Vague descriptions, sweeping generalizations, overly laudatory quotes — these are some of the things that we think news releases should avoid. But this release includes all three and accordingly received low marks on most of our criteria. What are the major problems? The news release provides no evidence to back up its central claim — that MRI imaging will help convince people to adopt healthier behaviors that reduce Alzheimer’s disease risk. It also provides no meaningful description of the review article that’s the basis for the release, and does not describe the methodology utilized in identifying the studies included in the review. The release also never establishes what exactly is new here that merits attention. And it displays no awareness that overuse of medical technology (including so-called “MRI abuse”) is one of the main drivers of spiraling health care costs. In fact, there is no mention of costs at all in this release.
Nearly 44 million people worldwide suffer from Alzheimer’s disease, which is the sixth leading cause of death in the US. Not only that, treatment is expensive: The cost of caring for Alzheimer’s patients in the US is estimated to be $226 billion in 2015, according to the Alzheimer’s Association. Since there is no cure for Alzheimer’s disease, any measures that could identify and prevent cognitive decline would be beneficial to patients and clinicians. What we don’t need are expensive new tests that will raise the cost of care without any evidence that they improve outcomes.
There is no mention of costs in the release, but overuse of medical technology such as MRI scanning is one major reason for soaring health care costs. According to personal finance website Nerdwallet.com, median prices of a brain MRI range from $525 in Atlanta to a whopping $3,310 in Milwaukee.
The main contention of the news release is that “imaging findings can help spur beneficial lifestyle changes in patients to reduce risk for Alzheimer’s disease.” But there’s no evidence presented to show that these images have any effect — good or bad — on patients’ adoption of beneficial lifestyle changes. Does performing an MRI increase the likelihood that someone will lose weight, exercise, and stop smoking?
The release also states, “institutions… meld these approaches into novel ways to improve patient care,” but the report doesn’t detail what those “novel” therapies are. Experts in the report talk about pinpointing “volume loss in the brain” and characterizing imaging markers, but these are all surrogate endpoints. In other words, how do these translate to tangible health outcomes for patients?
Bottom line: The idea that a brain MRI is going to help motivate people to adopt meaningful lifestyle changes — and that those changes will, in turn, lead to an actual reduction in the number of Alzheimer’s disease cases — requires several leaps of logic that have very limited support from evidence. The release owed it to readers either to point out the preliminary nature of the hypothesis or provide some evidence to back it up. The release did neither.
Procedures almost always carry risks, and MRI is no exception. Some physicians are concerned with “MRI abuse,” pointing out that MRIs often pick up abnormal – but harmless – findings that muddy up the clinical picture. These so-called “incidentalomas” can lead to more tests and treatments that cause harm and add to costs. Unnecessary imaging is a major contributor to spiraling health care costs in the US, since a single scan on average in the US costs $2,611, according to Medicare data.
Beyond stating that it exists, this news release provides no information about the journal article that is the subject of the release. Nor does it detail any of the studies that supposedly support the value of imaging for Alzheimer’s disease prevention. We’d add that the journal article itself provides limited-quality evidence — it doesn’t detail the process for selecting articles that are included in the review (raising the possibility of “cherry-picked” studies) and includes little in the way of critical evaluation of the studies that are cited.
Strangely, three physicians, who weren’t listed as authors of the study, are quoted in the release and allowed to tout the benefits of quantitative MRI technology. They make sweeping statements, such as that this technology “will have a huge impact in the future” and that imaging “can have a powerful impact [on patients]” But the report fails to go into detail.
One of these experts adds, “Patients seem to enjoy reviewing results of their imaging studies, more so than reading the results of their blood tests or other clinical evaluations.” But one physician’s anecdotal observation is not evidence of enhanced quality or effectiveness of care. Again, supporting data is needed.
The news release does not engage in disease mongering and states that as many as three million cases of Alzheimer’s dementia could be prevented with lifestyle changes. However, it does imply that there would be more cases prevented with the addition of brain imaging, a claim that is not supported by the release or the underlying review article.
The release does not specify funding sources for the work, which included the National Institute of Biomedical Imaging and Bioengineering and the National Institutes of Health. Many of the authors are consultants for medical device and pharmaceutical companies, including Toshiba (cited as “related” or relevant in the original research report). The release does not disclose this.
The main premise of the news release is that MRI imaging can help people lower their risks for cognitive decline by encouraging them to make lifestyle and behavioral changes. It states that risk factors include obesity, diet, sleep, hypertension, diabetes, depression and smoking. However, the release does not address any alternatives — besides brain imaging — that might help people make the desired changes. Behavioral change counseling, which is an established approach to reducing problematic behaviors, is not discussed.
The release doesn’t address the availability of quantitative MRIs of the brain. MRI in general has been used since the 1970s, and its availability is not in question. But since the issue is not specifically addressed by the release, we’ll rate it Not Applicable.
Using quantitative MRI technology to diagnose Alzheimer’s disease in its early stages is not a new concept. There have been blog posts and numerous studies in the past 10 years devoted to this topic. We’re not really sure what’s new here. The news release refers to “novel ways to improve patient care,” but does not specify what these new approaches are.
The language of the release bordered on sensational, with neurologist Majid Fotuhi touting the benefits of quantitative MRI technology and claiming it will have a “huge impact in the future of diagnosis and treatment of Alzheimer’s disease.” The release never clarifies the how and why of this statement.
Systematic, Criteria-Driven
We’ve written about the hype of liquid biopsies for years (see link in comment below). And now this…. https://www.statnews.com/2022/01/12/medicare-shouldnt-cover-liquid-biopsies-early-cancer-detection/
Case counts still matter. “(There) are stories that may not be told adequately if only hospitalizations and deaths are emphasized.” @garyschwitzer interviewed by @dbauder of @AP. https://apnews.com/article/omicron-changing-news-outlets-covid-data-da9272f7c4c8a109c3bfb56bed9e9c76
My friend Gary @garyschwitzer wrote to his city council representative in a Minnesota town about a Viva Las Vegas event scheduled for January.
The response he got seems to perfectly capture where we are now.
https://www.healthnewsreview.org/2021/12/2021-ends-with-covid-craziness-in-sports-and-politics/
Comments (1)
Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.
Norma Cartwright
June 13, 2015 at 1:56 pmI am not a scientist or doctor. Just a consumer.
I applaud your analysis. Your examination was comprehensive and helpful.
As an atheist and a skeptic, I find myself looking deeper into what has become “magical medicine”. Something has happened to medical science, in a very bad way. From anti-vaxxer Mercola to homeopathy to Dr Oz, some doctors have gone to the “dark side”, making outrageous health claims and peddling “nutriceuticals” – which have been cited for lack of evidence. Even “peer-reviewed medical journals have been infiltrated by “vanity publishing houses” that “publish” anyone’s research for as little as $150.00 (Australia). My favorite was just seven words repeated faithfully, from title to abstract to confusion to footnotes. (The seven English words are NSFW and unprintable-and say nothing of science.)
I hope we can restore ethics and good science right away. Could we start by removing Francis Collins from NIH?
Our Comments Policy
But before leaving a comment, please review these notes about our policy.
You are responsible for any comments you leave on this site.
This site is primarily a forum for discussion about the quality (or lack thereof) in journalism or other media messages (advertising, marketing, public relations, medical journals, etc.) It is not intended to be a forum for definitive discussions about medicine or science.
We will delete comments that include personal attacks, unfounded allegations, unverified claims, product pitches, profanity or any from anyone who does not list a full name and a functioning email address. We will also end any thread of repetitive comments. We don”t give medical advice so we won”t respond to questions asking for it.
We don”t have sufficient staffing to contact each commenter who left such a message. If you have a question about why your comment was edited or removed, you can email us at feedback@healthnewsreview.org.
There has been a recent burst of attention to troubles with many comments left on science and science news/communication websites. Read “Online science comments: trolls, trash and treasure.”
The authors of the Retraction Watch comments policy urge commenters:
We”re also concerned about anonymous comments. We ask that all commenters leave their full name and provide an actual email address in case we feel we need to contact them. We may delete any comment left by someone who does not leave their name and a legitimate email address.
And, as noted, product pitches of any sort – pushing treatments, tests, products, procedures, physicians, medical centers, books, websites – are likely to be deleted. We don”t accept advertising on this site and are not going to give it away free.
The ability to leave comments expires after a certain period of time. So you may find that you’re unable to leave a comment on an article that is more than a few months old.
You might also like