This news report on a study showing that compression stockings don’t reduce stroke patients’ risk of blood clots is cleanly done. The findings are of high quality, the results clearly explained, and two independent sources are used to provide context.
The story could have been made stronger in three ways:
At a time when health care reformers are looking closely at costs and benefits of various treatments, health journalists can play an important role by regularly reporting on price.
The story does not report the price of compression stockings [which range from $20 to $75 per pair through online retailers].
This is a surprising omission. Because in the UK these stockings are so commonly used, the costs of treatment for the population are significant. Even in the US where use is less common, the costs are meaningful.
Further, there are costs associated with treatment of skin ulcers and sores which the stockings cause. These should have been mentioned as well.
The story adequately describes the study population, size and methodology, and clearly states the key finding–that use of the stockings did not reduce risk of blood clots.
It also mentions the important secondary finding, that use of the stockings significantly increased risk of skin problems.
The story reports on the harms of stroke patients using compression hose, which include skin problems and blisters.
The story is based on a randomized clinical trial done with a large population in multiple centers.
The evaluators–who tested the patients for the presence of clots–were blinded, making this a very strong study design. The story could have mentioned this.
The story correctly treats the findings as credible.
The story does not engage in disease mongering.
Having said that, the reporter could have been more diligent about keeping the risk of using the stockings in perspective, particuarly for a U.S. audience. The recommended practice in the U.S. (per medical guidelines) is to use anticoagulants to prevent blood clots in sick hospitalized patients, with stockings as a primary treatment only for those who cannot tolerate the drugs and in some other subgroups.
This study is more likely to have impact on practice in the UK, where compression stockings are more commonly used.
Additionally, the reader should be cautious in applying the findings among hospitalized stroke patients to patients hospitalized for other reasons.
The story quotes one of the study’s authors and two independent medical experts, one of whom represents the American Heart Association. This constitutes adequate sourcing.
Since the study showed that compression stockings do not reduce risk of blood clots in stroke patients, the news story should have reported on the treatments that do.
Anti-clotting drugs are mentioned briefly but their benefits and risks were not explained sufficiently.
The story makes clear that compression stockings are widely available to stroke patients.
Compression stockings are widely used for stroke patients, particularly in the UK. No claim is made for their novelty.
There does not appear to be a press release linked to this report.
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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