This story didn’t meet as many of our criteria as the competing WebMD story did, but this one was much shorter.
Perhaps as a direct result of its brevity, it didn’t adequately address the current status of availability of the test, the cost (even projected cost), quality of the evidence, harms, benefits (potential number of unnecessary biopsies that might be avoided), and didn’t quote anyone except the lead author with the quote coming from a news release.
There is merit in helping readers understand that prostate cancers differ in the risks they pose to the health of men and that there is value in being able to better distinguish between those that do and don’t need to be treated.
The story did not discuss costs. While the test for the fusion protein mentioned is not yet commercially available, some estimate could have been given on what it may cost. The test for PSA3 is already available and a cost could easily have been cited.
Given how the story projects a possible widespread use for this approach, cost is an important consideration.
The story did not provide an estimate of the potential number of unnecessary biopsies that might be avoided with the use of this test – which is the potential benefit of concern.
While providing information about how the test might provide information that could be used by men faced with the decision about what steps to take following up on their elevated PSA level, the story should have stressed that while this test might reduce the number of false positives, there would still be substantial numbers of men whose results would fail to correctly predict their risk. Additionally – it is important to know that this test – at least in the current study design – does not change the absolute risk of missing an aggressive cancer.
We wanted the story to tell us the number of men whose tests fell in the low, intermediate, and high ranges. Without that, it makes it difficult to interpret the predictive values (e.g., % with cancer, % with aggressive cancer). Ultimately, we need to know how many (absolute risks) unnecessary biopsies could be avoided (and how many aggressive cancers missed) if we use the new biomarkers. It would also be helpful to note whether the investigators provided any indication of the cutoff that would be used clinically–and the performance of the cutoff for avoiding biopsies and missing aggressive cancers.
The story did not engage in overt disease mongering.
The story did not mention that the study reported on was funded by the company that makes the test; there were no experts without ties to the company or study quoted.
By providing a clear explanation of overtreatment of prostate cancer using the current approach to testing, the story provided readers with the insight to glean the value in a test that would better distinguish whether a man had aggressive or indolent prostate cancer.
The story only described this as a “new test.” Is it available? (No, the TMPRSS2:ERG is still experimental.)
This story was clear about the novelty of the test described.
The only quote in the story is attributed to a news release. There is no other source cited. If there was another source, it would be easy to list that at the end of the piece as a growing number of news organizations do.
Systematic, Criteria-Driven
We’ve written about the hype of liquid biopsies for years (see link in comment below). And now this…. https://www.statnews.com/2022/01/12/medicare-shouldnt-cover-liquid-biopsies-early-cancer-detection/
Case counts still matter. “(There) are stories that may not be told adequately if only hospitalizations and deaths are emphasized.” @garyschwitzer interviewed by @dbauder of @AP. https://apnews.com/article/omicron-changing-news-outlets-covid-data-da9272f7c4c8a109c3bfb56bed9e9c76
My friend Gary @garyschwitzer wrote to his city council representative in a Minnesota town about a Viva Las Vegas event scheduled for January.
The response he got seems to perfectly capture where we are now.
https://www.healthnewsreview.org/2021/12/2021-ends-with-covid-craziness-in-sports-and-politics/
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