This television broadcast explores Preimplantation Genetic Diagnosis (PGD), a technique that involves selecting and implanting embryos lacking genes linked to certain deadly cancers. This appears to reduce risk of the child inheriting the conditioins linked to that gene.
The segment falls short of health journalism best practices in many ways:
In addition to the above, the story has another serious flaw which is not captured by the review criteria.
Throughout the piece, but especially near the beginning, words like "never" and "guarantee" are used to imply absolute success of the procedure in preventing cancer.
This is misleading language.
A child who lacks a gene for a specific form of breast cancer is guaranteed to be free of only that specific type of genetic breast cancer–not free of breast cancer generally. Ditto for colon cancer. In fact, the host points out that 80 percent of breast cancers don’t appear to be linked to family history.
Near the end of the piece, Dr. Grifo says the technique is not 100 percent effective (presumably at screening for the disease genes). He also says that genetics is very complicated and our understanding limited, so eliminating one gene linked to a disease is not certain to prevent that disease.
These observations are at odds with the absolutist language that frames the piece. This appears to be another case of journalists using provocative language to sell the story to the audience, and ultimately indicating that the story is not quite that simple.
Best practice for health journalism would be to provide context and caveats right at the top, not at the end of a story that has been presented as a dramatic breakthrough in medicine.
At the end of the segment the fertility specialist who does these procedures says only that PGD is "very expensive." The price range should have been stated.
Figures are used twice to describe the benefits of the treatment:
As discussed previously, Dr. Grifo says that 25 to 50 percent of "many" parents’ babies will have "serious genetic illness." Which parents he is referring to is unclear, so the data do not help people understand underlying risk of serious genetic disease for most people.
Near the end of the segment he says the screening is "not 100 percent accurate" and that each screening-and-implanting cycle produces a pregnancy 40 percent of the time. These are useful figures that help viewers understand the procedures’ efficacy. But the statement that the tests are not 100 percent accurate should have been explained further to describe false positives and false negatives.
Dr. Grifo suggests the potential harms of high cost vs. low success rate near the end of the segment. This should have been mentioned earlier, so these facts could frame the viewer’s impression of PGD from the beginning.
The segment does not explore other potential harms, including risks to the health of the baby linked to embryonic selection. Could selecting out for one gene have unexpected consequences? False positive and negative results are possible and this is never discussed.
The segment presents no evidence to demonstrate the success rates and risks of the procedure.
The segment does a good job generally of resisting melodrama over a very emotional subject–children, serious disease and family deaths.
But the segment fails critically at one point. The specialist, Dr. Grifo, says the following:
"For many couples, 25 to 50 percent of their babies will have a serious genetic illness. And they usually find out because they have a baby with this horrible genetic disease and they’re living with it, and they don’t want to have another child experience that pain and suffering."
It’s hard to imagine what statistics Dr. Grifo is drawing on to make these statements. But the implication is that perhaps half of children of "many" couples will have "some horrible genetic disease" and parents can prevent "pain and suffering" by using PGD. This is demonstrably false and cruelly self-interested.
Live television can’t "edit" what guests say, so it’s hard to blame the producers or host for this statement. Regardless of fault, the segment includes an example of unacceptable disease mongering.
As indicated in the summary portion of this review, the language, especially at the top, is very provocative, such as when it asks, "What if you could stop hereditary breast cancer in its tracks?"
The segment draws on one family that has used PGD with apparent success, the physician who provided the treatment, and a fertility specialist who has pioneered fertility treatments of this sort.
There is a brief statement from an independent ethicist who urges caution and implies potential dire consequences.
The segment is too heavily weighted toward advocates of PGD. Comments from a well-informed but disinterested fertility specialist would have been very useful.
PGD is being used to prevent deadly cancers of genetic cause. There are no options for prevention, only to reduce risk and treat the cancers if they occur.
The story does not indicate how many fertility centers offer Pre-implantation Genetic Diagnosis (PGD)–is it super-specialized, or is any area fertility center going to offer it?
The segment accurately implies that PGD is not new, but its use to screen embryos for specific genes related to specific diseases is just emerging.
We can’t be sure if the story relied solely or 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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