This is a classic story of the potential promise of a new technology for the health care sector. A nice anecdote sets the stage and then a number of preliminary findings are used as proxies for real evidence. It is implied that the technology will keep people healthier, happier and at less cost to our costly system. This is, unfortunately, often a fairy tale mainstay of health news journalism.
It’s interesting that several leading journalists wrote to us with concerns about this story. One wrote, "She didn’t interview a real skeptic. It is still quite possible that these devices will only yield minor results, since heart failure is, after all, an end stage disease, so it may just be rearranging the deck chairs on the Titanic."
Mixed bag. The story explained that the devices "can cost as much as $30,000." And there was one data point from one study on one device that users’ hospital costs were $1,600 less per admission. But the device costs are variable and device performance will be variable. We’ll give the story the benefit of the doubt but it painted the cost picture with really broad strokes.
Information about the potential to increase longevity was presented from a study that has not yet been published. The information was presented as a relative increase rather than an absolute increase. The story didn’t contain sufficient information to quantify the benefit to any specific group of patients.
The story did mention the problem of potential information overload however there was no discussion of actual harm such as inappropriate shocks from implanted defibrillator devices, for example. There was no questioning of the accuracy of the data potentially transmitted by devices.
This was a far too rosy picture – almost as if all the data was so terrific that the only downside could be the volume of terrific data. Other things can go wrong as past experience shows when you try to regulate the heart.
In our eyes, a red flag went up when the story cited "a paper under review." We don’t know the quality of the paper nor have peer reviewers completed their review yet. So that’s giving the researcher free rein to say whatever he wants about that study. We also must address the headline which stated ‘New tools for helping heart patients’ before we have concrete demonstration that the new tools actually do help.
The story opened with an anecdote that implied that something terrible was avoided. That, of course, is always hard to know. The punch line is that without the device reporting in to a clinician, the situation was one in which it "could have gone for months before the problem was discovered." The story never considered the question of whether there is always value in immediate recognition of a situation.
Clinicians who were involved with the makers of the devices discussed were quoted in this piece.
The alternative of how things are currently done is not clear. Many involve the patient manually checking the device at home over a phone or going to the doctor. For many patients, this new technology may be of marginal benefit at unclear cost.
In addition to the new devices, one needs a new system of "non-visit" based care and monitoring. This is something that isn’t routine in most doctors’ offices and would require changes in how they operate and in theory how they get paid.
The story was a tapestry of information about devices that are currently available, devices in clinical studies, and the potential benefit from devices to be developed in the future. The story could have been clearer about products that are and are not readily available to patients. We had to read the piece several times in order to reflect on which device, from which company, was at which stage of research or development.
The story wove together information from devices that available – through those used in clinical trials and those under development.
Does not appear to rely on a news release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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