Health News Review

Researchers at Stanford University have developed a potentially pathbreaking blood test that, according to preliminary studies, is able to identify patients with Alzheimer’s disease – an ailment that has been notoriously difficult to diagnose.

Our Review Summary

This was a story about a method described in a recently published letter to the journal Nature Medicine for the early diagnosis of Alzheimer’s disease.  While providing some details of the results outlined in the letter, the story failed to provide context to help readers understand the risks and benefits that might be associated with the kind of test described.  The story failed to mention that if the test were to be demonstrated to have utility for early identification of Alzheimer’s disease, its initial greatest benefit would probably come from identifying individuals who might then participate in clinical trials to develop treatments for improved management of the condition.

The story did a good job in:

  • providing actual numbers (e.g., test was positive for Alzheimer’s disease in 38 out of 42 patients….) and % accuracy rate
  • using a lot of cautionary phrases (e.g., "preliminary studies") and has specific caution that will be at least 2 years before available (after further testing) and "…all technologies a long way from being available in clinics".

However, the story doesn’t give much discussion about the specific limitations of this study. For example, this case-control type of patient selection almost always overestimates test accuracy.  So it’s likely to perform worse in real world populations.

The story also didn’t comment on the fact that the publication in the journal Nature Medicine was actually a letter – which is curious and almost demands comment.  Although methods are published, why was it not published as an original article about original research? As a letter, was it peer-reviewed?  The same as original articles?  

When a news story discusses the potential of a new test for Alzheimer’s disease – a topic of great public interest – questioning the quality of the evidence is a key issue.  


Criteria

Not Applicable

Does the story adequately discuss the costs of the intervention?

Not Applicable

Potential costs not addressed.  However, this is not a commercially available test or even available in most research labs so costs are very difficult to predict.  But a story like this also could have touched on the whole issue of the downstream costs associated with testing everyone who forgets someone’s name or where they put their car keys – could be enormous – and the costs of providing what are now relatively ineffective current drug treaments.   

Not Satisfactory

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The story was really not clear about the benefits to be gained by early identification of pending Alzheimer’s disease.  Although one expert was quoted as saying that he was a "proponent of knowing what is ahead" and the value in doing so while people can still "speak for themselves", it is not clear from this story what one would do with advance knowledge that one was going to develop Alzheimer’s disease.Not everyone is a proponent of knowing what is ahead, especially given uncertainty about effective treatment. 

Not Satisfactory

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

Although the story did acknowledge that there are very few medical treatments for patients once they are diagnosed with Alzheimers’s, it failed to address the burden of such knowledge for the patient and the patient’s family.  There could be insurance ramifications, there should likely be a consulting component to go hand in hand with the test, and there is the possibility of false positive results.

The story did not do an adequate job of addressing the potential harms of this test.

Not Satisfactory

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

Mixed views on this criterion.  The story did a good job in:

  • providing actual numbers (e.g., test was positive for Alzheimer’s disease in 38 out of 42 patients….) and % accuracy rate
  • using a lot of cautionary phrases (e.g., "preliminary studies") and has specific caution that will be at least 2 years before available (after further testing) and "…all technologies a long way from being available in clinics".

However, the story doesn’t give much discussion about the specific limitations of this study. For example, this case-control type of patient selection almost always overestimates test accuracy.  So it’s likely to perform worse in real world populations.

The story also didn’t comment on the fact that the publication in the journal Nature Medicine was actually a letter – which is curious and almost demands comment.  Although methods are published, why was it not published as an original article about original research? As a letter, was it peer-reviewed?  The same as original articles?  

What’s missing is just as important as what was included, and for that reason, we rate this unsatisfactory.  

 

Satisfactory

Does the story commit disease-mongering?

Satisfactory

Although the story used some dramatic wording, it balanced the drama with hard, objective data on annual mortality rates due to Alzheimers and gave overall prevalence. 

Satisfactory

Does the story use independent sources and identify conflicts of interest?

Satisfactory

The story included quotes from two individuals with expertise in the field but no direct connection with the publication discussed or the company which has been established to market the test.

Not Satisfactory

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story made reference to several other tests which are currently being explored for use in detecting Alzheimer’s disease.  While it did mention MRI, the story did not mention current approaches to diagnosis (i.e. eliminating other possible diagnoses).

Satisfactory

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

Although the story used words like "proves" and "promising", it also included estimates for the time needed for further testing that made it clear that this was not something that was currently available.

Satisfactory

Does the story establish the true novelty of the approach?

Satisfactory

This was a story reporting on the development of a method for identifying individuals who will go on to devlop Alzheimer’s disease.  It was accurate in the portrayal of the novelty of the approach.

Not Applicable

Does the story appear to rely solely or largely on a news release?

Not Applicable

Does not appear to rely exclusively on a press release.

Total Score: 4 of 8 Satisfactory


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