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Read Original Story

‘Closed-heart’ a less-invasive alternative

Rating

5 Star

‘Closed-heart’ a less-invasive alternative

Our Review Summary

Minimally-invasive surgery, also known as percutaneous surgery, represents an important development in the treatment of aortic valve disease. Aortic valve disease typically occurs in adults over the age of 65 and is a common cause of heart failure. Risk factors include increasing age, obesity, and high blood pressure. Surgery to undergo aortic valve replacement is most often performed via ‘open heart’ surgery, a very invasive procedure in which the patient’s ribs are cracked open to access the heart.

In this story, we learn of an experimental minimally-invasive procedure in which artificial valves are moved to the heart using image guidance through an incision in the femoral artery. The prevalence and seriousness of aortic valve disease are accurately described.The story clearly points out that this is a new, experimental procedure that is performed only in the context of research (so far only 19 Americans have undergone the procedure). We also learn that because of the experimental nature of the procedure, it should only be used in those patients who are too sick to endure open heart surgery. The story correctly describes the nature of the existing evidence, with research still in progress; we don’t know if this procedure will extend lives or improve quality of life. The story provides balanced information on harms by presenting the death rates for both the experimental treatment and conventional surgery. By quoting multiple sources, it is clear that the story did not rely solely on a press release for information. No costs are presented.

Overall, this was a balanced and complete story.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story does not mention costs.

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

Satisfactory

The story presents what is known about the death rates in artificial valve and conventional valve surgery. The story also points out that we don’t know whether the artificial valve will extend life or improve quality of life. It explained that it is still unknown how this would work in “less sick patients who could survive open-heart valve replacement but want to avoid its rigors.”

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

Satisfactory

The harms of artificial valve placement are potentially very serious and are well described. The chance of death for both the artificial valve and conventional valve replacement surgery are presented.

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

Satisfactory

The story accurately describes the nature of the existing evidence, which is still research in progress. The story correctly points out that we don’t know if the treatment will extend life or improve quality of life.

Does the story commit disease-mongering?

Satisfactory

The seriousness and prevalence of aortic valve disease are accurately depicted. Appropriately, the story emphasizes that the experiments are now limited to use on the aortic valve.

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

Satisfactory

The story includes quotes from multiple sources.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story mentions conventional open valve surgery as the alternative. The story correctly states that currently the only candidates for the experimental surgery are those who are too sick to undergo open surgery. It emphasizes that it is still unknown how this would work in “less sick patients who could survive open-heart valve replacement but want to avoid its rigors.”

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

Satisfactory

The story emphasizes that this is an experimental treatment that has only been used in the context of research and only in 19 patients in the U.S. The story does not make claims about future FDA approval, which is appropriate.

Does the story establish the true novelty of the approach?

Satisfactory

It is clear in this story that this is a new treatment.

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

Satisfactory

Because multiple sources are quoted, it seems unlikely that the story relied solely on text from a press release.

Total Score: 9 of 10 Satisfactory

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