“Do not think, Pip. It never leads to anywhere edifying”

I promise that this is not a post extolling the works of Mr. Dickens or the BBC renditions of the same.  Instead it is a rant about the blatant misuse of truth found in news stories.

Tonight I watched the news with the Housemate. On the NBC Nightly News with Brian Williams.  Now I have to admit, I am very fond of the person of Brian Williams.  His various appearances on the Daily Show have revealed what a lively, intelligent, snarky man he is.  I am not so enamored with the newsman Brian Williams.  He is a good anchor, with gravitas.  However, I do not enjoy the newscast.  I roll my eyes often. Tonight was no exception, only this time it made me annoyed enough to rant about it to my poor, long-suffering housemate.

It all started with this story:

NBC News Clip

Here’s the deal. The story isn’t honest.  Not really.  And it speaks to the way we report things.  We set them up to be seen as true. We do not tell lies, but what is inferred, what is not spoken leads to a conclusion that is untrue.

Let me break this down.  The story leads with the premise that weight loss surgery can help cure diabetes.  It uses a personal anecdote to validate the premise, quickly explains the study, then repeats the conclusion that bariatric surgery is a good way to cure type 2 diabetes.

Yet the story never asks the difficult questions. It doesn’t  measures the study against anything else.  It does not put it in context.

The study measures two different kinds of stomach limiting surgery and compares it against a group that just treated their diabetes with medication. This news report shows the study to have discovered that the groups that have surgery lose more weight, and have improvements on their health, especially controlling their diabetes.

There are problems with this.

1. The report does not tell the study’s purview. Was the study about managing diabetes? Loosing weight? Health concerns?  Doesn’t show if there was anything else of value in the study.
2. The report does not explain how the study was conducted. What was the size of the study? What was the age group of people studied.  How severe was the diabetes? Did the two groups have other factors the same, say diet?  What is the difference? Is it just a few percentage points, or is it significant
3. The report does not put the study in context. So surgery shows promise over traditional medicine, but it doesn’t show it in comparison to say, a good regime of diet and exercise.  Thus the conclusion becomes that the best way to deal with diabetes is to get stomach reduction surgery.
4. The report does not make clear if the diabetes reversed itself, or if was just managed without ever needing medication.

I take issue with this.  Here’s why.  I have a friend named Margaret.  She is an amazing woman in her 80’s. She was diagnosed with Type 2 diabetes in her 60’s and was very loathe to go on medication.  She spoke to her Dr. who, after asking her pointedly “Will you obey me?” told her that 80% of all people with Type 2 diabetes could control it with diet if they were consistent and disciplined.  He referred Margaret to a nutritionist who repeated the Dr.’s question, and then told her the very same figures. 80%.  For 20 + years Margaret has been in excellent health, and never once needed medication for her diabetes. (This is not about the anecdote, but rather the statistics from the anecdote).

So look at this news report again.  It does a shoddy job of weighing the study.  For example, towards the end of the story Brian’s narrative mentions that the study conductors are not sure why surgery patients see such a good reduction in their diabetes. Really?  It seems to me, if the journalists were worth their salt they could have spoken to this, or at least have put this in context. Rather than crafting a story that seems to say “Get surgery to cure your diabetes”, they could have crafted a story about how this study shows that surgery is better than just life as normal on insulin and glucophage or metformin. Then they could have explored this in the greater context of what are risk factors for type 2 diabetes, such as obesity, and perhaps even talked about how the stomach reducing surgeries force people to be more careful with their diet and nutrition.  Perhaps they could have even suggested that the study was very incomplete.  Perhaps it should have included a group that had to do what the surgery patients did, watch portion size and quality of food eaten, and see if the diabetes could be controlled without having to have dangerous surgery.

Stories like this make me so frustrated.  It is shoddy journalism, and even more so, it shows how little we think. I am sad for all the people who will now want to have this surgery, based on evidence that really isn’t evidence. It is intimation. It drives me nuts. [1.]

How can we expect people to think or have informed opinions when the very sources of ‘news’ can’t even use basic rhetoric or logic to craft the stories we’re told.  Bah, Humbug!

Rant over.  I’m going to go think a while now, to make up for the great lack of it over at NBC News.

 

 

1. If you want to read an excellent treatise on other poor uses and interpretations of scientific studies might I suggest looking into Ben Goldacre’s book Bad Science .

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