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Study suggests a second LDL test
May 13, 2008
If your LDL cholesterol level is below 130, and you think your risk of heart disease is low, think again.
Our Review Summary
This brief newspaper report describes a test called the NMR LipoProfile, which is used to measure the number and size of LDL particles. The test maker says these particles provide a more accurate picture of cardiovascular disease risk than LDL numbers alone.
As the rating for this news story suggests, it falls far short of most health journalism best practices. It fails to report on price, availability, medical need, alternative approaches, related research or potential harms.
But the story's most serious flaw is its failure to include independent sources' assessment of the value of LDL particles in assessing heart disease risk--and of the LipoProfile test in particular.
Depending solely on the views of the test maker's former chief medical officer, who has collaborated in his research with a current company executive, was a bad journalistic decision.
Click on Criteria for definitions.
The article fails to report how and under what conditions the LipoProfile test is available.
The article fails to report how much the test costs.
The article implies that people who are ignorant about their LDL particle numbers cannot know their true heart disease risk. This can make people needlessly fearful that they need to have this test.
The article refers to an article "recently" published in the Journal of Clinical Lipidology. It does not name the article or specify the date.
It appears the study is a paper published in October 2007 based on data collected for the Framingham Offspring Study. This is an observational study, not a clinical trial.
The story does not mention the frequency of the test's false positives or false negatives, both of which could have serious consequences for the patient.
The article implies the LipoProfile test is a novel method of identifying otherwise hidden heart disease risk using lipid analysis.
In fact, there are several tests available and under development that seek to link heart disease risk with a variety of lipid measures other than LDL and HDL numbers.
The article implies that people with "low" LDL particles are linked to a 27 percent reduced risk of heart attacks. But the sentence is so unspecific and garbled it's hard to know what the claimed benefit is. And the story only gives this relative risk reduction figure, not the more helpful context of the absolute risk reduction.
The company's most recent press release was issued on March 28. It's not clear whether it triggered this story. No other media have written about the test or the company recently.
The article quotes only one source, William Cromwell, the former chief medical officer of LipoSource, which markets the LipoProfile test.
While the story says that Cromwell no longer has financial interest in the company, his co-author on the published study is an executive with LipoSource. This calls into question the reporter's assertion that Cromwell "no longer has a relationship with" his former employer.
Under the circumstances, the lack of a clearly independent source is a serious failing.
The story does not describe how heart disease risk can be assessed and managed by means other than using the LipoSource test.
Total Score: 0 of 9 Satisfactory
The U.S. Preventive Services Task Force is considered the gold standard of preventive health recommendations - including on screening tests. It's a good source for journalists and consumers.
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Rather than suggesting that everyone should be screened for everything, news stories could explain: "All screening tests cause harm; some may do good."
The first 38 network TV network morning health news stories reviewed in 2009 earned an average score of 1.2 stars. 13 of the 38 stories got ZERO stars.
Both TIME magazine and BusinessWeek have published terrific stories explaining the importance of the Number Needed to Treat - or NNT.
Knowing relative risk reduction is like knowing you have a 50% off coupon but not knowing whether it's for a Lexus or a lollipop. Absolute risk reduction tells you what the "coupon" is worth. Read more.
The website NoFreeLunch.org posts "a database of health care professionals who have pledged to accept no gifts from industry and to rely on non-promotional sources of information."
To help journalists cover stories responsibly, we post a list of independent experts who state that they do not have financial ties to drug or medical device manufacturers.
We apply the same ten standardized criteria to the review of every story.
We have about 30 story reviewers. Each story is reviewed by 3 different people.
Gary Schwitzer's seven words you shouldn't use in medical news: cure, miracle, breakthrough, promising, dramatic, hope, victim. Read why.
Our reviewers include two former CNN medical reporters and a former editor of the Washington Post health section.