September 5, 2013
Breaking down the “20 mind-blowing medical breakthroughs” hyped by Readers Digest
Shortly after the September issue of Readers Digest hit the newsstands, with “20 Breakthrough Cures” on the cover and “20 Mind-Blowing Medical Breakthroughs” on the inside, a longtime follower of HealthNewsReview.org wrote saying, “none of them looked like breakthroughs to me.”
So I turned to expert reviewer Harold DeMonaco, MS, who broke down some of the breakthrough claims. Here is his guest post:
Over the years, as a reviewer for HealthNewsReview.org, I have seen over the top reporting on medical news on an all too frequent basis. I must admit, this Readers Digest story ranks in the top ten for hyperbole.
Let me walk through a sample of the breakthroughs individually for you.
- Better stroke detector – The reporting on this breakthrough is based on, what the authors themselves called a proof of concept study involving 12 subjects. Yes, twelve subjects. Here is the authors conclusion from that study, Device-based physiological diagnosis of vertebrobasilar stroke in acute vestibular syndrome should soon be possible. If confirmed in a larger sample, this bedside eye ECG approach could eventually help fulfill a critical need for timely, accurate, efficient diagnosis in emergency department patients with vertigo or dizziness who are at high risk for stroke (note the underlining is mine)
- Protection for Big and Small Athletes – One device is called the Checklight Beanie . It is made by Reebok and is designed to note either a blow to or a twisting or forward motion of the head. It is not designed to detect a concussion. Similarly, the X-Patch is designed to detect blows to the head. Neither of these devices have been subjected to study and while both may be useful, their sensitivity and specificity to detect serious head injury is unknown. Are they useful? Maybe. But, it is a bit premature to suggest that they can be used to detect blows sufficient to cause a concussion.
- Foods for Lower Blood Pressure – Diet is a significant contributor to blood pressure. That has been known for decades (e.g., DASH Diet). So there is not much new here. What is new is overstated. The latest study on purple potatoes was done with 18 subjects. Half the participants ate two portions of purple potatoes a day for a month while the others ate a similar diet without the addition of potato. The groups then switched. End result, a 3% drop in systolic blood pressure and a 4% drop in diastolic when the purple potato was part of the diet. So, in a person with a blood pressure of 150/100mmHg, the average drop would arrive at a blood pressure of 146/96mmHg. It is lower, but using the National Heart Lung and Blood Institute Risk Calculatoras a guide, there is no difference in the 10 year risk assessment for a heart attack.The beet juice/hypertension study referred to in the story was previously reviewed by two of my colleagues on HealthNewsReview.org. Here is a portion of their summary : The statistically significant reductions in blood pressure reported by the story were found only in men (a subgroup representing only half the participants whose results should be interpreted very cautiously), at a specific timepoint (6 hours after ingestion), and only after the authors adjusted their analysis for baseline differences between the beet juice and placebo groups. Experts differ about the appropriateness of such statistical tinkering in a randomized trial, another reason why this result should be viewed very carefully. So the overall conclusion should have been that beet juice did not lower blood pressure (at least not a statistically significant degree), and that there were some interesting trends suggesting a possible benefit that needs confirmation in stronger studies.
- The Supplement Cardiologists Love – Co-Enzyme Q has been the subject of multiple studies. Some, as the story suggests, have shown it to be beneficial. Others however have shown no effect. The comments of Dr. Clyde Yancy noted in the story would seem to be in conflict with the title however:
he feels that more research is needed if this it to become widely recommended for patients. Doesnt sound like true love to me.
- Genes Predict Weight Loss Surgery Success – While this is the title, this is hardly what the rest of the section suggests. Here is what Dr. Lee Kaplan and his colleagues concluded in the publication, These findings provide strong evidence for specific genetic influences on weight loss after Roux en Y Gastric Bypass(RYGB) and underscore the biological nature of the response to RYGB. The authors go on to note, Given the wide distribution of outcomes after RYGB, including in individuals carrying the rs17702901 minor allele, we cannot recommend that rs17702901 allele status, in isolation, be used as an exclusion criterion for surgical therapy. Given the wide distribution of outcomes after RYGB, including in individuals carrying the rs17702901 minor allele, we cannot recommend that rs17702901 allele status, in isolation, be used as an exclusion criterion for surgical therapy (note: the underlining is mine) The linkage between genetics and surgical outcomes is a very interesting finding that at least in part potentially explains the wide variation in weight loss in patients undergoing bariatric surgery. It is certainly a step in improving our understanding but not a complete understanding and certainly not ready for prime time.
- Blockbuster Blood Sugar Drug – Indeed, Invokana is the first of a series of new drugs targeting the mechanism that promotes glucose reabsorption in patients with Type 2 diabetes. This is a new approach to the treatment of Type 2 diabetes and may offer patients who are not adequately controlled with existing oral drugs an alternative. Interesting? Yes. Blockbuster? That remains to be seen. The true test of a new drug comes only after its use in the real world. For those interested, you can take a look at the minutes of the FDAs Endocrinologic and Metabolic Drugs Advisory Committee Meeting held on January 10, 2013. The committee voted 10 to 5 recommending approval. Cardiovascular risk and use in patients with moderate renal dysfunction were cited by those voting no. And, by the way, a months supply of Invokana costs about $285 as compared to $8 for the combination of metformin and glimepiride . The difference in diabetes control (as measured by HA1c blood levels) between the two regimens while statistically significant was modest. (according to data from the FDA review )
These were just six of the 20 supposed breakthroughs as framed by Readers Digest.
By now, I hope you are getting the picture. While there is a nubbin of truth in each of these stories, the real truth that readers/consumers need is stretched a bit in most. Rather than educating the consumer, the majority of the 20 bulleted items overestimate the value of the breakthroughs. The net result is likely to be an ill informed reader and potential consumer.
The use of cures…mind blowing…breakthroughs” as descriptors should set off alarms in readers.
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