Overall this story did a good job on an interesting study. The story was well written and provided a reasonably balanced view of the study. There were several aspects of the study that could have provided readers with several important provisos. The results reported were based on a secondary outcome measure of the JUPITER study. The study was not designed to examine the effects of Crestor on the risks of developing venous thromboembolism (VTE) as a primary outcome. The population under study was not otherwise healthy individuals as was implied. 41% suffered from metabolic syndrome, a condition that increases the risk of VTE. The study results were reported as absolute numbers. The absolute number of VTE events was calculated using both provoked (potentially caused by other conditions such as cancer, surgery, hospitalization or trauma) and uNPRovoked. The true absolute number of uNPRovoked events was 44. The story also failed to explain that the rate of VTE was 18 per 10,000 in the statin group versus 32 per 10,000 in the placebo group. So the story may make the benefit appear larger than it really is. However, to its credit, the story did not use the 43% relative risk reduction figure that dominated some news coverage of this study.
The story also could have been improved by more fully describing the potential harms and side effects of statins. The story mentions muscle problems and bleeding as potential harms, but does not mention kidney problems as a potential serious harm and the other side effects people experience, such as constipation and nausea.
The story mentions the daily cost of Crestor as well as the CRP test.
The story does not adequately quantify the benefits of statins. The story uses language that makes the benefit appear larger than it is. By not presenting the rate of VTE in the study population, the story does not give the reader the adequate context to understand these numbers. In this study, the rate of VTE was 18 per 10,000 in the statin group versus 32 per 10,000 in the placebo group.
The story does not adequately describe the harms or side effects of Crestor. The story mentions muscle problems and bleeding as potential harms, but does not mention kidney problems as a potential serious harm and the many side effects people experience, such as constipation and nausea. Interestingly, the subjects treated with Crestor had a small but statistically significant increase in diabetes seen during the trial.
The story adequately describes the current study, however there are a few subtle points that are important to note. The story could have mentioned that VTE was not the primary endpoint of the original trial and that the population studied was not exactly healthy. 41% suffered from a condition known as metabolic syndrome (a condition that increases the risk of blood clots). So extrapolating the results of this single study to the general population is a bit of a stretch.
The story doesn’t exaggerate the seriousness or prevalence of venous thromboembolism (VTE).
The story quotes multiple experts and indicates which experts were related to the study or not, and notes potential conflicts of interest.
The story indicates that many doctors believe that other statins other than Crestor may provide similar benefits.
Clearly Crestor is widely available. Whether the CRP test is also widely available is not clear.
Using statins to treat inflammation is not a new idea and the story portrays it appropriately.
Since the story quotes multiple experts, the reader can assume the story did not rely on a press release as the sole source of information.
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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