This was classic morning show health news garbage.
"Three heart tests that all women should know about"? "All" suggests that even women without symptoms should be thinking about these tests. But the segment later says that the tests are only for women with symptoms, but then never gives a detailed description of these symptoms.
So viewers are left with another high-tech showcase: stress echocardiograms, screening ultrasounds, and CT scans looking for calcium in the coronary arteries – the menu for the morning news-viewing woman.
Does CBS and its physician-correspondent realize that the term "screening" (which they used in reference to ultrasounds) does not apply to those with symptoms?
So which women – precisely – should think about or pursue these tests? Those with symptoms – or those without symptoms?
On top of everything else, the segment included a glaring, unforgivable error. It said that the three tests involved no radiation – implying that they are harm-free. But a cardiac CT scan has an average radiation dose equivalent to 600 chest x-rays!!! In addition, according to a 2007 study in JAMA, there is an increased risk of breast cancer in women having the test due to the radiation dose. And this segment was all about women having these tests.
Who is responsible for this content?
Is this news? Is this public education? Or is it just another meaningless medical marvel morning show segment that fails to quantify benefits or talk about harms or acknowledge costs?
No discussion of costs. No discussion of the potential cost impact of telling all women that they "need to know about" these three tests. The costs of false positive tests in lower risk women is also not noted. Cost of diagnostic testing is a significant issue that is a major driver of healthcare costs.
There was no discussion of how many women who have these tests find things that need to be treated. No quantification of benefit.
The segment says the tests involve no radiation. This is a huge error. A cardiac CT scan has an average radiation dose equivalent to 600 chest x-rays!!! In addition, according to a 2007 study in JAMA, there is an increased risk of breast cancer in women having the test due to the radiation dose.
No evidence was given to support the use of any of these three technologies in women. More important to the theme of the story, it is unclear how these three tests were chosen as the gold standard out of the myriad of available tests. No evidence was provided concerning the sensitivity and specificity of the tests in women with lower risk of heart disease.
All women are told they need to know about these three tests. Later, though, the MD correspondent says it’s only for women with symptoms. Which symptoms?- the anchor appropriately asks. The question was never answered with any specific, meaningful descriptive detail.
So the impression is left with the audience that all women need to know about these tests – even if they have vague symptoms.
We call that disease-mongering.
No heart experts were cited, quoted, appeared or interviewed.
There was no discussion about the range of testing options for a woman with symptoms of heart disease (of course the symptoms were never described). No meaningful comparison of these three tests with other alternatives.
Women are not given any idea of how widely available are the three tests – or whether all three are available in some places, most places, any places?
There was no discussion of the novelty of the three tests, so this is N/A.
We are given no idea why this segment was put on the air now. No news. No sources. No idea.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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