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Genetic testing can help predict likelihood of disease

Rating

3 Star

Genetic testing can help predict likelihood of disease

Our Review Summary

This newspaper article presents an overview of genetic testing for common diseases, an important development in clinical medicine and one likely to increase rapidly in importance. It does a good job of providing lists and bullet points that help people understand key considerations.

But the story falls short of best practices in several important ways.

  • It draws only on professionals who support and provide testing. The result is a falsely rosy picture of the benefits of testing, without corresponding attention to risks.
  • It fails to refer to the well-documented cases of women who may have had prophylactic mastectomy unnecessarily. 
  • It fails to put genetic testing in the context of other options–essentially, not getting the tests and using close monitoring with lifestyle changes.
  • It fails to refer to any published research on the risks and benefits–particularly the effect genetic testing has shown on reducing morbidity and mortality. 

Essentially the article provides a one-sided view of genetic testing, with the addition of some useful consumer information provided by the practitioners themselves. For such an important topic about critical health decisions, readers deserve a well-balanced story.  

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The article fails to state how much these tests cost, a serious shortcoming in a story like this.

It makes generalizations about testing being covered by private insurance and Medicare, but this creates a false impression. Testing is often covered only for certain conditions and under specified circumstances. 

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

Not Satisfactory

The story does not attempt to quantify the benefits of testing and treatment based on the tests. For instance, it would be very interesting to know whether research has established reduced mortality or morbidity in patients who have had the testing and treatment compared to a control group.

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

Satisfactory

The article states that results need to be interpreted carefully and rationally.

But it fails to address two specific potential harms in a substantial way:

  • The possibility (and likelihood) of false positives and negatives 
  • The consequencs of overtreatment based on a hightened sense of risk not put in proper context. There are many documented cases of women who have had both breasts removed based on incomplete or incorrect interpretation of results of the BRCA tests, for instance. The story should have acknowled this.  

 

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

Not Satisfactory

The article provides no evidence to verify the claims about the accuracy and benefit of the tests.

Does the story commit disease-mongering?

Satisfactory

The article refrains from exaggerating the prevalence or severity of the diseases for which genetic testing is available.

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

Not Satisfactory

Sourcing for this story is inadequate. It does not provide a range of views and proper context.

  • Most information comes from the National Society of Genetic Counselors–a useful but self-interested source.
  • The only medical context comes from a researcher who has been doing genetics research for over 30 years.
  • The only patient interviewed is very satisfied with her testing and treatment decisions. 

What’s clearly missing are the perspectives of dispassionate sources–clinicians and researchers who can talk about the value of these tests more generally. Information from sources who can describe poor outcomes (excessive anxiety, emotionally-driven decisions, false positives, inappropriate testing and serious treatment side effects) would have been particularly useful.  

 

Does the story compare the new approach with existing alternatives?

Satisfactory

The story fails to mention the options facing those who choose not to be tested or who are tested but prefer to choose less invasive responses: lifestyle changes, medication (the birth control pill, for example, to reduce ovarian cancer risk) and close monitoring.

The choice is often testing vs. interventions to reduce risk, or testing plus treatment vs. testing with other interventions. This is not adequately explained.  

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

Satisfactory

This story is minimally satisfactory under this criterion. It provides a link to a source where to find a genetic counselor in your area.

But the article should have spelled out whether these services are widely available, only in large teaching hospitals, specialty clinics, etc.

Does the story establish the true novelty of the approach?

Satisfactory

The story correctly describes the testing as well-established but quickly developing as research into the links between specific genes and conditions continues.

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

Not Applicable

There does not appear to be a press release that may have triggered the article.

Total Score: 5 of 9 Satisfactory

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