do suggest that Americans may be overestimating the power of the drugs, and that the medicines' greatest benefits may come from the care and concern shown to patients during a clinical trial -- a context that does not exist for millions of patients using the drugs in the real world. What is infuriating here is that the headline and sub-head assigned to the article sensationalize the purported "conclusion" of one of the studies cited in the article, and thus distort the reader's impression of both the article itself and the science behind it. Our impression is that the reality of psychopharmacology is that the brain is an exquisitely complicated place, and that the mere fact that I'm paying attention to my mood has an effect on the mood itself.  Yes, the "care and concern" element plays a strong role, whether what's going into my mouth is sugar or Prozac.  But it's also clear (notably in the study by Mayberg et al. that gets buried at the bottom of the article) that the addition of active drugs brings additional, and often beneficial, effects. What is additionally infuriating here is that the Post, like the Times and any other ad-revenue-driven news site, won't provide links to the relevant scientific information.  How hard would it have been to provide a link list like this? Abstract of Mayberg, et al., "The Functional Neuroanatomy of the Placebo Effect" Abstract of Leuchter, et al., "Changes in Brain Function of Depressed Subjects During Treatment With Placebo" Summary article by Arif Khan in Psychiatric Times Sure, these abstracts and scientific articles are laden with carefully-selected sesquipedalia (i.e.,Big Words), but the conclusions cited in the abstracts of the Mayberg and Leuchter articles (both of which are cited in the Post article) flatly contradict the Post's headline, and even Khan notes: "The less-than-impressive difference between drug and placebo in this and other studies of clinical trials does not speak directly to the effectiveness of antidepressants in clinical practice."  But the reader of the Post's article won't get the chance to find that out, because a link off of the site is a doorway away from our advertisers. It's just bloody irresponsible.  Feh! 1:03:50 PM

Doc notes: Back on an upbeat note, there's a Larry Lessig interview. Says he's "already the Net's most famous freedom fighter." and asks, pointedly: What would that make Jack Valenti?  Hee hee! 8:19:24 AM