A review of 200,000 cases of individuals who underwent aortic abdominal aneurysm repair using two different repair methods uncovered the fact that patients taking cholesterol-lowering medications fared better than those who did not. Unfortunately, almost none of the abundant data in the study published in the journal Vascular found its way into the news release. Instead of creating a nuanced picture of the impact statins may have on reducing deaths in people who undergo aortic aneurysm surgeries, the release uses scare tactics and overly broad language to make people think that statins will save them from an unexpected and grisly death.
While aorticabdominal aneurysms are not terribly common, and while there is a genetic link to some cases, the rupture of such an aneurysm can be catastrophic. Research uncovering a connection between statin use and better outcomes for people with aortic aneurysms points to an important avenue to be explored in future studies.
There is no discussion of costs in the release, not costs of statins or costs of the surgeries and procedures referenced. If the researchers truly believe that statin medication before, during, and after the procedure are a significant factor in reducing mortality, talking about the medication costs would help make their point as statins are a relatively cheap therapy.
We are giving this a failing grade because there are no absolute numbers in the release. It describes a 26% reduction in mortality, but we have no idea how many patients that actually represents. If there were 20,000 records reviewed, how many died? We don’t know. How many who did not die were taking statins? We don’t know. There are ample data in the paper, none of which is in the story. When you read the study, you see that — depending on the group being compared — the mortality rates were quite close. For example, in the group of patients studied who underwent an endovascular surgical repair for their aortic aneurysm, 1% of those who took statins died. And 1.45% of those who did not died. Both of these are very low rates.
Despite the horror show picture painted in the opening sentence, there is no explanation of the harms associated with statin therapy. Some discussion of the impact of giving statins to someone not already taking them would have added value to the release.
The release mentions that the study was published in the journal Vascular, but there is too little else in the release for anyone to make a good assessment of the study’s quality. The published paper has good quality information for what is in essence an epidemiological study, but the news release offers almost none of the available information.
We rarely ding stories on this criterion, but this one struck us wrong because of the mismatch between the first few sentences and what the science found. It says, “Rupture of an abdominal aortic aneurysm is one of the most dramatic medical emergencies a person can face. It usually strikes without warning, killing approximately 50 percent of those who experience it before they reach a hospital. Of those who do get to a health facility alive, only about 50 percent survive.” Are you scared? Well, you probably are hoping that these researchers have found a way to save you from dying unexpectedly before you get to the hospital. But they haven’t. Nor have they found something that is going to guarantee that you won’t die once you reach the hospital, not if the aorta is already ruptured, although we must note that the release is confusing on this point because the provenance of the survival statistics is unclear. What’s also confusing is that the release is conflating an enlarged aorta — which is a serious but manageable condition known as an aortic aneurysm — with a ruptured aorta, which is what leads to people bleeding to death at high rates. The statins might be helpful for people who have an aneurysm that’s surgically repaired; they do nothing in the event of a rupture. In all, the picture painted is far grimmer than the actual context necessary for this release, which is that if people have an aortic aneurysm they might benefit from statins.
It appears this epidemiological study received no outside funding so we believe it’s safe to conclude there is no conflict of interest.
The news release compares surgery outcomes with or without statins.
It’s assumed that the public is aware that statins are widely available as a prescription drug.
While the release doesn’t explicitly state the study’s novelty, we think it is implicit that no one has studied the outcome of patients who had been taking cholesterol lowering drugs prior to their surgery for aneurysm.
The lead is unjustified and way over the top. We believe that a more temperate approach, especially for a summary of an epidemiological study, would have been appropriate here.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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