On Monday, The New York Times published a front-page story saying that "nearly one in five high school age boys in the United States and 11 percent of school-age children over all have received a medical diagnosis of attention deficit hyperactivity disorder," according to data from the government's Centers for Disease Control and Prevention.
The story, by Alan Schwarz and Sarah Cohen with reporting contributed by Allison Kopicki, did not say that the figures came from an announcement or publication by the CDC. It said that the Times had "obtained the raw data from the agency and compiled the results" itself.
That's tricky. The CDC could make a mistake compiling and interpreting its own data; such things happen. But for my money, I'd rather have the CDC doing that than entrust the job to Schwarz and Cohen. Where did they get the data? What form was it in? What did they have to do to come up with the figures they report? Did they enlist a scientist from the CDC or elsewhere to check and validate their analysis?
We are not told. The first quote in the story comes from a Yale neurologist who says he is "floored" by the rise in the diagnosis and treatment of ADHD. It's not a terribly insightful comment; I suspect most readers did not need an expert to tell them that the statistics were remarkable.
The next quote, midway through the story, comes from Dr. Thomas R. Frieden, the director of the CDC, who says, "We need to ensure balance. The right medications for A.D.H.D., given to the right people, can make a huge difference. Unfortunately, misuse appears to be growing at an alarming rate." That suggests that the Times analysis of the data is correct, but it doesn't actually say so. Did the authors of the piece ask Frieden whether they got it right? If they did, they're not telling us.
I should probably pause here to note that I was critical of a Feb. 6 Schwarz story that led with a 24-year-old who committed suicide after taking Adderall, in which Schwarz improperly implied that Adderall was the cause of the suicide. Of course, nobody can know whether that's true. I was friendlier toward a June, 2012 Schwarz story which also decried the overuse of stimulants in children, as this week's story does, but I quoted others who were critical of the story.
I should also admit that I made several errors in a post criticizing a story Schwarz wrote in 2009 in which he wrote, "Alzheimer’s disease or similar memory-related diseases appear to have been diagnosed in the league’s former players vastly more often than in the national population — including a rate of 19 times the normal rate for men ages 30 through 49." The data did not support that sweeping conclusion, I wrote, and that conclusion stands despite the errors I made in describing the story.
Schwarz can be a powerful writer, and he finds good stories. But the science supporting the stories often seems a bit wobbly to me, as I've explained in previous posts. In this story, for example, Schwarz notes that "some doctors and patient advocates have welcomed rising diagnosis rates as evidence that the disorder is being better recognized and accepted." But all of the quotes in the story take a negative view of the use of stimulants to treat ADHD. Where are the doctors who think this might be a welcome development? If they are not out there, Schwarz's unattributed reference to them should not be in the story.
Alice Park at Time reports more substantial problems with Schwarz's story. "To start," she writes, "the information on ADHD rates came from parents reporting on the diagnosis for their children during telephone interviews. Such reports are useful but not as reliable as the verified diagnoses from medical or school records, says Dr. William Barbaresi, director of the developmental-medicine center at Boston Children’s Hospital." And, she writes, "Most children are labeled with the disorder by their pediatrician or family doctor, who aren’t always trained in providing the in-depth evaluation that a reliable diagnosis requires."
Those are substantial caveats, and, again, they suggest that Schwarz should have been more careful with the data.
I should note one more thing. The story, published on March 31, now has a string of corrections appended to it. It picked up its first correction on April 1, another yesterday, and another one today. Each of the corrections fixes a misstatement concerning the statistics. If Schwarz had told us more about how he got that data and what it looked like, and if he'd brought in a scientist to help him analyze it, perhaps he would not have made those mistakes.