It gets three stars because of the number of criteria it did address. But it’s how the story failed on key criteria – such as evaluating the evidence, discussing harms and benefits – that really matters.
This was a cross sectional study in small group of men in a referral center. This type of study design is fraught with flaws, especially that one cannot make causal inferences. Obviously the length of the list of limitations the researchers address dampens any conclusions about length of a crotch.
One wonders what the journal editors or peer reviewers were thinking. Did they conclude “As long as the researchers list all the flaws in this study in a paragraph on limitations, then we’ll publish it” ???
At least the story ended with appropriate caution from an independent expert, who said:
“We would all like a simple, noninvasive way to predict potential problems with fertility in men, but unfortunately, this one is not ready for prime time. We have a long way to go before we can use anogenital distance as a determinant of future fertility in men.”
Then why was it worth the story?
Not applicable. The cost of such an approach is not in question.
Benefits are not addressed – and this ties in to our comments in the “harms” criterion above. You don’t test unless you know what good it will do. And the story is silent on that potential benefit. It just raises the picture of more testing without any discussion of benefit.
There was no discussion of harms. But this story promotes a “simple…noninvasive way to test testicular function and reproductive potential in adult men.” So presumably one would act on the basis of what this simple test shows. That opens questions about the sensitivity and specificity of this approach – neither of which are addressed and both of which raise issues of potential harm, overtesting and overtreatment for the man.
Maybe not so “simple” as described.
The journal article itself lists all sorts of potential limitations to the study, none of which are mentioned in the story. For example:
This was a cross sectional study in small group of men in a referral center. This type of study design is fraught with flaws, especially that one cannot make causal inferences. Obviously the length of the list of limitations dampens any conclusions about length of a crotch.
Two independent experts were quoted – although one is identified as doing research in this field so her laudatory comments about the importance of this work might be understandable.
No comparison is made with any other method of testing testicular function or reproductive potential in adult men.
The availability of such a measurement approach is not in question.
The story describes other research on short anogenital spans, so it’s clear there is other research on this topic.
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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