Letters

MONICA did not deliver on task it set out to accomplish

EDITOR --- What MONICA actually said grows murkier and murkier. I am baffled by Tunstall-Pedoe's criticism of the newspaper reporting of the project.¹ His first target is the Daily Telegraph, the first paper to spot the story, which reported on 25 August: "The largest ever cardiology study has failed to find a link between heart attacks and the classic risk factors, such as smoking and high cholesterol levels."

According to Tunstall-Pedoe, this account of the study was fantasy. He describes telling a researcher from the BBC who telephoned him about it to "discount what was written in the Daily Telegraph and use the project's press release." I have the press release in front of me. It is headed "Surprises from world's largest and longest heart study," and at the bottom of page 2, in bold type, it says: "Changing rates of heart disease in different populations did not appear to relate at all well to the change in the standard risk factors." The Daily Telegraph seems to me to have got it spot on, and I and others wrote pieces in its wake.

Tunstall-Pedoe makes some accurate points about the way the media feed off each other. But his identification of motes in others' eyes would carry more weight if he recognised the beam in his own. When MONICA was launched in the mid-1970s there was fierce disagreement, I understand, about whether such a large cross sectional study could deliver on the task it set out to accomplish. The "surprising" results seem to confirm that its original detractors were right.

Jeremy Laurance, Health editor. 
The Independent, London E14 5DL

1. Tunstall-Pedoe H. Did MONICA really say that? BMJ 1998; 317: 1023[Full Text]. (10 October.)