What’s wrong with NBC Today Show’s live atrial fib ablation?

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Blogger Larry Husten found plenty wrong. Let him count the ways. Excerpts:

“NBC Medical correspondent Dr Nancy Snyderman substituted schmaltz for substance and presented the “heartwarming” story of the patient, a great-grandmother, accompanied by stirring music and sentimental images. …

[2017 Update: The NBC video is no longer available but the transcript can be found HERE ]

Just in case anyone hadn’t somehow caught the positive message, Snyderman told her viewers that the patient’s life (even before the procedure was finished) now “has new promise thanks to a dedicated physician, a world-class medical center, and extraordinary medical advances…”

Didn’t anyone at NBC think about the ethics of broadcasting a live medical procedure? Suppose something had gone drastically wrong during the live broadcast? I think there are legitimate questions worth raising about the public display of any medical procedure, but a live broadcast on a major television network is indefensible, in my opinion. (In my previous job as the editor of heartwire we investigated the issue of live case demonstrations at medical meetings, though in those circumstances there was always at least a plausible case for medical education in a professional setting.) Now we have live operations for public consumption or, even worse, the spectacle of physician-reporters reporting on their own medical efforts in Haiti.

Even if you believe it is ethical to broadcast a live procedure, it’s unethical and irresponsible to report it with this kind of relentless, upbeat mindlessness. Let’s be clear: there is no evidence in the literature to support the statement of an 85-90% success rate for catheter ablation of AF (a rate cited in the segment). To present this kind of statistic to the general public, many of whom may have AF, or may know someone who has AF, is completely irresponsible. Catheter ablation is emerging as an important therapeutic option for some patients with AF, and it is indeed an impressive medical advance, but it comes with a lot of caveats. …

The shoddiness of the reporting becomes even more apparent when Snyderman declared the procedure a success, and the patient cured, before the actual ablation had even started, and without the long-term followup that can provide the only real measure of success. You would never know from the report that last year AF ablation received a mixed review from a Medicare advisory committee and was the subject of a critical AHRQ review. Further, it is typical of reporting like this that a genuine issue of concern like radiation is only mentioned in the context of saying “the radiation risk is minimal.”

An anecdote is not evidence. By focusing exclusively and obsessively on single stories with happy endings, reporting like this has raised viewers expectations to such a degree that they will inevitably be disappointed and give up on the very real but more modest and unmiraculous aspects of modern medicine.”

This was the first of a weeklong series on NBC’s Today Show taking viewers “inside the O.R.” I had commented more broadly about the series yesterday. Husten’s specific examination of the first of the series is important. I am encouraged to see smart observers like him weigh in on some of the health news misinformation that network TV delivers that can so mislead the American viewing public – dwindling though those numbers may be.

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Joseph Arpaia, MD

February 4, 2010 at 9:19 am

Interesting. Check out this post on an ablation device manufacturer from Health Care Renewal
http://hcrenewal.blogspot.com/2010/02/atricure-settles.html