3-D Surgery

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The segment does not mention how much the instrument costs or what the bill would be for a procedure involving it.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

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.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

The segment does not mention whether the equipment carries risks conventional surgery does not.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

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.

Does the story commit disease-mongering?

Not Satisfactory

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.

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

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. 

Does the story compare the new approach with existing alternatives?

Not Satisfactory

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.

Does the story establish the availability of the treatment/test/product/procedure?

Not Satisfactory

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.

Does the story establish the true novelty of the approach?

Not Satisfactory

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.