Great ending quote from an independent expert about how “there will always be questions, and an ongoing need to individualize therapy.” The story could have mentioned shared decision making as a solution here when men and their doctors are looking to “individualize” the care.
We especially appreciate how the story was “framed” right out of the box when it stated: “Don’t leap to any conclusions. Like every new study of prostate cancer, the results need to be carefully parsed”.
Individuals with early stage prostate cancer struggle to understand how to best make use of study outcomes to make a decision about whether to pursue active intervention to treat prostate cancer and this story helped provide some context for being able to do so.
There was no discussion of costs. Costs would include treating the double digit rates of incontinence and erectile dysfunction in these younger men who do have surgery. The surgery may help them live longer, but many, especially since younger at time of surgery, live decades with these potential harms and folllowup costs of the surgical choice. This should get at least a line in such stories.
The story reported only the relative difference in the number of men in each treatment group who died during the follow-up period. For readers to understand what the real difference in risk is, information about the absolute difference in risk needs to be reported. See the AP story for comparison.
The story provided quantitative information comparing the rate of all cause mortality in the two groups; it also indicated that more men in the group that didn’t have surgery had hormone therapy. To be balanced, the story should have indicated that there are commonly occurring side effects from surgery to remove the prostate such as incontinence and sexual problems.
The competing HealthDay and AP stories, by comparison, did a better job of this.
The story would have been better if it had indicated that for men with prostate cancer, taking hormone therapy means that the cancer has progressed; further providing readers with insight about the absolute rates at which men in the two groups needed hormone therapy would have provided a more complete picture.
The story did a fine job of explaining how the prostate cancers had been diagnosed as well as noting that the cancers were all early stage; it informed readers that the men in the study were randomly assigned to either have their cancer surgically removed immediately or not; and that the study being reported on was really just an additional report on the progress of men as they are farther out from the start of the study.
The story included quotes from the author of an editorial about the study reported on.
The story mentioned the use of newer surgical techniques than those used to treat the men in the study who underwent prostatectomy. It also mentioned newer radiation therapies. In addition, the story concluded:
The story discussed the treatments in the study, radical prostatectomy and watchful waiting, and explained how watchful waiting differed from the active surveillance approach used in this country.
It was clear from this story that the approaches to managing prostate cancer detailed in the study reported on are neither new nor novel.
This story did not rely solely on a press 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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