This AP story (the version we reviewed was published in the Denver Post) was superior in the way it clearly explained the researchers’ potential conflicts of interest and described the design of the studies.
Uterine fibroids are common, and although not life-threatening, can cause debilitating symptoms in some women. Although surgery remains the only curative treatment, drug treatments could reduce the number of women who opt for more invasive approaches.
This is a key area for fully informed, shared decision-making – a point that could have been emphasized in this story.
Nothing about costs, even though the drug in question is a version of a drug already on the market. We thought it would have fit nicely after the fifth paragraph.
Although it may seem intuitively obvious that drug treatment would be preferable to surgery, it is unclear how long women with fibroids would need to continue drug treatment since it is not curative. So cost becomes an important long term issue.
We will give the story a satisfactory grade on this because what was provided was adequately and clearly stated.
But we would prefer to see absolute numbers rather than just percentage comparisons. We’d also prefer some additional comments about the rate of surgery seen in the comparison study. Of the 100 women who completed the study who received ulipristal, 55 had some form of elective surgery (55%). In comparision, 53 of 95 women who completed the study who were treated with leuprolide had surgery. So, in the final analysis, there was no difference in the number of women who decided for surgery.”
The story focuses mostly on the side effects of the other treatments tested, not the low-dose morning after pill that was the subject of the story. It says, “In both studies, Esmya stopped the bleeding and shrank fibroids in most patients and worked as well as the shot, but with fewer side effects.” It does not make clear what the side effects were for Esmya.
The competing WebMD story included the statement that “it remains to be seen if the drug is safe for long-term, intermittent use.”
The story nicely describes the study’s design and provides more information than the WebMD piece we reviewed. For one, it provides the number of people studied, which signals to readers that the findings have the potential to actually make an impact. “The two studies involved about 550 premenopausal women whose fibroid symptoms were serious enough that surgery was planned.”
No disease mongering, and this story had a very measured tone. It says, “Fibroids are benign growths in the uterus that are common in women during their childbearing years, mostly in their late 30s and 40s. They usually go away after menopause.’
Unlike the WebMD story, AP explained that the study was funded by a drugmaker. The AP reported, “Drugmaker PregLem paid for the latest studies. The researchers included company employees; Donnez and others have been on its scientific advisory board.”
The comparisons to hormone shots that were made in the study are well described. But other options are not fully explained. The story says “Despite newer, less invasive alternatives, the rate of hysterectomies remains high, Dr. Elizabeth Stewart, a professor of obstetrics and gynecology at Mayo Clinic, wrote in an editorial in the journal.” But then Stewart goes on to say, “It’s amazing to me that so many women have uterine fibroids and yet the treatments we have available are pretty few and far between.” So which is it? Are there newer, less invasive options or are options to surgery few and far between?
WebMD’s story was similarly incomplete and confusing on this point.
The story does a good job spelling out what is available where, in both Europe and the United States.
The story starts out with a pretty strong claim for novelty, saying, “New research offers hope for the first pill to treat a common problem in young women: fibroids in the uterus.” But, in reality, there are other drugs – including mifepristone – that have shown some effectiveness in reducing symptoms.
The story did not rely on a press 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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