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.
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."
As with the HealthDay report, this article did not mention costs.
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.
This story made no mention of the serious risks associated with tPA therapy.
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.
There was no evidence of disease-mongering in this story.
As noted above, the story quotes an independent expert who does not appear to have a conflict of interest regarding this issue.
As with the HealthDay report, this criterion is not applicable for this story.
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.
This story does not suggest that tPA is a novel treatment for stroke.
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.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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