For readers in the local area, the story provides a glimpse of a minimally-invasive heart surgery approach that is “rare” in Texas. The story could have been improved in many ways. No evidence was given to describe the risks and benefits of the minimally invasive heart surgery. And the story only presented one positive patient experience. The plural of anecdote is not data. The medical evidence shows that the results and complications of minimally invasive surgery vary and may not be any better than other approaches – questions this story should have covered.
There is no discussion of the medical costs for open-chest CABG or for the newer minimally invasive heart surgery. The article does provides the cost of the special retractor, $5,000, that is used in the minimally invasive procedure. This is compared to the $2 million for a ‘robot’ that is used in other non-invasive procedures. But this is an incomplete view of the real costs of the procedures being discussed.
The story did describe the benefits of the minimally-invasive approach – smaller incision, lower risk of bleeding and infection, reduced post-operative discomfort and shorter hospital stay. But we look for the story to QUANTIFY benefits – how big (or small) are the potential benefits compared with other approaches? This story didn’t do that.
The story mentions potential harms such as risk of bleeding, infection, length of hospital stay, postoperative pain, and time to return to work are lower with minimally invasice heart surgery compared to open-chest CABG. However, it does not address the serious risks of heart attack, stroke or death.
This story does not provide any evidenced-based studies or supporting literature about minimally invasive heart surgery.
Should patients who are intending to have back surgery be evaluated for blocked heart arteries? Is the presence of one blockage sufficient indication for a patient to have bypass surgery even if it is only the minimally invasive kind?
The sources are two surgeons who use minimally-invasive approaches. So no truly independent source is interviewed. A better approach would have been to interview a cardiologist who does not do the surgery but who could provide a knowledgeable perspective.
The story mentioned some treatment options, open-chest CABG and robot assisted heart surgery. It did not discuss percutaneous coronary interventions or other medical treatments. We’ll give it the benefit of the doubt.
This story does state that minimally invasive heart surgery is not commonly available in medical centers across the country, or in Texas, because many cardiothoracic surgeons are not trained in this method and prefer conventional open-chest coronary artery bypass graft surgery (CABG).
The story tell us that the procedure is "rare" in Texas, but it is not clear how long this procedure has been done or the different types of minimally invasive surgery.
The story does not appear to rely solely on a news release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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