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Bypass Surgery Edges Stents For Heart Treatment

Rating

4 Star

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Bypass Surgery Edges Stents For Heart Treatment

Our Review Summary

This clear and concise piece touches on many of our criteria, but only lightly. A competing Wall Street Journal piece explained more fully how this study differs from the gold standard of a clinical trial and how this study in particular could have missed important distinctions between patients. We appreciated the story’s generally cautious tone.

 

Why This Matters

When the evidence to support one treatment over another is so marginal, reporters have a duty to full explore all the implications of a more invasive and more costly procedure over the standard treatment. Most coverage of this retrospective, observational study could have taken a little more time to delve into the study’s limitations.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

This story, along with the Associated Press and Wall Street Journal stories we reviewed, did not include information about costs.

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

Satisfactory

The story quantified the benefits two different ways. It says, “Four years after the procedure, patients over 65 who had coronary artery bypass surgeries (called CABG or “cabbages”) were almost 20 percent less likely to die. Put another way, 21 percent of stented patients had died after four years compared with 16 percent of surgery patients.”

This would have been a good time to use the Number Needed to Treat statistic.  Overall, the story made a good effort to give readers numbers in a way they could easily understand.

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

Not Satisfactory

This story, along with the Associated Press we reviewed, failed to mention harms. We did appreciate, though, that NPR noted that “doctors and patients have voted with their feet in favor of the less-invasive procedure — clearing clogged arteries and propping them open with tiny scaffolds called stents.”

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

Satisfactory

The story could have done more here, but, given the space devoted to the topic, we were happy to see some mention of the study’s limitations saying that only “studies that randomly assign comparable patients to surgery or stenting can” answer the question of which type of procedure is better for patients. The story also notes that the difficulty in doing randomized trials “calls into question the ultimate relevance of the findings.”

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

Dr. Laura Mauri, who wrote an accompanying editorial, has a few words of caution about patients switching from stents to open-heart surgery. And the story nicely points out that “Mauri is an interventional cardiologist – i.e., a specialist who does coronary stenting – at Brigham and Women’s Hospital in Boston.” That doesn’t mean that Mauri would recommend stents against the evidence, but it helps readers understand her perspective.

Does the story compare the new approach with existing alternatives?

Satisfactory

The study itself was a comparison between two treatment paths, and the story explains that. A mention of drug treatment as an option would have been welcome.

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

Satisfactory

Unlike the Wall Street Journal story and the Associated Press story we reviewed, this story at least mentioned the fact that more people have been opting for stents instead of bypass surgery.

Does the story establish the true novelty of the approach?

Satisfactory

Adequate: “Studies have been inconclusive” … “Now the biggest collection of cases so far comes out in favor of surgery”

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

Satisfactory

The story does not rely on a press release.

Total Score: 8 of 10 Satisfactory

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