This brief piece (only 320 words) tried to report on a longer-term outcome, increased fracture risk, seen with two common medications that are used for the treatment of diabetes. It failed to provide quantitative information about the absolute fracture risk for the individuals involved and did not include information about treatment options. And while the study raises questions about the long-term use of the drugs reported on, the story did not provide the reader with any sense of evidence based alternatives.
Obviously for women using these drugs the increased fracture risk is alarming. So use of absolute risks and placing this risk in the context of the potential benefit of the medication and the possible use of other lower risk medications would have provided more helpful information for the public.
The cost for the use of these medications is not discussed but is also not exactly relevant to the story, which is presenting evidence indicating that their use may not be desirable.
However – it might have been interesting to note that among the medications taken orally to treat diabetes, these 2 drugs are more expensive than most.
The story reported on the increased fracture risk that appears to be associated with two drugs used for the treatment of diabetes. The fact that they are commonly used medications at least suggests that there is a reason these medicines are being used. While it is true that there may be a trade-off to be made between what these medications do and the increase in fracture risk, the story did not provide any narrative about utility of these medications.
This story indicates that the increase in fracture rate that may be associated with the use of these medications ‘could have substantial effect’. But because the story doesn’t indicate what the absolute fracture risk is, a reader has no way of assessing what ‘doubling the fracture risk’ actually means in term of the likelihood a woman will break a bone.
The story explains that the study it was reporting on combined the results from a number of studies for its analysis.
There is no overt disease mongering about diabetes or about fractures.
Minimal input from a second source – that coming from an editorial writer who was not involved in the study reported on. The piece might have been improved by including insight from a diabetes expert about what options are available for individuals with diabetes who might be concerned about fracture risk.
The story did not provide any insight for readers about what options might exist for individuals with diabetes, who are using either of these medications and are concerned about fracture risk. Are there other medications that might be used? Are there lifestyle changes that might lessen the need for the medications reported on?
The story indicates that the two medications it mentioned are currently in use for the treatment of diabetes.
The story appropriately put the new study in context, stating that "Researchers had known there was an increased risk of fractures associated with the drugs, but not the magnitude of the risk."
We can’t tell the extent to which the story relied on a news release. The only experts mentioned were the author and the editorial writer.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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