This story failed to provide balance for a reader to understand the risks and benefits of this line of treatment, what other options are available, or the costs involved. Other than gaining the insight that the outcomes are better today than they were in 1989, the reader did not learn much beyond the fact that surgical treatment of coronary conditions may be an option for those in their 80s and 90s.
There was no discussion about the costs of the procedures discussed or whether there were additional costs associated with treating the older patient.
The story mentioned an ever increasing percentage of patients that survived to leave the hospital. And it mentioned that 65% had no long term complications from the surgeries. However the story failed to provide insight about the length of time needed for these individuals to recover from the surgery or how successful the procedures were at relieving the symptoms that they were attempting to address.
The story mentioned that those having these surgeries survived about the same length of time as similarly aged individuals who did not have heart disease.
However from the information in this piece, it is difficult to have a sense of the quantitative benefit gained from the surgical intervention.
The story made short shrift of harms that might be associated with the treatment. It mentioned that older patients want to decide for themselves whether to take the risk but then never detailed what risk was being alluded to. The story also mentioned that 65% of the patients had no long term complications, but again – there was no discussion about what complications were seen to affect 35% of patients studied.
The story did not adequately describe the studies cited. The 12-year bypass data came from a single institution; the story should have pointed out that the generalizability of the results is not known. In addition, there is likely to be selection bias in that those chosen for surgery are likely to be more ‘hale and hearty’ and so the results apply to this group and not all older individuals. Lastly, although it mentioned that the individuals who had open heart surgery survived about as long as individuals who did not have heart disease – the real question is how did their survival compare to those who had similar conditions but did not have surgery.
The story did not engage in overt disease mongering.
The story included comments from individuals involved in the study reported on. It failed to provide insight from experts who could comment objectively about the results of the study.
The story opened with a disparaging remark about patients being sent home with pills to ease their symptoms. However – it is often the case that medical management of heart disease is a most effective treatment. Though the story painted an optimistic picture for the benefits that might be obtained by the elderly undergoing open heart surgery, the story failed to discuss what other treatment options might be available.
The story sketched out the possibilities and potential merits for individuals in the 80’s and 90’s to undergo open heart surgery to repair valves and vessels. While these types of procedures are widely available, there was no discussion about whether all facilities admitted or were suited to handle older individuals for these sorts of procedures.
The story reported on bypass outcomes over the 12 year period from 1989 – 2001. This implies that it took a long time to compile information of sufficient numbers of patients in order to report on the outcomes. This suggests that at least at the institution reporting these outcomes, it is not novel nor is it extremely common to conduct these types of surgery in this population.
It is unclear as to how much the story relied on a press release.