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New robot may ease prostate surgery for Oklahomans

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New robot may ease prostate surgery for Oklahomans

Our Review Summary

This story about a local surgical center’s new daVinci "robot" surgical device describes the patient being operated on in the opening anecdote as "unconscious." So was someone at the newspaper.

The story fails to: 

  • describe the new daVinci machine sufficiently, and compare it to its predecessor or conventional surgery
  • cite any data that might verify the surgeon’s claims about the device’s benefits–including his provocative statement that using the new daVinci device in prostate removal reduces risk of incontinence and impotence
  • get commentary or context from an independent source
  • examine the assertion that the device saves money

The report is not very clear, coherent, informative or important. Its greatest virtue is that it is short.

How local newspapers deal with issues of medical technology assessment, of community ascertainment of need, of resource allocation. of costs, of evidence is vital to public understanding of why we spend more than any other country on health care without the outcomes to show for it.   Stories can educate or they can advertise.  This one falls in the latter category.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story says the new daVinci machine costs $1.7 million. But it fails to say how much this affects the cost of surgery.

It also accepts without verification the sketchy assertion that the cost of the machine is offset by shorter hospital stays. 

 

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

Not Satisfactory

The report does not provide any data on the benefits of daVinci-assisted surgery.

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

Not Satisfactory

The story does not cite any potential harms of the daVinci-assisted procedure.

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

Not Satisfactory

The writer cites no evidence to show the device is safe or effective, or how its use improves outcomes compared to conventional "open" surgery. Indeed, the U.S. Agency for Healthcare Research & Quality states that "there isn’t enough research yet to tell us how well (this works) compared with other treatments."  (It is easy for anyone to find it on the web.) That lack of evidence is a key issue that was completely ignored. 

Does the story commit disease-mongering?

Not Applicable

The story features at least three ineffectual attempts to generate false drama–the patient in the opening anecdote is "unconscious" (good thing!), his prostate is described as "cancer-ridden," and the machine is said to move into "tighter corners of the human body."

The story cites the fact that the surgery in question was stopped due to a fear of bleeding, despite its irrelevance to understanding the device itself. 

The story also quotes a satisfied patient who said he chose the daVinci because he didn’t want to be "cut open like a watermelon"–the fate, presumably, of those who do not get robot-assisted surgery. 

However, because the story really gives no background on prostate cancer, it is judged N/A on this criterion. 

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

Not Satisfactory

Only two sources are used:

  • A physician who has invested in a daVinci machine
  • A patient who was operated on with an earlier version of the device and is satisfied with the outcome

The story would benefit from the perspective of an independent expert.  

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story properly mentions that prostate cancer can also be treated wtih radiation and drugs. But it fails to mention watchful waiting, an important and often under-reported option people should know about.

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

Not Satisfactory

The story indicates that the Oklahoma University Medical Center’s Center for Robotic Surgery has a new daVinci surgery device.

It doesn’t say whether other facilities in the area [or the country] use these machines. A reader would have no idea if the technology is in widespread use and where.  They simply know one place to go for it – just like you’d get in an advertisement!

Does the story establish the true novelty of the approach?

Not Satisfactory

The story implies novelty, calling it the "lastest generation of high-tech machinery" used in surgery. 

Yet the daVinci machine has been used for a decade, with about 1,000 units operating in the U.S. The new version of the machine cited is a minor upgrade over exisiting models. 

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

Not Applicable

We can’t be sure of the extent to which the story may have been influenced by a news release.  We do know that all the cited info came from one doctor at one medical center.   Pretty much what you get in a news release.

Total Score: 0 of 8 Satisfactory

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