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Study: Stockings given to stroke patients don’t work

Rating

4 Star

Study: Stockings given to stroke patients don’t work

Our Review Summary

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:

  • Since the story finds that stockings don’t reduce risk of blood clots in stroke patients, the reader naturally will want to know what does reduce the risk. The story makes a brief mention of anti-clotting medications, but the reporter should have invited an expert to explain how clot risk is minimized and the highest-risk patients identified. 
  • The research was conducted, published and funded mostly in the UK, where use of compression stockings for stroke patients is widepsread. But they are not used as widely in the US. The editors of US publications should have edited the story to emphasize its more limited relevance to here.   
  • The story should have mentioned costs. These stockings are fairly technical garments, carrying different compression ratings and requiring precise sizing. Retail costs run from $20 to $75 per pair. The cost implications of changing a clinical recommendation are significant. 

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. 

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

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. 

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Satisfactory

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.

Does the story adequately explain/quantify the harms of the intervention?

Satisfactory

The story reports on the harms of stroke patients using compression hose, which include skin problems and blisters.

Does the story seem to grasp the quality of the evidence?

Satisfactory

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.

Does the story commit disease-mongering?

Satisfactory

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.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

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.  

 

Does the story compare the new approach with existing alternatives?

Not Satisfactory

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. 

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The story makes clear that compression stockings are widely available to stroke patients.

Does the story establish the true novelty of the approach?

Satisfactory

Compression stockings are widely used for stroke patients, particularly in the UK. No claim is made for their novelty.

Does the story appear to rely solely or largely on a news release?

Not Applicable

There does not appear to be a press release linked to this report.

Total Score: 7 of 9 Satisfactory

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