This was an uninformative piece about options available for angiogram/angioplasty insertion sites, sorely lacking in context. Viewers were given no information that would allow them to compare the risks and benefits associated with the use of the sites. There was no information about whether there was always a choice or whether some situations precluded the use of one or the other. While someone watching this discussion between host and physician guest might learn that the wrist might be an option for the catheter insertion site, the terms angiogram and angioplasty were used as though the two were synonymous, which they are not.
It’s not clear why the network chose to report this story now – what made it newsworthy now. No independent expert was interviewed. Other news coverage of the procedure has included independent expert questions about the learning curve for, and technical difficulty of, this approach. Shouldn’t consumers be told about that?
In the end, it was just a “gee whiz” story about something supposedly newer and better without any intelligent discussion of evidence and of tradeoffs.
Viewers were told that using the wrist as the insertion site for angioplasty cost $200 less than using the leg as the insertion site. Curiously, the physician interviewed indicated that this was a savings of $6 million dollars a year for the hospital, which begs the question as to whether these cost savings are passed on to the patient or their insurer. This estimate of savings assumes that all of the 8000 patients could have the procedure done through the wrist and that all of the procedures would be successful. Nonetheless, despite this incomplete discussion, we’ll give the story the benefit of the doubt on this criterion.
The benefit, as presented in this broadcast, was simply that it was ‘better’. Technically more difficulty, but less expensive. This would seem to be an inadequate amount of information for a consumer to go on. How effective was the treatment done this way? That’s what people should care about.
There was no mention of possible harms associated with the use of the wrist as the insertion site; nor was there any discussion of harms associated with either angiography or angioplasty.
There was no discussion of the evidence abouot how the two insertion sites compare. The anchor stated – without any supporting evidence – that use of the wrist was "better" and while it appeared that the doctor-guest concurred, there was no further discussion of the matter.
This story did not engage in overt disease mongering.
Unfortunately, the discussion did not venture beyond the site of insertion used to perform angiograms and angioplasties. While bandying about the terms angioplasty and angiography, the anchor and physician-guest never explained when and why people should consider having either.
The only source of information presented in this story was the physician-guest. There was no reference to any published work. No independent expert was interviewed. In other New York-area news coverage, independent expert input raised questions about the learning curve for, and the technical difficulty of, the procedure. None of that appeared in this story.
This piece discussed two sites that can be used for angioplasty or angiography. However – it failed to provide any sort of information that might be used to compare the two sites in order to help a person decide whether one or the other was preferable for them. In addition, if this was to be a discussion of all places that can be used as site of insertion, the conversation could have included entry through the brachial artery in the elbow.
While viewers would understand from this broadcast that angiography / angioplasty are less commonly done using the wrist as the insertion site as compared with the leg, the broadcast failed to include an important piece of information. People interested in having the procedure done through the wrist are best served by identifying a clinician who has experience with the technique. As the artery in the wrist is much smaller than that in the groin, problems in a relatively high proportion of patients (~30%) occur when this technique is attempted by doctors lacking experience using the wrist as an insertion site. Other news stories on this approach included independent perspectives on the steep learning curve for, and technical difficulty of, this approach.
The broadcast was about a less commonly used site of catheter insertion for angiography in the US. There was no discussion about when this technique was introduced, or what its track record has been, although it was mentioned as being used more commonly in Europe.
We can’t be sure if the story relied solely or largely on a news release. We can’t be sure why CBS did the story at this time. We do know that they interviewed only one believer from only one medical center and no one else. It walked like a news release-story, talked like a news release-story, but we can’t prove it.