Umbilical cord blood storage is an increasingly popular procedure done at the time of birth. It works by collecting a sample of blood after the umbilical cord is cut at the time of delivery. The blood is sent to a private or public blood bank where it is frozen and stored. In most cases the umbilical cord and blood are discarded as medical waste after birth. This story provides a good balance of information on the advantages and disadvantages of this preference-sensitive decision whether to store cord blood for potential use. Information elicited from expert testimony on both sides of the issue and testimony from mothers who have chosen different options is helpful.
But the advantages of having cord blood available are not explicitly compared in any numeric way or qualitative way to allow viewers to understand the comparative benefits or costs. The underlying unstated claim is that cord "blood can save your baby’s life" and that other options may not be available or work as well. This is the weakest part of the segment.
Including the commercial aspects and reality that a cord blood bank must be a sustainable business was important to frame the risks and benefits of cord blood storage.
This provides accurate cost estimates of initial processing and storage of the cord blood, up to $2,000, and storage, approximately $125, per year in private banks. It also accurately indicates that cord blood can be donated to public banks at no charge.
This story uses expert testimony and interviewer comments to communicate that blood cord storage is potentially beneficial if a child or family member needs a bone merrow transplant. It also presents the unknowns on the procedure. For example, it is not known how long cord blood is viable or how often the blood could be used. It is also not known how often blood cord transfer is successful. The only statement that inaccurately represents potential benefits is made by a mother interviewed for the story. She indicated that her child had improvement in cerebral palsy after a transfer of cells from his own cord blood. This case is highly experimental and contrary to current medical opinion that a child’s cord blood cannot currently be used to treat their own inborn genetic diseases. The interviewer tried to couch the statement saying that doctors cannot prove the benefit actually occurred as a result of cord blood transfer. Despite this the mother’s comments give the false impression that miraculous results are possible. A more appropriate case to present successful use of cord blood would have been treatment of blood disorders. While it is too new to say what "conventional uses" are, the story could have given some sense of what is currently being done with the majority of the 7,000 or so cases in which banked cells have been used. Also would be very useful to contenxtualize what the odds of not having a good outcome are with "usual care".
While this story does not explicitly state that there are no significant harms to either the mother or the baby, this is consistent with the American College of Obstetricians and Gynecology opinion statement that also does not address whether adverse events are associated with this procedure.
This story provides accurate statistics on the very slim odds that storing cord blood will be beneficial. There is a 99% chance that stored cord blood will not be used. Only one out of 2,700 cases, or possibly less, will actually benefit from cord blood storage. The story is not presenting the results of a new clinical trial or investigational use of cord blood. However, the "bad cells" comment by the correspondant about why the same child might not benefit from his/her own cord blood is not entirely accurate. The reason that the individual child is less likely to benefit is mathematical. The odds of a match in one person (the donor) are lower than the odds of a match in mulitple family memebers. Despite this, presenting evidence at a high level may be appropriate even though the rationale is not presented.
This story is even-handed in its approach to presenting storage of cord blood as a preference-sensitive decision. This decision making process and evaluation of advantages and disadvantages is well presented through interviews with two women who chose different options. The story balances expert interviews to compare the remote chance that cord blood will ever be used by the baby or family members versus the potential therapies that may be developed in the future.
This story mainly relies on an interview with an independent medical expert. It also includes a statement from an expert with ties to blood cord banking associations. The interviewer has researched the topic for personal reasons but is generally makes unbiased and informed comments. The variety and breadth of opinion provides balance to the story. The story also accuartely references statistics from the recent opinion statement issued by the American College of Obstetricians and Gynecology.
The weakest part of the story is the lack of information about alternate treatments. The medical expert’s comment that if a bone marrow transplant is needed in the future then stem cells from the umbilical cord can be used. The implication that there are no other treatment option is misleading. The story could have been improved by stating that banked cord blood can improve the likelihood of a good match. Statistics supporting this difference would have been helpful to put the potential benefit in context, particularly given the remote liklihood, one in 2,700, of a child using their own saved cord blood in the future.
Umbilical blood cord banking is widely available in both private and public banks. However, the story correspondant misrepresents the availability of public banks by stating that "there are only six in the entire country." In fact 20 states have public banks with several banks in each state. These can be located through the National Marrow Donor Program at www.marrow.org which also collects cord blood. It is possible that the story correspondant confused the number of public banks with the number of banks (six) that are not part of the National Marrow Donor Program. These six non-affiliated banks may accept cord blood donated for public use or directed donation for a child with a disease that might be treated by transplant.
Blood cord storage is not a new practice and accordingly this story does not portray it as a novel procedure.
We can’t be sure if the story relied largely on a news 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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