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Study cites new link between artery plaque and birth control pills

Rating

4 Star

Study cites new link between artery plaque and birth control pills

Our Review Summary

The article does a competent job of conveying findings about a potential link between some birth control pills and arterial plaques in a small population study. The article includes necessary information about the preliminary nature of the findings and the shortcomings of the research methodology.

The crucial question about this article is whether it should have been done at all. It also raises fundamental questions about journalists’ roles as gatekeepers of medical study information. 

The findings are riddled with caveats that raise serious questions about their value. To cite a few of the most important:

  • The study was done on a homogenous population of women living in one small town in Belgium.
  • The study linked a firm clinical endpoint (ultrasound data on arterial plaques) to drug exposure that was not controlled and about which critical data–including which drug was taken, at what dose and at what age–is missing.
  • The article does not report on whether the data was controlled for other potential confounders, including smoking, diet and underlying risk of heart disease.
  • The study has not been submitted to the rigorous peer review required before publication in a major journal.

While the article notes these caveats at least briefly, and in some cases thorougly, it does so in the context of a story that implictly raises fear about a widely used drug. For instance, the article states:

The theory needs much more rigorous testing than this single small study, but is important because of the sheer number of women now taking the pill — 100 million worldwide.

It could be argued that this same reason–the fact that so many women take or have taken this drug–could disqualify this study from news coverage at this point.

Is it in the public interest to report at length about such preliminary, uncertain findings about a drug that is so widely used?

Criteria

Does the story adequately discuss the costs of the intervention?

Not Applicable

The cost of the treatment is not necessary or particularly useful in the context of this article.

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

Not Satisfactory

The relevant question here is the quantification of harms.

The article reports a 20 percent to 30 percent increase in prevalence of plaques for every 10 years of taking birth control pills. But it does not translate this into terms the reader can easily appreciate, because the underlying risk of plaques is not reported.

The reader doesn’t know whether the risk of plaques in the population studied is, for instance, 1 percent, in which case this data could mean that 12 or 13 women rather than 10 women per 1,000 taking the pill for 10 years would develop plaques. If the underlying risk of plaques is 40 percent, the potential harms–while still unknown–could be more significant. 

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

Satisfactory

The article focuses almost exclusively on the potential harms of treatment. It does not mention benefits.

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

Satisfactory

The article explains that the study is retrospective and lacking in important controls. It describes the study’s methodology adequately and indicates which kind of study–a prospective clinical trial–would be required in order to confirm the hypothesis the current study has generated.

Does the story commit disease-mongering?

Not Satisfactory

The article creates a false sense of alarm about the cardiovascular risks of a drug that has been in use worldwide for years.

A small additional risk of cardiovascular problems long has been linked to these pills. This study uses one marker of heart disease–measurable but not particularly lethal arterial plaques–that may help explain that well-established small risk. The study is not published. It looked at data gathered in one town. The clinical endpoint is very specific–a measure of vascular plaques–yet dosing, long-term exposure and type of drugs taken are unknown.  

These caveats, taken together, do not justify the sense of alarm the article generates.  

 

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

Satisfactory

The article conveys findings from an unpublished study whose details do not appear to have been made available to any of the reporters covering the American Heart Association meeting at which the findings were presented.

The article quotes the study author and two independent sources who help put the study in context, which is adequate.  

Does the story compare the new approach with existing alternatives?

Not Satisfactory

Despite the story’s capacity to generate fear about the safety of birth control pills, it does not mention other forms of birth control currently available.

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

Satisfactory

The article makes clear that the birth control pills under discussion have been in wide use for many years.

Does the story establish the true novelty of the approach?

Satisfactory

The article makes no claims for the drugs’ novelty.

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

Satisfactory

Because the story included input from several independent sources, it’s safe to assume it didn’t rely solely or largely on a news release.

Total Score: 6 of 9 Satisfactory

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