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Studies endorse ‘virtual colonoscopy’

Rating

4 Star

Studies endorse ‘virtual colonoscopy’

Our Review Summary

The article describes a new study that supports similar accuracy of virtual colonoscopy (or CT colography) cused to screen for colon cancer compared to traditional colonoscopy. The article does a nice job of describing benefits (providing absolute numbers), costs, availability, novelty, a range of harms, and sources.  The article could have been improved by describing the strength of the evidence.  For instance, the results are not based on a randomized trial, yet without this information or any other information about study design, readers don’t know how strong these results are.  The article also could have included a discussion about absolute risks and benefits of colon cancer screening. While there is no obvious disease mongering, the absolute reduction in risk of dying from colon cancer due to screening is relatively small and some may find the risk or inconvenience of the procedure not worth the benefit.  Similarly, presenting the option of not screening is always valid when discussing any screening program. 

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

The article provides costs of "regular" colonoscopy and that of CT colography. 

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

Satisfactory

The article does state that "about the same number of advanced polyps" were found in each group (comparing virtual to regular colonoscopy).  It then goes on to give absolute numbers of people with an advanced polyp (the total number of people within groups is also given so that an absolute percentage could be calculated).  The story also describes how many people required a regular colonoscopy after virtual colonoscopy and how many people decided to have their polyps watched.

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

Satisfactory

The story provides harms of "regular" colonscopy, including the number of people in the study who experienced a perforated bowel and those who also required surgery to repair it.  Less objective harms, like embarrassment or inconvenience, are not reported, but are also harder to measure.  For virtual colonoscopy, the story includes a reference to a concern that radiation from the CT scanner might be a harm.  It also implies that because virtual colonoscopy did not measure smaller growths, this could be a harm if that growth somehow went on to develop into cancer.  The story also mentions that a bowel prep is needed for the virtual test, which is often a drawback for people.  The story does not mention that it’s quite possible and even likely that if a regular colonoscopy is needed, it will probably be done on a different day requiring the prep to be repeated.  While the study arranged to have these performed on the same day, this is not likely in the real world. 

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

Not Satisfactory

The article doesn’t mention the type of study that the findings are based on.  This study was not a randomized trial, which is important, and is not discussed.  Readers don’t know how strong these findings are or are not. 

Does the story commit disease-mongering?

Satisfactory

The information provided by the article about the condition in general is correct and not exaggerated. However, the article could have been improved if a discussion about how much colon cancer screening could benefit an average person was included.  While it’s true that colon cancer screening can reduce the chance of getting or dying from colon cancer, most people aren’t aware that the absolute reduction in risk is quite small.  For some, this relatively small benefit may not be worth the risks or inconvenience of the procedure. 

Does the story use independent sources and identify conflicts of interest?

Satisfactory

As above.  Multiple sources are used, at least two of whom don’t appear to be affiliated with the research.  The story also cites potential conflicts of interest of the researchers. 

Does the story compare the new approach with existing alternatives?

Not Satisfactory

No other screening options are discussed (like FOBT, sigmoidoscopy, or a combination of the two).  Additionally, the option of not screening is always valid when describing a screening program and was not mentioned. 

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

Satisfactory

The article states virtual colonoscopy (or CT colography) is currently available at some hospitals and centers.  The article also describes that many, if not most, insurers don’t currently pay for this. 

Does the story establish the true novelty of the approach?

Satisfactory

The story doesn’t provide information on when virtual colonoscopy started to be used.  But, perhaps more importantly, it does make it clear that virtual colonoscopy would be a new option for colon cancer screening with new evidence. 

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

Satisfactory

Since there a sources of information not affiliated with the research, it appears this story does not rely on a press release. 

Total Score: 8 of 10 Satisfactory

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