I know I might go blind by self-replying, but I have been so struck by
the TV reverb on two apparently different stories this week that I
feel the need to risk it.

Last Sunday night Patriots coach Bill Belichick made a very
controversial decision to "go for it" on 4th down and 2 from his own
28. He did not make it and lost the game to the Colts. Two days later
the US Preventive Services Taskforce  came out with its recommendation
that women in their 40s  who are not otherwise "at-risk" should not
get mammograms, and that breast self-exams have no value in treating
cancer.

I suppose it is an indicator of our screwed up societal values that
these two stories led to about an equal storm of media debate and
punditry. While you can find views supporting the scientific,
empirical conclusion on both issues (see Dr. Nancy Schniederman, below
on breasts and for Belicheck, see here:
http://sports.espn.go.com/espn/page2/story?page=easterbrook/091117&sportCat=nfl),
the majority of what I saw on TV this week took what seems to me to be
the more emotional, intuitive side of both issues, often specifically
noting and rejecting the rational analysis (e.g. "I don't care what
the numbers and the eggheads say, you always punt the ball from deep
in your own territory/my college roommate's sister found an early lump
when she got a mammogram at age 44").

Breast cancer is more important than football. There is more to
important life decisions than quantifiable, scientific data. Science
and statistical analysis are not infallible.

Given these provisos, it is frustrating that we have made it this far
into the 21st century and still can't weigh properly the contribution
of empirical data when making important decisions. I attribute this
partly to the innate anti-intellectualism of Americans, but also to
the acceptance of the profit motive as the dominant justification for
television programming. While there were advocates of the data on many
(though I doubt most) of the TV news segments discussing these stories
this week, they were almost always introduced and concluded by a
studio anchor whose skepticism of the empirical view was detectable
and at times oozing. I believe this is because ESPN and CNN and NBC
know that most people in their audience either don't understand or
don't trust the quantifiable analysis, and they want to reassure this
large audience that they (the news organization) are in touch with the
everyday John and Jane Q Publics, rolling their eyes at the ivory
tower egg heads who "just don't get it". This is an example of TV news
giving viewers the information they think their audience wants, not
the information that is most accurate.

There are non-empirical factors to consider in both of these
situations. While the data is clear that going for it on 4th down gave
Belicheck's team the best chance to win the game, one could at least
reasonably argue that it communicates a lack of confidence in the
defense, which might hurt the team down the road. While mammograms for
women in their 40s decreases mortality by only 1/10 of 1%, while
exposing them to much higher rates of negative outcomes and
redirecting funds from procedures that have much stronger health
benefits, one could at least argue that the peace of mind benefits
that come from getting negative mammogram results to women in their
40s is worth the cost. But these arguments should always be made
against the background of what our best understanding of the empirical
data tells us, not some emotional hysteria.

What happened to all the talk of TV being a "cool" medium? It would be
nice if TV information was less emotionally hot.



On Tue, Nov 17, 2009 at 8:13 AM, PGage <[email protected]> wrote:
> United States Preventive Services Task Force came out with
> recommendations based on independent review of new data that women in
> their 40s should not get a mammogram, women over 50 only every other
> year, and that breast self exams have no real value
> (http://www.nytimes.com/2009/11/17/health/17cancer.html?partner=rss&emc=rss).
> The small increase in benefit from early and more frequent mammograms
> is outweighed by multiple risks, and those health care dollars can be
> better spent elsewhere.
>
> Two things on this. One of course is a note of regret that we have
> lost one of the best excuses for local tv news anchors to say the word
> breast, and show video of those self-exams during sweeps. Second is to
> give props to Dr. Nancy Schniederman on The Today Show. I am often
> frustrated with the quality of science and health reporting on
> television, and have not always liked Dr. Nancy, but they put her in
> the first 15 minutes today and she took a clear and reasonable stand
> on what has proven to be a controversial report (The American Cancer
> Society has already come out against the Report, and the USPS is being
> accused of medical rationing and putting dollars ahead of women's
> lives). Nancy did a real good job explaining the data and the
> rationale, and her reporting should help cool down what could become a
> very overheated and irrational response. I can't always say this, but
> I thought they did a good job with this story on the Today Show and
> they deserve commendation.
>

-- 
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