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Heart Attack Study Casts Doubt On Routine Use of Angioplasty


4 Star

Heart Attack Study Casts Doubt On Routine Use of Angioplasty

Our Review Summary

The article describes a new study that shows a commonly used procedure, angioplasty, is not more effective than medical therapy (taking medications and lifestyle change) in preventing heart attack or death in people with stable heart disease.  The story does a good job of clearly letting readers know the availability of this treatment, that it's not new, the costs of treatment,  and the alternate treatment options. It also turned to several independent sources.

One area that could have been clearer was stating that this was a randomized trial – the gold standard in research.  It's hinted at several times in the article, but it's never clearly disclosed and this is a major point to make to establish the strength of the evidence.  The story could have also done a better job quantifying the benefits seen in the trial, although a secondary outcome is given in absolute terms.  The actual numbers for the primary outcome were not given, except to state that they were not statistically significant.  Yet, readers aren't given any context about what that might mean.  Finally, harms of angioplasty are not discussed. 


Does the story adequately discuss the costs of the intervention?


The story mentions that angioplasty typically costs $50,000.  While it would have been helpful to have a sense for the cost of angioplasty in in comparison to medical therapy, the story does give a sense of the cost burden to the healthcare system by providing procedures that don't benefit a significant proportion of patients. 

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

Not Satisfactory

The story does not provide actual rates of events (the primary outcome) between the two groups, although it does state that the numbers were not statistically significant.  The story does provide absolute rates for angina, a secondary outcome which was significantly different between groups.  Yet, it would have been best to report absolute rates, even if they are non-significant, for the primary outcome. There was no discussion about what "statistically non-significant" might mean. 

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

Not Satisfactory

The story states the procedure is considered "safe" but that it does carry some risks.  However, what those risks are and their frequency or severity is not discussed. 

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


The story doesn't mention explicitly that this study was a randomized trial, the gold standard in research, even though there were multiple opportunities to clarify the type of evidence the findings are based on.  The story describes the study as "the first well-designed comparison…" which doesn't make it explicit that this is a randomized trial.  A quote from a clinician talks about the fact that "nobody had done a proper randomized trial" but that doesn't necessarily make it clear that this is a randomized trial.  Nonetheless, we'll give the story the benefit of the doubt on this criterion. 

Does the story commit disease-mongering?


No obvious disease-mongering.

Does the story compare the new approach with existing alternatives?


The story discusses lifestyle changes and medication as alternate treatment options, and these alternate options were directly compared to angioplasty in the study. 

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


The article states the new study challenges routine use of a procedure – angioplasty – that has become standard care, thereby letting readers know that this procedure is currently used and widely available. 

Does the story establish the true novelty of the approach?


The story accurately states this has been routine practice for the past 20 years. 

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


Since several sources were used, it is safe to assume that this story did not rely solely or largely on a news release. 

Total Score: 8 of 10 Satisfactory


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