This story reports on the controversial issue of lung cancer screening. A recent study published in the October 26th issue of the New England Journal of Medicine has added to the debate, but the question about whether or not lung cancer screening is effective remains open. Proponents say that the study showed that lung cancer can be identified early and successfully treated. Critics cite the study's limitations – including the lack of a control group and the use of survival, not mortality, as the outcome. More studies are underway that will help deal with the limitations of the current evidence. However, these results will not be available for some time. Although this story attempts to highlight the controversy, this story does little to enlighten the reader.
The story does not adequately quantify the benefits of screening. Furthermore, highlighting a patient who had symptoms is inappropriate in this situation. The purpose of screening is to find people before they have symptoms, not after, when treatment is less likely to be helpful.
The story also only quotes the prinicipal investigator of the study about the benefits of screening. Although the story quotes another physician, he only discusses his patient's case, not the concept of lung cancer screening. The story needed other experts to provide more information about the controversy.
The story does not mention any harms – such as radiation exposure, the harms of biopsies and the consequences of a false positive result. Nor does the study adequately describe the strength of the available evidence. Although the story says that "more studies need to be done," it does not mention the limitations of the exisiting evidence. Furthermore, the story implies that the screening would be equally effective in former smokers, current smokers and those exposed to second-hand smoke. The current study does not adequately address the differences between these populations. Furthermore, the current study does not give much information about the demographics of the population that was studied. So the question of whether it would work as well in older people or in a more diverse population is not adequately addressed.
The story does mention that the cost of the scan is about $300 and is generally not covered by insurance.
The story does not adequately quantify the benefits of screening. Furthermore, highlighting a patient who had symptoms is inappropriate in this situation. The purpose of screening is to find people before they have symptoms, not after, when treatment is less likely to be helpful. Also, the story implies that the test can save lives, a fact that is still uNPRoven.
The story does not mention any harms – such as radiation exposure, the harms of biopsies and the consequences of a false positive result.
The story does not adequately describe the strength of the available evidence. Although the story says that "more studies need to be done," it does not mention the limitations of the exisiting evidence. Furthermore, the story implies that the screening would be equally effective in former smokers, current smokers and those exposed to second-hand smoke. The current study does not adequately address the differences between these populations. Furthermore, the current study does not give much information about the demographics of the population that was studied. So the question of whether it would work as well in older people or in a more diverse population is not adequately addressed.
By accurately describing the prevalence and seriousness of lung cancer, the story avoids disease mongering.
The story quotes the prinicpal investigator of the study about the benefits of screening. Although the story quotes another physician, he only discusses his patient's case, not the concept of lung cancer screening. Some independent perspective was needed on this important topic.
The story does mention chest x-rays and stopping smoking as alternatives to CT screening.
The story does not mention if lung cancer screening is widely available.
The story does say that lung cancer screening is not new, but that using CT for screening is a new idea.
There is no way to know if the story relied on a press release as the sole source of information.
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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