The independent expert’s perspective: “I wouldn’t send a middle-age obese man for surgery as their first option. I would say let’s lose the weight; lets use CPAP and see a nutritionist; lets avoid the alcohol and let’s see how you do.” The apnea can probably be taken care of with these non-invasive techniques, she says, and invasive surgery can be avoided.
What matters most is that there is not sufficient experience/data to determine the benefits and risks of the robotic procedure.
No mention of costs – not on the robotic surgery, not on CPAP.
Mixed bag but we’ll give the story the benefit of the doubt.
It said the CPAP “works for about half who try it” – but we wish it had provided a source for that info.
It said surgery (apparently referring to non-robotic surgery) is effective only 20-30% of the time.
And it said that maxillomandibular advancement is effective more than 90 percent of the time.
We don’t really know anything about the harms or benefits of the robotic surgery. The story could be more explicit about that.
The story only discusses success rates but doesn’t mention any potential harms. What are the actual problems people encounter when having “a series of surgeries to completely treat apnea” or when they have the more “highly invasive surgery”? And what has been found even in the limited series of robotic procedures?
The story doesn’t deliver any evaluation of the quality of the evidence. We hear from the surgeon that the nonsurgical CPAP approach “works for about half of all patients who try it” – at least that appears to be attributed to the surgeon. We’re actually not sure who the source is.
And we’re not given any caveat about the limitations of drawing conclusions based on one surgeon’s 6 robotic surgery cases. Instead, we’re given the glowing anecdote of one patient who says that surgery gave him “a whole new life.” We already learned that his case was one of the worst his doctors had ever seen. So how representative is his before/after experience?
The end of the piece refers several times to surgery – generically – and it’s not clear if it’s referring to a robotic approach or a more traditional approach.
No overt disease-mongering. And at least the story disclosed that the patient profiled had “one of the worst cases of apnea his doctors had ever seen.”
The story includes the perspective of one independent expert.
Gold stars for NPR finding someone to talk knowledgeably about the alternatives and risks.
Not totally clear on this point. The story states this one doctor has done the robotic surgery on only six patients. But it’s not clear if she’s the only one who’s done this surgery. And if not, where else and how often?
The story explains that only six patients have had the robotic procedure – at least in this one doctor’s practice.
It’s clear that the story did not rely solely on a news release.