This story demonstrates a careful and contextual analysis of the evidence, making clear what the study did show and what it didn’t.
The trials aren’t long enough to show downstream effects on mortality, which is, unfortunately, a problem with most primary prevention trials. The real question here (which is not answered but is discussed) is what is the balance of benefits and harms.
We’ll accept the brief mention – at the very end of the story about aspiring being “cheap” and “cost effective for men over 45.” We all know it’s cheap. But it doesn’t hurt to include a few words about cost and cost-effectiveness.
Appropriate context. With a meta-analysis it is not statistically appropriate to pool absolute risk reductions, so the way the story treated the evidence is as good as can be done (showing the relative risk reduction and an “anchor” in terms of absolute risk. Excerpt:
“The researchers found a 19-percent reduction in non-fatal heart attacks among participants who took aspirin compared to those who did not.
They don’t mention how many people actually suffered such a heart attack, but an earlier analysis of six of the trials showed that out of every 1,000 people, 18 individuals taking aspirin had heart attacks every year, compared to 23 individuals taking placebo pills.
On the other hand, that analysis also found aspirin increased the rate of bleeding from 0.7 to 1 per 1,000 people per year, making the authors conclude the drug was of “uncertain net value.”
The story stated “aspirin increased the rate of bleeding from 0.7 to 1 per 1,000 people per year, making the authors conclude the drug was of “uncertain net value.”
Excellent analysis of the evidence.
Two independent experts were quoted. And the story noted that the research was funded by Bayer.
Embedded in the analysis was at least a nod to other approaches. For example, the story stated:
“There is not universal agreement on what is high risk,” he told Reuters Health. “In my mind, if you have diabetes or multiple risk factors for heart disease — such as smoking or obesity — it is reasonable to take aspirin.” In addition, working to eliminate those risk factors by other means will not only slash the risk of heart disease, but also a host of other health problems.”
Not applicable. The availability of aspirin is not in question.
The story explained that “The new work…pooled the results of the nine trials that have tested the drug in the prevention of heart disease so far, including three that weren’t part of the 2009 USPSTF review.”
It’s clear that the story did not rely solely 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
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