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Cleaning up nasty clots

Rating

2 Star

Cleaning up nasty clots

Our Review Summary

This story reported on a new method for detecting clots that can cause cardioembolic strokes and a new method for treating massive deep vein thrombosis in the leg. The information came from presentations at a scientific meeting. 

The second sentence of the story lumped all clots together, warning that they bring 'danger and death in the form of a stroke'.  A stroke results from a clot that travels to the brain; not all clots that form in the body have the potential to be life threatening. Weaving in a link to Vice President Cheney's recent venous clots further confuses the issue.  His problems had little, if any, relevance to the two topics covered in the story. 

The story did explain that the use of MRI technology might result in 'false signals'.  It should have explained that this means that some patients who did not have clots that could cause a cardiopulmonary embolus would have been treated as if they did.  There was no discussion about the harms associated with this treatment; nor was there any discussion of the mental anguish that might accompany the diagnosis in the absence of the condition.

Similarly – the story included no discussion of the possible harms associated with the Angiojet.  Although it appears, from the summary of safety and effectiveness data filed with the FDA, that the risks of bleeding complications, heart attacks, and death are less with the Angiojet than with the treatments for large deep vein thrombosis with which it was compared, there was no discussion of the harms associated with this device in the story.

There was no discussion of costs for the MRI scans or for the Angiojet device.  Benefits of the two approaches were not adequately quantified. 

 

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

There were no estimates for the costs of either treatment.

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

Not Satisfactory

The benefits of adding MRI for diagnosis of clots was reported this way – that the "MRI detected more clots and heart damage that could lead to them."  How much more?  In another place it said nearly twice as many, but twice as many as what baseline?  

 The success of the Angiojet was reported as 83%; however there was no estimate of 'success' in patients who were not treated with the Angiojet.  The measure of success was defined in the story as getting patients "back in the flow".  This is not a quantitative measure.  Further – it is not even clear what it means.

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

Not Satisfactory

The story did explain that the use of MRI technology might result in 'false signals'.  It should have explained that this means that some patients who did not have clots that could cause a cardiopulmonary embolus would have been treated as if they did.  There was no discussion about the harms associated with this treatment; nor was there any discussion of the mental anguish that might accompany the diagnosis in the absence of the condition.

Similarly – the story included no discussion of the possible harms associated with the Angiojet.  Although it appears, from the summary of safety and effectiveness data filed with the FDA, that the risks of bleeding complications, heart attacks, and death are less with the Angiojet than with the treatments for large deep vein thrombosis with which it was compared, there was no discussion of the harms associated with this device in the story.

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

Satisfactory

The story was explicit that the information it reported on came from recent presentations at a scientific meeting.  The story would have been most useful to readers if it had explained the ramifications of this, i.e. that the results may not have been replicated or held up to scientific scrutiny. See our primer on news from scientific meetings.

Does the story commit disease-mongering?

Not Satisfactory

The second sentence of the story lumped all clots together, warning that they bring 'danger and death in the form of a stroke'.  A stroke results from a clot that travels to the brain; not all clots that form in the body have the potential to be life threatening.

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

Satisfactory

A neruologist from the National Institute of Neurological Disorders and Stroke and an expert in cardioembolic stroke were quoted and added insights that were helpful to readers.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

MRI was presented alongside the traditional echocardiography test.
But there was no discussion of other methods of treating massive deep vein clots in the legs other than the Angiojet device. 

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

Not Satisfactory

This story reported on a new method for detecting clots that can cause cardioembolic strokes and a new method for treating massive deep vein thrombosis in the leg.  The story could have emphasized that neither of these is routinely used.  Although the story did say that they are new, readers could easily be confused about this application of MRI because they may be familiar with the use of MRI for other diagnostic procedures.

The story also included no information about the availability of the Angiojet, the medical device discussed.  While the story made it sound like this was something new, this device has had FDA approval since 1999.  http://www.fda.gov/cdrh/pdf/P980037b.pdf

Does the story establish the true novelty of the approach?

Satisfactory

The novelty of the diagnostic method and the treatment were accurately reported.

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

Satisfactory

 There was a second source questioning the MRI data, so it does not appear that the story relied solely or largely on a news release. 

Total Score: 4 of 10 Satisfactory

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