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Read Original Story

Endometriosis? Robot surgery may not be the answer

Rating

3 Star

Endometriosis? Robot surgery may not be the answer

Our Review Summary

What could have been a John Henry style man-triumphs-over-technology story with outsized language and overheated quotes turns out to be a fairly straightforward, clear-eyed piece of reporting – but with some missing elements.

 

Why This Matters

Robots are supposed to make everything better.They are smarter than us, faster than us and less prone to error, the thinking goes. Here is one piece of evidence that robots, in their current stage of development, are not actually able to perform at least one important surgical task better than humans.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The reporter notes that the robots cost $1.5 million apiece, a cost that has to be asorbed at some point by the insurer or the patients. The story also includes some great context from Dr. Tommaso Falcone at Cleveland Clinic saying spending a lot of money on robots might not be money well spent.

But we’re not given any per-patient per-treatment cost estimates and we’re not told that the robots may drive up cost with longer operating room time and added costs for facility, anesthesia and surgeon – huge cost drivers.

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

Satisfactory

There are two possible benefits here. 1. People spend less time in surgery to achieve roughly the same outcome and potentially a better outcome, which, by all accounts, is better. 2. Hospitals and medical groups spend less money on robots and are allowed to devote those health resources elsewhere. Both are not so much quantified as addressed. In order to truly establish the second point, one would need to perform a longer term and larger study to find out whether humans outperform robots on a wider range of surgeries. These $1.5 million machines are not just specific to endometriosis. They are used for hundreds of procedures, and so to decide whether they are worth the money would require more research. Still, the story is measured in its claims.

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

Satisfactory

The story says that there were no complications in either group and goes on to say that the robotic surgeries took longer, making it more likely that surgeons would make mistakes (although they did not, apparently, make any mistakes.) It says in passing that "the incision is smaller (and) the manipulations are more controlled" when a surgeon works without a robot, a counter-intuitive piece of information that merited at least an additional sentence of explanation, even in a story this short.

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

Satisfactory

The study seems fairly simple and perhaps a bit too small to draw any big conclusions. The story has a measured tone, though, and provides all of the necessary information for readers to judge for themselves whether a robotic surgery is a good buy. Note: originally we ruled this unsatisfactory but we missed the fact that the online story linked to the journal article. 

Does the story commit disease-mongering?

Satisfactory

The story could provide a source for the 5 million figure used to calculate how many women suffer from the condition, but, as far as we can tell, it doesn’t make the condition sound worse than it is.

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

Satisfactory

As noted above, the comments from Falcone were essential. It might have been worth noting that both the hospitals mentioned in the story actually promote robotic surgery for endometriosis quite heavily. Here’s one example:
http://www2.northside.com/RoboticSurgery/Robotic-Surgery-At-Northside/Gynecologic-Surgeries/Robotic-Endometriosis.aspx

Does the story compare the new approach with existing alternatives?

Not Satisfactory

This was the entire point of the study and the point of the story. At least a mention of non-surgical treatments of endometriosis would have been nice, especially since the majority of cases can be treated nonsurgically.

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

Not Satisfactory

This was one of the missing elements. At a minimum, the story should have said how many companies even make these things, how long they have been in production and how many hospitals/surgical centers have them. As far as we know, the major manufacturer is da Vinci, and we’re sure they would be glad to provide some numbers. If you just do a search on the da Vinci site of how many surgeons in western Washington use these machines for gynecological procedures, you come up with a list of 1,500 names. imagine what that would be like in an area like Los Angeles or New York?

Does the story establish the true novelty of the approach?

Not Satisfactory

The novelty here is that the humans beat the robots. It would have been nice to see at least a sentence about whether other studies had shown similar results with other types of surgeries. Was this the first man-vs.-machine study of this kind?

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

Satisfactory

Because of the second source who was quoted, it does not appear that this story relied on a news release.

Total Score: 6 of 10 Satisfactory

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