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Limits of New Screen for Heart Disease

Rating

4 Star

Limits of New Screen for Heart Disease

Our Review Summary

This story reported on a study which found that using coronary CT angiography to screen for heart disease did not result in improved outcomes for patients during the 18 months in which they were studied.

It could have emphasized that neither this CT test – nor traditional cardiac catheterization – is recommended for the kinds of people evaluated in this South Korean study.

And it should have discussed the potential harms of the newer test – thereby missing the punchline that Reuters delivered:  “Testing might lead to more harm than good.”

 

Why This Matters

The story offered the context that “The study of CCTA screening comes as medical experts are re-evaluating the frequency and usefulness of other types of health screening, including mammographies for women and PSA testing for prostate cancer in men.”

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

The story provided information about the costs for the test.

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

Satisfactory

The story indicated that 215 individuals who were screened were identified as having heart disease and received additional testing and treatment.  Nonetheless, there was no statistical benefit between the groups of healthy individuals who did and did not undergo a CCTA test.

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

Not Satisfactory

The CCTA test was reported as a non-invasive alternative to angiography.  But there was no mention of the harms associated with this test which includes radiation exposure, which is higher than that associated with angiography; the potential for allergic reaction to the material injected to allow the vessels to be seen; and the potential for there to be harms from following up on something seen on the CCTA which turns out to be nothing.

(A sad, but fascinating case report can be found in the Archives of Internal Medicine Dec 14, 2010)

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

Satisfactory

The story provided information about the study reported on including the number of people in the study, a little about those studied (i.e. these were people in South Korea around 50 years of age participating in a health screening) and that they were followed for a period of 18 months.  The outcomes reported were that one person in the non-tested group had a fatal heart attack, and that one person in the tested group developed symptomatic heart disease.

Does the story commit disease-mongering?

Satisfactory

The story did not engage in overt disease mongering.

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

Satisfactory

The first author of the study reported on and the author of the editorial about that study appear to have been interviewed for this piece.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story indicated that the CCTA was a possible non-invasive alternative to a cardiac catheterization.  While this may be true in certain circumstances, neither test is recommended for the population of individuals who were in the study. That point could have been emphasized more clearly.

The story could have reported on the fact that the researchers did not report the effect of coronary calcium scores (information that the researchers collected but did not feed back to patients and providers); that is the test most often touted for coronary heart disease screening in asymptomatic people.

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

Satisfactory

The story indicated that the test is available in the U.S. and is being used with increasing frequency.  It is actually not clear how often it is being used – the article said “Some anecdotal evidence suggests such screening is happening and becoming more common.”

Does the story establish the true novelty of the approach?

Satisfactory

The story reported that CCTA use is becoming more common, though it is not currently recommended for use in people without symptoms to screen for heart disease.

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

Satisfactory

Does not appear to rely on a news release.

Total Score: 8 of 10 Satisfactory

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