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New Therapy for Enlarged Prostate May Bypass Unpleasant Side Effects

Rating

2 Star

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New Therapy for Enlarged Prostate May Bypass Unpleasant Side Effects

Our Review Summary

Strong points:  there were several clear caveats, mostly from independent experts interviewed.

Weaker points:  failure to evaluate the evidence, failure to put into appropriate context of other alternative treatments for which there is FAR more data and experience.

 

Why This Matters

Experimental outcomes need to be presented in a framework that avoids generating unrealistic expectations.  There are many men who are affected with benign prostatic hyperplasia, so the information presented needs to do a better job of providing them with accurate, balanced, complete information that can facilitate a truly informed shared decision-making encounter with their doctors.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

There was no discussion of costs. Why not?  You can let a researcher say it’s ready to be used in certain patients, yet you can’t estimate a cost?

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

While reporting that 66 out 67 patients in the study experienced ‘improvement’ in symptoms, it was not clear to readers what exactly was improved, the extent to which it was improved, and what the satisfaction level with the improvement was.  There was not an adequate presentation about the benefits from this procedure.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

The story did not report on any harms observed in the 67 men who took part in the study reported on.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

The last line of the story indicated that the findings should be considered ‘preliminary’ and an early paragraph indicated that the study had not yet even been presented at the meeting.  And, while the story did note that 9 months was insufficient time to measure outcomes, it did not explicity address the limitations of a small case-series (with no comparison group).

A story like this must do a better job of helping readers understand why not all studies are equal, why when a researcher says this is “ready to be used” that needs to be backed up by data, and how there is a far greater evidence base for many other approaches to BPH, including other so-called minimally invasive procedures, and including a watch-and-wait approach that many men are happy with – which was never mentioned.

Does the story commit disease-mongering?

Satisfactory

The story did not engage in overt disease-mongering.  It would have been helpful to know that BPH rarely causes problems that require medical attention, though it can result in symptoms that are bothersome for some men.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

Clinicians with expertise in treating benign prostatic hyperplasia and without apparent ties to the study reported on were quoted in this story.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story provided some insight about how this new minimally invasive treatment for benign prostatic hyperplasia compared with TURP.  However it neglected to mention that there are number of surgical techniques and minimally invasive techniques available for which there is comparable effectiveness and fewer complications than TURP.  And while the study authors claim the new procedure has value because it didn’t have the higher risk for the need for re-operation, the 9-month follow-up was too short to actually be able to lay claim to this benefit.

The oddest part of the story was the line that other minimally invasive treatments “are less effective and have a greater risk of a need for reoperation according to background materials that accompanied the study. (emphasis added)  Does that mean according to marketing materials provided?  What was that source of that material?  What a silly, unsubstantiated, unsourced thing to include!

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The story allowed the lead researcher to boast that prostatic artery emoblization was ‘ready to be used in certain patients’.  But then it quickly countered that with “but other experts aren’t so sure.”

The story could have stated much more emphatically that it is a stretch to think that PAE would be utilized in this new population on the basis of a single, small scale study, presented as an oral presentation at a meeting.  Given that the procedure is still experimental at this point, it is unlikely to be widely available.

And although the story noted that few physicians are ‘trained to perform the procedure’ it should have been explicit that this is currently not an option for most men.

Nonetheless, we’ll give the story a BARELY satisfactory on this criterion.

Does the story establish the true novelty of the approach?

Not Satisfactory

The story seemed to suggest that the procedure reported on was novel; it should have mentioned (as the competing WebMD story did) that it is already in use to treat other non-cancerous, hyperplastic conditions.

Does the story appear to rely solely or largely on a news release?

Satisfactory

Does not appear to rely solely on a news release.

Total Score: 4 of 10 Satisfactory

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