The Wall Street Journal took a medical review of surgical techniques that trumpeted it was “inconclusive” and wrote a story making it sound as if sugery is the best answer for rotator-cuff tears. The headline was especially biased toward surgery, even though the story included some good context and balance that consumers deserve.
Shoulder pain is a common problem that increases with age. If one buys what this story is selling, one could think that half the population over 60 needs shoulder surgery. While that may make the surgeons quoted in this story happy, the reader should do just the opposite of what this story recommends.
There are no dollar figures at all in this story. The story touts “lower costs” of repairing a torn shoulder “earlier rather than later” but
never delivers the data. The story should have compared costs of surgery to non-surgical alternatives and factored in the possible six-months of rehabilitation following surgery. From the available evidence, it appears the only reference to costs in the story is at best an overstatement. It says “that repairing a tear earlier rather than later may result in better patient outcomes, earlier return to work and lower costs.”
There are no data provided for the potential benefit of “increased strength” that the article says is possible if surgery is chosen “earlier” in the progress of the damage to the rotator cuff. The story does not give attribution for this claim: “one’s strength tends not to improve without surgery.” While the entire story makes a case for the benefits of the newest surgical techniques, no data is provided comparing new to old or new to non-surgical alternatives directly.
The story does a credible job of explaining that there are complications with any surgery. They did not explore the potential of surgery – even without complications – to leave a patient with reduced range-of-motion or other results that are less than desired outcomes.
This is a mixed picture. The story accurately states “there isn’t enough high-quality evidence” to recommend any surgical technique. Yet the story touts “new” surgery as better. The story fails to attribute one very important statistic: “surgery results in reduced pain and improved function in 80-95 percent of patients.” Who said that? What kind of surgery?
When a story peg is all about “new techniques” your data should be specific to technique – not mixing all surgery types together for a “success” rate without any attribution.
Another troubling issue is that the story refers to a review in the Annals of Internal Medicine. That Annals article states that the review was “inconclusive.” So, why is the story relying on that review if its own authors call it “inconclusive”?
Yes, the story avoids this. Cuff tears are so common, as the story says, that more than half of all adults over 60 are walking around with them.
The story quotes two surgeons who were not authors on the review in the Annals.
The story does mention that tears can be managed “without surgery,” but then it discredits this statistic by saying “one’s strength tends not to improve” without surgery. It does not attribute that assessment, and readers may be left in confusion.
Existing traditional surgery methods and non-surgical alternatives are not given the same weight in the story as new techniques. The Annals journal article referenced in the story stated: “Future studies of high quality are needed to explore the relative effectiveness of early vs. delayed surgery, nonoperative versus operative treatments.”
The story does not tell us whether what it calls the “mini-open” and other less invasive surgical techniques are widely available. It implies that they are, but by calling them “new” it likewise makes one wonder whether it may take time for them to penetrate to all surgical practices.
The story explains that a variety of surgical repair techniques – all lumped in the non-open incision category – are available. None of
these are truly novel.
The story does not 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
Comments
Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.
Our Comments Policy
But before leaving a comment, please review these notes about our policy.
You are responsible for any comments you leave on this site.
This site is primarily a forum for discussion about the quality (or lack thereof) in journalism or other media messages (advertising, marketing, public relations, medical journals, etc.) It is not intended to be a forum for definitive discussions about medicine or science.
We will delete comments that include personal attacks, unfounded allegations, unverified claims, product pitches, profanity or any from anyone who does not list a full name and a functioning email address. We will also end any thread of repetitive comments. We don”t give medical advice so we won”t respond to questions asking for it.
We don”t have sufficient staffing to contact each commenter who left such a message. If you have a question about why your comment was edited or removed, you can email us at feedback@healthnewsreview.org.
There has been a recent burst of attention to troubles with many comments left on science and science news/communication websites. Read “Online science comments: trolls, trash and treasure.”
The authors of the Retraction Watch comments policy urge commenters:
We”re also concerned about anonymous comments. We ask that all commenters leave their full name and provide an actual email address in case we feel we need to contact them. We may delete any comment left by someone who does not leave their name and a legitimate email address.
And, as noted, product pitches of any sort – pushing treatments, tests, products, procedures, physicians, medical centers, books, websites – are likely to be deleted. We don”t accept advertising on this site and are not going to give it away free.
The ability to leave comments expires after a certain period of time. So you may find that you’re unable to leave a comment on an article that is more than a few months old.
You might also like