Read Original Story

Ultrasound may cut deaths in high-risk pregnancies

Rating

4 Star

Ultrasound may cut deaths in high-risk pregnancies

Our Review Summary

This story clearly explains that a new review of the available evidence from published trials backs the use of Doppler ultrasound to monitor high-risk pregnancies. Notably, the story reports the absolute risk calculation of fetal or newborn deaths (1.7 percent among women who did not receive ultrasound monitoring vs. 1.2 percent among those who did), rather than trumpeting a large reduction in relative risk. By including the absolute risk numbers, the story helps readers understand both that the test appears to reduce the death rate and, importantly, that the overall risk of fetal or newborn death in developed nations is very small, thus putting the results in perspective.

This story also pointed out that there is some uncertainty about the findings because of concerns about the quality of the underlying studies including in the review. What’s more, it highlights the point that the studies included only women who had high-risk pregnancies and that there is no evidence to suggest the use of Doppler ultrasound to monitor low-risk pregnancies.

The story would have been ranked as satisfactory on all criteria if it had reported the typical cost of Doppler ultrasound monitoring and included an independent source in addition to the lead author of the review.

 

Why This Matters

When there is concern about potential problems with a pregnancy, Doppler ultrasound is a commonly recommended test used to help make decisions about cesarean section, induced labor or other interventions; thus misuse of the test could lead to inappropriate interventions.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story does not give any estimate of the cost of Doppler ultrasound examinations.

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

Satisfactory

The story clearly states the reduction in fetal death rates the review authors calculated by combining the results of the studies ithey looked at. It reports the absolute risk calculation of fetal or newborn deaths (1.7 percent among women who did not receive ultrasound monitoring vs. 1.2 percent among those who did). This reporting of absolute (as opposed to relative) risk reduction is a strong point of the story since it conveys to readers that while the intervention did improve outcomes, the underlying risk is small. We only wish, however, that the story had cited the Number Needed to Test that was included in the study – 203 would need to be tested in order to find one case of fetal distress that would otherwise not have been seen using other routine exams.  

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

Satisfactory

The story notes that there has been concern that the use of Doppler ultrasound might increase unnecessary interventions, including cesarean section deliveries in cases where it is not actually needed. It says the studies indicated that Doppler ultrasound appeared to lead to better decisions about cesarean sections and inductions of labor.

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

Satisfactory

The story explains that this report is a review of other studies. It also points out some shortcomings in the underlying studies. The story also includes a comment from one of the study authors that since the technique is established in current practice it is unlikely that there will be future studies of the use of the technology in high-risk pregnancies.

Does the story commit disease-mongering?

Satisfactory

The story clearly states that the evidence on the use of Doppler ultrasound applies only to high-risk pregnancies and that there is no evidence the examinations should be done in low-risk pregnancies.

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

Not Satisfactory

There is no information in the story that appears to come from an independent source. Comments from experts in the field would have helped put the authors’ comments into perspective.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story says other types of testing, including electronic fetal-heart monitoring, may also be done during high-risk pregnancies.

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

Satisfactory

The story notes that Doppler is an established technique used to monitor high-risk pregnancies.

Does the story establish the true novelty of the approach?

Satisfactory

The story notes that Doppler ultrasound is an established technology and that most of the studies reviewed were done in the 1990s.

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

Satisfactory

The story does not appear to rely solely on a news release. It says the lead researcher was interviewed.

Total Score: 8 of 10 Satisfactory

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.