Niacin shrinks artery plaque; Merck's Zetia does not and may carry risks, new study finds November 16, 2009 ![]() The story provides a reasonable amount of information on the study and places it in context of other studies and in context of other treatment options. Our Review Summary Overall, a reasonably complete story that addressed our criteria. The story provides a reasonable amount of information on the study and places it in context of other studies and in context of other treatment options.
Click on Criteria for definitions. The story made it very clear that the medications discussed are all currently commercially available. ![]() Discuss costs? - SATISFACTORY
A cost for the medications discussed was provided; in addition the story noted that niacin was available in a less expensive, generic version. ![]() Avoid "disease-mongering"? - SATISFACTORY
The story did not engage in overt disease mongering. ![]() Evaluate the quality of evidence? - SATISFACTORY
The story provided information about the study in a piece meal fashion which included the number of individuals studied and that the study was stopped early because one group appeared to be faring better than the other with respect to size of carotid plaque. A comment from a representative of the other drug makers mentioned that the end point (size of plaque buildup in the carotid) needs to followed up on because in and of itself does not have a health impact. Coming from him it almost seemed as though it was sour grapes, but it is a very valid concern for interpreting the results of the study. It would have been better to have a less involved expert comment on the surrogate endpoint/ ![]() Quantify the potential harms? - SATISFACTORY
The side effect, flushing, associate with naicin was mentioned in the story as well as an estimate (1/3 of those taking Niaspan) for how many in the study were affected. None of the medicines discussed in this story are new or novel and they were not presented as such. ![]() Quantify the potential benefits? - SATISFACTORY
The story adequately discussed the benefits observed in this study, in a somewhat scattered fashion. It mentioned the difference in heart attacks and other heart problems observed and though they were few, the difference was statistically significant. The story does note the issues related to the surrogate endpoint and puts the study into context. The use of a spokesperson from the manufacturer of eztimibe in comments on the value of the surrogate endpoint is curious and takes away from the legitimate discussion on its value. This is offset somewhat by the comments of another presumably less conflicted expert.
![]() Appear to rely solely or largely on a news release? - SATISFACTORY
Does not appear to rely exclusively on a press release. ![]() Use independent sources and identify conflicts of interest? - SATISFACTORY
Comments from several expert sources outside of the study investigators or the manufacturer of the drug that appear to provide a better outcome were included in this story. ![]() Compare the new approach with existing alternatives? - SATISFACTORY
The story discussed several of the available medications that could be used in addition to statins to lower heart attack risk. It might have been useful to include some information about dietary and lifestyle changes that could also be used to lower heart attack risk. Total Score: 10 of 10 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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