Criterion #7 Does the story compare the new approach with existing alternatives?

Just because something is “new” in health care doesn’t mean it’s better. When reading about a new drug, test, surgery, etc., readers should come away informed that there are other options on the table.

We understand that journalists want to cover what’s new. But without a discussion of alternatives, readers can come away with the impression that the new option is the only good option. Therefore, the new intervention or findings must be put in context with existing alternatives that have a longer, more proven track record.

Alternatives to an intervention can mean lifestyle changes, another drug, surgery, no treatment, or “active surveillance” – declining immediate aggressive therapy while remaining under close medical care.

We don’t expect a thesis–just a brief discussion of the other treatments on the table, and how they compare in effectiveness and cost.

Stories may get rated ‘Not Satisfactory’ if they:

  • Discuss a surgical approach without mentioning non-surgical alternative approaches.
  • Discuss a new test without mentioning other tests that are available; including the option of not being screened in the case of a screening test.
  • Fail to discuss the advantages/disadvantages of the new idea compared with existing approaches.
  • Fail to discuss how the new treatment, test, product or procedure fits into the realm of existing alternatives.

Gary Schwitzer is publisher of

Satisfactory examples

NY Times deftly describes findings of study on using hormone blockers for prostate cancer recurrence
When it comes to treating prostate cancer, one option that’s on the table for many men–but often overlooked in news stories–is active surveillance. This story got a nod from reviewers for making sure that this alternative was included as an example of treatment options.

Inquirer emphasizes alternatives to brain games like Lumosity
Reviewers noted the the story does a thorough job of exploring alternatives: “First, it mentions that studies have shown that physical activity improves cognitive function, and second, it suggests that doing cognitively challenging things like learning a language or taking music lessons should not be replaced by computer-driven brain games. The story also includes a box highlighting beneficial factors including exercise, staying socially and intellectually active, healthy diet, getting good sleep, and keeping your heart healthy.”

Brief but informative report from AP on newly approved shingles vaccine
This is a strength of the story, which states near the top that a new vaccine will be the second shingles vaccine in the U.S. market. It compares available data on the two vaccines in a number of ways–including efficacy, duration, and cost. It also notes that they are “made differently.”

Not Satisfactory examples

‘Dramatic benefit’ of surgery in kids with epilepsy–but what does that mean in absolute numbers?
The Reuters Health article notes that drug therapies are standard of care, but does not specify what drugs are used. More significantly, because the article does not specify in any real detail what kinds of surgeries were performed on the study group, it is difficult for readers to compare alternatives.

U.S. News & World Report story on COPD and vitamin A left us wondering ‘what’s the news? Treatments for COPD may include medications, oxygen therapy, and (in severe cases) surgery. None of these are discussed in the story. Even a brief mention of the alternatives and standard treatments would be useful to readers.

WSJ story on prostate procedure: No independent sources were quoted
This story looks at a new treatment that involves targeted blasts of steam to shrink prostate tissue. However, it left out that there are numerous minimally invasive treatments (laser, thermotherapy, radio frequency ablation) for men. How does this one stack up to the more time-tested alternatives? Readers won’t find out.

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