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Silent heart attacks: What you don’t know could kill you
April 21, 2009
This segment on MRI to help assess heart disease risk could have been much improved with just a few additional statements. The reporter did try, at least, to inject some cautious interpretation.
Our Review Summary
This segment on the use of MRI to help assess heart disease risk could have been much improved with just a few additional statements.
- It needed an independent expert to put the new research into the context of existing methods of predicting heart risk.
- It didn’t discuss costs.
- It didn’t discuss clear potential harms that were mentioned in the journal article upon which the story was based.
- It didn’t quantify “silent heart attack” prevalence or potential benefits of the MRI approach in the most meaningful way.
- It didn't mention that the researchers in the study in question hold a patent to the machine used in the study.
The anchor twice provided openings that may have led to overinterpretation of the findings, but the correspondent resisted admirably both times. And to her credit, the reporter did try, at least, to inject some cautious interpretation.
Click on Criteria for definitions.
The segment makes clear that MRIs have been available for a long time but are now being studied for their ability to reveal previous "silent" heart attacks.
The medical correspondent gets points for mentioning that MRIs are "expensive" and by extension too costly for use in population screening. But even in such a short segment, given the context, it would have been useful to specify.
Costs are usually $2,000 to $3,000.
The correspondent accurately describes "silent" heart attacks as deadly.
The story does nothing to exaggerate the severity or prevalence of the condition.
The story failed to put this new study into any context of other existing ways of assessing risk.
It is also important to note that the study was done in patients scheduled for coronary angiography, not just anyone off the street; by definition, this is a high-risk group.
The journal article upon which the story is based explained that there is a recently described problem wherein the contrast dye used in the imaging test causes a lung scarring that is very debilitating. It occurs in some people with kidney disease, and is an important downside mentioned in the journal article but not mentioned in the story.
The segment accurately states that MRIs have been around a long time and that this application is novel, not in clinical use and just now under study.
The segment uses brief data points displayed on the screen to illustrate how common silent heart attacks are and how they elevate the risk of death by 11 times.
Still, we don't know what percentage of all heart attacks are silent [we are given only a raw number] or what the underlying risk of death is for those who had and didn't have silent heart attacks.
Even a short segment could have added these numbers, even in the brief screen graphic.
Since no expert is interviewed in the segment, it is impossible to know whether the story relied solely or largely on a news release.
The researchers in the study in question hold a patent to the machine used in the study. This was never mentioned in the story. An independent source should have been cited - someone who could answer whether there are other ways of determining risk - and what should be done with this information.
The segment failed to put the new approach into the context of other methods of predicting risk.
Nuclear imaging can detect some similar findings. Stress testing and resting echocardiogram are also used.
Moreover, it is not clear that this new information can be used to guide therapy.
Total Score: 3 of 9 Satisfactory
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