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.
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.
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.
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.
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.
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.
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.
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
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.
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?
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?
Because of the second source who was quoted, it does not appear that this story relied on a news release.
Systematic, Criteria-Driven
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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