This was a story about a recent study indicating that at least in the case of dialysis for individuals with acute kidney disease, more is not better. Although the story could have been clearer about the differences and definitions for chronic and acute kidney disease, it did a good job explaining that at least for the type of patients studied (those with acute kidney disease), additional dialysis failed to prevent death or rate of organ failure. It also mentioned that the additional dialysis did not improve in recovery of kidney function.
The story then went on to inform the reader that although additional dialysis did not demonstrate benefit in this type of patients, that there may be a specific confluence of medical conditions wherein additional dialysis may be appropriate.
There was no cost information provided, but the story was about the results of a study that demonstrated that more dialysis did not provide additional benefit.
The clinician quote near the end suggested that more dialysis may have benefit for certain patients but did not provide data. However – the story said that the study reported on did not find additional dialysis to provide benefit, thereby quantifying the benefit as "none"
The story qualified the information about additional dialysis not being beneficial by having a quote from a clinician indicating that there are some specific situations where additional dialysis is warranted. In so doing, the story was able to present a harm of not allowing for additional dialysis.
The evidence presented in this story comes from a study which has not yet been published, though it is available online. The story mentioned the number of people studied as well as the fact that they were randomly assigned to the different treatment groups. It included both the percentage of people in each group that died as well as the fact that the difference between the groups was found not to differ.
The story did not appear to engage in disease mongering apart from the fact that it seemed to conflate chronic and acute kidney disease.
The story included quotes from several clinicians with expertise in dialysis.
No other treatment options were mentioned, though other than refusal of treatment, there usually aren’t any. The story is about two commonly used approaches to dialysis in acutely ill patients. Decision-making is largely physician based; the over-arching decision then is dialysis or no dialysis (which because of the seriousness of the patient condition would likely be fatal).
It’s clear from the story that more versus less frequent dialysis would be based in normal clinical practice on a variety of clinical indicators (as mentioned by one of the physicians).
The story described the results of a soon-to-be published study and described this clearly. That said, it also mentioned that there had been previous studies, which were smaller and were based on outcomes from individual institutions with different outcomes from the study reported on. This provides a context for the reader to understand that the study reported on was not done in a complete vacuum of information.
Does not appear to rely on a press release.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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