April 2, 2008

We should expect better from a medical journal

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I’ve reported many times on news organizations hyping medical technologies. But this past week, a medical journal – BMJ – did the same thing in its “news” section, presenting only the fantastic potential of robotic surgery without any evidence – any quantification – of potential benefits and harms and without any discussion of costs.

The BMJ “news” story was entitled, “Robotic prostatectomy transmitted live to engineers to promote collaboration.”

Read my letter and that of a British oncologist in response to that article. I wrote:

“…the story was completely devoid of any data.

We learn that robotic radical prostatectomies are much more common in the US than in the UK but we learn nothing about outcomes.

We learn that there are ethical issues but none is specified.

We learn that a urologist believes robotic surgery has several advantages. But those are not quantified. What does “better results” mean?

We learn that “patients recover more quickly” but we’re not told how many patients. We learn of “better cancer control” without any definition of that term.

Ditto for reported claims of more precision, “less collateral damage, resulting in less blood loss, faster recovery, and fewer complications.” No numbers.

I’m trying to teach my health journalism students, “No numbers? No story.” I hope they weren’t reading this week’s BMJ “news” section.”

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Aurel

April 3, 2008 at 6:50 pm

Several weeks ago, I sent faxes, as the requested mode of communication, to a urologist in Dallas, to a urological hospital practice in Dallas, and to a urological hospital practice in Houston, in anticipation of my need for a prostatectomy I’m planning for January 2009. I asked each to tell me how many robotic procedures each physician has performed and how many each has performed in the past 3 months for patients like me within a range of Gleason scores and for localized cancer. As of this date, no one has acknowledged receipt of my fax, much less responded with any data. My hometown urologist, with whom I had a paid office visit tells me he’s done “about 40”, but says he doesn’t have any data on outcomes. The prostate industry thrives on a lack of data.