This is a story about a study examining the costs, harms and the impact of doctor experience associated with the use of robotic prostatectomy. The story raised some important issues that are not ordinarily broached during patient – doctor conversations. While raising some potential red flags with respect to doctor experience, the story failed to critically examine what, if any, benefit there might be to this particular surgical approach. While it is valuable to know that after completing 80 procedures of this type, a surgeon is no longer apt to leave cancerous tissue behind, it is also important to know if there is any value added by having this more expensive procedure.
The story does serve as an important reminder to consumers that more modern sounding approaches do not necessarily offer the patient a less problem plagued experience.
This story is provides an example for consumers to consider about the value in knowing about both the benefits as well as the harms associated with whatever treatment option they are considering. Further – the story raises the point that newer or seemingly more sophisticated treatments are not always superior to lower-tech options.
The story indicated that the robotic procedure was more expensive than a standard surgical prostatectomy. In addition, it included information about the expenses associated with obtaining and running the equipment.
It is not clear from this story what, if any, the benefits are of having a robotic prostatectomy instead of a standard surgical prostatectomy. There was no discussion about the decreased hospital stay or reduced recovery time that has been reported with this approach. Although these are short term benefits, they may be of interest to certain patients. In this sense, the story was the flip side of what we often see – exaggerated benefts and no mention of harms. This story mentions harms (although data comes from biased literature review) and no benefits.
The story provides readers with some potentially interesting questions to raise with a doctor (e.g. how many of these surgeries have you done using this equipment; is this approach the best for the type of cancer I have, i.e. early or more advanced). The story mentions in passing potential harms such as impotence and incontinence, referencing a study published in October.
However – the story did not really follow-up on one of the key issues it raised. For example, the story mentioned that a surgeon will have to do 80 procedures with this equipment to ensure that they don’t leave any cancerous tissue behind. The story could have completed this thought and indicated the ramifications of leaving cancerous tissue behind in terms of health consequences.
The story indicated that the publication reported on examined data from a number of previously published reports. The story then extracted several salient facts to highlight some variables that affect outcomes of interest to patients. The story would have been improved by noting the weaknesses or biases associated with a simple literature review. This is not a systematic review of the literature or a meta-analysis. This is simply a literature review and the methods are flawed — for example, the authors chose 68 papers of 412 on basis of selection/inclusion criterion "…those with greatest relevance to the paper."
The story did not engage in overt disease mongering. It might have been useful to note that not all prostate cancers result in morbidity or mortality meaning that not all prostate need active treatment.
The story does not use any comments from experts in the field without a direct connection to the study reported on.
The story mentioned that the authors of the study reported on did not compare robotic surgery complication rates to traditional surgery rates. In a perfect world, we would have hoped that the story would have investigated these data points anyway.
The story mentioned that robotic prostatectomy was the ‘dominant approach’ to this procedure in the United States. But that is an erroneous statement by the physician who is from Australia. It is certainly booming in popularity, but that doesn’t make it the dominant approach.
The story indicated that robotic prostatectomy is not a new procedure.
Does not appear to rely exclusively on a press release.
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
Comments
Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.
Our Comments Policy
But before leaving a comment, please review these notes about our policy.
You are responsible for any comments you leave on this site.
This site is primarily a forum for discussion about the quality (or lack thereof) in journalism or other media messages (advertising, marketing, public relations, medical journals, etc.) It is not intended to be a forum for definitive discussions about medicine or science.
We will delete comments that include personal attacks, unfounded allegations, unverified claims, product pitches, profanity or any from anyone who does not list a full name and a functioning email address. We will also end any thread of repetitive comments. We don”t give medical advice so we won”t respond to questions asking for it.
We don”t have sufficient staffing to contact each commenter who left such a message. If you have a question about why your comment was edited or removed, you can email us at feedback@healthnewsreview.org.
There has been a recent burst of attention to troubles with many comments left on science and science news/communication websites. Read “Online science comments: trolls, trash and treasure.”
The authors of the Retraction Watch comments policy urge commenters:
We”re also concerned about anonymous comments. We ask that all commenters leave their full name and provide an actual email address in case we feel we need to contact them. We may delete any comment left by someone who does not leave their name and a legitimate email address.
And, as noted, product pitches of any sort – pushing treatments, tests, products, procedures, physicians, medical centers, books, websites – are likely to be deleted. We don”t accept advertising on this site and are not going to give it away free.
The ability to leave comments expires after a certain period of time. So you may find that you’re unable to leave a comment on an article that is more than a few months old.
You might also like