1 Are journalists not setting the example for conflict-of-interest discussions?Gary Schwitzer Publisher, HealthNewsReview.org Adjunct Associate Professor U. of Minnesota School of Public Health @garyschwitzer @HealthNewsRevu

2 Disclosure and outlineThe sole funder for our project is The Laura and John Arnold Foundation True to the theme of this event, most of my talk will be about pharma-related issues, but a few other health care industry COI examples will be sprinkled in as well because they represent some of the broader issues in health care journalism.

3 2,400 stories reviewed in 11 years.......half got unsatisfactory grade for not using independent sources and/or not identifying COI. A coin toss. Glass half empty.

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6 MD-bloggers & journalists jump on issues like this...

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8 On April 12, Elisabeth Rosenthal, Editor-in-Chief Kaiser Health News, ex- NYT, tweeted:To which, Ben Harder of US News & World Report responded:

9 Concerns about high-quality, respected news organizations taking pharma $

10 STAT’s PhRMA deal may have ended, but...

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13 Alzheimer’s Biotech Cancer Diabetes Ebola Measles Obesity Pain Substance abuse TB Vaccines

14 Lauren Sausser covers health care at the Post and Courier newspaper, Charleston, SC She attended an NPF obesity training in May 2013 at University of Colorado’s Anschutz Health & Wellness Center – “no red flags” jumped out at her A year later she had 2nd thoughts and pulled out of a cancer issues program, also sponsored by Bayer “I would not accept lunch from a local hospital so why would I accept a hotel and airfare from a drug company.” She said she didn’t notice Bayer’s funding until she was accepted. “I said thanks but no thanks. I was uncomfortable accepting the free trip....I felt duped by the organizers.”

15 More about University of Colorado

16 “The tactic bore fruit. In one example, a CNN reporter attended the 2014 journalism conference and later contributed to a story that argued that obesity’s cause could be lack of exercise, not consumption of sugary soft drinks. Critics told The BMJ that Coca-Cola’s $37,000 support for that particular conference and the resulting story was a better bargain than an advertisement placed on CNN’s website.”

17 But Thacker also reported on the National Press Foundation being involved in an earlier University of Colorado health journalism workshop that received Coca-Cola support. “I feel like I was lied to,” then-journalist Kristin Jones told The BMJ. She said she would not have attended the conference had she known of Coca-Cola’s funding.

18 Journalism ethics questions swirl around U of Kansas opioid survey, pharma fundingInvitation letter to survey stated: “To our knowledge there are no pharmaceutical industry funds used to sponsor this research and the results will not benefit or be shared with the pharmaceutical industry.” One of the survey funders – the Center for Practical Bioethics - has established pharma ties. The Center was one of 7 organizations targeted in a recent Senate Finance Committee investigation for their decade-plus relationship with Purdue Pharma, a major producer of oxycodone and other opioid-based painkillers, and in 2007 pleaded guilty to misleading the public about oxycodone addiction risks.

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20 Association of Health Care Journalists3 Mayo Clinic-sponsored sessions at annual conference wherein Mayo Clinic researchers appeared alone or as 1 of only 2 speakers Reporter who attended said it wasn’t helpful because only story idea would be “writing about the Mayo way”

21 Tweets from AHCJ annual conferenceIronic that, in another session, one journalist-speaker said: “Let’s be clear about where the funding for patient advocacy groups is coming from.... Follow the money and think about it” But we think some of those same questions should have been asked about AHCJ fundraising, in this case, with the Mayo sponsorship.

22 Other policies I think AHCJ should revisitField trips to “host sponsors” to show off their best & brightest. This year, e.g., in Orlando... Twin robotics x-ray suite Magnetic resonance elastography – a new diagnosis tool “High-tech patient monitoring” FL Hospital’s Translational Research Institute How about field trips one year dedicated solely to access to care, quality of care, disparities in health care, uninsured/under-insured, social determinants of health, public health issues, health care reform initiatives in the field?

23 AHCJ exhibitor policy Exhibitor policy that takes $ from, for example, the Society for Breast Imaging – a group whose Facebook & Instagram handle

24 $400,000 gift

25 “It is difficult to get a man to understand something when his salary depends on his not understanding it.” - Upton Sinclair Or when his/her perceptions of his/her career, promotion & tenure, corporate bottom line, operational viability or x number of other factors render one tone deaf about even the perception of COI.

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27 We asked for more details but got none6 days later we blogged, “Why won’t the University of Maryland talk about the chocolate milk/concussion study it was so eager to promote?” We were being stonewalled, but clearly, the University was stunned as they looked further at our questions. Remember: no one had ever systematically reviewed news releases like this.

28 Then nationwide news coverage followed our lead….

29 Clearly, the University couldn’t run from thisSo, just 8 days after our initial news release review, they announced an internal investigation.

30 3 months later…and after we’d written 9 articles about the PR fiascoThe University said it found: “...a concerning lack of understanding of the basic principles of conflict of interest in research at all levels of the process. The principal investigator, as well as several others, expressed less concern for, and were perhaps less attentive to, the potential for a research conflict of interest in part because they felt that this project was in support of small business which is highly encouraged by the state and actively promoted by the university.” The lead researcher did not declare a conflict of interest when his project received $200,000 from the Allied Milk Foundation

31 15 recommendations to bring University in line with accepted normsAnd it’s a safe bet that none of this would have come to light if our little non-profit watchdog effort hadn’t been looking at health care PR news releases & hadn’t stumbled onto this one. How many other examples will we find?

32 Josh Billings (pen name of humorist Henry Wheeler Shaw, 1818 – 1885)“The trouble with people is not that they don't know, but that they know so much that ain't so. … I honestly believe it is better to know nothing than to know what ain’t so.” Josh Billings (pen name of humorist Henry Wheeler Shaw, 1818 – 1885)

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34 @HealthNewsRevu @garyschwitzer