This news release looks at a program to introduce a quality improvement initiative aimed at reducing complications and deaths among frail older adults undergoing major elective surgery.
The release contained a welcome summary of the findings–the quantified benefits are very clear. But we wanted to know more about the screening tool used to determine how frail patients were, as well as the implementation plans: Is this a brand-new concept, or are there similar efforts out there? How much did the program cost? The news release also could have been more clear about the limitations of the study, such as the lack of a control group.
Given how successfully the intervention apparently worked to reduce deaths, this study is likely to be read with wide interest.
No costs are mentioned.
This is a very strong point for the release. It states clearly that absolute reductions were seen before and after the intervention: i.e.: “overall 30-day mortality decreased from 1.6 percent (84 of 5,275 patients) to 0.7 percent (26 of 3,878 patients) after FSI implementation. Improvement was greatest among frail patients (12.2 percent to 3.8 percent), although mortality rates also decreased among the robust patients (1.2 percent to 0.3 percent).”
Given that this was a study about a quality improvement initiative, we’ll rate this N/A. However, it might have been worth raising the question of whether the time and emphasis placed on this screening test by clinicians detracted from other work they could have been doing to improve patient care and outcomes.
More was needed on the limitations of the study. For example, the abstract said that the causal connections between the use of the screening tool and mortality outcomes required “additional investigation” to be confirmed–but the news release contained no such important caveat.
And also from the study: “Most important, although we were able to control for frailty, we were unable to account for patients who screened as frail and did not undergo surgery. This limitation may be a source of significant selection bias, although it is clear that surgeons continued to operate on frail patients. Further research using a randomized controlled design will be necessary to establish the causal connection between the FSI and mortality outcomes.”
No obvious disease mongering in this release.
We learn that the study “was supported by a grant from the U.S. Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Health Services Research and Development. We did not detect any conflicts of interest that should have been disclosed.
The release mentions no alternatives to this screening program but presumably there are other methods and techniques that are used to reduce harm done on frail people who undergo elective surgery. Since this is a “before-after” trial presumably there would be some kind of frailty assessment, even an informal one, that happens prior to surgery?
It is not clear if the screening index and action plans for surgery among frail patients are readily available for other institutions to use.
The release establishes what’s novel by stating: ““This study reveals the feasibility of facility-wide frailty screening in elective surgical populations.” We would have liked a bit more information on the risk analysis indicator used to assess frailty–is this a well-established tool or being used uniquely here?
There is no unjustifiable language in the news release.
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
Comments
Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.
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