Highlights of this issue

Drugs in the news: Can you believe what you read?

Figure. Photo by: Alan King

Increasingly, patients are learning about new medicines not from physicians but from the Internet, television and newspapers. However, it is unclear how well news stories accurately represent the true benefits and risks of therapeutic interventions. Alan Cassels and colleagues looked at newspaper coverage of 5 different prescription drugs in 24 of Canada's largest daily newspapers to determine how well news reports presented benefits, harms and potential conflicts of interest of quoted spokespeople. Sixty-eight percent of articles that mentioned at least one benefit made no reference to any potential side effects or harms. A small minority of articles provided quantitative information about benefits and harms. After exclusion of industry and government spokespeople, for only 3% of quoted interviewees was there any mention of potential financial conflicts of interest. Cassels and colleagues challenge newspapers to provide their readers with a more balanced assessment of drug benefits and harms.

See page 1133

International medical graduates and CaRMS 2002

International medical graduates (IMGs), or physicians who graduated from medical schools outside Canada, are an important component of the Canadian physician workforce. Rodney Crutcher and colleagues examined the demographic and educational characteristics of IMG applicants to the second iteration of the Canadian Resident Matching Service (CaRMS) match and identified their preferred clinical disciplines and practice locations, in order to help inform the work toward integrating unlicensed IMGs into Canada's health professional workforce. They found that these IMGs are a heterogeneous group of physicians, some with substantial medical training and experience and others at an earlier stage of their medical career.

See page 1119

Clinical trials on the Internet

The Internet provides tremendous access to information for both physicians and patients, in a way not possible even 10 years ago. One of the many areas in which it is hoped that online access can enhance medical care is by providing information to the public about clinical trial availability and eligibility criteria. This is particularly important for patients with cancer, a group of people who would benefit from increased, reliable access to trial information. Using a combination of MEDLINE and Web searching, James Till and colleagues attempted to detail the completeness of online databases of breast cancer clinical trials available in Canada. Surprisingly, the most complete database was the Physician Data Query (PDQ) Clinical Trials Database of the US National Cancer Institute, which identified 86% of trials. Canada's most comprehensive online site identified 29%.

See page 1127

Adaptation of Inuit children to a low-calcium diet

Figure. Photo by: Health Canada

The traditional Inuit diet provides considerably less calcium than the more southern “market” diet that most Inuit children are now consuming. An observation of severe hypercalciuria and nephrocalcinosis in children from northern communities caused Elizabeth Sellers and colleagues to hypothesize that the adaptation of the Inuit to a diet low in calcium might be through altered absorption. To test this, they gave 10 healthy Inuit children a standardized calcium load. Five had hypercalciuria despite a normal serum calcium level. A preponderance of the bb genotype for the vitamin D receptor allowed them to conclude that dietary calcium absorption is more efficient in these Inuit children, representing a possible genetic adaptation to dietary constraints. This might lead to adverse consequences if standard North American dietary recommendations are followed.

See page 1141