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A new Da Vinci code

Rating

3 Star

A new Da Vinci code

Our Review Summary

The use of a robotic system for the surgical removal of fibroids (a procedure known as myomectomy) could, in theory, allow easier, less invasive access to difficult-to-remove fibroids that would otherwise only be reachable through a large incision. However, the relatively limited experience performing myomectomies with the robotic system means that little can be said about how the system compares in terms of safety and efficacy with standard surgical approaches. And serious economic concerns raise questions about whether the benefits of the system are worth the considerable additional expense.

This story does a good job of outlining the novelty and availability of the robotic system.

However, the story fails to adequately address the cost issue. Although the story describes how much the equipment costs and mentions that reimbursement is the same regardless of whether the equipment was used, this is not adequate information on costs. Because of insurance issues and the fact that the system is so expensive relative to traditional surgical approaches, this is important information that should have been covered in more detail.

Nor does the story adequately quantify the benefits of treatment or describe the potential harms. In fact, with such statements as "it’s hard to see the negative impact of new technology" and "the robot is very precise," the story appears to suggest that there aren’t any downsides.

The story also to adequately describe the strength of the available evidence to support the use of the robotic system. Specifically, it is not clear how strong the evidence is that the new system is as safe or effective as it is claimed to be. To date, there have been no controlled trials comparing the system to other myomectomy methods.

Finally, the story explained that the robotic device came on the market just 8 years ago, that Minnesota hospitals started using it just three years ago., and that there are already nine da Vincis in the state. But the story didn’t address the obvious followup questions: how many does a state or a community need? Who’s asking these questions?

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

Although the story describes how much the equipment costs and mentions that reimbursement is the same regardless of whether the equipment was used, this is not adequate information on costs. Because of insurance issues and the fact that the system is so expensive relative to traditional surgical approaches, this is important information that should have been covered in more detail.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The story does not quantify the benefits of the robotic system.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

The story does not mention any potential harms of the robotic system. In fact, with such statements as "it’s hard to see the negative impact of new technology" and "the robot is very precise," the story appears to suggest that there aren’t any downsides.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

The story does not adequately describe the evidence to support the use of the system for myomectomy. Specifically, it is not clear how strong the evidence is that the new system is as safe or effective as it is claimed to be. To date, there have been no controlled trials comparing the system to other myomectomy methods.

Does the story commit disease-mongering?

Satisfactory

The story does not appear to exaggerate the seriousness or prevalence of uterine fibroids or prostate cancer – the two conditions mentioned.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story does mention open myomectomy and laparoscopic myomectomy as alternatives to the robotic system. However, the story should have mentioned other non-surgical options.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The story does a good job of describing the availability of the robotic system in the Minneapolis area (which is the target audience of the paper). The story rightly points out that it is a new system and as a result is only available in a few large hospitals. However, the story could have also mentioned that another part of the issue of availability is the limited number of surgeons with training and able to get access to the system to train.

Does the story establish the true novelty of the approach?

Satisfactory

The story clearly states that the technology is not a new idea (it was approved by the FDA in April 2005) but that it is only recently being used for myomectomy.

Does the story appear to rely solely or largely on a news release?

Satisfactory

Because the story quotes multiple experts, the reader can assume that the story did not rely on a press release as the sole source of information.

Total Score: 6 of 10 Satisfactory

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