This article reports on a study with inconclusive results about the benefits of using automated external defibrillators (AEDs) in a home setting.
The article does several things well:
But it also has one serious flaw: By emphasizing successful use of the device with two elaborations on a single incident–and by interpreting the results data in a positive rather than skeptical light–the report creates a more favorable view of the benefits of home AED use than the study itself calls for.
A key finding of the study is that certain subgroups of high-risk individuals may be well served by a home device. This was not made clear in the article.
The article reports that some home defibrillators can be purchased on the Internet for $1,200.
The reporter includes useful data from the study, including the number of patients in the study, the number who had cardiac events, the number treated with AED and how survival rates compared between the AED and CPR groups.
It’s worth noting, however, that the New England Journal editorial accompanying the study views the same data in a less positive manner: "The AED was used in 29 unresponsive patients: a shock was advised and delivered in 14 patients, only 4 of whom were long-term survivors."
The report fails to mention the potential harms of using a home AED.
There is the potential/possibility to generate a shock to oneself or bystanders if the AED not used appropriately (the users needs to to say "all clear," for example). There may also be emotional stress and discomfort if a person found down is actually conscious and/or breathing and inappropriately receives a shock. The AED needs upkeep, so there is a potential for a device malfunction or battery failure.
The news report is based on a trial comparing survival rates in homes with and without AEDs. While this research does not rise to the level of gold-standard, double-blind, placebo-controlled clinical trail, it is published in a major journal and presented at a major medical meeting.
Despite its inconclusive findings, the study is considered significant in the field. But the story should have explained that this was a randomized clinical trial – and why that’s important.
We’re torn on this criterion. The story does give adequate statistical background information on cardiac arrest. But it uses an anecdote that demonstrates AEDs saving lives. This could have the effect of generating reader anxiety about not having one at home. Given that this study shows no proof of benefit for home use (except for diabetics who have survived a previous heart attack), the choice of the anecdote demonstrating benefit is puzzling.
The article uses the following sources: the lead author of the study; family members of a patient successfully treated with a defibrillator; a skeptical physician-editorialist; the head of the sponsoring government agency; a company spokesman; and a nurse/American Heart Association spokesperson.
The reporter properly discloses the in-kind contributions the device maker made to the study.
While the patients and the company spokesmen get more prominence than the conclusions of the study deserve, the sourcing is adequate.
The article correctly indicates that the two options for responding to a heart attack at home are CPR or AED.
The article makes clear that automated external defibrillators are available for purchase by individuals. It lists a maker’s name.
The article makes no claims for the novelty of AEDs.
The article was triggered by publication of the study in the New England Journal of Medicine and its presentation at a cardiology meeting.
Systematic, Criteria-Driven
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