This brief article (380 words) reports on a significant finding about the genetic makeup of acute myeloid leukemia cells. According to the study, published in the New England Journal of Medicine, differences between the cancer cells’ microRNA profiles appear to indicate which cases of AML will respond to conventional treatment and which will require stem cell transplants or other approaches.
The newspaper article shows few signs of original reporting. Mostly it summarizes information that appears in the press release and in the editorial accompanying the published study.
The story appears to have been written because the research was conducted at the local university.
Cancer cell genetics is a very complicated field, and its clinical applications are not well understood. It’s an area journalists should move into carefully. When they do, they should make a full commitment to learning about it before trying to explain it to the public. And if an editor forced a reporter to file a 380-word story on such a complex topic, that is unfortunate because it is almost impossible to convey any level of understanding on this complex topic in such a brief report.
Although the cost of microRNA analysis is not yet established, it is important for the story to include some estimate of what one more additional test might contribute to the overall cost of analysis. As noted below, there are both clinical and biologic markers already in use today to guide treatment decisions. So some projection – even if based on the cost of these existing tests – is possible. Could it double the costs? Could it halve the costs?
The story did not provide sufficient detail to help readers understand the findings or their significance. The findings are summarized far too briefly in the final two sentences of the story.
Further, the story generally portrays the benefits more favorably than the facts allow. The article implies the technique can cleanly distinguish between those who will and won’t do well. In fact, the five-year event-free survival rate for the two groups was 36 percent vs. 11 percent.
The stratification procedure under study is not harmful. The risks of the disease itself are implicit.
The report is based on a paper appearing in the New England Journal of Medicine. The study looked at blood samples of a small number of patients.
The article should have stated more plainly that the study was small, retrospective and not a sufficient basis for clinical decision making.
The reporter’s statement that the genetic differences "can" predict outcomes overstates the implication of the findings. A more conditional statement–"could" or "may prove useful"–would have been more accurate. The authors themselves plainly state that additional studies are needed before clinical applications can be considered.
The article does nothing to exaggerate the impact of the disease.
The article does not reflect original reporting. It summarizes two comments by lead author Guido Marcucci, though it’s not clear the reporter talked to him.
An editorial that appeared in the same journal is briefly quoted.
No independent clinicians, researchers or disease experts were interviewed.
This report was not put in the context of another important paper on the same topic that appeared in the same issue of the journal.
The microRNA analysis is being studied to determine whether it can drive treatment decisions for AML patients.
But there are both clinical and biologic markers are in use today to guide these treatment decisions. These were not mentioned in the article.
The use of microRNA analysis to select treatments and predict outcomes for patients with acute myeloid leukemia is experimental.
The story makes clear that the technique is new but could eventually be used clinically.
The article makes clear that this is the first time microRNA has been studied in this way with AML, and that its use in stratifying these patients is novel. However, while the microRNA approach is new, there are a number of biologic and clinical markers used to predict treatment outcomes. This was commented on by the authors of the study in the New England Journal of Medicine, on which this story is based, but those comments were ignored in this report on the study.
We can’t be sure if the story relied solely or largely on a news release, although there isn’t any evidence of any original, independent reporting on this story.
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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