This story explores approaches to the management of the non-life-threatening condition of benign prostatic hyperplasia (BPH). It did a good job of covering the options available to men. But it did not adequately address appropriate indications for treatment. The comment that "many doctors are now urging men to become proactive" is difficult to interpret. What data support this statement, how many doctors are there, and who are they? Professional guidelines remain relatively conservative, recognizing that the truly bad outcomes are still relatively uncommon.
The story provided no framework to understanding how the various treatments compare in terms of how effectively they relieve symptoms, whether some options are better suited for use to manage certain symptoms, how long relief can be expected to last, costs associated with the various treatment, or the risks associated with these various treatments.
Instead, this piece had a "you better get this treated soon" emphasis that did not serve the interests of readers.
There was no discussion of costs associated with any of the treatment options mentioned – a glaring omission given the variation in costs among the approaches discussed.
Other than the quote from a clinician which mentioned that almost all patients "end up with less bothersome symptoms once they chose to do something," the story did not provide much insight about the extent of symptom relief, the proportion of men who will experience symptom relief, and the length of time the different treatments could be expected to provide symptom relief.
The only harm associated with any of the treatments was the possible need for additional treatment some time in the future for the minimally invasive and surgical options mentioned. However – there was no mention of the sexual function and incontinence issues that may accompany these invasive treatments; nor was there discussion of the side effects associated with medication use.
The story actually provided no quantitative information about the risks and benefits associated with any of the treatments mentioned. The story did indicate that problems associated with BPH did recur for some individuals who are treated with minimally invasive therapy, surgery to treat BPH, and even surgical removal of the prostate, but it provided no indication of how often this was the case for any of these.
While there was clear that benign prostate hyperplasia was not life threatening and did mention that there is a difference between symptoms and being bothered by symptoms, the story was strongly suggestive that postponing active treatment could have dire consequences without backing this up with information about how commonly serious problems develop.
Additionally, the discussion of disrupted sleep was rather specious. Treatments rarely completely eliminate symptoms so the problem of getting back to sleep will still be present. The comment that "many doctors are now urging men to become proactive" is difficult to interpret. What data support this statement, how many doctors are there, and who are they? Professional guidelines remain relatively conservative, recognizing that the truly bad outcomes are still relatively uncommon.
Three urologists were quoted for this story. It would have been helpful to include the perspective of a clinician who would have made the point that postponing active treatment is a viable option.
The story provided a pretty extensive laundry list of approaches that can be taken to manage benign prostatic hyperplasia from not doing anything to surgery.
The story listed a number approaches to dealing with benign prostatic hyperplastia, including watchful waiting, medical therapy, minimally invasive procedures, surgery as well as experimental treatment involving botox. The story was clear that the use of botox in this context is something under investigation and not something that is in current use. The discussion of the other approaches indicated that they are available to men interested in treatment.
The story did an acceptable job laying out the currently available approaches to BPH management; it also mentioned research with Botox for use in treating BPH as well as the novel use of erectile dysfunction drugs for treating BPH.
The story does not appear to be rely 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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