Here’s some of what was missing in the story:
There’s been a lot of prostate cancer news in the past two weeks, largely because the American Urological Association annual conference was just held. But are we really telling men something they need to know with a story like this? Or are we just turning up the force on the firehose of information that we flood readers with?
Not applicable. Cost is not much of an issue here.
We think a story like this should present raw numbers.
So, instead of:
Why not explain 38% of what baseline? And 51% of what baseline?
Projected benefits may be exaggerated by presenting them in the manner of this story.
No drug – not even acetaminophen – is without risk. So, when the story starts in cavalier fashion – “Pop a Tylenol…” it should also find time and space somewhere to mention that popping pills comes with some risk – especially given that the safe daily maximal dose of acetaminophen has been lowered in recent years.
There was NO evaluation of the quality of the evidence. There is not one word about the limitations of such observational studies – on walking or on acetaminophen use.
Aside from general problems with adjusting for confounders in observational studies, both exposure measures–exercise and acetaminophen use–were self-reported and thus of uncertain validity. Also, interpreting “daily use” is difficult–is this one pill a day, the maximal dose, somewhere in between? Do you have to use acetaminophen for 5 consecutive years or just a total of 5 years? Another issue related to acetaminophen is that for a variety of medical conditions (kidney disease, heart failure, gastrointestinal bleeding), the non-steroidals are contraindicated and so patients are preferentially placed on acetaminophen. Sicker patients may also be less likely to be screened for cancer, so the observed “protective” effect could be quite spurious.
Further, the column lifted material from another news source (MedPageToday):
The casual reader may assume that the study actually analyzed such physiological reactions, which it did not. The researchers projected interesting hypotheses, but they should have been labeled as such.
We do think there was a subtle element of disease mongering in this story.
The facts at the end are all correct – “Prostate cancer is the second leading cause of cancer death in men. According to the National Cancer Institute, about 32,050 men died from prostate cancer in 2010 and 217,000 new cases were diagnosed. More than 2.2 million men in the U.S. are living with prostate cancer.”
But there is no context given about prostate cancers not being the same as other cancers – that many are not killers – that many men die WITH prostate cancer, not FROM it.
And crediting acetaminophen for a “51% reduced risk of developing an aggressive form of the disease” without every quantifying how relatively few men develop an aggressive form of the disease among the 217,000 new cases diagnosed each year is not helpful. 51% of what?
No independent expert source was cited to comment on either finding.
Neither finding was put into the context of other treatment/prevention approaches for prostate cancer. For example, the 5-alpha reductase inhibitor drugs (finasteride and dutasteride) have been rigorously evaluated for chemoprevention.
Not applicable. There’s no question about the availability of the two “interventions” – walking and acetaminophen.
The story explained that there’s been prior research in both fields – studying effects of anti-inflammatory drugs and walking on prostate cancer.
So it didn’t inappropriately paint either pursuit as totally new.
Not applicable because no one was directly interviewed and quoted. The story did draw from another news source – MedPage Today – but we don’t know if any original reporting was done.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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