This report on the University of Chicago’s new program in robotic cardiac surgery has several key flaws.
The impression created by the article–that the device is safe and effective, that it can spare patients signficant pain and recovery time, that this program brings an important new medical treatment to the Chicago area–may be correct. But there is insufficient reporting in the story to verify it.
The reporter fails to indicate how costs of robot-assisted bypass compare to costs of conventional bypass operations. The article does not report whether insurance companies pay the additional costs, if any. And since the device maker offers a comparison between bypass surgery and stents, the report should compare prices of stent insertion to robot-assisted bypass surgery.
The article does not cite specific figures of benefits. It uses several anecdotes that suggest the surgery is safe, effective and likely to speed recovery time.
The article fails to compare key risks–of death, complications, need for additional surgeries, infection rates, etc.–of robot-assisted to conventional surgeries. Again, since the article raises the comparison between stenting and robotic surgery, these risks should have been compared too. Because the story uses anecdotes that suggest better outcomes and fewer side effects, the reporter should have looked for data to compare those anecdotes to.
The article offers no evidence of safety or efficacy beyond anecdotes. In fact, it does not refer to any studies of the robots’ use.
Quoting the marketing director of the company that makes the robotic systems, the story suggests that bypass surgery may be safer than using a stent to keep an artery open, generating fears about the safety of stents. The data about stent risk is complex and in dispute. This implication of greater risk from stenting should not have been reported unless it was investigated further.
The article’s sources include a physician who has devoted the last five years of his career to the robotic surgery, three satisifed patients, a marketing representative of the company that makes the device and one doctor who is skeptical about the device’s utility in heart bypass surgery. Interviewing additional dispassionate sources would have strengthened the story.
The article makes a brief refererence to the device maker being an "enthusiastic backer" of the Chicago program, but fails to indicate whether there is a financial relationship beyond that of customer and vendor. The subject of whether Srivastava has financial ties to the maker should have been explored, or, if it was, should have been addressed in the story.
The article indicates that conventional bypass and stenting are alternatives to the robot-assisted surgery.
The article does not clearly state how widely robotic treatments are available, either for bypass surgery or other operations. The article reports 504 units are in use in the U.S., but it’s not clear how they are distributed or what they are used for, even in the Chicago area. Nonetheless, we’ll give the story the benefit of the doubt on this criterion.
While the article implies that use of the robotic device for heart bypass surgeries is rare, insufficient data is provided to help readers understand how rare it is. Since the report says the machines have been in wide use most of this decade, it should have been clearer about how many hospitals use the machines for bypass surgery, what else they use them for and which patients are considered best candidates for it. Nonetheless, we’ll give the story the benefit of the doubt on this criterion.
A University of Chicago issued a press release on the robot surgery program and its head, Sudhir Srivastava, on July 31. The Chicago Tribune article does not draw on the language or facts in the press release.