Preterm labor occurs in 8 to 10 percent of all births. Despite various strategies to reduce this percentage, it has remained relatively stable. Diagnosing preterm birth is difficult and has a high false-positive rate. As a result, many women are needlessly hospitalized, miss work or restrict their activies. The fetal fibronectin test could potentially reduce the need for hospitalizations by more accurately diagnosing preterm labor and providing peace of mind to women.
The story perpetuates fear of preterm birth among asymptomatic women by focusing on only a small part of the preterm labor population and by not distinguishing the risk of preterm labor in asymptomatic versus symptomatic women. The test is really intended for and is only useful in symptomatic women, not as a screening test in women without symptoms.
Furthermore, the story does not comment on the strength of the available evidence to support the use of the test. Specifically, the story does not comment on whether we know if the use of the test will result in better outcomes, such as reduced hospitalizations or prevention of preterm birth. The story does not quantify the benefits of the test. The simple question, how many hospitlizations could be prevented?, is not answered.
Finally, the story does not really comment on the harms, or potential harms of the test. For example, the story could have commented on hte possible consequences of a false negative or false positive test result. Simply stating that "no test is perfect" is not sufficient.
The story mentions the cost of the test and comments that most insurance companies cover it, however it is not clear if insurance companies will cover it in asymptomatic women.
The story does not quantify the benefits of the test. How many hospitalizations could be prevented?
The story does not really comment on the harms, or potential harms of the test. For example, the story could have commented on hte possible consequences of a false negative or false positive test result. Simply stating that "no test is perfect" is not sufficient.
The story does not comment on the strength of the available evidence to support the use of the test. Specifically, the story does not comment on whether we know if the use of the test will result in better outcomes, such as reduced hospitalizations or prevention of preterm birth.
The story perpetuates fear of preterm birth among asymptomatic women by focusing on only a small part of the preterm labor population and by not distinguishing the risk of preterm labor in asymptomatic versus symptomatic women. The test is really intended for and is only useful in symptomatic women, not as a screening test in women without symptoms.
The story quotes multiple experts.
The story mentions examination of the cervix as the alternative for diagnosing preterm labor but could have also mentioned ultrasonography.
The story describes how widely available the test is.
Clearly the test is not new.
Because the story quotes mulitple experts, the reader can assume that the story does not rely on a press release as the sole source of information.
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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