This article reported on unreviewed research results about an elevated risk of developing blood-clotting in patients with Taxus drug-eluting stents used in the treatment of coronary artery disease. While providing information about the impact of the study results on the company’s stock, the article was not as helpful as it might have been in helping patients understand the potential risks and benefits that may be derived from the use of drug-eluting stents, nor how the magnitude of the risks might compare with the various treatment options that exist.
There was no information about the cost of either drug-eluting or bare-metal stents
Describing the risk of blood clotting as ‘slightly higher’ is not helpful for the reader. It would be useful for readers to know what the risk of blood clotting is with and without the different types of stents and other treatments for coronary artery disease. It would also be helpful for readers to be able to compare the restenosis rates and timeframe for the two types of stents as well as for bypass surgery. The article should have included information from the same meeting which suggests that the use of drug eluting stents may increase the risk of cardiac events (including blood clots) and death (http://www.escardio.org/vpo/News/events/wcc_drugelutingstents_events.htm)
One harm of treatment, I.e. blood clotting, was presented in this article without providing numbers that would allow the reader to see how often this occurred and how the rates of its occurrence differed in patients receiving bare-metal and drug-eluting stents. The article failed to explain that the FDA has previously issued two warnings about late stage blood clotting problems with drug eluting stents. This is useful for the reader to put the report from the latest study into perspective.
Some of the information came from a company spokesman. Some came from the reporter citing another news source (the Wall Street Journal). Some may have come indirectly from a report at scientific meeting. The article failed to explain that such results have not been peer reviewed and that it is not certain that they will stand the test of time. (See “News from scientific meetings” in the “Things You Should Know About Research Stories” section on the right side of the home page.)
The article provides no context and provides a confusing array of information. For example, the article indicates that the Taxus stent is one of two drug eluting stents available and then several paragraphs later mentions the Cypher stent without any description. The article also notes the “Journal” (meaning the Wall Street Journal) noted no problem with the Cypher stent while also noting that a company spokesman noted it to be a class problem with all drug eluting stents.
There is no overt disease-mongering in the story, although the size of the risk increase is unstated giving the impression that the problem is more common than it really is. But we address this in the “Harms of Treatment” criterion.
The article included a quote from a spokesperson from the company that produces the drug-eluting stent that was reported to increase risk of blood clotting. However, there did not appear to be any expert quoted to put the potential risks and benefits from this treatment in context. And for one news outlet to rely so strongly on what was reported by another news outlet is weak.
The article only mentioned the two categories of stents that are currently used in the treatment of coronary artery disease (drug-eluting and bare metal stents). It did not mention bypass surgery or drug treatment as alternative options for coronary artery disease. It also did not mention that there is a limit to the number of drug eluting stents a person can get because of concerns over exposure to the material coating the stent.
It’s clear from the story that the drug-coated stents discussed are readily available and commonly used.
The use of drug-coated stents in the treatment of coronary artery disease is not novel and there have been previous suggestions that these stents may increase risk of blood clots. This article did not appear to be making any suggestion that what it was reporting on was novel.
We can’t be sure if the story relied solely or largely on a news release, although it did seem to rely to a large extent on company spokesmen and news reported by another news outlet.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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