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Most angioplasties not necessary, study finds

Rating

5 Star

Most angioplasties not necessary, study finds

Our Review Summary

This story presented the seemingly counterintuitive results from a large, randomized trial that found that non-emergency heart patients faired equally well in terms of chest pain, risk of heart attack, or death whether they were treated with medications alone or medications plus angioplasty and the placement of a stent in the partially blocked artery. 

The story explained that the study followed those who were non-emergency heart patients and that angioplasty is still thought to be the best treatment for those having a heart attack or those w ho are hospitalized with worsening symptoms.  The story did a good job of explaining the idea that a large number of people (> 500,000/year) are having an invasive procedure without obtaining additional benefit.

Unlike many studies presented at the American College of Cardiology meeting, this one was also peer-reviewed and published in the New England Journal of Medicine, something the story pointed out. 

Overall good job. 

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

This story did not include a comparison of the costs for the two treatments.  This was not a part of the journal article describing the study but was contained within the presentation given at the recent meeting of the American College of Cardiology. (Note: both the journal article and the meeting were mentioned in the story.)

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

Satisfactory

The benefits of treatment, reduction in chest pain, rates of heart attack and death, were presented.

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

Satisfactory

The story mentioned the percent of individuals in each group that initially had angina and then compared that with the percent affected at 3 and 5 years.  It also mentioned the rates of heart attack and death in both treatment groups.

While the story mentioned 1/3 of those in the medication-only group later went on to have a stent put in or had coronary bypass surgery, it could have compared this with the number of individuals in the stent and medication group who went on to either have an additional stent placed or had bypass surgery. (30% vs. 20%) 

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

Satisfactory

The story did a good job reporting on the results of the study; it explained that all the people in the study were treated with medication and that half of the people were assigned to have angioplasty.

Does the story commit disease-mongering?

Satisfactory

This story did not engage in disease mongering.

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

Satisfactory

The story included quotes from two of the authors of the study as well as the director of the National Heart, Lung, and Blood Institute and the president of the American College of Cardiology.

It might have been useful to readers to have a comment from a clinician in primary care.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story touched on several different treatment options for non-emergency heart patients: angioplasty, drug therapy, stents, bypass surgery, and healthy lifestyle interventions (diet, exercise and smoking cessation). 

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

Satisfactory

This story reported on a comparison of treatments for coronary artery disease that are used widely and described them as such.

Does the story establish the true novelty of the approach?

Satisfactory

The treatments reported on were not new and were not presented as being new.

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

Satisfactory

Does not appear to rely solely or largely on a press release.

Total Score: 9 of 10 Satisfactory

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