There was a very clear explanation of the difference between relative and absolute risk. And a very clear summary statement: “That’s obviously a lot more benfit than risk.”
The story ends with another strong point: discussing some of the issues that women should be discussing with their doctors in a truly informed shared decision-making environment.
This study has the potential to confuse readers and listeners. But the story addresses the seemingly contradictory elements well. Women over 65, who face most of the risk from osteoporosis, will have to question their providers as each new bit of evidence emerges balancing the risk of treatment with drugs against the benefits. An estimated 10 million people in the United States have osteoporosis.
The story gives no cost information. We wish the story had given the yearly cost of at least one of these therapies, and even some comment on the high cost of recovery from a typical hip fracture for the thousands of elderly women who suffer them.
The story did a good job explaining the tradeoffs of benefits and harms and quotes a doctor who worries that fear of rare events may be preventing women from taking drugs that could save them from the typical hip fractures.
If only the article took the extra step by talking about treatment benefits in absolute terms, rather than relative. The competing Reuters article tries to put the absolute benefit in perspective by noting that about half of people with osteoporosis will have a fracture in their lifetime.
NPR does a good job of parsing the harm described in the JAMA article. Extra credit for including the notion of a “drug holiday” that is a practical reaction from treating physicians to a confusing landscape of discoveries about these drugs.
The fact that this was the largest study to date is important, since large groups are needed to evaluate rare events like these thighbone fractures. There is helpful discussion of how to interpet the risk vs. benefits outlined in the study.
The story avoids being alarmist and takes pains to point out the low absolute risk of the unsual thigh fracture.
If anything, the story could have pointed out how devastating a typical hip fracture can be for an individual and society overall. The CDC estimates that one in four who suffer a hip fracture are dead within a year, and one in five will spend at least a year in a nursing home.
NPR provides us with three fresh sources beyond the JAMA article itself.
One strength of the story was its ending, with a discussion with a bone specialist about the option of taking a drug “holiday” from time to time, and the question of whether women who stop taking it temporarily should start again.
The story describes the drugs as commonly available.
The drugs are not novel, and the story says so.
It’s clear that the story did not rely solely or largely on a news release.