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“Heart disease potential breakthrough”

Rating

2 Star

“Heart disease potential breakthrough”

Our Review Summary

This story covers a new study in which very high doses of the statin drug Crestor regressed atherosclerosis, or coronary artery plaque buildup, as shown on intravascular ultrasound, in high risk patients.The story states that the patients showed a 7 to 9% reduction in plaque. It is not clear if this is clinically meaningful. The story says “Crestor reduced so called bad cholesterol by more than 50 percent and increased good cholesterol by nearly 15 percent.” But 50 percent of what? 15 percent of what? What is the absolute increase or decrease? Although there is some mention of side effects, these are downplayed. Given that this trial used such high doses of Crestor, side effects are an important issue. The story also fails to mention that 12% of the patients discontinued using the drug before the end of the study. No costs are mentioned and only a single source, the lead author of the study, is quoted. The story doesn’t mention any alternatives, such as diet, exercise, or regular doses of statins (which is current practice). Although there is some description of the design of the study, there is no mention of the study’s limitations. The story hints at this point but doesn’t drive the point home: there can be a difference between surrogate markers (lowering LDL, raising HDL, shrinking plaque) and outcomes such as fewer heart attacks, strokes or deaths. These are important pieces of information that the viewer would need in order to critically evaluate the strength of the evidence. It was good that the story included the line, “Doctors say this does not suggest that everyone should start taking Crestor.”

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

There is no mention of costs in the story.

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

Not Satisfactory

Quantitative estimates are given in relative frame only. The story states that the patients showed a 7 to 9% reduction in plaque. It is not clear if this is clinically meaningful. The story says “Crestor reduced so called bad cholesterol by more than 50 percent and increased good cholesterol by nearly 15 percent.” But 50 percent of what? 15 percent of what? What is the absolute increase or decrease?

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

Not Satisfactory

Although there is some mention of potential side effects, these are downplayed. Given the high dose of Crestor used in this study, side effects are important. The story also fails to mention that 12% of the patients discontinued using the drug before the end of the study.

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

Not Satisfactory

Although the story describes some aspects of the trial, there is no mention of the limitations of this trial. Specifically, there was no direct comparison of high-dose Crestor to current medical practice for this population, such as a lower dose statin. Furthermore, the study was not designed to look at the effects of the drug on hard cardiovascular end points, such as heart attack or death. The story hints at this point but doesn’t drive the point home: there can be a difference between surrogate markers (lowering LDL, raising HDL, shrinking plaque) and outcomes such as fewer heart attacks, strokes or deaths.

Does the story commit disease-mongering?

Satisfactory

No disease mongering. Story did a good job of including the line, “Doctors say this does not suggest that everyone should start taking Crestor.

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

Not Satisfactory

Only a single source, the lead author of the story, is quoted. Even in a short TV piece, time and space should be found to include the input of independent sources.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story doesn’t mention any alternative treatment options.

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

Satisfactory

It is clear from the story that Crestor is currently available.

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

Not Applicable

We can’t be sure if the story relied solely or largely on a news release, although, as noted, the story only included the input of the lead researcher.

Total Score: 3 of 9 Satisfactory

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