“Encouraging news about reversing heart disease” March 13, 2006 ![]() Dr. Steven Nissen and his team at the Cleveland Clinic studied 500 people who’d already suffered heart disease. The volunteers took high doses of a cholesterol lowering drug, a statin, in this case – Crestor. ...(Nissen:) "We saw somewhere between 7 and 9 percent of the plaque was gone after 24 months of treatment." Our Review Summary This is an enthusiastic story about the results of the ASTEROID Trial, which showed that very high doses of Crestor (a statin) caused regression of atherosclerosis as shown on intravascular ultrasound (IVUS) in high risk patients. The story did not make clear that, while these results are intriguing, it is not clear that they will have any clinically meaningful impact on real cardiovascular outcomes, such as heart attack or death, compared to current practice. In fact, the story almost seems to makes leaps beyond what the evidence showed when it said, “The study was not big enough to detect changes in the numbers of heart attacks or strokes but evidence suggests that eliminating plaque should lower the risk.” There is no explanation of the availability of Crestor. Is it FDA approved? Is it on the market? The story can't assume that everyone knows. The story also does not place the treatment within the context of other existing therapies. This is important given that the study did not compare the treatment to current practice - regular doses of statins. Although the story is based on trial results, so little information about the design of the trial is presented that the viewer has no basis on which to interpret the strength of the evidence. No harms or side effects are mentioned, which are likely to be significant given the high dose of the drug. No costs are mentioned and only a single source, the study's lead author, is quoted. The lack of balanced information in this short story makes it very difficult for the viewer to be able to interpret the study results.
Click on Criteria for definitions. ![]() Establish the availability of the treatment/test/product/procedure? - NOT SATISFACTORY
There is no explanation of the availability of Crestor. Is it FDA approved? Is it on the market? The story can't assume that everyone knows. ![]() Discuss costs? - NOT SATISFACTORY
The story never mentions costs. ![]() Avoid "disease-mongering"? - SATISFACTORY
There is no obvious disease mongering. ![]() Evaluate the quality of evidence? - NOT SATISFACTORY
Although there is mention of a trial, so little information is provided that the viewer cannot evaluate the strength of the evidence. ![]() Quantify the potential harms? - NOT SATISFACTORY
No harms or side effects are mentioned. ![]() Establish the true novelty of the treatment/test/product/procedure? - NOT SATISFACTORY
The story does not explain if the drug is new, old, investigational, or already approved. ![]() Quantify the potential benefits? - NOT SATISFACTORY
Quantitative estimate is provided in relative frame only. The lead author of the study says that 1 to 9% of the plaque was gone, but we have no context for these numbers, nor do we know if this is clinically meaningful. ![]() Appear to rely solely or largely on a news release? - NOT APPLICABLE
We can't be sure if the story relied solely or largely on a news release. But only the lead author is interviewed. ![]() Use independent sources and identify conflicts of interest? - NOT SATISFACTORY
Only a single source, the lead author of the study, is quoted. ![]() Compare the new approach with existing alternatives? - NOT SATISFACTORY
Although there is mention of diet and exercise, there is no mention of the advantages/disadvantages of high-dose Crestor by comparison. There was also no mention of current practice - use of regular doses of statins. Total Score: 1 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.
About 70% of the stories reviewed from 2006-9 failed to adequately discuss costs, or to explain how big (or small) are the potential benefits and harms of treatments, tests, products and procedures.
We have documented a disturbing trend of news stories taking an advocacy stance, promoting certain screening tests outside the boundaries of scientific evidence.
Stories on new technologies like Cyberknife, DaVinci robotic surgery systems, and proton beam cancer therapy often fail to scrutinize the evidence and/or to discuss the costs involved.
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.
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