It puts both the potential benefits and potential harms of this scanner used to detect cancerous skin lesions in the proper context. It explains that, while new to the market, the device is not a medical breakthrough. It provides cost information, for both the physicians and patients. And it carefully makes note of all potential conflicts of interest.
Despite the well-known risks of excessive sun exposure, many Americans remain “sun worshipers.” Rates of skin cancer, specifically melanoma, have been on the rise. While most skin cancers represent local disease and do not risk distant spread, melanoma is the exception. It can metastasize and ultimately kill. At biopsy, the depth of penetration is the key feature that is associated with risk of spread. Thus, identifying which lesions are high risk leads to the potential to remove these lesions before they have metastasized. The question is whether this machine does it better than a skilled dermatologist. One can see the potential in this device, but there is no evidence presented that this has saved a life – or done so more efficiently than a dermatologist
The story takes the rare step of talking about costs from three different angles. The cost to the physician. The cost to the patient. And the cost to insursers. “Doctors will pay a one-time fee of $7,500 to lease and receive training on the device. Patients will pay $150 out of pocket for a MelaFind scan, which analysts say may limit use to more affluent patients who are willing to pay extra for the latest medical care. Mela Sciences does not plan to ask insurers to cover the device until several years from now, after it is more widely used.
The story shows that the device is fairly effective at finding cancerous lesions. “In a company-sponsored study published last year involving around 1,300 patients, some with multiple growths, doctors reported that MelaFind correctly suggested biopsies on 125 of 127 melanomas that doctors had removed.”
It’s a bit confusing, but the story explains that the device also makes the wrong call too often, giving too many false positives. “However, the device did not raise an alarm about non-melanoma growths only about 10 percent of the time; that was still better than doctors in the study who correctly ruled out melanoma in less than 4 percent of such cases, on average.” Just presenting the false positive and false negative rates would have been more helpful to readers.
We would have liked to have seen a little more about the latest study of the device, but there was enough information in the story to let readers know that this is the case where the evidence is still not quite settled. It says, for example, “MelaFind underwent a contentious, years-long review by the Food and Drug Administration, which initially rejected the device and concluded it could ‘potentially cause more harm than good.'” And later it says that “an FDA-required follow-up study would help determine how much of a benefit MelaFind represents for patients.”
The story both gives the broader context about melanoma while taking care to pinpoint the appropriate patient population. It says in the second paragraph, “The device is approved only for dermatologists and only for use on growths that don’t have obvious signs of cancer but still have one or two worrisome traits.” It also says, “Nearly all patients diagnosed with early-stage melanoma can be treated and cured, but 85 percent of patients with late-stage melanoma die from it within five years.” The story could have more clearly stated that while many are diagnosed with melanoma only a small number actually will die from it. The late stage cases are a small fraction of the total.
The story does not use a truly independent source because everyone appears to have some sort of conflict, but this is also one of the stories strengths. Rarely have we seen conflicts presented with this kind of detail. For example, the story says describes Dr. Leonard Goldberg as “a dermatologist at the Texas Medical Center and vice president of the Skin Cancer Foundation, a disease awareness group that accepts donations from makers of sunscreen.”
The story compares the device to clinicians throughout, and shows clearly that dermatologists are still the ones with the best authority in this area.
The story says clearly that the devices are not currently available in most areas. “But don’t expect to see a MelaFind machine at your next doctor’s appointment. The company plans a limited rollout next year of just 200 dermatologists on the East coast, all of whom must undergo company training before they can begin using the device.”
The story calls the device a “first of its kind,” but it also explains that it is only approved for use in a subset of patients and that much more work needs to be done.
The story does not rely on a news release.
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
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.
Our Comments Policy
But before leaving a comment, please review these notes about our policy.
You are responsible for any comments you leave on this site.
This site is primarily a forum for discussion about the quality (or lack thereof) in journalism or other media messages (advertising, marketing, public relations, medical journals, etc.) It is not intended to be a forum for definitive discussions about medicine or science.
We will delete comments that include personal attacks, unfounded allegations, unverified claims, product pitches, profanity or any from anyone who does not list a full name and a functioning email address. We will also end any thread of repetitive comments. We don”t give medical advice so we won”t respond to questions asking for it.
We don”t have sufficient staffing to contact each commenter who left such a message. If you have a question about why your comment was edited or removed, you can email us at feedback@healthnewsreview.org.
There has been a recent burst of attention to troubles with many comments left on science and science news/communication websites. Read “Online science comments: trolls, trash and treasure.”
The authors of the Retraction Watch comments policy urge commenters:
We”re also concerned about anonymous comments. We ask that all commenters leave their full name and provide an actual email address in case we feel we need to contact them. We may delete any comment left by someone who does not leave their name and a legitimate email address.
And, as noted, product pitches of any sort – pushing treatments, tests, products, procedures, physicians, medical centers, books, websites – are likely to be deleted. We don”t accept advertising on this site and are not going to give it away free.
The ability to leave comments expires after a certain period of time. So you may find that you’re unable to leave a comment on an article that is more than a few months old.
You might also like