Alzheimer’s disease is a common and tragic disease. In spite of much research, there is currently little that can be done to stop or slow its progression. A hot area of research is in early detection. Two years ago, Medicare decided to cover PET scanning for diagnosing Alzheimer’s, with the hope that it could help with treatment and allow patients and their families to help with future planning. However, Medicare’s decision was very controversial and there are many issues surrounding the use of PET scanning for this conditon. This story does little to enlighten readers and is flawed in several ways.
The story does not attempt to quantify the benefits of PET scanning. Most importantly, the story does not mention that even if Alzheimer’s is detected early, there is not much that can be done for it. The drug Aricept has only minor effects on the progression of the disease. Although the story mentions neurologic exams, the advantages and disadvantages of PET scanning compared to existing approaches are not described. How will the scanning fit in with current practice? These questions are not answered in the story.
The story does not comment on the novelty or availability of PET scanning. Although the story hints at false alarms, this is insufficient information on the harms of scanning. How do such “false alarms” impact peoples’ lives?
The story does quote two directors of major Alzheimer’s research centers. The story could have quoted other clinicians or researchers who could have provided some additional perspective. By accurately describing the prevalence of Alzheimer’s, the story avoids disease mongering. The story does mention that the scans are expensive – $1000 to $3500 and are not necessarily covered by insurance. The story could have provided costs of the traditional neurologic exam by comparison.
The story does mention that the scans are expensive – $1000 to $3500 and are not necessarily covered by insurance. The story could have provided costs of the traditional neurologic exam for comparison.
The story does not attempt to quantify the benefits of PET scanning. The story states, “several studies suggest it can effectively provide an early warning”, but does not give any quantification for the magnitude of effects observed in these studies. Most importantly, the story does not mention that even if Alzheimer’s is detected early, there is not much that can be done for it. Aricept has only minor affects on the progression of the disease.
Although the story hints at false alarms from the use of PET scans, this is insufficient information on the harms of scanning. What would a “false alarm” entail? What does it do to a person who receives this news?
The story does not adequately describe the strengths of the available evidence. It says “Neurologists say PET is an excellent tool for distinguishing between Alzheimer’s and frontotemporal dementia.” But it then notes that “experts disagree over whether PET is useful for determining whether people with mild memory problems are suffering from early Alzheimer’s. Several studies suggest it can effectively provide an early warning. The catch is that there is insufficient research to determine exactly how accurate it is.” The story could have explained why there is such uncertainty; what is the nature of the studies that have been done?
By accurately describing the prevalence of Alzheimer’s, the story avoids disease mongering.
The story does quote two directors of major Alzheimer’s research centers. The story could have quoted other clinicians or researchers who may have provided some additional perspective.
Although the story mentions neurologic exams, this is insufficient information on the alternatives. What are the advantages and disadvantages of PET scanning compared to existing approaches? How will the scanning fit in with current practice? These questions are not answered in the story.
The story does not comment on the availability of PET scanners.
The story does not comment on the novelty of PET scanning. How long have they been used for this purpose?
We can’t be sure if the story relied on a press release. However, given that sources from several institutions were interviewed, it appears that independent reporting took place.
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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