Let’s start by saying there is nothing inherently wrong with a gee-whiz TV segment that does a live demo of cool new medical technologies. In a perfect world the segment would be coherent and would feel apropos of something, but even that is not essential.
Television is an ideal medium for this kind of demonstration.
The problem is that when they put the segment together, the producers disposed of fundamental journalistic practices as efficiently as the daVinci Si HD bags up old organs to throw them away.
Even if we accept that this piece is nothing more than a few minutes of techno-tainment, it still has inexcusable, almost inconceivable lapses in journalistic hygiene.
Yes, it is wonderful, even inspiring to see a doctor peel a grape and thread a needle with these tools. It’s great entertainment and eye-opening. [See the video in order to appreciate how fun and fascinating the demo is. The transcript does not do justice to how engaging the segment is.]
But as journalists, the producers were simply asleep at the switch. One hopes this would not be the case for the medical professionals who use these technologies on patients.
The story makes no mention of how much all of this equipment costs, or how much it adds to the price of medical treatment.
This is a serious–and baffling–omission. The gee-whizness of the story almost immediately begs the question of how much all of this stuff costs. Not a word is mentioned.
The established daVinci models cost about $1.5 million. The price of the new Si HD has not been published yet. It is certainly higher than $1.5 million.
Analyses have been done that suggest that because surgeries done with daVincis generally produce fewer complications and shorter hospital stays, the devices actually result in lower total costs. This may be true. But again, the story should have mentioned costs.
The story does not attempt to quantify the benefits of any of the procedures discussed. Yet it allows interested sources to claim the benefits of better outcomes and fewer side effects.
The piece is silent on the potential harms of robot-assisted surgery, which include misapplication [as hospitals that have invested in it seek to use it as much as possible] and exposure to inexperienced users [because this surgery has a learning curve of a reported 18 procedures].
The piece discusses the advantages of belly-button laparopscopic surgery but does not discuss any risks.
Being the 9th person in the world to undergo a procedure is not necessarily a good thing.
The story presents no evidence that the techniques and technologies profiled are safe or effective.
The anecdote at the beginning highlights a prostate cancer patient, who emotionally discusses his desire to live for his family and friends. Yet his case says nothing about the type of surgery he had, trans-navel, and whether that might improve his prognosis. There is no evidence it will.
This is therefore a clear case of disease-mongering–using an irrelevant anecdote for nothing more than generating emotions to make the technology seem necessary.
The piece at various points says the robot-assisted procedures reduce pain and recovery time and allow previously inaccessible levels of control over minute movements. The segment vividly demonstrates how the device can be used to thread a needle and peel a grape. This all appears to oversell the benefits, another form of disease-mongering.
And the host at one point suggests the robotic surgery tools could "make human hands a quaint artifact of the past"–a statement that makes accuracy and plausibility look like quaint artifacts too.
Sources include:
While it does not appear Michael Stifelman of NYU has a standard, disclosable financial conflict of interest regarding the daVinci’s maker, he clearly is an interested party as someone who has devoted his career to use of robotics in surgery. He leads a center that has invested heavily in the technology, needs to generate a lot of patient cases to pay for it, and has ambitions to play the role of leader in the field.
There is nothing like balance or context in sourcing here.
The segment refers to laparoscopic surgery not done through the navel, and surgery not assisted by a robot, only to assert their inferiority.
Several technologies are mentioned in this segment.
Navel surgery is presented as cutting-edge–the patient is said to have "ma[d]e medical history" as the ninth to have his prostate removed via his navel. Yet the piece says surgeons are also using the technique to perform a variety of surgeries, including hysterectomies and removal of lymph nodes. In either case, the piece doesn’t say where navel surgeries are being done.
The story reports that 930 daVinci surgical robots are in use around the country, but that’s a census of mostly the old da Vinci machines, not the featured daVinci Si HD Surgical Systems, with the newer, finer controls and optics. This machine was introduced in April. It is not clear where these newer models are in use.
It is reported that voice-activated robot assistants are being developed at Georgia Tech and Emory University, and it’s clear on the video that the devices are not yet on the market.
The new generation of daVinci surgery robots was just introduced in April, so it’s safe to call that novel.
Surgery through the navel is not widely practiced yet, and the piece is reasonably clear on this. It would have been useful to explain that laparoscopic surgery–through the navel or not, or with a robot or not–is standard practice for many types of surgery.
The life-assistant robots mentioned briefly at the end are clearly just in development.
We can’t be sure what motivated ABC to devote so much airtime to this segment at this time.
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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