A recent paper in the Journal of the National Cancer Institute was entitled, "Gene Expression–Based Prognostic Signatures in Lung Cancer: Ready for Clinical Use?" The authors concluded, "From our review, it is clear that medical utility for any of the reported prognostic signatures has not yet been convincingly demonstrated. We hope that future research in this important field will strive to move away from being another exercise in clinical correlation to one that truly makes an impact on widespread medical practice." We wish the story had applied more of that kind of context to the coverage of this latest genetic signature.
The study reported on is of interest because any early diagnostic tests for lung cancer that worked and were available would have public health importance, given that lung cancer is the leading cause of cancer mortality in the US. But these findings reported on are very preliminary.
Not applicable. Given the early stage of research, it is understandable that costs weren’t estimated.
At a very elementary level, the story never reported on what would be the key quantifiable benefit – the sensitivity of the test. What were the numbers from the trial?
Given the early stage of research, and the fact that we don’t even know if the test will work in broader testing it seems early to speculate on whether the genetic chain reaction could be reversed by a drug, but at least the story referred to this as an "early hint among a handful of people."
Is there any risk in obtaining an endobronchial sample via bronchoscopy? The story didn’t tell us. And is there any harm from the un-named compund at the end of the story?
Our reviewers were split on this one. One felt it should have been emphasized that these were small scale studies that were actually inadequately powered to support the claims made.
But there was enough cautious language about the evidence for us to give this a satisfactory score. For example:
A quote from an apparently independent source was included in this story. Mentioning that Dr. Spira is a co-founder of a company promoting the test and the agent being tested as a treatment provided interesting insight.
There was no discussion of how the test described compared with other methods available or under development for detection of lung cancer.
Although the story describes the test as something that is being developed, there is no explicit mention that it is now purely a research tool, is currently not available nor FDA approved for the purpose described. And there is no discussion of the availabilty of the "compound" used. In fact, it’s not even named.
The story didn’t mention that several companies are following leads on various gene expression signatures as means of early lung cancer detection. That kind of context would have helped.
Given the fact that an independent researcher was interviewed, it does not appear that the story relied solely on a news release.
Systematic, Criteria-Driven
We’ve written about the hype of liquid biopsies for years (see link in comment below). And now this…. https://www.statnews.com/2022/01/12/medicare-shouldnt-cover-liquid-biopsies-early-cancer-detection/
Case counts still matter. “(There) are stories that may not be told adequately if only hospitalizations and deaths are emphasized.” @garyschwitzer interviewed by @dbauder of @AP. https://apnews.com/article/omicron-changing-news-outlets-covid-data-da9272f7c4c8a109c3bfb56bed9e9c76
My friend Gary @garyschwitzer wrote to his city council representative in a Minnesota town about a Viva Las Vegas event scheduled for January.
The response he got seems to perfectly capture where we are now.
https://www.healthnewsreview.org/2021/12/2021-ends-with-covid-craziness-in-sports-and-politics/
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