Health News Review

If the independent expert you interview states that the findings are “not incredibly novel,” then why is this newsworthy?

Our Review Summary

The story actually came very close to being a quite complete story.  But it made silly, clumsy mistakes in wording – all easily fixed.  But since they weren’t fixed, the story, as published, was frustratingly incomplete.  Read the full review to learn more.


Why This Matters

Clearly, better treatments for metastatic tumors that spread to the lung from elsewhere would be welcome.  The study authors’ caveats were clearly stated in this story.  The reporting – wrapped around those researcher caveats – was not that clear.

We have repeatedly suggested that reporting on the results of studies presented at scientific meetings is fraught with hazard.  Why then would this be viewed as important?  The reader is told that the technology has been around for years, one of the experts quoted (Dr. Carbone) indicates he has in fact used this approach in his practice but prefers stereotactic radiation therapy. And finally these are preliminary results on a very small population of patients likely with a mixed bag of primary cancers which resulted in lung metastases.  To recap, very preliminary results reported at a scientific meeting (and we aren’t certain that the story was written after the presentation) in a small number of patients using a technology that has been around for a number of years and is routinely used by others.


Criteria

Not Satisfactory

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

There was no discussion of cost of cryoablation nor of cost for stereotactic radiosurgery which was mentioned as an alternative.

Not Satisfactory

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

Not Satisfactory

Yes, the story did explain – although in a way we find flawed and incomplete:

“The result: Among the 15 patients seen roughly three months post-procedure, tumor control was found to be 100 percent, although six patients were found to have developed new lung tumors in the interim.

Among five patients seen six months after the procedure, tumor control continued to be 100 percent.”

The story goes to some length to note the study is preliminary, and involves a small number of subjects to date.  However, we believe that it overstates the benefits by not providing any context.  A bit of background would have been helpful. The people treated have metastatic disease, these were not primary tumors.  So eliminating single metastatic lesions does not automatically equate to improved survival.  There is a high likelihood of additional lesions appearing as was the case with 6 of the 15 seen three months after the procedure.

Satisfactory

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

Satisfactory

The story was cautious in reporting:

“The authors noted that side effects were minimal, typically involving air or fluid around the lungs after the procedure, and in all cases were resolved quickly.

The team concluded that cryoablation appears to be both safe and effective, at least in the short-term. But they acknowledged that more research needs to be done to track the treatment’s impact over the long haul.”

A further caution could have been that we don’t know what patients think about such side effects being described as “minimal” and that we were only hearing this from the researchers announcing their findings.

Not Satisfactory

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

Not Satisfactory
  1. Let’s go back to what was reported about benefits:

“The result: Among the 15 patients seen roughly three months post-procedure, tumor control was found to be 100 percent, although six patients were found to have developed new lung tumors in the interim.

Among five patients seen six months after the procedure, tumor control continued to be 100 percent.”

What do researchers have to say about the six patients having new lung tumors?  Were these in parts of the lung not treated?  What’s going on here?

And, as for the final statement about five patients seen after six months, this begs several questions:

  • Were these the only five seen after six months?
  • If not, what happened to the others?

This is a comment on the wording, which requires more precision than what we got in this description.

2. The story noted that “The U.S. National Cancer Institute points out that while cryoablation (also known as cryosurgery) is a well-known practice, researchers are still in the process of assessing its long-term benefits.”  But no source/link was provided, which was frustrating.  We saw the story online.  We would have appreciated a link to the source – easy to provide.

3. We appreciate that the story attempted to explain the limitations of reporting on talks at scientific meetings, when it stated: “Because this study was presented at a medical meeting, the conclusions should be considered preliminary until published in a peer-reviewed journal.”  But again the clumsy wording bothers us.  These conclusions should be considered preliminary EVEN IF they were published in a peer-reviewed journal.  The fact that they weren’t yet published in a peer-reviewed journal is a comment on how they haven’t yet undergone more rigorous peer-review.  Not on how mature the evidence.  That’s almost a non-sequitur.  It could be easily fixed.

4. We did appreciate the words of caution from the study authors and from the one independent expert quoted.

Satisfactory

Does the story commit disease-mongering?

Satisfactory

There was no sign of disease mongering about lung cancer.

Satisfactory

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

Satisfactory

The one “independent” expert quoted provided another valid perspective, although it seems that we may simply have dueling physician preferences at play here – the study authors possibly preferring cryoablation and the other expert quoted preferring stereotactic radiosurgery.  And not enough evidence was provided to help readers/patients decipher where the weight of the evidence aligns.

Not Satisfactory

Does the story compare the new approach with existing alternatives?

Not Satisfactory

Granted, as already noted, the “independent” expert discussed “multiple different technologies for doing this kind of very localized approach.”  But he also stated his own preference for stereotactic radiosurgery and the story didn’t include any data/evidence comparison to help readers. This represents a major flaw in the reporting.  There are multiple approaches to treatment currently including surgery, chemotherapy, radiofrequency ablation, stereotatic and other forms of radiation and proton beam therapy.  There are data on the success of each of these in improving survival in patients with metastatic disease.

Not Satisfactory

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

Not Satisfactory

The story at least noted that cryoablation “has been around for years.”  But to what degree?  Around for years in how many places?  What level of proliferation/penetration?  How likely is a lung cancer patient in Arkansas or Alabama or Albuquerque to find the approach in use nearby?

Satisfactory

Does the story establish the true novelty of the approach?

Satisfactory

We’ll give the story the benefit of the doubt for at least quoting the “independent” expert as saying the findings “are not incredibly novel” although there was no meat hung on those bones to help reader comprehension.

Satisfactory

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

Satisfactory

There isn’t any evidence that the story relied solely or largely on a news release.

Total Score: 5 of 10 Satisfactory


Comments

DDH posted on April 22, 2013 at 11:40 am

All points well taken.
This treatment for lung metastases can be done.
But…do the patients treated with this modality live longer or better than those treated with other modalities, or nothing at all?
The majority of lung metastases are asymptomatic.
What benefit is there to treating lung metastases at all?
In what clinical scenarios?

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