NOTE TO READERS: When this project lost substantial funding at the end of 2018, I lost the ability to continue publishing criteria-driven news story reviews and PR news release reviews - once the bread-and-butter of the site going back to 2006. The 3,200 archived reviews, while still educational, are getting old and difficult for me to technically maintain on the back end of the website. So I am announcing that I plan to remove these reviews from the site by April 1, 2021. The blog and the toolkit - two of the most popular features on the site - will remain. If you wish to peruse the reviews before they disappear, please do so by the end of March 2021. After that date you may still be able to access them via the Internet Archive Wayback Machine - https://archive.org/web/.
Read Original Story

Ultrasound of Neck Arteries May Help Gauge Stroke Risk

Rating

3 Star

Categories

Ultrasound of Neck Arteries May Help Gauge Stroke Risk

Our Review Summary

There were elements of this story that may have confused readers, but the money quotes from an independent expert helped clarify the take-home message:

  • ” (the) director of the Duke University Stroke Center, said that “what remains uncertain is whether surgical intervention would result in an overall improvement in stroke-free survival.”

    “It is also unclear how optimal medical management [lifestyle changes in addition to anti-platelet medication and statins] would affect overall stroke and cardiovascular risk, and stroke-free survival,” he said.

 

Why This Matters

Understanding that the actions taken on the basis of test results can have both harms and benefits is key to being able to make an informed decision about the true value of the test to the individual.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story included no discussion of costs.  How much would these methods cost?

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

Satisfactory

The story got the “gist” correct that surgery’s benefit increases with increasing risk. One of the saving graces of the piece was this independent perspective:

  • ” (the) director of the Duke University Stroke Center, said that “what remains uncertain is whether surgical intervention would result in an overall improvement in stroke-free survival.”

    “It is also unclear how optimal medical management [lifestyle changes in addition to anti-platelet medication and statins] would affect overall stroke and cardiovascular risk, and stroke-free survival,” he said.

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

Not Satisfactory

The story reported that 10 individuals in the study of 435 had TIAs.  While transient ischemic attacks is one outcome of interest, the study presented the number of study participants that had strokes, and died of either stroke or cardiovascular death.

The story reported the likelihood that individuals with one or another of the problems visualized with ultrasound would have a stroke – but did not report the absolute increase in stroke that was actually observed.  This information is essential for understanding the magnitude of benefit possible.  And although the story included quotes from clinicians indicating that the risk of stroke is higher with carotid endarterectomy, there should have been some number provided to enable readers to understand the risks associated with the intervention that might result from having undergone the tests.

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

Satisfactory

The story explained that the study followed 435 individuals who are known to have carotid stenosis and then followed them to see how well the two ultrasound measurements predicted those that would go on to have a stroke.

The story could have done a more complete job of explaining early on in the piece that the people studied were all 70 years of age or older, and all had known carotid stenosis.  The results of this study are not generalizable to others who do not have this condition meaning that the tests should not be used for identifying those individuals with carotid plaques.

Does the story commit disease-mongering?

Satisfactory

No overt disease mongering.

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

Satisfactory

Quotes from two individuals who were not involved in the study reported on were included in this story.

Does the story compare the new approach with existing alternatives?

Satisfactory

Sorting throught the quotes from experts, it would seem that the combination of ultrasound tests could be used to better predict those individuals at lower risk who would be best off managed with medical therapy; and to better predict which individuals stand to benefit the most from surgery because their risk was higher.

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

Not Satisfactory

The story is based on what was found with “two ultrasound methods.”  But it never clarified whether there was something extraordinary about these methods and, if so, how well known are they?  How widespread?  How available?

Does the story establish the true novelty of the approach?

Not Satisfactory

It is really not clear from this story whether the 2 ultrasound techniques are new, are currently in use for other applications, are both in use for visualizing carotids but are not usually used in combination as in the study.  Is this something new or not?

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

Satisfactory

This story did not appear to rely on a news release.

Total Score: 6 of 10 Satisfactory

Comments

Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.