The results of the latest breast cancer prevention trial, the STAR trial, received wide press coverage across a variety of media. The coverage varied tremendously in its quality. This New York Times piece, with the benefit of a few weeks to prepare, does an excellent job of explaining the controversy surrounding this trial and why many groups, including the American Cancer Society, are skeptical about the findings.
This story does a great job of quantifying the benefits of raloxifene compared to tamoxifen. Not only did the story provide absolute numbers in quantifying the benefit, but it also explained why presenting only relative risk reductions can be deceiving. The story also provides sufficient information on the harms of raloxifene compared to tamoxifen (including highlighting the fact that the differences between the two were not statistically significant) and adequately describes the design of the study. The story does explain that one downside of raloxifene is that it does not appear to reduce the risk of ductal carcinoma in situ (DCIS), which tamoxifen does. There is one error in the story – about 50% of DCIS will progress to invasive cancer, not 10% as stated in the story.
The story mentions that raloxifene is already marketed as Evista, a drug used to prevent osteoporosis after menopause, but that Eli Lilly has petitioned the FDA to approve it to prevent breast cancer.
The story does not engage in disease mongering; it accurately describes the 5-yr. risk of developing breast cancer for an average 60-64 year old woman. The story even provides a link where the reader can calculate their own predicted risk.
Because the story quotes multiple sources from different backgrounds, the reader can be reassured that the story does not rely solely on a press release as a source of information.
The story does not discuss costs of treatment.
No costs were mentioned.
The story does a very good job of quantifying the benefits of raloxifene compared to tamoxifen. Not only did the story provide absolute numbers in quantifying the benefit, but it also explained why presenting only relative risk reductions can be deceiving.
The story provides sufficient information on the harms of raloxifene compared to tamoxifen. The story does explain that one downside of raloxifene is that it does not appear to reduce the risk of ductal carcinoma in situ (DCIS), which tamoxifen does. There is one error in the story – about 50% of DCIS will progress to invasive cancer, not 10% as stated in the story.
The story adequately describes the design of the study.
The story accurately describes the 5-yr. risk of developing breast cancer for an average 60-64 year old woman. The story provides a link where the reader can calculate their own predicted risk.
The story quotes multiple sources who have differing opinions of the significance of these findings.
The story mentions tamoxifen as the alternative to raloxifene.
The story mentions that Raloxifene is already marketed as Evista, a drug used to prevent osteoporosis after menopause, but that Eli Lilly has petitioned the FDA to approve it to prevent breast cancer.
The story is clear that raloxifene is an existing drug but that Eli Lilly is asking the FDA to approve it for another purpose.
Because the story quotes multiple sources from different backgrounds, the reader can be reassured that the story does not rely solely on a press release as a source of information.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
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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