This is a cardiologist-penned article on the benefits of intensive cardiac rehabilitation (ICR) versus “ordinary” cardiac rehabilitation (CR). While it doesn’t seem to be a standard reported news story, it was published in the health section of U.S. News & World Report, placing it within our purview.
At first glance, this story appears to be hyper specific. A sample sentence: “Most of these hospitals averaged over 48 sessions per patient in the second half of 2015–over double the industry average for ordinary CR.”
This sentence is emblematic of the piece overall, because it does not reveal anything about the actual impact of intensive cardiac rehabilitation on health outcomes. Nor does it provide any information about the quality of the research being cited.
About 40% of adults will have a coronary problem–and the effectiveness of rehabilitation programs has huge health and economic implications.
Costs were not included, even though the price tag for this type of care is likely quite high–regardless of whether the bill is paid by patients, insurers or Medicare. Some explanation of costs was warranted.
The story relies on relative terms to quantify the benefits of the treatment and provides no absolute numbers.
More troubling is that it only refers to health outcomes in one sentence, saying that cardiac rehabilitation–which is not actually the focus of the piece–has “been proven to be particularly effective in helping patients recover and stay healthy. Research indicates that CR improves five-year mortality rates by 25 to 46 percent for patients following a heart attack or other cardiac event.”
But what about the “intensive” CR, which is the focus of the headline and the article?
Medically supervised cardiac rehab carries relatively minimal potential for harm, so we’re giving this a Not Applicable rating.
The story tells us this: “One of the Medicare-approved programs, Pritikin ICR, is based on a lifestyle change program that has more than 100 peer-reviewed studies validating its effectiveness, including significantly reducing levels of cholesterol and triglycerides, body mass index and blood pressure, as well as reducing risk factors for diabetes, breast cancer, prostate cancer and other comorbidities.”
That’s a lot of beneficial outcomes being touted as validated. But readers can’t ascertain the quality of those studies based on this summation alone. Were these mostly large, randomized trials? Or small, early trials? Have there been any systematic reviews or meta analyses of these studies? Any notable criticisms? What about the other types of ICR–does this research apply to those programs as well?
The story does a good job of explaining the need for improving outcomes for people who have suffered a heart attack or other serious cardiac event, and it doesn’t disease monger.
One of the sources in the story, R. James Barnard, Ph.D, is a paid consultant at the Pritikin Longevity Center, which promotes “Pritikin ICR.” His ties with that group should have been made clear. Also, one of the doctors interviewed in the story works for a hospital system that announced recently it also has partnered with Pritikin.
There are various approaches to post-heart attack rehabilitation–including within the ICR universe–but this wasn’t made clear. How do those other approaches stack up?
The reader can infer that both CR and ICR are available to the general population. But we’re not given an idea of just how widely available ICR is, even though it’s being positioned as the newer, more beneficial option. It’s also not clear if there is insurance coverage outside of Medicare.
The story provides background information on intensive cardiac rehab programs becoming available in “recent years,” establishing that this isn’t a brand-new or emerging concept. That’s a sufficient enough effort to rate Satisfactory.
The story does not appear to rely on a news release.
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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