Getting the Message Right

Guidelines International NetworkNorth America Interest Group/

New York Academy of Medicine

Sandra Zelman Lewis, PhDAmerican College of Chest Physicians

EGAPPS Conference 2012December 11, 2012

Workshop Format

1. Sandy: Overview of experiences with guidelines and the media

2. Brief Q&A3. Sharon and Shannon: How the press covers

guidelines and increasing the likelihood of coverage, including how to avoid pitfalls

4. Brief Q& A5. Everyone: Interactive Workshop:

• Propose topics/ receive advice• How to market guidelines to the media• How to get the message right

• Share experiences good and not-so-good

Past Experiences

• A non-random sample of guideline developers were solicited for experiences – good and not-so-good

• Most reported only good experiences

• We know they were not all good

• Let’s review them

American Society of Clinical Oncology

Example of a good response:

PSA Testing 2012• ASCO conducted one-on-one outreach with top-tier

science and consumer health media • Distributed an embargoed news release to media 3 days

ahead of publication• Resulting coverage in more than 400 online, print and

broadcast news stories • Associated Press, Reuters, HealthDay, Boston

Globe, The Atlantic, UPI, CBS News Radio, ABCNews.com and Medscape Medical News

USPFTF

Example of a not-so-good experience:

Mammography guidelines 2010• Controversy: No longer advising screening

mammograms for women 40-49 without risks or symptoms

• Mary Barton reviewed in the plenary session – just previous to this workshop

Infectious Disease Society of America

Pneumonia (joint with ATS) 2005• In 2011, the Lancet Infectious Diseases published a QI

project at 4 hospitals highly critical of these guidelines.• The PR suggested following the guideline could increase

mortality rates –generating some initial press coverage (Business Week’s website) but neither IDSA nor ATS had been contacted

• Coordination between IDSA and ATS to ensure that their perspective was included in follow-up media coverage

• Led to an article in PulmonaryCentral.com • Guideline authors said: flawed study design in QI project and

overstatement of results• Guideline authors submitted letter to editor of Lancet ID• Unfortunately, there was very little follow-up press

coverage

Infectious Disease Society of AmericaLesson learned: Since 2011, regular practice to issue a PR when publishing new

guidelines, which helps ensure that guideline information is disseminated more broadly and key messages included in coverage

MRSA January 2011• Expected press coverage so wrote a press release and their PR

firm pitched the story to various media outlets• WebMD, MedPage Today, Medscape, CBS Newspath (picked

up by numerous local CBS affiliates), Healthday (picked up by US News & World Report, Businessweek, Newsday, iVillage, and Health.MSN.com), Ivanhoe Newswire, and UPI

Rhinositis • 55 articles reaching 5.3 million people

• FOX News, The Los Angeles Times, Huffington Post, MSN Health, and the Wall Street Journal

American College of Chest Physicians Cough 2006: Most OTC tx ineffective, can be harmful to kids: M&M

• Over 1,600 media placements spanning Internet, television, radio, and print – estimated reach nearly 130 million people• National shows such as “ABC World News Tonight” and

CNN’s Headline News and Live Today and all 3 national network morning shows: NBC’s Today, ABC’s Good Morning America, and CBS’s The Early Show

• 9 front page stories: USA Today, Chicago Tribune, Chicago Sun-Times, US News & World Report, The Post-Crescent, St. Paul Pioneer Press, Dallas Morning News, Los Angeles Daily News, and Salt Lake Tribune

• Health section front page: Wall Street Journal, Washington Post, Baltimore Sun, Chicago Herald, Los Angeles Times, Myrtle Beach Sun News, and San Diego Union-Tribune

• All 3 national weekly news magazines (Newsweek, Time and U.S. News & World Report) - 9 million ≧

American College of Chest Physicians

Cough 2006• Media attention generated additional editorials & original

articles• Pharma pushed back when interviewed• FDA investigated

• Companies not listed with FDA must immediately cease manufacture & distribution of over 500 unapproved cough formulas (Jan 2011)

• Those companies listed were granted a few months

All this was made possible by a carefully constructed press release and a hot topic

American College of Chest Physicians

Antithrombotics (Thrombosis)7th edition - 2004• Long-distance travel of 7 hours or more increases

risk of VTE• Provided advance press release to media• Wide media coverage• No pushback from airline industry despite

expectations• Today many airlines include information at the

bottom of e-tickets and on their websites about movement and exercises during flight.

American Academy of Pediatrics

ADHD- Updated 2011• Expanded diagnosis and treatment from ages 6-12 to

4-18• Correctly anticipated media would focus on 4-5 year

olds• Prepared spokespersons to articulate benefits of early

identification and initial behavioral interventions• Great coverage, including NBC Nightly News, USA

Today, WSJ, Reuters Health, Chicago Tribune, LA Times, Boston Globe, NPR, etc

American Academy of Neurology

Published 2 guideline updates with the American Headache Society on Episodic Migraine Prevention in Adults in 2012:- Pharmacologic Treatment - NSAIDs and Other Complementary Treatments • Held a press conference with the lead author, co-

author, and lay person suffering with migraines• Press conference was recorded• Authors were trained in responding to questions from

the press• Amazed at the response and uptake• Pleased with coverage, including over 1200 online

publications, USA Today, US News and World Report, and the Huffington Post.

Ensure Your Success• Prepare and send press releases

• Well-constructed, succinct, and explicit• Ensure most controversial elements are properly framed• Target media contacts and outlets (lay and medical

media)

• Teamwork• Level of discussion between the PR and guidelines staff

and lead panelists • Identify the points that are important, could be

controversial, and are “newsworthy”• Anticipate the controversies, identify speakers,

prepare talking points, train speakers

Questions?

Sandra Zelman Lewis, PhDslewis@chestnet.org

Clinical ResearchClinical Research

Evidence ReviewEvidence Review

Evidence Synthesis• SRs• MAs• HTA

Evidence Synthesis• SRs• MAs• HTA

Clinical Decision Support

Clinical Decision Support

Medical EducationMedical Education

Quality Improvement

Quality Improvement

Healthcare PolicyHealthcare Policy

• PMs• PIMs• Other PI projects

• PMs• PIMs• Other PI projects

• CME/non-CME• Simulation/VR • Other education

• CME/non-CME• Simulation/VR • Other education

Evidence-based Medicine Spectrum

Practice Experience

Practice Experience

• Reimbursement• Facilities planning/ approvals

• Reimbursement• Facilities planning/ approvals

Consensus Statements

Consensus Statements

• E-Decision Support• EMRs/e-reminders• Checklists pocketcards, etc

• E-Decision Support• EMRs/e-reminders• Checklists pocketcards, etc

Evidence-based Guidelines