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Study From Duke University: Favored heart-bypass method found harmful

Rating

3 Star

Study From Duke University: Favored heart-bypass method found harmful

Our Review Summary

This was a story reporting on the result of a recently published study examining long term consequences of the method used to harvest leg veins for use in coronary bypass surgery.  It contained a clinician quote that helped to provide some balance for comparing the two methods.  While it may be true that the less invasive way of harvesting leg veins may result in a greater chance of having a heart attack or dying in the next 3 years, it is also true that the less invasive way of harvesting leg veins results in a faster recovery with less immediate complications than the open procedure.  

It would have been useful for the story to have contained some exploration on how the trade-off of benefit now for increased risk later may be factors in decisions made by doctors and patients. 

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

There was no discussion of cost differential for the two methods of harvesting veins; further there was no discussion about how the shortened hospital stay associated with the small incision method affected the cost.

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

Not Satisfactory

The story compared the relative risks of long term problems; this does not provide readers with any sense about how frequently the problems mentioned occur.  Instead, the information should be presented as absolute risk.

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

Not Satisfactory

The story did not provide quantitative information for assessing how the procedures compare with respect to length of hospital stay and immediate complications.  Beyond this, for balance, the story should have included more detail about the short-term benefits of harvesting veins with a smaller incision.  These include reductions in wound-related complications, postoperative pain, hospital length of stay, outpatient wound management resources which are not trivial considerations.

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

Not Satisfactory

While the story included information about the number of patients that were in the study reported on, it neglected to discuss the nature of the study. The story did not include information about the limitations of the evidence in the study – particularly that it was a non-randomized study with wide variation in the rate different procedures were used to harvest veins, there was no standardized patient selection or the means of harvesting and preserving the veins.

Does the story commit disease-mongering?

Satisfactory

The story did not seem to engage in overt disease mongering.

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

Satisfactory

Quotes from a co-author of the study reported and two local cardiovascular surgeons were included as part of this story.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

While discussing two methods for harvesting leg veins, it seems curious that it did not also mention the use of mammary arteries as a source of vascular material.  Although the study reported on did not cover this, this would have provided readers with a more complete picture of the available options.

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

Satisfactory

The story included estimates of the frequency of harvesting legs veins through a small incision, one a general estimate for the US (70%) and one specific to Ohio State (90%).  

Does the story establish the true novelty of the approach?

Not Applicable

This wasn’t a story about a new treatment but rather about new information about two procedures currently in use.

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

Satisfactory

Does not appear to rely exclusively on a press release.

Total Score: 4 of 9 Satisfactory

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