Kevin Lomangino is the managing editor of HealthNewsReview.org. He tweets as @Klomangino.
We often plead for journalists and public relations people to slow down when reporting on breaking new research that makes big claims about health benefits.
Whether that news is coming from a company announcement or a scientific meeting, chances are good that the new findings haven’t been thoroughly evaluated by experts and are likely to overstate the significance of the research.
Journalist Larry Husten today provides a fresh example of why slow and steady wins the competition that really matters to readers.
Husten is in Italy reporting on the European Society of Cardiology meeting, and his post concerns a debate regarding the NIH’s controversial SPRINT trial on blood pressure targets.
You may recall that it was nearly a year ago that NIH issued a breathless news release calling the SPRINT study a “landmark” that “provides potentially lifesaving information” to health care professionals. The study apparently found that more intensive blood pressure management, below current targets, “greatly reduces” the rate of heart disease and death in adults with high blood pressure.
We immediately called on the NIH to slow down the hype train. Its news release never quantified the results, addressed potential harms, or provided other key specifics that are essential to interpreting the data. And as Husten’s new piece makes clear, the findings are much more complicated than some fawning news coverage at the time suggested.
Husten reports on a session where many cardiologists in attendance gave a “thumbs down” to the trial, saying it shouldn’t be used by guideline committees to develop new practice recommendations. The reason? Attendees were apparently swayed by arguments from panelist Sverre Kjeldsen, who revealed that the study adopted what Husten calls “an unprecedented and novel method to measure blood pressure, making it impossible to compare with previous trials.”
In all the major recent hypertension trials blood pressure had been measured three separate times with an automatic monitor in the presence of a healthcare professional. In SPRINT, however, the healthcare professionals were trained to leave the room before the measurements started. This method has not been validated and Kjeldsen presented multiple lines of evidence suggesting that it would lead to much lower blood pressure readings, as much as 10-20 mm Hg lower than usual. He said that the systolic BP target of 120 mmHg in SPRINT when examined in this light is actually closer to the prevailing standard of 140 mm Hg in other trials. He was also strongly critical of the SPRINT investigators for not reporting this significant fact in the original New England Journal of Medicine paper or in its supplement. He said it was unethical not to report this since many clinicians have tried to apply the findings to their patients but were not aware of this important change.
Here we are, almost a year after the promotional NIH news release was issued and some 10 months after the peer-reviewed study was published in the New England Journal of Medicine, and key details about the study are still dribbling out that impact how cardiologists view the findings.
This shouldn’t be surprising to anyone. Pendulum swings likes this are almost inevitable in scientific research. The optimism of an initial announcement gets tempered as other experts point out flaws and limitations in the research. This process takes time but should be anticipated with cautions and caveats.
We’ve gone from “lifesaving landmark” to “thumbs down” in less than a year. Who knows where the next swing of the pendulum will take us?