This was a story about a method described in a recently published letter to the journal Nature Medicine for the early diagnosis of Alzheimer’s disease. While providing some details of the results outlined in the letter, the story failed to provide context to help readers understand the risks and benefits that might be associated with the kind of test described. The story failed to mention that if the test were to be demonstrated to have utility for early identification of Alzheimer’s disease, its initial greatest benefit would probably come from identifying individuals who might then participate in clinical trials to develop treatments for improved management of the condition.
The story did a good job in:
However, the story doesn’t give much discussion about the specific limitations of this study. For example, this case-control type of patient selection almost always overestimates test accuracy. So it’s likely to perform worse in real world populations.
The story also didn’t comment on the fact that the publication in the journal Nature Medicine was actually a letter – which is curious and almost demands comment. Although methods are published, why was it not published as an original article about original research? As a letter, was it peer-reviewed? The same as original articles?
When a news story discusses the potential of a new test for Alzheimer’s disease – a topic of great public interest – questioning the quality of the evidence is a key issue.
Potential costs not addressed. However, this is not a commercially available test or even available in most research labs so costs are very difficult to predict. But a story like this also could have touched on the whole issue of the downstream costs associated with testing everyone who forgets someone’s name or where they put their car keys – could be enormous – and the costs of providing what are now relatively ineffective current drug treaments.
The story was really not clear about the benefits to be gained by early identification of pending Alzheimer’s disease. Although one expert was quoted as saying that he was a "proponent of knowing what is ahead" and the value in doing so while people can still "speak for themselves", it is not clear from this story what one would do with advance knowledge that one was going to develop Alzheimer’s disease.Not everyone is a proponent of knowing what is ahead, especially given uncertainty about effective treatment.
Although the story did acknowledge that there are very few medical treatments for patients once they are diagnosed with Alzheimers’s, it failed to address the burden of such knowledge for the patient and the patient’s family. There could be insurance ramifications, there should likely be a consulting component to go hand in hand with the test, and there is the possibility of false positive results.
The story did not do an adequate job of addressing the potential harms of this test.
Mixed views on this criterion. The story did a good job in:
However, the story doesn’t give much discussion about the specific limitations of this study. For example, this case-control type of patient selection almost always overestimates test accuracy. So it’s likely to perform worse in real world populations.
The story also didn’t comment on the fact that the publication in the journal Nature Medicine was actually a letter – which is curious and almost demands comment. Although methods are published, why was it not published as an original article about original research? As a letter, was it peer-reviewed? The same as original articles?
What’s missing is just as important as what was included, and for that reason, we rate this unsatisfactory.
Although the story used some dramatic wording, it balanced the drama with hard, objective data on annual mortality rates due to Alzheimers and gave overall prevalence.
The story included quotes from two individuals with expertise in the field but no direct connection with the publication discussed or the company which has been established to market the test.
The story made reference to several other tests which are currently being explored for use in detecting Alzheimer’s disease. While it did mention MRI, the story did not mention current approaches to diagnosis (i.e. eliminating other possible diagnoses).
Although the story used words like "proves" and "promising", it also included estimates for the time needed for further testing that made it clear that this was not something that was currently available.
This was a story reporting on the development of a method for identifying individuals who will go on to devlop Alzheimer’s disease. It was accurate in the portrayal of the novelty of the approach.
Does not appear to rely exclusively on a press 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
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