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On Haikus, Headlines and a One Size Fits All Pill

11/11/2008

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masthead
It has been a real learning curve over the last few weeks figuring out the natural rhythms of TrackerNews: How often should the story list update? Is there enough balance in the mix of health, humanitarian and tech? What adds meaning and real value to a grouping of stories?

The idea for TrackerNews grew out of series of conversations bemoaning the “silos of expertise” that make it difficult to see the bigger picture, identify opportunities or develop collaborative relationships across disciplines. The hope is that a sparky enough story mix will eventually begin to draw an equally sparky mix of readers.
I am often asked about metrics. Good question. In the coming months we will no doubt be obsessing over clicks and click-through’s, but to me the most important metrics are intangible. Did someone see a story or a grouping on stories on TrackerNews that started a conversation, sparked a new line of thought or perhaps even began a chain of events leading to a collaboration? (extra credit for something cross-disciplinary…)

A part of me wonders whether people are secretly so comfortable in their oft-decried silos, they will find TrackerNews’ format more overwhelming than enlightening. We purposely decided not to segregate stories by subject, or create a typical news site with a standard navigational structure. TrackerNews is as broad as you can imagine and one page deep. Stories, or groups of stories, cycle through the columns, just as one moment follows another. The only hard-wired hierarchy is the green bar banner where one suite of stories gets special focus for a limited time

The Haiku Challenge

In these first few “learning to walk” weeks, one of the biggest issues has been figuring out how to cover breaking news, such as hurricanes or the rumblings of war. It makes no sense to duplicate what other, much larger news organizations are doing. If the weather is going kerflooey, tune into Weather Channel, or check the wires, fergoshsakes. Rather, I have tried combining links to those larger news services, with links that provide background (research and/or older news stories) or tools (e.g., streaming audio from Congo’s only national radio station, Radio Okapi). If another website does a better job aggregating information, TrackerNews links to them (hats off to Andy Carvin’s work at the Hurricane Information Center and Hurricanwiki.org for coverage of Gustav and Ike).

The minimalist nature of TrackerNews’ links makes the selection of those links that much more critical. Much like syllables in a haiku, the limitations become a strength and a challenge. And, as I am fast learning, there is an art to it, too…

One Pill Fits All

The current quartet of “Green Bar” stories about statins is a case in point:
Picture
The video link is breaking news about a new study showing statins can prevent heart attacks in people with low cholesterol. Many expect millions more people will be put on long-term statin use as a result.

The next link is a story in the India Times about a big multinational study testing out a “polypill,” an inexpensive combo drug with aspirin, a statin and a couple of blood pressure medicines. It is designed to cheaply treat people with heart disease both in the West and in the developing world. According to the article, “17 million people die of heart disease and strokes every year and 80% of these deaths are in developing countries.”

The next link is BusinessWeek cover story from last January about “numbers needed to treat” (NNT) data for statins. Here’s the nut:
The second crucial point is hiding in plain sight in Pfizer’s own Lipitor newspaper ad. The dramatic 36% figure has an asterisk. Read the smaller type. It says: “That means in a large clinical study, 3% of patients taking a sugar pill or placebo had a heart attack compared to 2% of patients taking Lipitor.”

Now do some simple math. The numbers in that sentence mean that for every 100 people in the trial, which lasted 3 1/3 years, three people on placebos and two people on Lipitor had heart attacks. The difference credited to the drug? One fewer heart attack per 100 people. So to spare one person a heart attack, 100 people had to take Lipitor for more than three years. The other 99 got no measurable benefit. Or to put it in terms of a little-known but useful statistic, the number needed to treat (or NNT) for one person to benefit is 100.

Compare that with, say, today’s standard antibiotic therapy to eradicate ulcer-causing H. pylori stomach bacteria. The NNT is 1.1. Give the drugs to 11 people, and 10 will be cured.
Finally, I linked to a post on “germtales,” a blog I started a few years ago and for which I still write occasionally. I have a deep interest in animal health and had written about statins used as a contraceptive for wildlife. It makes sense: Eggs have cholesterol for reason. Remove it and you don’t have a viable eggs. Weirdly, statins work as a contraceptive for both boys and girls. While animals were given higher doses, they were also given fewer doses. Nobody knows what long-term low-dose use might do. Of course, humans taking statins are mostly past child-bearing age, but this is a real flag about the global effects of drugs. Even aspirin acts as both a pain reliever and a blood thinner. Before we start putting statins in the water, like fluoride, as some have suggested, it is important to consider it from all angles.

And now I’ve done it again—written a ghastly long post. I promise in the future to work on my “pithy”. If TrackerNews can do headlines as haikus, surely I can whittle down words, too.
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