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Today’s Matters of the Heart: Dr. Nancy’s Personal Wake-Up Call

Rating

1 Star

Today’s Matters of the Heart: Dr. Nancy’s Personal Wake-Up Call

Our Review Summary

This long (almost 6 minutes – very long for TV news) segment was, nonetheless, almost completely devoid of evidence and of data.  So it rode the single personal anecdote of the network’s medical editor, her vague complaints of feeling “tired, short of breath, just not feeling like myself”, and her path to getting a CT scan of her coronary arteries.  The segment was presented in a manner we deem as disease-mongering, likely to frighten many women into thinking THEY needed such a scan.  A line like the following – “The symptoms of heart disease in women can be so subtle, the disease process so quiet, so insidious, that many women don’t get in to see their doctors until it’s too late” – demands some data to back it up. How often is this case?  How representative was the medical editor’s story?  

But without data and without evidence, there were heaps of squishy, unverified claims.  The medical editor said, “There’s no doubt that plaque is a result of the cheeseburgers I ate as a teenager.”  No doubt?  Sorry, that doesn’t cut it.  

The segment failed to indicate that the kind of picture provided by the CT angiography may not actually change the course of treatment in cases like the medical editor’s.  She earlier explained that she had an elevated cholesterol level, which likely would have been treated with cholesterol lowering medication anyway.  So it is unclear how the CT angiography provided her with any benefit.

Studies have not consistently shown that imaging test results improve adherence to treatment.

There was also no mention of the harms of incidental findings – things the CT finds that only cause worry but don’t help with diagnosis or treatment.

All in all, the six minutes could have been used much more wisely. But the networks – NBC in particular (with recent stories about their own Mike Taibbi, George Lewis and now Nancy Snyderman) love to tell their own health sagas – whether or not they include evidence and data that viewers need.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story indicated that CT angiography was not routine and that it was ‘expensive’.  The story failed to provide any framework for understanding how expensive.  Does expensive mean several hundred or several thousand dollars?  Is it something that is or is not commonly covered by insurance? Is it something that only TV doctors can have access to and afford?  This could have been explained.

 

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The benefit presented in this segment was the relief of symptoms experienced by the medical editor.  The viewer has no context for understanding how commonly this benefit occurs.

There was no real discussion about how the picture of the medical editor’s coronary arteries actually influenced her treatment, other than for it to serve to motivate her about treatment.  That said – there is actually no evidence that having a picture of one’s heart helps a person to adhere to treatment any better.  In addition, the segment did not provide any insight about how often the test actually provides information that results in decreased heart attack risk. 

The long segment was completely devoid of data. 

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

The segment did briefly mention that the quality of the CT angiography institution can result in differences in radiation exposure.  However this was not an adequate discussion because it leaves it up to the viewer to grasp the implications of differing exposures and clearly does not provide any indication of the magnitude of the risk involved.

The segment failed to indicate the picture provided by the CT angiography did not actually change the course of Dr. Snyderman’s treatment.  She earlier explained that she had an elevated cholesterol level, which likely would have been treated with cholesterol lowering medication.  The daily aspirin she reported to be taking likely derives from the recommendation from the United States Preventative Services Task force – which stipulates that both the potential benefits and harms of aspirin therapy should be discussed.  It is unclear how the CT angiography provided her with any benefit.

Studies have not consistently shown that imaging test results improve adherence to treatment. 

There was also no mention of the harms of incidental findings – things the CT finds that only cause worry but don’t help with diagnosis or treatment.  

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

This segment did not actually provide viewers with any indication of the sort of evidence demonstrating the effectiveness of medical therapy for the reduction of heart attack risk.  Instead, an inaccurate statement was made suggesting that lifestyle changes alone have been shown to impact the risks from heart disease.

The medical editor’s personal story is presented as sufficient indication about the best approach to treatment.  This sends the inappropriate message that anecdote is as well grounded as information from clinical trials.  

Does the story commit disease-mongering?

Not Satisfactory

The segment was introduced with the concept that heart disease is the #1 cause of death for women in the United States. Does this vary by age? 

Starting there and going on to present the idea that symptoms are often vague suggests that all viewers can conclude that heart disease is likely lurking around the next turn. 

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

The segment relied on the narrative of a single doctor-patient, discussed by the doctor of that doctor-patient. The segment should have included comments from some independent cardiologist about the role of CT scans and of optimal medical therapy to reduce heart attack risk.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

There was no discussion about the options available for diagnostic testing nor about approaches to treatment.

Does the story establish the availability of the treatment/test/product/procedure?

Not Satisfactory

This story was a mixed presentation of information about a particular diagnostic test and medical therapy for the treatment of coronary artery disease.

In terms of the diagnostic test, although it was made clear that there were some issues about radiation exposure differing among sites, there was no discussion about the availability of the test.  Is it available in some hospitals, most hospitals, in speciality clinics? What does "not routine" really mean? 

Regarding treatment for heart disease, although statin and daily aspirin use were mentioned in passing, they appeared to be rolled into what was categorized as ‘lifestyle changes’.   The viewer was not given any sense about how common or uncommon was the use of these particular medications for the treatment of heart disease. 

Does the story establish the true novelty of the approach?

Not Satisfactory

The segment adequately discussed the relative novelty of CT angiography.  It did not adequately explain its limited utility.

Does the story appear to rely solely or largely on a news release?

Satisfactory

Did not rely on a press release.

Total Score: 1 of 10 Satisfactory

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