Thursday, March 23, 2006

NIH Update II

When last we left the saga of the NIH posting incorrect medical information about the progestin-only emergency contraceptive pill (ECP):

  • I had emailed Dr. Marchiano, the last one to review/update the information according to MedlinePlus. [Still no reply from him.]

  • I'd contacted the NIH. [Received a prompt reply from C. Marks, NIH Librarian, National Library of Medicine, letting me know that 1) the info is provided by A.D.A.M., and 2) my email will be forwarded to the publisher.]

  • I had also emailed Dr. Trussell, for an expert second opinion, and to bring the situation to his attention. [Received an uber prompt reply (I must say, I was impressed) verifying the accuracy of my data (well, actually, his data.]

  • Last, but not least, I'd contacted A.D.A.M., using their site Contact form. [Received a fairly prompt call from C. Tenorio, an educational sales rep. He promised to forward the info to Kelly (couldn't remember her last name), a content editor.]

    As soon as I hear from A.D.A.M.'s editor I'll let you know.

    In the interim, I can't help but notice that the NIH site continues to display incorrect information about the emergency contraception pill. I wish I was even marginally skilled in the art of PR, because if this type of news makes the wires, I most certainly think a press release about the government's incompetence/ignorance when it comes to disseminating health information would be newsworthy.

    On a related note, a reader wonders Where did the 10 times risk statement come from? I've asked myself the same question and I must say, I don't know. It certainly looks like it came from a study, but, despite repeated literature searches, I haven't been able to find even one source for the statement.

    I do have a theory, but I must caution you that the underlying assumption--that anyone with any medical knowledge would make such a basic mistake--is quite far-fetched. Here it goes. The prescribing info for Plan B contains this statement (.pdf) [emphasis mine]:

    Ectopic pregnancies account for approximately 2% of reported pregnancies (19.7 per 1,000 reported pregnancies). Up to 10% of pregnancies reported in clinical studies of routine use of progestin-only contraceptives are ectopic. A history of ectopic pregnancy need not be considered a contraindication to use of this emergency contraceptive method. Health providers, however, should be alert to the possibility of an ectopic pregnancy in women who become pregnant or complain of lower abdominal pain after taking Plan B®.

    Now, clearly, the statement is about ectopic pregnancies in users of the regular progestin-only birth control pill (different drug, different regimen, etc.; tells us nothing about ectopic risk in users of the progestin-only emergency contraception pill). However, it is possible for someone to misinterpret the information and mistakenly assume it refers to Plan B. I don't know; I told you my theory was pretty out there. All I can say is that, on the off chance that I'm right, someone who makes this kind of mistake has no business providing educational content to frogs, let alone the NIH.

    To be continued.



    At 9:59 PM, Anonymous Anonymous said...

    Could it be possible that women with a susceptibility for ectopic pregnancies could also find progestin-only contreception more acceptable (has less side effects) than the general population?

    At 3:10 PM, Blogger Rachel said...

    Since the encyclopedia in which the ectopic pregnancy article appears is based on content generated by A.D.A.M. rather than the NIH or NLM itself, have you tried contacting them? Their editorial feedback page is at

    At 11:45 PM, Blogger Rachel said...

    Sorry, I missed it earlier that you had contacted A.D.A.M. Have you had any new responses?

    At 12:44 AM, Blogger ema said...

    No, nothing yet.


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