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Read Original Story

A Guiding Hand: Robots are showing up in ever more surgical suites.

Rating

3 Star

A Guiding Hand: Robots are showing up in ever more surgical suites.

Our Review Summary

The article describes a newer surgical technique for prostate cancer that involves using robotic devices controlled by a surgeon. Unfortunately, this is just another article on how to “slice and dice” the prostate when it’s not even clear that surgery is needed for early prostate cancer. Prostate cancer is often slow-growing and many men may not ever need treatment. What’s more, it’s not clear that one treatment option is superior to another. The article also overstates what is currently known about robotic radical prostatectomy; a meta-analysis reported that it was too early to tell whether the technique actually improved outcomes, yet the article uses one study to make claims of benefit without telling readers anything about the strength of that study. The article also becomes unbalanced by focusing on one man’s particulary rosy experience with the new technology, even if experts quoted point out that there isn’t evidence that this new technology is superior. The story story also failed to discuss side effects or harms of the new technique and didn’t mention other treatment options besides various surgical approaches and seed implantation.

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

The article’s main focus is about robotic surgery for prostate cancer, although other applications are mentioned. Comparitive costs are given for a robotic radical prostatectomy, laparoscopic prostatectomy, and open prostatectomy.

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

Not Satisfactory

The article does not quantify benefits. It reports puported benefits (less blood loss, avoid damaging nerves during surgery) but there isn’t much evidence to support these claims.

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

Not Satisfactory

There are no harms of treatments mentioned. The article mentions in a general way that “impotence and incontinence are common following surgery to remove the prostate…” Yet presenting one person’s very rosy experience with the new technology–…”had no difficulty with either incontinence or impotence”–seems unbalancing.

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

Not Satisfactory

The article mentions a study published in the British Journal of Urology in 2003, but it fails to state the nature of the study. Readers don’t know whether the article’s conclusions are based on a randomized, controlled trial–the gold standard–or some other, weaker evidence. What’s more, this is only one study. A meta-analyses published in 2004 (Humphreys) found no compelling evidence for claims that robotic prostatectomies resulted in improved outcomes.

Does the story commit disease-mongering?

Not Satisfactory

Since the focus is on prostate cancer, more information about the natural history of prostate cancer, particularly early prostate cancer should be given. Importantly, there is no mention that early prostate cancer may not even need to be treated and that a man may survive just as long with or without treatment, which would make the distinction between which way to “slice and dice” the prostate less important. Unfortunately, researchers can’t predict which prostate cancers will eventually harm a man or even whether treatment for early prostate cancer is beneficial.

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

Satisfactory

The article appropriately obtains various expert opinions about the claims of superiority of this surgical approach. Some experts appropriately point out that there is no evidence that this is superior to other approaches.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

While the article does mention cryo, seeds, and other forms of surgery for prostate cancer, the article doesn’t mention other treatments, which could include active monitoring or radiation. Viewers are left with the impression that surgery is needed and is really the only option for treating prostate cancer.

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

Satisfactory

The article states the robotic tool is available at selected hospitals throughout the country and that availability is expected to increase.

Does the story establish the true novelty of the approach?

Satisfactory

The article appropriately describes the emergence and history of this treatment–it is not new, but is becoming more popular.

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

Satisfactory

No obvious elements of a press release.

Total Score: 5 of 10 Satisfactory

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