The Sixth Estate

Margaret Wente has published another column, sans apology for specific “careless mistakes” (as she calls them) in the past and also complete with her unique pre-moderated comments section (since she needs extra protection from rabid readers). And this one, entitled “The Best Protection Against Bullying Isn’t Legislation,” appears to rise to the standard I have been regularly setting for professional journalists: sources must be attributed, and word-for-word passages must be quoted. Thank you, Wente. That’s all I wanted from you.

However, since Wente did not explain in her most recent apology what she was apologizing for (or how often it happened), and because the Globe is protecting her with this comments section, the investigation must continue. Wente was publicly accused of plagiarism. Apparently, her media colleagues tell us, it’s much harder to judge that than you might think. What we certainly can judge, however, is the originality of reporters. And by originality, I mean the strangely high number of cases in which Wente and some other reporter happen to publish almost exactly identical sentences. Who knows why that might happen.

Our text for the day is an article Wente published a year ago called “Cures for Cancer At Any Cost,” arguing that we’ve over-invested in ineffective diagnostic and screening tests and consequently caused unnecessary suffering and hardship for millions of men (prostate cancer) and women (breast cancer). Her two main targets are the PSA test and mammography, and yes, there continues to be some degree of uncertainty over exactly how much benefit we’re getting from both tests, on large scales. But…

Wente gets off to a rather horrific start by almost immediately misplacing her quotation mark key:

Wente: In 2009, the New York Times published a front-page bombshell: The American Cancer Society was about to reconsider its message about the risks and benefits of cancer screening.

New York Times: The cancer society’s decision to reconsider its message about the risks as well as potential benefits of screening was spurred in part…

At least she cited it.

The next part gets a bit uglier. Wente announces that the mammography debate is back in the news because

Wente: this week, when an expert panel said that women in their 40s do not need routine screening with mammography.

The recommendation in question was published here, and as you can tell, Wente’s wording does not match theirs. So it looks like a bona fide paraphrase. Except that it does very nearly match news coverage of the recommendation published with an earlier dateline, at MedPageToday.com:

MedPageToday.com: Women ages 40 to 49 do not need routine breast cancer screening with mammography, according to a Canadian preventive care task force.

This would be a fairly trifling objection, except for what follows. After a cursory reference to another Globe reporter’s work on the subject, Wente wrote the following:

Wente: In one Danish study, for example, women between 55 and 74 who had regular mammograms had a 1 per cent annual decrease in breast-cancer mortality. But women who were unscreened had a 2 per cent annual decrease.

That very same MedPageToday.com article says this about the Danish study:

MedPageToday: A Danish study showed that women ages 55 to 74 who had regular mammography had a 1% annual decrease in breast cancer mortality, as compared with a 2% decrease each year in an unscreened population.

There’s also a striking similarity between the next statistic cited by Wente, and the same MedPageToday article:

Wente: Another analysis of six European countries that introduced breast cancer screening 10 to 15 years apart showed no relationship between the beginning of screening and breast-cancer mortality. In fact, all of the countries had similar breast-cancer mortality.

MedPageToday.com: An analysis of six European countries that introduced breast cancer screening 10 to 15 years apart and showed no relationship between the start of screening and breast cancer mortality. In fact, all of the countries had similar breast cancer mortality.

MedPageToday is paraphrasing — and citing — this editorial by Peter Gotzsche in the Journal of the Canadian Medical Association. Something weird happens here, where Wente references Gotzsche for the first time, after referencing some studies he mentioned in an editorial but using the wording of MedPageToday.com, and then going somewhat farther:

Wente: “As Danish cancer expert Peter Gotzche concluded, ‘If screening was a drug, it would have been withdrawn. You don’t market a drug that harms so many people for such uncertain benefit.’”

MedPageToday: “Peter Gotzsche, MD, of the Nordic Cochrane Center in Copenhagen, wrote, ‘If screening had been a drug, it would have been withdrawn from the market.’” Period full stop.

The original editorial doesn’t contain the full quote given by Wente either, but a September 2011 report in the Times (UK) does contain her quote. Wente does not mention where her sources for any of this material come from in the article.

Wente then moves on to impress us with her intimate knowledge of epidemiology, spitting out the following statement without any attribution whatsoever, but which can be easily found using Google in the CMA Journal’s 2011 breast cancer guidelines:

Wente:[T]he benefit is vanishingly small: For example, 2,100 women in their 40s would have to be screened every two years for more than a decade to prevent a single breast-cancer death. Of those 2,100 women, 690 would have a false positive result, 75 would undergo unnecessary biopsies and others would have needless surgery.

CMA Journal: Screening about 2100 women aged 40-49 years once every 2-3 years for about 11 years would prevent a single death from breast cancer, but it would also result in about 690 women having a false-positive test result on a mammogram, leading ot unnecessarily follow-up testing, and 75 women having an unnecessary biopsy of their breast.

It doesn’t need quotation marks but surely it needs proper attribution. Wente follows it immediately with another reference to an unattributed “recent study,” which I haven’t read, but which CBC did read, and reached pretty much the same conclusion as Wente does. In fact, exactly the same conclusion, except that theirs was published one month before hers. Weird, eh?

Wente: Another recent study found that more than half the women who have annual mammograms in their 40s will be called back for more testing because of false positives.

CBC: More than half of the women who have annual mammograms starting at age 40 will be called back for more testing because of false positives, a new U.S. study suggests.

To add insult to injury, this is the first sentence of CBC’s coverage.

After this, Wente finishes up with breast cancer and moves on to prostate cancer, once again reaching conclusions noticeably similar to an earlier New York Times report:

Wente: The panel found that between 1986 and 2005, one million men were treated for prostate cancer because of the [PSA] test. At least 5,000 died soon after surgery. As many as 70,000 suffered serious complications, and 200,000 to 300,000 suffered impotence, incontinence, or both.

New York Times: From 1986 to 2005, one million men received surgery, radiation therapy or both who would noat have been treated without a P.S.A. test, according to the task force. Among them, at least 5,000 died soon after surgery and 10,000 to 70,000 suffered serious complications. Half had persistent blood in their semen, and 200,000 to 300,000 suffered impotence, incontinence, or both.

Wente follows up immediately by quoting Richard Ablin, the man who invented the PSA test. Just by coincidence, I’m sure, the Times also followed up by citing Ablin, and by helpfully providing a link to a recent op-ed by Ablin. I think Wente clicked on that link, because first she provides a sentence that is identical to the Ablin op-ed, and then she gives a quote that comes from the Ablin op-ed. Note that Wente’s first quotation mark is out of place:

Wente: Among its leading critics is Richard Ablin, the man who discovered the prostate-specific antigen for which the test is named. He argues that the test is harmful and costs a fortune — the annual bill for PSA testing in the U.S. is at least $3-billion…. Drug companies “continue peddling the tests and advocacy groups push ‘protstae cancer awareness’ by encouraging men to get screened,” he wrote in an opinion piece published last year in the Times. “… I never dreamed tha tmy discovery four decades ago would lead to such a profit-driven public-health disaster.”

Richard Ablin: The annual bill for P.S.A. screening is at least $3 billion… Because drug companies continue peddling the tests…

The quote goes on, but there is no need to reproduce it here; Wente’s quoting is accurate when she wants it to be.

So, in sum, that’s three New York Times articles, one CBC article, one CMA journal article, and one MedPageToday.com article. I’ll say this about Wente: she certainly does her research.