This story covers less-invasive alternatives to hysterectomy for the treatment of uterine fibroids. One of the techniques–radio frequency (RF) ablation–is an experimental method in early clinical testing, whereas the two other approaches–uterine artery embolization and focused ultrasound–are more established techniques that are being compared head to head for the first time. This story mostly gets things right in its portrayal of the excitement and uncertainty that surround these treatments. If not for the lack of any cost perspective and the use of a single unbalanced anecdote, this could have been a five-star story.
There are a number of different treatments for fibroids that are less invasive than hysterectomy. However, there is very little good research to tell us which approach is most effective for which patients. Add to this the financial incentives that device makers and hospitals may have to promote their favored approach, and patients can be left deeply confused about which choice is right for them.
Treatment for uterine fibroids represents a big cost burden for our health care system and for individual patients. However, this story does not discuss the costs of any of the treatment options mentioned. We think it should have.
The story gets a bit unbalanced in its coverage here. It offers a single positive anecdote from a patient who experienced "drastic improvement" with RF ablation. But because this apparently is an ongoing study whose results haven’t been reported yet, there’s no way to know if this patient’s experience is representative of the typical result. We feel the story relied a bit too heavily on this single anecdote, and should either have omitted this "success story" or sought out other patient perspectives to balance things out.
Although this story overall doesn’t spend much time communicating risks, it does mention at least one key downside for each of the techniques mentioned (e.g. uterine artery embolization carries a risk of premature menopause). The story could have mentioned some of the other serious risks associated with these procedures, including postoperative infections, the formation of scar tissue that can cause pelvic organs to stick together, and the need for blood transfusions during surgery due to excessive bleeding. However, we think it did enough to satisfy the criterion.
The primary thrust of the story is the need for better evidence regarding which treatment alternatives work best for uterine fibroids. Although it did a good job communicating this uncertainty and the need for more research, it could have placed more emphasis on the fact these were ongoing studies that were being reported on, not reports of research findings. The story lets one expert comment that RF ablation "looks very promising," but because this is research in progress, we have no idea how solid the evidence is to back up the assertion.
No evidence of disease-mongering in this story.
The story includes quotes from a National Institutes of Health expert and an American College of Obstetricians and Gynecologists spokesman. It doesn’t rely on sources who are likely to be biased for or against specific treatments.
The story lays out the pros and cons of the new approaches compared with the standard surgical approach of hysterectomy. The story probably should have been more explicit in its discussion of watchful waiting as an approach for women with minimal symptoms or those approaching menopause, when fibroid symptoms typically resolve on their own. And it also could have provided some discussion of drugs that can shrink uterine fibroids and which are an option for some women. Nevertheless, since the story was primarily about surgical approaches to treatment, we’ll give the benefit of the doubt since they covered the major bases.
The story makes it clear that RF ablation is an experimental technique and contrasts it with the other alternative techniques, which it notes are already approved.
The story draws a distinction between the experimental new RF ablation treatment and the better-established alternatives. It doesn’t mislead readers regarding the novelty of any of the treatments and gives a decent overview of why the new approach might be better for some patients.
The story quotes multiple experts and doesn’t appear to rely unduly on a press release.