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Weekend stroke care more aggressive but not better

Rating

4 Star

Weekend stroke care more aggressive but not better

Our Review Summary

To its credit, this story noted early and prominently that the study found no decrease in the death rate among patients with stroke who were admitted on the weekends compared with those admitted during the week. However, it shared many of the shortcomings of the HealthDay report, including lack of information on costs and harms and a vague description of the benefits of tPA. Perhaps most important, the story inflated the difference in treatment between patients admitted on weekdays and weekends. They call it a "20% difference," but fail to show that it is 1.1% vs 0.9% – a 2 in 1000 difference that is not clinically important.

 

Why This Matters

As the story points out, when you suffer a stroke on a Saturday or Sunday, "waiting until Monday for aggressive treatment is not an option."   

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

As with the HealthDay report, this article did not mention costs.

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

Not Satisfactory

The story makes the vague claim that tPA "can improve patient outcomes following stroke." Some detail on what outcomes are improved, and by how much, would have been useful for readers. The story also did not quantify the results of this study very well.  It says there was a "20% difference" in the use of tPA between the groups, but fails to show that it is 1.1% vs 0.9% — a 2 in 1000 difference in absolute terms. Given the relatively finely balanced benefit to harm ratio, this finding is not clinically important even though it is statistically significant due to the huge sample size.

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

Not Satisfactory

This story made no mention of the serious risks associated with tPA therapy.

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

Satisfactory

Although it did not mention some of the limitations that the HealthDay report correctly called attention to, this report got it right regarding the issue of mortality. The lack of mortality benefit among patients admitted on the weekends was identified in the second paragraph of the story, and an expert quote emphasizes that no clinical trials have ever shown a mortality benefit from tPA therapy.    

Does the story commit disease-mongering?

Satisfactory

There was no evidence of disease-mongering in this story.

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

Satisfactory

As noted above, the story quotes an independent expert who does not appear to have a conflict of interest regarding this issue.

Does the story compare the new approach with existing alternatives?

Not Applicable

As with the HealthDay report, this criterion is not applicable for this story.

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

Satisfactory

Similar to the story from HealthDay, this report emphasizes that an early diagnosis is a critical factor in the availability of tPA for stroke patients. Although more detail could have been provided, this is the key point.

Does the story establish the true novelty of the approach?

Satisfactory

This story does not suggest that tPA is a novel treatment for stroke.

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

Satisfactory

The story quotes from an email exchange with one of the study researchers and another independent expert. There is no evidence that the story relied on the AMA press release about the study.

Total Score: 6 of 9 Satisfactory

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