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Angioplasty through the wrist backed by new study

Rating

4 Star

Angioplasty through the wrist backed by new study

Our Review Summary

This is a good piece of reporting about a recent study comparing two different insertion sites to obtain access for angioplasty. While not providing any insight about the specific circumstances when there may be medical reasons to chose one access site over another, the story did a nice job of informing readers that there might actually be a choice when having an angioplasty.  It provided information that a reader could use to have a conversation with a doctor about the decision.  However – the story should have included some insight about the strength of the observation obtained from the current study.  As it was not a controlled study – so it did not evaluate the two procedures in a controlled environment – any predictions are tentative and require further examination.

Overall, though, this was a balanced, clear and concise story about an approach that might be a safer alternative to the dominant way of doing an angioplasty.  The story included an independent expert to comment on the study.  And it reported absolute rates as well as relative rates so the reader can really get a sense of the safety of the new procedure. 

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story did not provide cost estimates for either approach; the story did mention that the through-the-wrist approach was associated with shorter hospital stays (and therefore reduced costs.)  There was no discussion in the story about whether there are different costs associated with the procedure itself.

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

Satisfactory

 The story explained that the through-the-wrist approach was associated with lower risk of bleeding and shorter hospitalizations but should have included a caveat explanation about the strength of research and that the results of the study reported on require follow-up investigation.


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

Satisfactory

The story mentioned risk of bleeding at the site of catheter insertion as a possible harm of treatment which was greater for those who had a the catheter inserted in the leg.  To its credit, the story provided absolute risk information, i.e. pointing out the 60% reduction in bleeding was the difference between 2 and 1% of patients having this complication.  

The story did not mention whether there were any particular side effects or harms associated with catheter insertion at the wrist.

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

Not Satisfactory

The story explained that the study was an analysis of information contained within a national registry.  But it should have explained that this is the weakest type of study from which to draw a clinical conclusion (such as this procedure is safer or as safe as the alternative).  Thus the statement in the story ‘both methods were equally effective’ should have been more tentative. The underlying weakness of the study, that it is not a controlled trial, may mean that the patients who had the wrist approach had something else about them that helped to reduce risk and that the researchers may not have been able to take into consideration.

Does the story commit disease-mongering?

Satisfactory

The story did not engage in overt disease mongering.  

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

Satisfactory

The story included interview material from one clinician who was not associated with the study reported on.  The quality of the piece would have been improved if it had included input from physicians who might have explained some of the reasons why not all interventional cardiologists use the wrist approach.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story did an adequate job of reporting about a recent study comparing two approaches to angioplasty.

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

Satisfactory

The story indicated that the angioplasty using access through the wrist as opposed to a leg, was used much less frequently.vThe story explained that extra training is required in order to use this procedure and many doctors are not trained in this technique.  This would contribute to the procedure’s limited availability.

Does the story establish the true novelty of the approach?

Satisfactory

The story did a good job of explaining that neither of the two approaches compared were new and that the point of the study was to determine how the two sites compare in terms of their use.

Does the story appear to rely solely or largely on a news release?

Satisfactory

The story does not appear to rely exclusively on a press release.

Total Score: 8 of 10 Satisfactory

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