Overall, this story does a good job summarizing the results of a recent study on watching waiting vs. preventive surgery for hernias. Hernia operations are a common procedure and the study challenges conventional wisdom that all hernias should be fixed. Watchful waiting, including active monitoring of symptoms, appears appropriate and safe for middle-aged men with asymptomatic hernias; however, neither strategy proved superior over the two-year observation period. The story summarizes the study design, and notes those included were middle-aged men with asymtomactic or mildly symptomatic hernias; however, according to the source article, half of referred patients were ineligible to participate in the study. In order for the authors, and in turn the journalist, to report that the finding is generalizable to real patient populations, this issue of how and why patients were excluded from the trial needs to be explained. The journalist and the authors might need to clarify that this study does not apply to men who have had ANY hernia related pain in previous six weeks (and that’s a lot of people!). Surgical complications are casually mentioned, however, the discussion is limited when compared to that of untreated hernias. There is also no mention that a hernia can recur even with the surgery (1.4% in this study.) 31% of the watchful waiting group decided to have surgery over the four-year duration of the study, though reports of pain at two years were similar in both groups. The journalist could include more information on why so many in the trial crossed over and decided to have surgery. The story could have further developed the effect of hernia pain on quality of life. Secondary pain and function outcomes were better in the surgery group, but this was not mentioned by their authors in conclusion, nor by the journalist. Lastly, there is no mention of the cost of hernia operations, which may be an important factor for someone trying to make this choice.
No mention of the cost of
hernia operations, which may play a role in someone opting for watching waiting.
The story does not provide enough information on
the effect of pain or the limits a hernia might place on daily activities. There is some information on this in the study in
JAMA, but little is mentioned in story. 30% of the watchful waiting group decided to have surgery during the 4 years,
though reports of pain at 2 years were similar in both groups. More information on why they decided to have surgery and the
effect of hernia pain on quality of life would be useful in order to better inform patients who are trying to make a choice.
However, overall, this criterion was met. The reporter used absolute numbers, not just relative — always a good idea.
The story
mentions harms and the frequency of surgical complications in this study, however, the discussion is limited when compared to
the discussion of untreated hernias. Does not mention the harm that a hernia can recur even with the surgery (1.4% in this
study.) The most significant harm reported may be the one case of nerve injury, which was not mentioned in the story. While
the story states 20% had complications, three of them life-threatening, readers could have used more detail.
Mentions some evidence from the
Journal of the American Medical Association (JAMA) article. Mentions the randomization and an overview of the study design.
Provides some appropriate quantitative evidence. This study raises an interesting question for medicine and for journalism:
does the failure to demonstrate a significant difference mean that the treatments are equivalent? We think “no.” The story
could have also further scrutinized the evidence by asking about the condition of the men in the trial. One of the trial’s
inclusion criteria was having no pain or no interference with activities in the previous six weeks. So it’s not clear
whether they really had no symptoms or just minimal symptoms.
The story does a satisfactory job of explaining that hernia surgery is a common procedure and
that this study challenges the conventional wisdom that all hernias should be fixed.
Story includes perspective from
editorial writer.
We rate this
satisfactory, although, in comparing treatment options, the possible harms of surgery could have been explored more fully.
The story does not mention specific potential surgical or post-operative complications. 22.3% of those who underwent surgery
(this included those randomized to the surgery group or those from watchful waiting who crossed over into the surgery group)
had complications which included wound infections, urinary tract infections, and in a few cases, serious cardiovascular
problems requiring hospitalization.
This
rating does not apply, as the story focuses on watchful waiting and active surveillance in lieu of preventative surgery for
hernias. Hernia operations are a common procedure and available in most hospitals; the new treatment (no intervention, save
for monitoring general health or symptoms typical of a hernia) is also now an evidence-based option for treatment.
The story provides accurate
information that watchful waiting vs. preventive surgery is a newer approach to treating men with mildly symptomatic hernias.
Systematic, Criteria-Driven
Puleeeeease... this 'game changer' weight loss drug causes more nausea and vomiting than a placebo. Some game, some change. My friend Gary would spank you for using the eighth word medical reporters should never, ever use. @garyschwitzer @thackerpd
https://www.healthnewsreview.org/toolkit/just-journalists-writing-tips-case-studies/7-words-and-more-you-shouldnt-use-in-medical-news/ https://twitter.com/OttawaCitizen/status/1361426796126830597
A scary @statnews Op-Ed warns that govt attempts to rein in Pharma may cut off access to "life-changing" drugs.
It takes @garyschwitzer to let us know: the author spent 10 years as Pfizer's public-policy chief. https://twitter.com/garyschwitzer/status/1360325022578053123
.@TranspariMED criticizes STAT op-ed for not disclosing pharma funding of author’s institute - similar to criticism we’ve made of STAT op-eds in the past. @transparify @ThinkTankWatch @icer_review https://www.healthnewsreview.org/2021/02/transparency-watchdog-criticizes-stats-non-disclosure-on-pro-pharma-op-ed/
Comments
Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.
Our Comments Policy
But before leaving a comment, please review these notes about our policy.
You are responsible for any comments you leave on this site.
This site is primarily a forum for discussion about the quality (or lack thereof) in journalism or other media messages (advertising, marketing, public relations, medical journals, etc.) It is not intended to be a forum for definitive discussions about medicine or science.
We will delete comments that include personal attacks, unfounded allegations, unverified claims, product pitches, profanity or any from anyone who does not list a full name and a functioning email address. We will also end any thread of repetitive comments. We don”t give medical advice so we won”t respond to questions asking for it.
We don”t have sufficient staffing to contact each commenter who left such a message. If you have a question about why your comment was edited or removed, you can email us at feedback@healthnewsreview.org.
There has been a recent burst of attention to troubles with many comments left on science and science news/communication websites. Read “Online science comments: trolls, trash and treasure.”
The authors of the Retraction Watch comments policy urge commenters:
We”re also concerned about anonymous comments. We ask that all commenters leave their full name and provide an actual email address in case we feel we need to contact them. We may delete any comment left by someone who does not leave their name and a legitimate email address.
And, as noted, product pitches of any sort – pushing treatments, tests, products, procedures, physicians, medical centers, books, websites – are likely to be deleted. We don”t accept advertising on this site and are not going to give it away free.
The ability to leave comments expires after a certain period of time. So you may find that you’re unable to leave a comment on an article that is more than a few months old.
You might also like