The use of three-dimensional optics in surgery has been studied for years. It could someday be proven to produce outcomes so good the technology is worth the extra cost. The device makes a legitimately interesting story, with obvious gee-whiz appeal.
But the CBS News segment on the technology ignores most important health journalism best practices. The result is a story that exaggerates benefits and provides virtually no information that can help a viewer understand its significance. To cite the most serious flaws:
The story does not indicate that 3-D surgery has been studied and in clinical use for over a decade. It does not say that the surgery itself–intranasal endoscopic surgery on the front of the brain–is routine.
The broadcast fails to mention how much the machine costs or where it is being used.
The segment cites no research that would indicate whether the machine produces better outcomes or carries any additional risks. This material is easily available and obviously germane.
The report does not include observations by an independent source. It depends entirely on a physician with a conflict of interest and a patient who had what appears to be a successful outcome.
The segment does not mention how much the instrument costs or what the bill would be for a procedure involving it.
Despite the significant body of published research on 3-D surgery, the segment does not cite any of it. The story suggests that the approach is unique as is the use of a 3-dimensional scope. While the 3-D scope is perhaps new, the surgical approach is a standard and has reasonably well described advantages over traditional open surgical approaches to base of the brain lesions. The successful outcome in the case presented is commonplace across the country in similar patients. The implied benefits of the 3-D scope may not in fact bear out after scientific investigation. A single successful case is no more demonstrative than is a single unsuccessful case.
The segment does not mention whether the equipment carries risks conventional surgery does not.
The segment cites no evidence to support the device’s use other than the surgeon’s enthusiasm and the single patient’s apparently successful outcome.
Minimally invasive surgical procedures, while offering the advantages of fewer complications and reduced recovery times, have had a mixed history. The minimally invasive approach described in this segment is used by many if not all academic medical centers in the country using standard endoscopic equipment. While there is evidence that the minimally invasive approach may provide for better recovery times and reduced morbidity, the advantages of a 3 dimensional view for the surgeon remain to be seen.
By citing only one example of an apparently successful surgery–on a frightening yet never specified brian tumor that put the patient’s vision at risk–the segment exaggerates the benefits of the device.
Sources include a physician who uses the device and a patient who appears to have had a successful outcome.
Neither of these sources is unbiased. It’s not clear whether the surgeon interviewed has a financial conflict of interest. But as the user of expensive equipment his hospital has purchased or is otherwise committed to, he is not in a position to evaluate its benefits objectively.
The segment does not indicate how the patient’s procedure would have been different using conventional methods. Presumably little, since the type of surgery itself is so widely practiced without the add-on of 3-D optics.
The segment does not indicate whether the 3-D surgical device featured is available anywhere other than the New York City hospital that employs Dr. Schwartz.
The story implies the device is novel, saying that "for the first time" doctors are using 3-D technology for brain surgery.
This is factually accurate but potentially misleading. As one device maker’s website shows, 3-D surgery on various body parts has been in clinical use and the subject of journal articles since at least 1996. This should have been mentioned.
The base-of-the-brain intranasal surgery itself has been used since the mid-90s at academic medical centers across the country. The use and outcome described are typical rather than extraordinary.
We can’t be sure if the story relied solely or largely on a news release. A hospital press relase from July 11, 2008 touts the hospital as the first user of 3-D endoscopy on the brain. We do know that the story presented only on one source at one hospital.