Adherence to medication is a major hurdle in the management of osteoporosis. Because the oral medications are difficult to tolerate, many women stop taking them. However, there are now several different options that do not require a daily dose. A recent study published in the New England Journal of Medicine describes the use of a once-a-year intravenous treatment. This story reports on the results of that study.
The story adequately describes the harms of treatment and accurately represents the novelty of the treatment.
However, the story does not mention the availability of the treatment, does not describe the costs, does not adequately represent the strength of the available evidence, does not quote an independent source, and does not adequately cover the treatment alternatives.
Most importantly, the story quantifies benefits in relative terms only. The story should have provided context for these numbers by showing the actual rates of fracture in the treatment group compared to the placebo group. Furthermore, the story only presents one outcome, vertebral fractures. These are fractures found on x-rays that only sometimes cause symptoms. Treatment reduced the chance of vertebral fractures from 10.9% to 3.3%. Equally important would be risk of hip fracture, which can substantially impact an individual's quality of life. In this study, the risk of hip fracture was reduced from 2.5% over 3 years in the placebo group to 1.4% in the treatment group.
The story only ran 176 words. If they'd given the reporter a little more space, perhaps these important missing elements would have been addressed. But they didn't, and they weren't.
The story does not mention costs of the treatment.
The story quantifies benefits in relative terms only. The story should have provided context for these numbers by showing the actual rates of fracture in the treatment group compared to the placebo group. Furthermore, the story only presents one outcome, vertebral fractures. These are fractures found on x-rays that only sometimes cause symptoms. Treatment reduced the chance of vertebral fractures from 10.9% to 3.3%. Equally important would be risk of hip fracture, which can substantially impact an individual's quality of life. In this study, the risk of hip fracture was reduced from 2.5% over 3 years in the placebo group to 1.4% in the treatment group.
The story mentions the most serious harm of the treatment, an increased risk of atrial fibrillation. Other risks include post-infusion reactions, including fever, headache, flu-like symptoms and joint pain.
Although the story mentions the recent trial, it does not adequately describe the strength of the available evidence to support the use of the IV drug.
The story does not appear to engage in disease mongering.
The story does not quote any independent researchers or clinicians who could comment on the impact of this new development on the management of osteoporosis.
Although the story does mention Fosomax and Actonel, this is not sufficient information on the alternatives and the advantages and disadvantages of the different approaches. The story should have also mentioned calcium supplements, physical activity, estrogens, and smoking and alcohol cessation as alternatives.
The story does not mention if the intravenous (IV) zoledronic acid (Reclast) has been FDA approved or whether it is available or not.
The story does point out that this treatment represents a novel way of treating osteoporosis.
There is no way to know if the story relied on a press release as the sole source of information, although the only source is the author of a study in a journal.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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