Ingelfinger Again

Today I'm engaged in an interesting colloquy with Dr. Ben Goldacre, a physician and author of the always provocative Bad Science Blog.

In a blog post entitled The Joy of Ingelfingering Dr. Goldacre argues that embargoes and the Ingelfinger Rule are good things, and that journalists should refrain from publishing articles about research that has not been peer reviewed, and that when they write about peer-reviewed research they should include links to the full text of the original research paper.

I've written about the Ingelfinger Rule before, and I clearly disagree with Dr. Goldacre's conclusions, although his analysis is very interesting.

In the comments to Dr. Goldacre's post I asked him whether he'd prohibit coverage of medical conferences, considering that virtually no presentations are peer reviewed with full experimental details fully published. He replied that covering medical conferences could lead to inaccurate reporting about "turkeys." No argument there, but at some point we have to recognize that journalism is not meant to be the last word, only "the first draft of history."

You Don't Have to be a Physician to Get Some of that Nice Pharma Dough. Journalists Qualify Too (Or Do They?)

According to a recent article in the prestigious British Medical Journal, many medical journalists, particularly those covering medical conferences, have conflicts of interest as bad as or worse than the physicians they're covering.

The article, entitled "Journalists: anything to declare?" is by Ben Goldacre, a physician and writer in London who has a column in The Guardian (a British daily) and is the author of the entertaining Bad Science blog.

[The full reference is BMJ 2007;335:480 (8 September), doi:10.1136/bmj.39328.450000.59 -- You can read an excerpt for free, but in order to read the full article you'll need a subscription or $$.]

According to Dr. Goldacre,

Much as I like to think that I am cynical and worldly, being a doctor and a journalist, the world still holds some surprises for me. Conflict of interest is a subject that creates heat and concern, not least among journalists, who often stumble on a banal and openly declared interest and use it to build fantasies of medical corruption and Pulitzer prizes . . .

Given the puritanical stance of so many journalists, I was surprised last week by an email circular I received from a science writers' mailing list. It was from the Aspirin Foundation, a group funded by the drug industry, and it was offering—on behalf of Bayer Healthcare—to pay expenses for journalists to attend the European Society of Cardiology's conference in Vienna. . . .

[I]n my naivety I had no idea such things went on. I pinged off a few emails to friends and colleagues. Most poked fun at my innocence—quite rightly—but some were helpful. Not only is it extremely common for journalists to take money from drug companies, but there have been some astonishing cases in recent history, including one memorable case where a PR company invited journalists to "an exclusive preview" of new laser eye technology, with the offer to "discuss free treatment in return for editorial features."

"I organise the media programmes for a number of medical conferences run by scientific societies," said one person who, without wishing to be melodramatic, has asked to remain anonymous, "and I reckon at least 50% of the journalists present are paid for by drug companies. They get pretty well looked after too—first class travel, five star hotels, posh dinners, etc. Some of them indulge in double dipping, where they are paid by the day by the drug company and then by the publication that takes whatever they have written.

 

Dr. Goldacre goes on to decry the closeness between journalists and the PR folks from the pharmaceutical companies and the revolving door between journalism and PR.

I have a number of reactions to Dr. Goldacre's article.

1. I subscribe to many science writers' mailing lists, but I never saw that venal enticement from Bayer's astroturf organization. I wonder what list it was on and what exactly it said.
2. What am I, chopped liver? I've never received such an offer from a pharmaceutical company.
3. I simply don't believe Dr. Goldacre's correspondent who estimates that 50% of the journalists (or more!) are "paid for by drug companies." I've been in this profession for decades, and while I've heard whispers about such practices, I would have heard shouts if every second reporter was in the pocket of Big Pharma.
4. Perhaps this is a case of a paranoid meeting organizer. Some seem to spend a lot of time trying to weed out people who (by their definition) are not "legitimate, credentialed press."
5. Maybe it's that I'm as naive as Dr. Goldacre, or maybe this practice is far less common than he maintains. I do know that some pharmaceutical companies send writers to medical meetings and pay them to write meeting reports, but those are almost always for internal consumption.
6. The only time I've ever seen medical journalists flying First Class is when they're using their hard-earned frequent-flyer miles.
7. And don't get me started on five star hotels. Not every reporter likes staying there. As I've written before, "You can tell you're in a five-star hotel by the beautiful view, the plush bathrobes, and the disquieting sensation of a disembodied hand rooting around in your pockets for every last bit of spare change."
8. And posh dinners? I feel fortunate if I have a minute to set my pen down and gobble a little piece of the rubber chicken at a dinner presentation.
9. I think that in his article Dr. Goldacre is engaging in a bit of playground repartee: "I'm rubber you're glue, your words bounce off me and stick to you," or, "I know you are, but what am I?" I'm afraid I don't find those "arguments" any more persuasive now than when I was in third grade.
10. Having said all that, of course I'd be appalled if I learned that a journalist accepted money from Big Pharma and then published a seemingly objective article in the independent press. Just as I'm appalled when I see physicians hawking drugs made by their pharmaceutical company overlords at supposedly independent medical meetings.
11. If journalists are doing this, they're ashamed and they're keeping it secret. Physicians, on the other hand, seem all too delighted to brag about how many companies they've served as a consultant for, or to express sorrow that they don't have as many conflicts as their colleagues.

(Tip of the hat to PRWatch which called my attention to Dr. Goldacre's article.)

Restrictions on Recording Medical Meetings

The organizers of most medical meetings allow members of the press to have unlimited access to their meetings. But every so often I'll run into a meeting where there are restrictions against photography (most frequently) and against audio recording (less frequently).

I think there's little justification for any of these restrictions; if reporters are allowed to be present, they should be allowed to do their jobs as long as they don't disrupt the meeting.

At the recent annual meeting of the American Psychological Association a member of the press office staff apparently attempted to enforce a silly rule against a reporter from Democracy Now!: a 10-minute limit on recording during the session. The APA was debating a resolution on the participation of psychologists in military torture.

Science writer Norman Bauman chronicled what happened in a post on the nasw-talk mailing list, which is maintained by the National Association of Science Writers. With Mr. Bauman's permission, I'm quoting his message in full:

Amy Goodman, broadcast producer of DemocracyNow!, had a showdown with the

American Psychological Association's PR department this weekend, when they

ordered her to stop recording a session about psychologists participating in

military torture.

She refused to stop, and the PR department threatened to call security.

Goodman publicly announced to the audience that the APA leadership was

refusing to let her record, and asked the members whether they wanted her to

continue recording. As you can hear on the recording, the audience

overwhelmingly wanted her to record, because they wanted their debate to be

disseminated to the public. Someone made a motion, and they voted to let her

continue recording.

The APA meeting this weekend in San Francisco debated a resolution, which an

APA committee had approved, on the participation of psychologists in

military interrogations. 6 members of the 10-member committee worked for the

military. Dissident members said that ethics code has a loophole which

permits torture -- if there is a conflict between the ethics code and a law

or military regulation, a psychologist can follow the law or regulation.

The APA PR department had limited Goodman's taping of the session to 10

minutes, and tried to stop her when she ran over 10 minutes.

The APA prohibited her from recording some sessions at all, but she recorded

them anyway.

The APA is the last medical professional organization to let its members

participate in torture. The American Medical Association and American

Psychiatric Association declared that it was unethical for their members to

participate in torture.

Here's the transcript:

AMY GOODMAN: Not long after the town hall meeting had begun, the APA's

public affairs officer approached Democracy Now! and told us to stop

filming. She said we could only tape ten minutes and that we had passed our

time limit. I got on the microphone and told the people gathered at the

meeting what was happening.

AMY GOODMAN: Excuse me, just [inaudible] a point of procedure. We're told

that reporters are only allowed to record for ten minutes, and Pamela

Willenz of the APA said that she will call security on us now, because we're

going to be recording for more than ten minutes. So I was wondering if there

could be any sense of the meeting, or a rationale, since this is a town hall

meeting, for not being allowed to record for more than ten minutes.

AUDIENCE MEMBER: We want to vote.

UNIDENTIFIED WOMAN 1: Can we vote to allow recording at the town hall

meeting? Can we all vote to allow recording?

AUDIENCE MEMBERS: Yes.

UNIDENTIFIED WOMAN 1: Can we vote to allow recording?

UNIDENTIFIED WOMAN 2: We want the press to witness this.

UNIDENTIFIED WOMAN 1: Can everyone who approves of allowing the reporters to

record please raise your hand?

UNIDENTIFIED MAN: OK, folks, the recording will continue through the session

###

I think this is a good example of how to deal with organizations that won't

let you cover a legitimate news event of public importance.

I've been in situations like this, where people threated to have me

arrested, and I stood up to them. They backed down.

In the analysis of how the news media failed us in Iraq, one White House TV

reporter said that it's hard to stand up in the White House press room and

challenge the President of the United States.

Journalists have a privileged position in the U.S., because we have a role

set out for us in the Constitution. We can have a good time, and lots of

perks, writing interesting stories, but in exchange we have an obligation to

supply our readers with the information they need. A lot of journalists

failed their job, because they were too timid to stand up to authority when

it was their responsibility to do so. As a result 500,000 Iraqis died.

DemocracyNow! is broadcast (in New York, anyway) on the radio at 9am EST,

but you can see it on the Internet. Theyalso make a full transcript available in the afternoon. I recommend that everyone read the transcript or listen to it, and in particular listen to Goodman's confrontation with the APA.

The next time you have to stand your ground, you can remember how Goodman

did it.

I previously said that I think Goodman is the best interviewer in the U.S.,

since the demise of the Playboy Interview. Her best interview, I think, was

her interview with Bill Clinton . She was the only reporter I can think of who asked him about solid issues.

Goodman was once reporting on a peaceful demonstration in East Timor, when

the (U.S.-supported) military opened fire, killing several demonstrators,

and beat her and another reporter to the ground with rifle butts. So she

doesn't have any trouble standing up to Presidents of the United States. She

was in more combat than they were. [end of Norman Bauman's nasw-talk post]

Link to the Democracy Now! segment with that exchange.

Link to the entire 20 August 2007 show.

What do you think? Are restrictions on recording or photography ever appropriate at medical meetings?

Science writers protest $675 fee for influenza conference

As reported in Jim Romanesko's column, the National Association of Science Writers has written a letter of protest objecting to an outrageous fee that the Options for the Prevention and Control of Influenza IV conference (Toronto, June 17-23.2007) is charging reporters for the privilege of doing their jobs.

In addition to the $675 fee (which clearly favors large mainstream-media organizations), reporters are being barred from covering some of the scientific sessions (what will they be discussing in those closed sessions, I wonder?), and in what seems like a juvenile display of petty spite, reporters will not have access to the scientific abstracts.

The organizer of this conference is Nancy J. Cox, Ph.D., an employee of the U.S. Centers for Disease Control and Prevention. Dr. Cox was named Federal Employee of the Year in 2006. She is apparently unaware of the decades-long practice of allowing reporters to cover medical and scientific conferences without paying an admission fee. Or maybe she is aware but doesn't care. Or maybe the decision was in someone else's hands, and she'll quickly correct this mistake after receiving NASW's protest letter.




The letter was signed by NASW president Robert Lee Hotz, formerly of the Los Angeles Times and currently of the Wall Street Journal. I've reproduced his letter below. He makes the excellent point that much of this research was supported by public funds and deals with a subject of vital public interest. If you'd like to add your voice to his, you can reach Dr. Cox at nancy.cox@cdc.hhs.gov, phone: 404.639.2748, fax: 404.639.2334. Or you can reach CDC director Dr. Julie Gerberding at julie.gerberding@cdc.hhs.gov, phone 404.639.7000.

Here's the NASW letter:

Director, Influenza Division
Director, WHO Collaborating Center for Epidemiology and Control of Influenza
National Center for Immunizations and Respiratory Diseases (proposed)
Coordinating Center for Infectious Disease
Centers for Disease Control and Prevention
Atlanta, Georgia, USA

April 30, 2007

Dear Dr. Cox,

As president of the National Association of Science Writers, which represents 2,500 science and medical writers, I was surprised to learn that reporters will be charged $675 to attend and cover the Options for the Control of Influenza VI conference in Toronto, June 17-23, 2007. I was also dismayed to be informed that members of the press will not be given access to the conference abstracts and will be barred from some scientific proceedings.

For decades, it has been accepted practice for legitimate members of the press to be admitted to scientific and medical conferences without charge, in order to promote the timely dissemination of accurate scientific information to the public that funds such research. In this instance especially, which concerns matters so vital to public health, we would expect that you, as conference chair, and other organizers would actively encourage public dissemination of the scientific results to be presented, as a matter of sound public policy and professional conscience.

I join with our board of directors in urging the organizers of the Options for the Control of Influenza VI conference to drop their policy of charging reporters an admission fee and lift the other restrictions on open coverage of its proceedings.

I would be happy to discuss this matter with the conference organizers at their convenience.

Sincerely yours,

Robert Lee Hotz
President, National Association of Science Writers
New York, NY 10012
hotz@nasw.org

UPDATE 5/3/07

The conference organizers appear to have changed some of their objectionable
press registration policies. The $675 fee has disappeared, but the restrictions
on reporters attending some sessions and the ridiculous refusal to provide
reporters with abstracts still remain. See here. More to come later.

8 Rules for a Happy Press Room at a Medical Conference

Today I'm one of the dozens of journalists covering the American Association for Cancer Research (AACR) meeting in Los Angeles. This is a terrific meeting, with lots of interesting news. One of the things that makes this meeting great—at least from a reporter's point of view—is that it has an exceptionally well-run press room. Here are 8 factors, some critical, some trivial, and some frivolous, that make for a happy press room at a medical meeting.

1. The number one rule is to put a highly competent PR people in charge. Staci Vernick Goldberg, Greg Lester, Angela DeCicco, and their AACR colleagues exemplify this sort of competence. They're knowledgeable, they're friendly, they're helpful, and they're solicitous without being smarmy.

2. Help reporters out by identifying the most important and newsworthy stories in advance of the meeting. Prepare embargoed news releases about these stories that include all the important details such as the investigators' affiliation, their titles, and their sources of funding. The most important aspect of the story should be in the lede, the way reporters write, and not at the end, the way scientists do.

3. Arrange news briefings with the investigators associated with these top stories. These news briefings need to be close to the time of the actual presentations, and not a day or two later.

4. Contact researchers' institutions well in advance of the meeting and encourage their PR departments to issue their own news releases. This is, perhaps, the only area in which the AACR folks fell short. For such a large meeting, there were relatively few external news releases. I've written about this issue before.

5. Prepare a press kit containing basic information about the association sponsoring the meeting, the news releases mentioned above, and the actual abstracts of the scientific presentations. For bonus points, make sure reporters preregistered for the meeting received this press kit at least a week in advance. For double bonus points make sure the press kit is available in both printed and electronic forms. For triple bonus points see item 8 below.

6. Pay attention to the physical layout of the press room. It should be big enough and have enough table space to accommodate the expected number of reporters. It should be carpeted to dampen the sound of folks chatting so others can work. It should have an adequate electrical supply, lots of phones, a good number of computers for reporters who don't lug their laptops, printers, and lots of ethernet connections or WiFi capacity to satisfy those who do lug their laptops. The AACR press room has computer terminals, printers, and ethernet cables all around the room as well as a high capacity WiFi system.

7. At a minimum a press room should never run out of coffee. To reporters covering a medical meeting caffeine is more important than oxygen. For bonus points have bottled water and soft drinks. For double bonus points provide snacks such as cookies or fruit. For triple bonus points provide some sandwiches at lunchtime, because reporters on deadline often find it difficult finding time to take bathroom breaks, not to mention finding time to hunt down a decent restaurant. For quadruple bonus points and the grand prize, do what the AACR folks did: provide a hot breakfast and a hot lunch every single day, and make sure the food is excellent. The food at this press room exemplified the critical difference between oncologists and cardiologists that I described previously.

8. Provide useful swag. Every AACR attendee, not just reporters, received a high-quality tote bag. Reporters additionally received a swanky metallic pen in a velveteen envelope and a 512 MB flash drive containing a preloaded electronic version of the 99-page press kit.

13 Rules for Finding the Perfect Seat at a Medical Conference: A Journalist's Guide

These rules are more or less in the order of importance.

1. This may seem almost too obvious even to mention , but you can't sit in a seat that someone else is occupying. The key to getting a good seat is to get to the room as early as possible. As you'll see, there are so many constraints defining the perfect seat thatin many conference rooms there are only a handful of acceptable choices. (Actually, since some of the constraints are quite stringent, in many rooms there's not a single seat that satisfies all of them, so the only choice is to choose the least bad seat.)

2. You want to be sitting near the front, especially if you hope to grab the speakers for interviews or photos immediately after their talks.

3. You want to be sitting at a conference table, if possible, not in the rows of chairs behind the conference tables in many conference rooms. A table allows you to spread out your material, your notepad, the conference program, your recorder, your camera, your glass of water, and your coffee. If the room's not completely full, I often try to spread my material over two adjacent spaces at a conference table.

4. Don't sit by the pitcher of ice water often placed at intervals on the conference tables. Not only does it decrease the amount of real estate available to spread out, but there is a danger of spills or drips as people lean over you to get glasses of water. Murphy demonstrated conclusively that those spills and drips will certainly land directly on your sensitive electronic equipment.

5. If there are no conference tables, it's critical to appropriate two adjacent chairs. The alternative is to balance the notepad, program, recorder, and camera on your knees, putting the coffee and water underneath the seat. That way lies madness.

6. Aisle seats are critical. Otherwise you'll be annoying people every time you need to run up for a photo or for a word with the speaker.

7. You want to sit as close to the front as possible, but notice where the loudspeakers are. Often they're located behind the first few rows and pointed to the back of the auditorium. If you're closer to the front than the loudspeakers, your recording will sound muffled. If the sound is bad in one part of the room, you may have to move to another during the first talk

8. You want to sit where there's a clean line of sight to the screen, especially if you plan to photograph the speakers' PowerPoint presentations. It's really annoying when the bald head of the guy sitting in front of you obscures the one piece of data you need to complete your article. It's often best to sit a bit farther from the screen if that allows you to put the center aisle between the screen and your camera. That aisle makes it less likely that you'll have an obstructed view.

9. Don't sit too close to the video projector. Not only is the warm air blown by the exhaust fans annoying, but your recorder is likely to pick up a lot of background noise.

10. Some meetings have rules against taking photographs or making audio recordings. I believe such rules don't--or at least shouldn't--apply to reporters, in much the same way that TV camera crews at a major news event refer to designated no-parking areas as "the minicam zone." But if you're anticipating an argument with one of the medical society employees, discretion being the better part of valor, you may want to sit in the middle of the auditorium and away from an aisle.

11. If you're at a big meeting, and you're covering parallel sessions in different rooms, you're going to want to sit fairly close to an exit door.

12. If you take notes on your laptop, try to find a seat at the edge of the auditorium, near a source of electrical power.

13. If you're going to be sitting through some boring talks before you get to the good ones, sit where there's good WiFi reception. That way you can catch up on your e-mail and even write blog posts to while away the time.

Ghost Writers on the Sly

I noticed something strange about a couple of posters I covered at a recent conference. Both reported clinical trials on the same drug, and both acknowledged that the studies were supported by GlaxoSmithKline, the drug's manufacturer.

That wasn't strange. Pharmaceutical companies sponsor clinical trials all the time, and they frequently report the results of the trials (at least the favorable ones) at medical conferences.

What was strange was the authorship of those studies. In one study the first author was a physician at an obscure hospital in an obscure town in Ohio, and the other five authors were GlaxoSmithKline employees. In the other study four of the six authors were physicians at a private specialty practice in Southern California, and the other two authors were GlaxoSmithKline employees.

I suspect that the physician in Ohio and the physicians in Southern California were not truly the investigators who carried out the study or analyzed the results, and they almost certainly didn't write the poster presentations. They were "beards," enticed by GlaxoSmithKline to add the appearance of independence to studies that were designed and analyzed by company scientists, with the results written up in-house by a ghost writer.

This is an unfortunately common practice in the pharmaceutical industry, and GlaxoSmithKline is certainly not the only offender. One of the most highly publicized cases of ghostwriting by pharmaceutical companies involved Procter & Gamble, their osteoporosis drug Actonel, and a scientist named Aubrey Blumsohn, a pathologist, bone specialist, and formerly a professor at Sheffield Teaching Hospitals, Sheffield, UK.

Dr. Blumsohn relates this complex--and still evolving--story on his blog, and it's been covered fairly extensively in the press, including in a detailed article that appeared in Slate at the end of 2005. Briefly, after giving a $252,000 research contract to Sheffield Teaching Hospitals for a study on Actonel, Procter and Gamble employees analyzed the data and had a ghost writer prepare abstracts for several medical conferences, listing the Sheffield scientists as senior authors. Dr. Blumsohn suspected that the analyses may not have been kosher, and he requested access to the randomization codes that would allow him to conduct independent analyses. Incredibly, Procter & Gamble repeatedly denied the senior author of the study full access to the data that he himself had generated.

You'll have to read Dr. Blumsohn's blog for all the ins and outs of this astounding story. He ended up losing his job for daring to discuss that story with journalists. He finally did get access to some, but not all, of the raw data. He has reanalyzed this data and has begun publishing these re-analyses, which to no one's surprise are somewhat less favorable to Actonel than the original analyses.

In his latest blog post, Dr. Blumsohn describes how Procter & Gamble continues to act very strangely. He submitted an abstract of his reanalysis to be presented at an upcoming meeting of the International Bone and Mineral Society. As he is required to do by the society's disclosure rules, he acknowledged that the original research was supported by Procter & Gamble. Somehow, a mysterious Procter & Gamble scientist named Dr. Purple got a hold of this abstract in advance of publication and demanded that the society remove the funding disclosure. The society agreed at first, but when it became apparent after Dr. Blumsohn's complaints that he had not authorized the disclosure's removal, they put it back in. Dr. Blumsohn includes documentary evidence of his allegations on his blog, including the orginal abstract as well as email correspondence between the society and Dr. Purple (who may well have stepped out of a game of Clue, holding a candlestick in the conservatory).

I'm a writer myself, and I know honorable writers who ghostwrite scientific articles for pharmaceutical companies. I don’t believe that this, in itself, is unethical, as long as all the study's authors are aware that this is being done, as long as they have all had full access to the data, and as long as they endorse all of the study’s results and interpretations. Some medical journals have begun insisting that all co-authors of a paper describe their roles in the study and formally state that they endorse its results and conclusions. Perhaps the organizers of medical meetings should take similar steps.

A Poster with Bite

There's a big difference between science writing and scientific writing. That difference nearly bit me on the ass at the last meeting I attended.

Scientific writing is highly formalized. Following the abstract, articles start with an Introduction that describes the background of the study. In the Methods section, which comes next, the investigators describe how the experiment was conducted. Then come the Results, the actual data generated by the experiment. At the end will be a section called the Discussion or the Conclusion that explains what the results mean.

In journalistic science writing the order is completely different. Journalists typically lead with the most interesting conclusion, go on to describe some of the results, and only then give the important background. (This is true for news articles; it tends to be less true for feature articles or personal essays.)

When I cover poster sessions, therefore, I look for promising titles, and when I find one I tend to go straight to the lower right-hand corner of the poster to read the conclusions. If the conclusions seem newsworthy enough, I'll go back and read the Introduction, the Methods, and the Results.

I'm not normally under heavy deadline pressure when I'm covering a medical conference. Since I usually work with publications that have monthly deadlines, I have the luxury of spending most of my time at meetings collecting stories that I'll write when I return to my office.

But last week I was working for a wire service that needed a fresh, newsworthy story from the meeting completely written by 11:30 a.m. No problem, I thought. There was a poster session starting at 9 a.m., and sitting in my hotel room the night before I circled about a dozen promising titles in the program. I showed up at the poster session as soon as the doors opened, and I figured I'd have no trouble choosing one of the posters by about 9:30, and then I’d have two full hours to write.

Trouble is, none of those dozen posters was exciting enough or newsworthy enough to make a good wire story. A handful of them were decent, and I planned to write about them in the coming weeks, but none had that certain je ne sais quoi.

Abandoning the list of posters I identified by their titles, I started walking up and down the aisles at a gradually increasing pace and with a growing sense of alarm. Nothing was grabbing me, and time was a'wasting. Finally I found a poster describing an epidemiological study of a disease that was difficult to diagnose. Moving straight to the conclusions, I found a sentence about "the high frequency of death from asphyxia in undiagnosed patients" in the 15-year interval between when symptoms appeared in the average patient and when that patient received a proper diagnosis.

Bingo! There's my lead, I thought. Short of time, I snapped a few shots of the poster with my digital camera and ran up to the press room while composing a sexy lead in my head. "Patients with Roueche's syndrome [not its real name] wait an average of 15 years between the appearance of their first symptoms and the proper diagnosis, and during that time x% of them will suffocate to death, according to a poster presentation at the annual meeting of the blah, blah, blah."

By this time it was 10 a.m. I still have 90 minutes to write, I thought, no problem. So I sat down, uploaded the photos of the poster to my laptop, and started reading the Introduction, the Methods, and the Results. The poster contained a relatively complex presentation of the results, with some data described in prose, some data in tables, and some data in grafts. I stared at that for another 15 minutes, all the while searching for the numbers to back up the "high frequency of death from asphyxia" conclusion, but as far as I could tell there wasn't a single sentence, table, or graph that dealt with that.

I ran down to the poster session hoping to find the study's author. Although this was the time period set aside for authors to stand by their posters, she was nowhere to be found. I stood next to that poster so long waiting for her to return that passersby assumed I was the author and started asking me questions.

After another ten minutes I realized that the first author apparently wouldn't be returning, but I also realized that the author of the poster immediately to the left was the second author (out of ten) of my poster. Shifting anxiously from foot to foot, I waited until he was free of the person he was talking to, and I introduced myself and asked him if he'd be able to answer one question about the poster I was interested in. He agreed, so I asked him what data supported the "high frequency of death from asphyxia" sentence in the conclusions.

"Oh, that's not correct," he said. He went on to say that only about one person dies from asphyxia due to undiagnosed Roueche syndrome every couple of years.

"So how did this conclusion get into the poster?" I asked.

"I don't know."

"But you're the second author."

"Yes, but I wasn't involved in preparing the poster. I’ll have to have a word with Dr. Smith [the first author]."

With less than an hour before my deadline, my life started flashing before my eyes, and my own death from asphyxia began to seem preferable to the conversation I'd soon be having with my editor. "How the hell am I going to salvage this situation?" I wondered.

It was too late to find another poster to write about, so I was stuck with this one. I ended up keeping the 15-year gap in diagnosis as the lead while leaving out the dramatic bit about the "high frequency of death from asphyxia." I wrote like the wind, and I uploaded the story at about 11:29:45.

The moral of the story? Don't assume that the conclusions of a scientific study are supported by its data.

Why So Few News Releases at Medical Meetings?

When covering medical meetings became a routine part of my job, I was surprised at how few news releases I found in the press rooms. Sure, the big meetings—the ASCOs, the AHAs, the RSNAs—would have a decent number of news releases, but even those had fewer than I would have expected.

I started my in science writing career in the public relations office of a major university. Part of my job involved writing news releases on important scientific advances. I was pretty successful at this; on a number of occasions articles sparked by my press releases ended up on the front page of the New York Times and other major publications. I discovered that reporters are essentially lazy. If you hand them a tasty morsel on a silver platter, they're more likely to take it than an equally tasty morsel they have to dig for. This is no insult to reporters; we all have a limited amount of time, so it's not surprising that we take the story that's handed to us. Furthermore, reporters are subject to competitive pressures. When there's a news release attached to a research result, I know that my competition is likely to pick up the story, and if they do and I don't, my editor will want to know why we were scooped.

Every university and virtually every hospital in the United States has a public relations, media relations, or public information office. Every one of those offices employs writers whose job is to promote the institution's research. A medium-sized medical meeting will include talks from researchers representing several dozen institutions, and the large medical meetings will include talks from researchers representing hundreds of different institutions. Why then is it unusual for me to find more than a handful of news releases at all but the largest meetings? Here are some possible answers:

• Most of the research studies presented at medical meetings are not newsworthy. They involve minor advances that are of interest only to a narrow handful of specialists. This is the best excuse a public information officer can give for not issuing a news release. You don't want your institution to become known for issuing news releases on research that is not newsworthy, because reporters will quickly learn to toss all news releases from your institution into the circular file.

But this doesn't explain why so many truly newsworthy studies from institutions with large PR offices are unaccompanied by news releases.

• There are different levels of newsworthiness. Some studies are of interest to the lay public and the mass media, and PR folks tend to focus on these studies, ignoring studies that would be quite newsworthy to the trade press. To many researchers, having their study covered by Oncology Times (for example) would confer more prestige among their peers than having it covered by the New York Times. (Maybe that's a little bit of an exaggeration, but you get my point.)

• In my experience, the main reason that PR folks often don't issue news releases to accompany an interesting talk at a medical meeting is that they simply don't know about it. Calling the PR office is often the last thing on a researcher's mind when she's about to present an interesting paper at a meeting. Getting the data together, practicing her talk, and making airline reservations all take priority.

There are several things that a PR person can do about this. She can cultivate relationships with researchers, their postdocs and graduate students, and even departmental secretaries. Merely asking, "Are you going to be presenting any interesting results soon?" will often do the trick.

At big institutions, of course, it won't be possible to cultivate relationships in every lab. But a least one can cultivate relationships in every department. The department chair will often know who's about to present important results.

And it's worthwhile cultivating relationships with the PR folks at the societies sponsoring the major meetings. In a perfect world, those PR folks would be contacting the PR folks at the major universities a month or so before the meeting with a list of all that institution's presenters and the titles of their talks. Some societies, notably the American Association for the Advancement of Science (AAAS), have this down to, well, down to a science. But if this isn't a standard part of meeting prep for, say, the American Association for the Advancement of Liposuction, or if their press office sucks (ha), the AAAL PR person can often be persuaded to allow the university PR person advanced access to the meeting program, where she could search for her institution's researchers.

I suppose I've spent an evening in a hotel room writing this this because I'm one of those lazy journalists who loves to find several meaty news releases in the meeting's press room, or better still, on Eurekalert or Newswise a week in advance. Not one institution has issued even a single news release at the meeting I'm at now, even though I've found several very interesting stories from this meeting. This includes the first results from a very large and groundbreaking study from a top university medical center demonstrating the superiority of one surgical technique over another. I think hundreds or thousands of lives may be saved when this result is disseminated throughout the medical community, but as far as I know I'm the only reporter who attended this talk and realized its importance.

How to Find Medical Conferences

It would be nice if there were a comprehensive database of all upcoming medical conferences. An ideal medical-conference database would be easily searchable by date, by location, by specialty, and by keyword. It would present basic information about the conference including contact information and a link to the conference's web page. And it would also be nice if it had travel information, including lists of local restaurants and attractions.



Below you'll find an alphabetized list of 16 19 medical-conference finders, along with my highly subjective evaluations. I've assigned each site a "Roueche Score," based on its usefulness. If I've missed any sites, or if you disagree with any of my evaluations, I encourage you to let me know in the comments or by emailing medmeeting (at) gmail (dot) com.



I tested each site by searching for all meetings in the 2007 calendar year, by using a few keywords to search for certain obscure meetings including several on my list of Excellent but Little Known Medical Conferences, and by searching with a few city names.

UPDATE
I updated this page on October 30, 2010 in preparation for my session on How to Cover a Medical Conference at ScienceWriters 2010.


In keeping with its name, allconferences.com lists meetings in all areas including such topics as arts, humanities, business, and recreation in addition to medicine. Unfortunately its listings in medicine (and in a few other areas I checked) are highly incomplete. It has fairly detailed information on the meetings it does list, however. Roueche Score: 2 out of 10



Like allconferences.com, Conferencealerts.com covers a wide range of academic meetings, not just medicine. Its listings in medicine are very weak, missing many important meetings and just about everything on my list of Excellent but Little Known Medical Conferences. It provides only limited information on the meetings that are listed, typically just the dates, the location, and the meeting's URL. Roueche Score 2 out of 10



Doctor's Guide is very promising, with an intuitive interface and unusually extensive listings for meetings in the U.S. and around the world. It turned up a number of obscure meetings that I'll be attending in the coming months, but to my surprise it failed on several of my Excellent but Little Known Medical Conferences. Roueche Score: 8 out of 10


Although it's targeted at Canadians, Doctor's Review provides a fairly extensive listing of medical meetings in the U.S. and elsewhere in the world. I was only able to stump it on a few of the meetings mentioned in Excellent but Little Known Medical Conferences. The listings are very basic; just the conference title, location, date, a phone number and/or email address of a contact, and the URL of a web page, which, annoyingly, is not hotlinked. Someone needs to tell those Canadians that PUTTING LISTINGS IN ALL CAPS SEEMS LIKE SHOUTING, AND IT'S VERY HARD ON THE EYES. Roueche Score: 7 out of 10



I've been a fan of Google for many years, but the Google Directory of science conferences is amazingly incomplete. It lists a total of just 76 conferences in medicine, for example. The search function is essentially non-existent, and the only information provided about each conference is a link to the conference site. Worthless. Roueche Score: 1 out of 10 Update 10/2010. Now completely defunct. Roueche Score: 1 out of 10



Healthcareconferences.com fails to list many huge and popular medical meetings, not to mention the more obscure ones. That's too bad, because the interface has promise, and the site has many features that could be useful to meeting travelers, including maps, weather, tourist information, restaurant lists, and checklists. Roueche Score: 2 of 10 Update 10/2010. Defunct. Roueche Score: 0 of 10


The Health on the Net Foundation has a conference finder site that has some excellent features. The listings are fairly extensive, especially so for CME meetings, but it still fails to list many of my Excellent but Little Known Medical Conferences. The standout feature of this site is the ability to subscribe to RSS feeds and podcasts (!) that provide alerts to meetings in a long list of medical specialties. The site has detailed descriptions of meeting content and links to the meeting's web site, but no direct-contact phone numbers or email addresses. Roueche Score: 6 out of 10

The HUM-MOLGEN (human molecular genetics) list of meetings and conferences is narrow but deep. If you're looking for a basic-research or clinical conference on cell biology, molecular genetics, biotechnology, or related fields, this is probably the place to come. No real search feature, except that you can list meetings by date, by subject, or by continent. Links lead to reasonably detailed meeting info. Roueche Score: 9 of 10 (for its narrow subject area) or 3 of 10 overall.



The Journal of the American Medical Association and it's 10 sister "Archives" journals have a very selective calendar of events. Hardly any of my Excellent but Little Known Medical Conferences are listed, and there are even some fairly large conferences without listings. But the conferences that are listed are described completely, with all the details one would need for obtaining additional information. The search function is full-featured; too bad that there's not that much to search. Roueche Score: 4 out of 10



Medicalconferences.com claims to list 7,000 medical conferences, and indeed their listings seem to be fairly extensive, especially when it comes to CME. The search function is intuitive. But I couldn't find listings for many of my Excellent but Little Known Medical Conferences, and there were significant errors in some of its listings. For example, the site claims that the huge American Academy of Allergy, Asthma, and Immunology (AAAAI) 2007 meeting is in Honolulu, when it's actually in San Diego. I can't trust a site with an error that big. Roueche Score 2 out of 10 Update 10/2010: Appears to be defunct. Roueche Score: 0 of 10



MediConf appears to be the detritus of a business plan gone bad. It promises the visitor a look at one month of meetings for free. Additional viewing costs $19 (U.S.) per month per country or region. Unfortunately the site doesn't seem to have been updated with any new meetings since December 2004. It's puzzling that this site shows up so high a Google search for medical conferences. Roueche Score: 1 out of 10 Update 10/2010: Defunct. Roueche Score: 0 of 10




The MeetingsNet Medical Meetings Finder misses many meetings, even some of the bigger ones. Hardly any of my Excellent but Little Known Medical Conferences are listed. Information on the meetings it does find is very limited, offering only dates, locations, the name of the meeting hotel (but no phone number or link), and the name, address, and phone number of the meeting sponsor (but no URL or email address). Roueche Score: 2 out of 10 Update 10/2010: This site focuses on meeting planners.


NatureEvents, sponsored by Nature magazine, covers all areas of science, not just medicine. I didn't evaluate listings in physics, astronomy, or basic biology, but in medicine the listings are woefully inadequate. Many big meetings aren't listed, not to mention the more obscure ones. On the other hand, the meetings that are listed include detailed information, even lists of speakers in some cases. Roueche Score: 2 out of 10



The New England Journal of Medicine lists only the largest meetings, and not even all of those. Hardly any of my Excellent but Little Known Medical Conferences are listed. Results of a search are, annoyingly, in alphabetical and not date order. Roueche Score: 2 out of 10

I wanted to like the Newswise conference listings, because Newswise is an excellent resource for journalists, with searchable, embargoed press releases, lists of writing awards, and a number of other interesting features. Unfortunately its Calendar of Medical Meetings is woefully inadequate. Hardly any of my Excellent but Little Known Medical Conferences are listed, and some popular meetings are missing as well. There's no search function at all. Roueche Score: 1 out of 10 Update 10/2010: The Newswise conference listings are somewhat improved since I last visited, but it still misses many important meetings. Roueche Score: 3 of 10



The Physician's Guide to the Internet lists only the largest, most popular meetings, but it has a pretty good list of those, including links to the meeting sponsor. No search function, but all meetings listed fit on a single web page, making it most convenient to employ a browser's text search function. The nicest feature of the listings on this page is that they have the dates and locations of not only this year's meetings, but also next year's and the year after that. If you want to know where some of the big meetings will be in 2009, this would be a good place to come. There are also links to sites that will help find restaurants near meeting sites. Roueche Score: 3 out of 10

The Bottom Line
Only 4 of the 16 sites listed here scored above 5 out of 10 on the Roueche Scale. Only two--Doctor's Guide and Doctor's Review--come close to being comprehensive, although props to the HON Meeting Finder Site for its innovative use of RSS feeds and podcasts and to HUM-MOLGEN for excellent listings in its narrow field of interest.


Update, March 27, 2008
Thanks to reader Adam for alerting me to CME Networks, a new player in medical conference listings. Here's my review:


This site is fairly decent on strictly CME meetings, but very, very poor indeed on larger meetings, even ones that have large CME components. While it has a search feature that allows you to search by specialty or keyword, you can't easily combine keywords. For example, there's no convenient ways to find all pediatrics meetings in May or all emergency medicine meetings in San Francisco. They do offer monthly newsletters related to individual specialties, which is nice, as well as an embryonic and little used blog function. Roueche Score: 3 out of 10


Update, October 30, 2010
Thanks to reader IV for alerting me to Clocate, another new player in medical conference listings. Here's my review:

A near perfect site. Listings appear to be fairly comprehensive, and in many cases meetings are listed several years in advance. There's an excellent search function that lets you find meetings by date, category, subject, and location in additional to keywords. Highly recommended, but I docked them a half-point since they didn't have a listing for next year's American Academy of Pediatrics meeting (but this year's just ended). Roueche Score: 9.5 of 10

Gear, Part 1: Digital Voice Recorders

I record all my interviews and all the conference sessions that I cover, and I've been doing so ever since I started in this profession 27 years ago. I'm just not fast enough at taking notes to get exact quotes down, and I also find that listening to a talk a second time enhances my understanding.

In that 27 years I've gone through somewhere between 6 and 10 recorders. At the start I was buying fairly cheap cassette recorders. They were bulky, the sound quality was lousy, and they tended to break in a year or two.

Then I bought a microcassette recorder. It was small, which was terrific, but the sound quality was even lousier. And although the microcassettes were much smaller than standard cassettes, they didn't stack as well, so they were more difficult to store and organize. And the recorders tended to break in a year or two.

Then I decided that I needed something of higher quality, something intended especially for journalists. Sony came out with a line of high quality Pressman cassette recorders. Although they used standard cassettes, they were hardly bigger than 2 or 3 cassettes. They seemed quite sturdy, with metal casings, and they had lots of neat features, the best of which was an index function. When someone came out with a good quote, I could push a button. When listening to the tape later, I could fast-forward until I heard a special sound, which marked the index location. The sound wasn't broadcast quality, but it was much better than I had been used to. These Sony Pressman recorders didn't come cheap--about $200. But they tended to break in a year or two. I went through four of them.

The last one broke in the middle of a meeting. On a Sunday. At a resort far from any big cities. It was 20 miles to the nearest open Radio Shack, where the only cassette recorder was this big bulky thing that cost $19.95. I considered myself lucky when it lasted for the remaining day of the conference.

It was at that point that I started looking into digital voice recorders. I quickly determined that Olympus made the ones that were best for my purposes. I ended up with an Olympus DM-1 (which is no longer made). I've had it for almost 4 years now, and I haven't had the slightest problem with it.

I think the main reason is that it has no moving parts. Cassette recorders have lots of moving parts, and they need to move with quite a bit of precision. If one little plastic gear in its guts gets a little bit out of alignment, the recorder is toast. But digital recording does not depend on moving a long magnetic ribbon past a recording head at a constant speed. Instead the sound information is digitized and stored on the equivalent of a flash drive; a SmartMedia card in the case of the DM-1. A single 128 MB SmartMedia card can store 22 hours at the highest quality setting (still well below broadcast quality), enough for an entire meeting.

Each separate talk can be a separate file, and within each file I can put up to 16 index marks. That makes it far easier to go straight to the talk I want to listen to, and then straight to the most interesting or quotable parts of that talk.

Then I download the files to my computer through a USB cable or with a card reader. And then I use the free software that came with the recorder to transcribe the recording. I also purchased a foot pedal that makes it even easier to transcribe. The recording plays as long as I keep the middle pedal pushed down, and stops the instant I lift my foot. And I've set the software to back up 2 seconds automatically, so when I put my foot back on the pedal it's easy to pick up where I left off. (The left pedal is fast forward, and the right one is reverse.)

The biggest drawback of the DM-1 is that the sound quality with the built-in mic isn't great. I've purchased an external Sony ECM-F01 Flat Mic, which helps a lot, although it's still no where near broadcast quality.

The Olympus DM-1 isn't being sold any more, which is too bad because I like its snazzy blue color. The ones out right now are pretty much silver or black. But I covet the top-of-the-line DS-50, which offers 275 hours of stereo recording and a removable stereo microphone. Unfortunately, I don't expect my DM-1 ever to fail.