Churnalism on NPR

I was hopeful that our series on churnalism would change the world of healthcare and biomedical research journalism. I thought that journalists would never again commit one of the seven deadly sins of churnalism.

They would never assume causation when a study only showed an association (1). They would be cautious about extrapolation and generalization (2). They would never ignore confounding or selection bias (3). They would consider if a doctor’s or researcher’s claim was plausible before gullibly reporting it (4). They would rarely use the “disclaim and pivot maneuver” – wherein an author states something like, “Of course this finding might only represent association and not causation” before spending the next eight paragraphs assuming causation (5). They would always be aware that there is a world of research, published, unpublished, or “undone” that might question their contention. And, most importantly, they would be relentlessly curious (7). They would always think deeply about what they are reporting and seek out alternate points of view. They would spend the time to figure out that, although the study fails to show what the author contends, the research does tell us something worth discussing; exposes a rich and lively controversy.

Oh well, at least we tried.

I was once a total NPR junky. An unabashed fan. I dreamt of seeing Linda Wertheimer in an airport and kneeling at, what I imagined would be, her Birkenstock clad feet. After the voices of me and my wife, those of NPR hosts were probably those most familiar to our kids.

NPR has lost me over the last few years. When not listening to Cubs games, I mostly listen to podcasts rather than public radio.¹ I still occasionally do tune in, hoping for a dose of Nina Totenberg or Elenore Beardsley and pining for Baxter Black and Wade Goodwyn. In the last couple of weeks, I heard two stories on the national feed, that were profoundly disappointing. Both stories demonstrated a profound lack of curiosity on the part of the reporter. There was an obvious, glaring question, begging to be answered, that was not asked. In neither case can the unasked question be definitely answered at this time but just asking the question would make us all smarter.

There first story was on Morning Edition, reported by A Martinez, “3 women are infected with HIV after undergoing a vampire facial at a N.M. spa.” This is a tragic story. No person should be infected with HIV during a medical procedure in 2024. The obvious question (which was not asked) is how could this have happened? What was the breakdown in sterilization and regulation that led to this. This could be answered with good old-fashioned reporting. The other question, the one that I wanted asked, was, “is there evidence that the so-called vampire facial is at all beneficial?” If it is not, then this is an even more tragic occurrence where a useless intervention leads to an irreversible complication.

The story itself included a Chicago area dermatologist, Jordan Carqueville, describing the procedure in what sounded like a barely concealed advertisement with giddy agreement by the host.

CARQUEVILLE: …So the PRP is like a smoothie booster, so PRP gives you that little kick with the growth factors to stimulate your collagen even more so than just the needles.

MARTÍNEZ: Ooh, now, maybe I should just click yes, give me the full treatment.

CARQUEVILLE: (Laughter). I always tell my patients it's like a smoothie booster, so you don't...

MARTÍNEZ: I mean, Doctor, when you put it like that, a smoothie booster - my God.

CARQUEVILLE: (Laughter).

MARTÍNEZ: I can feel it on my skin already.

 The only real question Mr. Martinez asked was, “What are some of the things that consumers should be looking out for when they walk into a spa or facility, and they want to get this done?” Not, “does this procedure actually work?” Not, “Could you describe the evidence that supports a cosmetic procedure that infected three people with a treatable, but incurable, virus?” These would have been very good, and very difficult questions.

The second story was on Weekend Edition Sunday, CDC report finds 1 in 9 American kids has been diagnosed with ADHD. Now, I shouldn’t only attack NPR here. I’ve heard these data, which were released by the CDC on May 16, 2024, reported equally poorly on many outlets. NPR reported the CDC data with a conversation between host Ayesha Rascoe and NPR health correspondent Maria Godoy. The discussion covered there obvious talking points that rates have risen because of increased awareness of the disease, remote schooling during COVID, and the resulting greater time for parents to observe their children.

What there was not were questions about overdiagnosis. Maybe it is not that we are diagnosing more children in need of treatment, but we are diagnosing more children slightly further from the mean. Are the extra million children diagnosed with ADHD in the last eight years benefiting from diagnosis and treatment?

A plea to journalists covering healthcare and biomedical research. Please think about the story you are telling. Ask questions beyond the easy and obvious. Make the people you are interviewing work a little and think a little.

An obvious objection to this post is that I am annoyed that the journalist did not do the story that I wanted them to do. During my years publishing in the academic journals, this is what I most hated, a paper getting rejected, not because it was bad but because it wasn’t the one that the reviewer would have written (if the reviewer had gotten off his or her butt to write it). This is a reasonable objection. However, I’d contend that the microneedling story and the ADHD story were actually bad. They were churnalism. They repackaged a bit of news without any further analysis and, in doing so, missed the opportunity to ask interesting questions. Listeners came out of these stories worse off, thinking that microneedling is mainstream and worried about the growing threat of ADHD.

1. Here is a link to my obsessively kept podcast recommendations if you’re interested.

Photo (of irritated cat) by Carlos Quintero