This story abounds in pretty pictures and a tale of tragic loss, but it lacks any context or facts that would allow viewers to understand what is new or relevant about a device to screen for melanoma skin cancer.
The technique, confocal microscopy, uses a low-power laser to peer into the upper layer of the skin in order to examine moles or other lesions. Trials of the device have examined whether it is accurate enough to allow some patients to safely skip a biopsy of suspicious lesions, but without any supporting evidence this story sells the test as a lifesaver.
Viewers are given the false impression that there are no options other than biopsy or the new confocal microscopy device.
Even though one handheld device is currently being sold in the U.S., the story does not offer any information about cost or availability. There is no warning that proper use of this device requires extensive training or that improper use or interpretation could lead to either unnecessary treatment or undiagnosed cancer.
In the end, viewers are given hope and amazement, but no useful information.
The story failed to provide any cost information, even though at least one confocal microscopy device intended for diagnosis of skin diseases is being sold in the U.S.
The story states that confocal microscopy could save lives; but that claim misstates the evidence and even the intended use of this technique.
The clinical trials of confocal microscopy simply demonstrate that under ideal circumstances it can identify suspicious lesions with higher sensitivity and specificity than other non-invasive screening tools. There have been no trials to determine whether people screened with this technology are less likely to die of melanoma than those screened by other methods.
The story fails to mention the limitations of this device and its application. One review article pointed out that currently available confocal microscopy devices can examine only the upper layer of skin, so it cannot reliably spot tumors growing in deeper layers. Another review states that interpreting the images is challenging, so practitioners need “a prolonged and careful training program.” Nowhere does this story make the point that in unskilled hands, the device could be useless or worse.
The anchor lead does point out that the main benefit of this technology would be to reduce the number of unnecessary biopsies to examine suspicious skin lesions. However, by focusing on a family in which a young woman died of melanoma, her husband was diagnosed with an “early stage” melanoma and treated successfully, and stating that the technology could someday save the life of the couple’s daughter, the story trumpets a benefit for which there is simply no supporting evidence.
This story fails to mention any potential harms of this technology. While the low-power laser device may not cause direct harm, the story did not mention other undesirable outcomes, such as false negative results that could actually delay a melanoma diagnosis. Also, the reviews of this technology point out that rigorous training is needed to assure appropriate use and interpretation. Use of the device by inadequately trained practitioners could lead to serious harm from both over- and under-diagnosis of melanoma.
The story makes no mention of any evidence. The reporter says this test could save lives, but that point has not been tested in clinical trials, so there is simply no evidence to support the statement.
The story shows a “gee whiz” image of blood vessels in the skin, apparently to demonstrate the power of the device; but blood vessel imaging is not part of the diagnosis of melanoma, so the display is mere razzle-dazzle.
The story acknowledges that confocal microscopy for melanoma diagnosis is still being studied, but it fails to provide any specifics, so viewers are left without any sense of whether this technology is just a distant dream or is about to enter regular clinical use.
The story highlighted a very unusual family and posed melanoma as a huge threat to the little girl. Melanoma is rare. The story presents one spouse dead and another who has the condition – suggesting that it is much more common than it actually is.
No independent sources or experts were shown in this story. Viewers were not told whether or not the sole researcher interviewed has any financial or other interest in the device.
The story failed to make any mention of other non-invasive techniques for identifying skin lesions that could be melanomas. Review articles in the medical literature discuss alternatives such as epiluminescence microscopy (dermoscopy), high-frequency ultrasound, optical coherent tomography and magnetic resonance imaging, as well as simple mapping and tracking of skin lesions.
The story failed to give any details about whether or when confocal microscopy screening for melanoma might be available. At least one company (Lucid, Inc.) has FDA clearance to market a handheld device "…for review by physicians to assist in forming a clinical judgment." http://news.thomasnet.com/companystory/550594
Older devices are already in use, although they are faulted as unwieldy.
Confocal microscopy is a relatively new method to screen for melanoma, but clinical trial results have been available for several years and the technique is already being used by some dermatologists. At least one handheld device won FDA marketing clearance in 2008; so it is not as new as the story implies.
We can’t be sure if the story relied on a news release.