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Saving Your Life: Modern Medical Miracles: Matt Lauer’s heart scan

Rating

2 Star

Saving Your Life: Modern Medical Miracles: Matt Lauer’s heart scan

Our Review Summary

TV anchor Matt Lauer, an asymptomatic 47 year old man with no history of diabetes, with normal blood pressure, borderline high cholesterol, and with a family history of heart disease (his 72 year old father had coronary artery bypass graft surgery) undergoes a heart scan on national TV. We learn that two of his arteries are “pristine” while there is a small “bad” plaque in one artery that could “eventually develop into a problem.” The cardiologist suggests lifestyle modification, baby aspirin, and a statin. There is no independent, second opinion in the story. What have we gained from this experience? Nothing, unless we are GE (parent company of NBC), and manufacturer of the scanning device used in the story.
There are many problems with this story. At the end, we are told that this technology should be used only for people experiencing symptoms such as shortness of breath, chest pain, etc. Yet the story featured asymptomatic Matt Lauer modeling the procedure. That is an example of disease-mongering. In the end, the true message of what this technology can and can’t do is completely distorted by the beautiful pictures (3-D rendering of the heart) and empty, non-evidence-based promises. The costs of this technology are ignored. Insurance coverage (an important issue) is downplayed. And the potential harms of having such a scan are not mentioned at all.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

Does not specify what the costs are, which are entirely out-of-pocket since most insurance companies do not cover

it. The cardiologist downplays cost saying that they have had “good luck” getting insurance companies to cover it.

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

Not Satisfactory

No information on harms is provided, which is a glaring omission. Harms might include: reaction to beta-blockers

(to slow the heart rate) or to the contrast dye, exposure to radiation that is many times greater than an x-ray, not to

mention any risks from any interventions (catheterization) needed to follow-up on any abnormal findings (that may or may not

result in any benefit to the patient). Furthermore, the cardiologist recommends taking statins and aspirin as a result of the

findings, but what about the harms of these drugs? What if the lesion were a false positive and the drugs were entirely

unnecessary?

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

Not Satisfactory

There is absolutely no evidence provided. In order to really

evaluate this, we would need to know how the images correlate with his actual plaque buildup and we would want evidence that

early intervention with these scans can actually do anything to prevent an event or bad outcome. Furthermore, we don’t know

if this lesion could be confirmed with a catheterization (gold standard).

Does the story commit disease-mongering?

Not Satisfactory

Although the story doesn’t exaggerate the prevalence of heart disease, it does not

accurately portray the natural history of heart disease. It is still controversial to say that these scans “can show us

exactly what’s going on in the heart.” We still don’t know whether plaques (good or bad) found with these scans are

actually going to be the ones to cause problems down the road. Matt Lauer’s father’s heart disease is actually not a major

risk factor, which raises the controversy that we don’t know what to do with asymptomatic, active and healthy people who

could have ‘bad’ plaques. Matt Lauer also confuses his plaque value of 56 as being ‘mild’, when in reality this indicates

a ‘soft’ plaque that is more vulnerable to developing an MI.

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

Not Satisfactory

No attempts are

made at independent corroboration. Only a single source is quoted. Does mention that GE makes the machine and owns NBC.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

Mentions cardiac catheterization but

neglects exercise tests, MRI and older CT scan alternatives. Does not attempt to place this kind of CT in context or explain

the advantages or disadvantages.

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

Satisfactory

Mentions the availability of the machine in the U.S. since May, 2005.

Does the story establish the true novelty of the approach?

Satisfactory

The story is clear that this

is very new technology.

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

Not Applicable

We

don’t know if the info came from a press release.

Total Score: 2 of 9 Satisfactory

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