Controlling Blood Pressure August 10, 2009 ![]() Story on implanted pacemaker for HBP called it "a breakthrough…a game-changer…proven highly effective…could help millions." Long on hyperbole but short on evidence, cost or independent voices. Our Review Summary
This story on an implanted pacemaker to control previously uncontrolled high blood pressure called it a “breakthrough” a “game-changer,” and said it has “proven highly effective” and could help millions.
Click on Criteria for definitions. ![]() Establish the availability of the treatment/test/product/procedure? - NOT SATISFACTORY
The broadcast segment did not emphasize that the device is currently being tested in clinical trials and is not available outside of the trials.
![]() Discuss costs? - NOT SATISFACTORY
There was no discussion of estimated price for this device and treatment. If it's not too early for the network to say this is "proven highly effective" and a "game-changer," then it's certainly not to early to discuss costs. ![]() Avoid "disease-mongering"? - SATISFACTORY
It didn't exaggerate the seriousness of uncontrolled high blood pressure. ![]() Evaluate the quality of evidence? - NOT SATISFACTORY
The story gave no data - just saying the device had "proven highly effective." The piece provided no indication about the percentage of individuals whose pressure was reduced with the use of this device; it also did not indicate the extent to which pressure was reduced. Further - merely showing that the device lowers blood pressure is not enough evidence of benefit. Studies would really need to demonstrate thatuse of the device results in a decrease in heart attacks and other cardiovascular events. Just because lowering BP in medication trials does this doesn't mean that lower BP with the device would do this. ![]() Quantify the potential harms? - NOT SATISFACTORY
One patient mentioned noticing every once in a while that the device was there. The patient who was interviewed said that there were no downsides that he was aware of. However - this does not adequately describe the harms of an implanted medical device, nor possible side effects from stimulating the baroreceptors. The broadcast described the device as a 'breakthough'. It is premature to use this terminology as the device is still only being studied to determine whether it is effective for this purpose. However - the broadcast was clear that this was a new application of the technology. ![]() Quantify the potential benefits? - NOT SATISFACTORY
There was no information provided about the extent to which this device might be expected to reduce blood pressure or any information about its impact on cardiovascular events. ![]() 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. We do know that physicians at only one medical center appeared in the segment. ![]() Use independent sources and identify conflicts of interest? - NOT SATISFACTORY
Besides a patient, two doctors involved in the clinical trial (one of whom is the CEO and president of the company manufacturing the device) were interviewed for this segment. There were no independent clinicians or physiologists interviewed to provide background and some perspective about the device reported on. ![]() Compare the new approach with existing alternatives? - NOT SATISFACTORY
Medical therapy for the control of hypertension was mentioned during the course of this segment. There was no discussion of other medical devices currently being investigated for the purpose of controlling blood pressure or lifestyle factors that affect blood pressure and cardiovascular risk. There was no discussion of secondary causes of hypertension or interventions that can be used to improve adherence to treatments that have been shown to lower cardiovascular risk. Total Score: 2 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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