Good details in reporting on the study, and valuable additional context and perspectives.
This story rose above simply rehash-reporting of what the study found and added important perspectives to help readers understand the possibilities but the limitations of looking at CT scans for signs of osteoporosis.
As new technologies are added to medicine’s arsenal – and existing technologies are applied to new uses – it is important that people understand the tradeoffs that may occur as a result: the potential for tradeoffs of some good but some harm. This story was a solid piece of journalism in doing just that.
The story explained the cost of DXA tests and CT scans.
The story never actually described the sensitivity, specificity or positive predictive value of CT scans – something described clearly in the study on which the story is based. Granted, this can get to be complicated stuff, but we think the story could have tried.
The benefit of the strategy of using CT scans obtained for another purpose to also diagnose osteoporosis could have been discussed in more detail. The article correctly notes that CT scans are regarded as an overused test. CT overuse carries the harms of radiation exposure, costs and risks associated with additional testing for incidental findings that are more often than not clinically unimportant. The notion that these downsides of an overused technology can be mitigated by the benefit of picking up a small number of cases of osteoporosis seems like a stretch.
The story mentioned that both DXA and CT scans involve radiation, although it would have been helpful to note that the radiation exposure is much higher with CT scans.
More importantly, it addressed the risk of “incidentaloporosis” – or incorrect osteoporosis diagnoses that arise when doctors are looking for something else. We wish, though, that the story had added a line to drive home the point of the potential harm from such overdiagnosis.
Adequate job describing the size and methodology of the study.
We appreciate the moderation in the quote from the lead author, “What we found is that there is pretty good correlation.” Not a home run. Not a breakthrough. Just a pretty good correlation.
And we appreciate that the story placed a caveat from the editorial up high in the 6th sentence of the story.
There was no disease mongering of osteoporosis. In fact, quite the opposite, as the story explained the risk of overdiagnosis or “incidentaloporosis.”
The perspectives from the editorial writer and from an independent expert were important contributions.
The entire frame of the story was a comparison of DXA tests to CT scans.
The story touched on availability and use patterns in this succinct statement:
“Despite DXA scans being safe and cost effective, Pickhardt and his colleagues say the test is underused. CT scans, however, are considered overused – with more than 80 million performed in the U.S. during 2011.”
The relative novelty of the study and its findings were clear in the story.
It’s clear that the story did not rely on a news release.