Too often when a reporter learns about a developing medical technology used locally, the result is a gee-whiz rave. This well-reported, judiciously written story on navigation-assisted joint surgery is a welcome exception.
The story plainly says the surgical technique has not been proven effective. The reporter interviewed four physicians about its value, including one who has not used the machine. The story discusses the potential benefits and harms without falsely emphasizing either one.
The reader takeaway is that there is an interesting but uNPRoven new technology available for local joint replacement surgery. Some may want to talk to their doctors about it, but none will go expecting a miracle treatment certain to improve outcomes.
The story could have been improved in two ways:
It’s good that the report states the price of the device–above $200,000–and that at least one insurer does not pay for its use. But the story should have stated what it costs a patient to get treated with the device, and who bears any additional costs.
The story says the device’s efficacy is uNPRoven, but it does not explore the body of inconclusive data.
There is a 2007 study that shows 5 years of outcome data. The fact that that study did not demonstrate improved outcomes suggests the device does not have big, measurable benefits. The story would have been stronger had it referred to this study.
The story reports that the extra time required to do a navigation-assisted surgery may lead to more complications.
The story would have been stronger if it had mentioned the potential risks associated with the surgeon learning curve.
The story does an excellent job of stating, plainly and repeatedly, that there is no conclusive evidence the surgical device improves outcomes.
The story doesn’t exaggerate the severity or prevalence of the underlying joint conditions. Neither does it make false claims for the relief the device can provide.
The story does use one positive anecdote, which could be read to mean the navigational device contributed to the positive outcome. The reality is that most patients do very well with the surgery without the need for a navigational prompt to the surgeon.But since the story states repeatedly that the technology’s benefits are uNPRoven, this is not a serious flaw.
The reporter interviewed four surgeons, three of whom use the device and one of whom does not. The reporter did not quote the device maker, an impressive show of restraint.
A key shortcoming: The reporter did not explore potential conflicts of interest of the sources. Doctors who are early adopters of expensive new technologies often have relationships with the device makers. So do the medical facilities where the doctors practice. Such relationships should have been disclosed, or the lack of relationship should have been plainly stated.
The story indicates that most surgeries are done without the navigation device, and that other similar devices are in development.
The story names four Iowa institutions that have the computer assisted surgery device. It also names four surgeons who use it.
Ideally the story would stated how many of the devices are in use in Iowa, Des Moines or the U.S.
But the story includes sufficient information to be rated satisfactory under this criterion.
The report makes clear that the device has been in use for a few years but is still considered investigational.
By reporting how many surgeries certain centers and surgeons have done with the device, the story provides an adequate view of its clinical use.
There is no evidence that the story relied solely or largely on a news release.