This was a well-done story about a new business strategy in medicine, direct to consumer diagnostic testing – in this case for skin cancer. It provided readers with a lot of information about approaches to skin cancer screening, including what they can do on their own, organizations that provide free screening, and how the medical professionals most closely associated with skin cancer screening view this new organization and its approach. While pointing out that screening is only as good as the person conducting the exam, it also highlights the fact that many people are not screened in accordance with current recommendations. However – there was no evidence presented for efficacy of the screening method use in this new facility or for traditional screens conducted by physicians. A particular flaw was the lack of discussion of harms associated with both false positives (increased surveillance and worry) and diagnosis of early cancers that would not progress, with a possible cascade of medical intervention and all that entails.
Overall, the story was informative and successful in not being merely a shill for the new enterprise.
The story included the costs of a Molesafe screening as well links to organizations offering no cost screening.
To be more complete, there are three pieces of information the story could have included: the cost for yearly follow-up at Molesafe, whether or not Molesafe screening would be covered by some, most, or no insurance companies, and the estimated costs of such screening by a dermatologist.
The story did not quantify the benefits that might be derived from increasing the number of people being screened for skin cancer. It did not include any discussion about the value of such screening in any of the settings mentioned. But it did provide some discussion around the information that fewer people are screened than recommendations would suggest and that this type of setting had the potential to increase the screening rate.
The president of the American Society for Dermatologic Surgery expressed his concern that "Dermatologists consistently do better than non-dermatologists" which could be interpreted as a suggesting that MoleSafe screening could miss lesions. A false negative is one of the harms of screening. The story should have been more explicit on this.
The story could have explained that the other harm of screening is a false positive, which in this case would be where something is diagnosed as a potential cancer and the individual goes for unnecessary follow-up and/or treatment.
Although the clinician who is opening this clinic and stands to gain financially from its operation stated that the process "is proven to detect melanomas and save lives," the story did not contain data supporting this claim. It should be available as this sort of clinic has been in operation for several years in New Zealand and Australia under the name MoleMap. If there is no evidence about the efficacy of this particular screening system, this should have been mentioned.
The story did not engage in disease mongering. In fact, it alluded to the fact that not all cancers are dangerous. This is a concept that is not often mentioned.
The reporter working on this story did an excellent job of obtaining comments from people with vested interest in the disease but without connection to the clinic at the heart of the story. The comments provided a very interesting perspective on how medical professionals view competition.
The story mentioned screening by dermatologists and even included links to groups conducting free screening. In addition, a side bar included information that provided information a reader could use to do a first pass screening on their own.
The story explained that the first Molesafe screening center is in the process of being opened in New Jersey. It also offer links to organizations offering free screening.
The story was quite clear on this being a newly available clinical setting in the United States but one which has a longer history in New Zealand.
Because of the number of sources used, we assume that the story did not rely solely or largely on a news 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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