This AP story reports on a new study presented at a cardiology meeting and published online via the New England Journal of Medicine. The research is particularly newsworthy because of the dramatic effects on both LDL (“bad”) and HDL (“good”) cholesterol. The story was better in a number of ways than the competing USA Today coverage of the same study. (Please note: we reviewed the first version of each story that we found – not any subsequent versions the news orgs may have published.) Important caveats were conveyed up front and potential conflicts were described more completely. In addition, this story presented the data on patients’ cholesterol levels before and after treatment, and compared them with what is considered healthy; USA Today only provided the percentage change in cholesterol. Both stories contained quotes that were overly optimistic, but this story avoided the worst excesses that the USA Today piece succumbed to. This story could have been improved with the inclusion of at least some information about the likely costs of the drug, if approved.
Cardiovascular disease remains number one cause of death in the US and other developed countries. And many people still suffer heart attacks despite being treated with high doses of statin drugs, which lower bad cholesterol. So researchers are looking for new ways to lower bad cholesterol further or increase good cholesterol, which might also help reduce risk. But it’s not enough to show that a drug has beneficial effects on these measures, which are only markers for heart disease risk. We also need data showing that the drug actually prevents heart attacks and deaths.
As with the competing USA Today coverage, this story didn’t mention costs. We feel that some discussion of this issue was warranted.
The story did a better job than the competing USA Today coverage of focusing on what was actually shown in the study. Importantly, it told us the average good and bad cholesterol levels for drug and placebo-treated patients before and after treatment. It also told us how these levels compare with those that are considered healthy. By contrast, the USA Today story only provided the percentage increase and decrease, and didn’t tell us whether the patients achieved targets associated with reduced disease risk.
We learn that the new drug doesn’t raise blood pressure the same way its predecessor, torcetrapib, did, but we don’t learn that the new drug lowered LDL cholesterol to levels that might not be safe in 17.6% of patients, who had to stop taking the medicine.
This story was better than the competing USA Today piece on several fronts. Most notably, it cautioned within the first three paragraphs that we don’t know whether the cholesterol benefits seen in this study will translate into reduced risk of heart attacks and deaths. We have to wade to the bottom of the USA Today piece before any similar reservations are expressed. Similarly, while the story contains some syrupy quotes, it avoids the worst excesses that we saw in the USA Today coverage.
With that being said, we think the story could have done a better job of tempering the enthusiasm of some these sources.
For example, an NPR online story concluded:
“Still there were four deaths from cardiovascular causes among the 800 patients taking Merck’s drug compared with just one among the same number in the the just-released trial results. So don’t count Merck’s drug approved just yet.”
Several sources not affiliated with the study are quoted. And, unlike the competing coverage, the story points out that the story was funded by Merck and that several investigators on the study consulted for Merck and other drug makers. Still, could they find no one who was skeptical of the practical value of such a drug?
The story mentions that niacin can also be effective for individuals with low HDL cholesterol. The story might have also pointed out that statins are effective for the majority of people who have high LDL cholesterol.
The story notes that this drug won’t be on the market anytime soon.
The story tells us that the new drug would be “the first of its kind,” but we also learn about the problems seen with a competing drug that worked through similar mechanisms.
The story does not appear to be based 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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