This story reported on the application of a technology to the problem of distinguishing prostate cancers which are life threatening from those that are not. It did a good job with an initial description of this problem while at the same time failing to adequately report on the status of the technology reported on. The headline far over-sold the state of the art for using the "new scan." The story opened by stating that the technology "promises to achieve" something rather than as a technique which the study authors describe as having "promise." The semantics are important. It is far from a done deal that this technology will be able to differentiate prostate cancers that threaten health from those that don’t.
The story then went on to provide some information about a test which is currently available without providing any information about risks, benefits, harms, or cost.
The headline and introductory paragraph presented something early in development as a success story. The reason this sort of hyperbole is important and troublesome is that it raises unrealistic expectations.
The story did not discuss the costs of magnetic resonance spectroscopy, which is understandable to a degree since this work is at a very early stage in research. Nonetheless, the story did make clear that current MRI would not be sufficient and would need to be upgraded. Some estimate of this cost could have been generated.
And the story ended by introducing a discussion about another technology which it stated was commercially available – without mention of its costs.
These are not trivial issues with such high-powered technologies.
The story mentioned that the new technology was compared with the standard technique, and found that "five of seven regions identified as cancerous by that method scored high" by the new technology. As worded, doesn’t suggest that the new technique will identify fewer lesions than the standard technique??
Granted, quantifying benefits after having scanned five prostate glands in the lab is difficult, but we’re not the ones who wrote the "scan may help find aggressive prostate tumors" headline.
There was no discussion of harms. Although the story did include a quote from a study author indicating testing of the technology in human patients is something that remains to be done, the story should have included a clear statement that we don’t yet have information about possible harms from this test.
The story reported on a study that examined properties of five prostate glands removed from men and scanned in a controlled setting. Although this was clearly stated, there should have been an explanation that looking at five prostate glands outside of the body is only a very preliminary step in determining the value of this technology – and far too early to warrant the headline this story received. In fact, it almost seems ludicrous that a wire service would distribute a story – and one that got considerable pickup from other news organizations – when it was based on a scan of five glands.
The story did not engage in overt disease mongering. Kudos for indicating that prostate cancers are common but most often pose no danger to life.
The story included only quotes from an author of the study reported on and a marketing VP – not quite independent perspectives.
Including the estimate by the study author that "getting data showing that the technology can be used in human patients" will take only one or two years of study is potentially misleading. It would take years to know whether low-risk patients could safely avoid treatment and whether high-risk patients benefit from treatment. After scanning five glands in the lab, there’s no way a meaningful comparison with existing alternatives can be made. And this story failed by promoting the new technology without being able to put in into proper clinical context.
It wasn’t until ten paragraphs deep that the story explained that the new method required a magnetic field more powerful than currently available in medical use. We think a lot of readers may have missed that point. The story did quote the study author saying that "getting data showing that the technology can be used in human patients" will take a year or two. But there’s no independent perspective questioning that projection. That could be unrealistically optimistic. The effort "to make the method usable in less powerful devices" may take a long time – or it may be unsuccessful. So any timeline projections seem dicey. That’s one of the pitfalls of reporting on something after it’s only been done on five prostate glands removed from men and scanned in the lab.
The story did not include any information about the history of magnetic resonance spectroscopy for mapping the metabolic activity of cancerous and normal cells. At the end, there was some discussion about already marketing tests for diagnosis of prostate cancer using magnetic resonance imaging without giving readers any idea as to how the technology used in the study reported on might be different.
We can’t be sure of the extent to which the story may have been influenced by a news release. We do know that only a study author and a marketing person were quoted.
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
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