Doctors & patients are saying about 'A-Fib.com'...
"A-Fib.com is a great web site for patients, that is unequaled by anything else out there."
Dr. Douglas L. Packer, MD, FHRS, Mayo Clinic, Rochester, MN
"Jill and I put you and your work in our prayers every night. What you do to help people through this [A-Fib] process is really incredible."
Jill and Steve Douglas, East Troy, WI
“I really appreciate all the information on your website as it allows me to be a better informed patient and to know what questions to ask my EP.
Faye Spencer, Boise, ID, April 2017
“I think your site has helped a lot of patients.”Dr. Hugh G. Calkins, MD Johns Hopkins,
Baltimore, MD
How Big Pharma Issues Misleading News and Why it Matters
Part of our Don’t Be Fooled series: TV commercials, print ads and news releases by pharmaceutical companies often include misleading statements. As healthcare consumers we all need to use a critical eye (and ear) when considering any health benefit claim.
A Prime Example: A Xarelto News Release
Recently Janssen Pharmaceutical issued news about their anticoagulant Xarelto. The news release was targeted at journalists, hoping they would write and publish articles about Janssen’s news report. (Read the full Jun 14, 2018 news release here.)
It’s a prime example of misleading journalists into passing on inaccurate information to the public. The headline reads:
XARELTO® (rivaroxaban) Associated with Significantly Reduced Time in Hospital and Decreased Costs Compared to Standard of Care in New Study of Patients with Low-Risk Pulmonary Embolism (PE)
A Health News Review Evaluation
HealthNewsReview.org is an online watchdog group that reviews health news stories and news releases that include a claim about medical treatments, tests, products or procedures.
They use a 10-point grading scale to assess whether a story gives information about its sources and their competing interests, quantifies the benefits of a treatment, and appraises the evidence supporting the story’s claims. (To learn about their 10-point grading scale, see the end of this post.)
As an example of a flawed news release, let’s look at the Jun 14, 2018 Janssen/ XARELTO® release. I’ll quote from the summary report by HealthNewsReview.org.
HealthNewsReview.org began their summary by describing the study design:
“The news release is about a study that explores if patients with pulmonary embolism, a blood clot in the lungs, who are at low risk for complications can be sent home from the emergency department early rather than be admitted to hospital.
The patients were divided into two groups: One group of patients were sent home early while taking rivaroxaban (Xarelto), a type of blood thinner,
…whereas the “usual care” group could get any blood thinner of their physician’s choosing, including rivaroxaban, and hospitalization.”
Next they discussed the study findings as reported in the news release:
“The study findings suggest that early discharge of low-risk patients was safe and feasible and also resulted in cost savings because of less time spent in hospital.
Unfortunately, the news release seemed to suggest that it was the use of rivaroxaban (Xarelto) that resulted in cost savings–rather than the strategy of sending low risk patients home early.
The news release failed to state that over half the patients in the comparison group who got usual care also received rivaroxaban.
In other words, the news release implies that rivaroxaban (Xarelto) was being compared to other anti-coagulants when what was actually being compared was an early vs. late discharge strategy.”
Total Score: After completing the 10-point criteria, HealthNewsReview.org gave the Janssen Pharmaceutical press release a score of 6 of 10. (Read the full evaluation on the HealthNewsReview.org website.)
Why This Matters
Not so good a score, 6 out of 10. While the news release writers did many things right, overall the release had a “spin” that misrepresented crucial facts.
First, the headline of this release crosses the line into unjustified language. It credits rivaroxaban with reducing the time patients spent in the hospital, when the early discharge strategy was actually the main difference between the groups—not the use of rivaroxaban (Xarelto).
Read the full evaluation on the HealthNewsReview.org website.
Next, the writers implied their product (Xarelto) was responsible for cost-savings, when it was not. They implied their product (Xarelto) was compared to other anti-coagulants, when it was not. They neglected to mention that most of the usual care group also got rivaroxaban.
And finally, the news release obscured the actual purpose of the study—to compare the safety of an early discharge strategy compared to keeping patients in the hospital.
To quote from the HealthNewsReview review again:
“Janssen’s misleading news release could result in news stories trumpeting rivaroxaban (Xarelto) as a superior blood thinner, when that is not what this study looked at.”
“In addition, the principal investigator quoted in the news release has financial ties to the company, which should have been disclosed.”
What This Means to Patients
Journalists can fall for misleading information as well as consumers (but not the good ones). They can write articles and pass on misleading data and results.
Some news sources are no better. Many news sites on the web and small newspapers often reprint a news release word for word, and present it as a “news” story.
As a healthcare consumer: You should question the benefit claims in ads. For any health-related news story, look for the source(s). Are they legitimate and from a credible, independent source?
If it’s about a new treatment, ask yourself is this news story balanced? Are alternatives presented (such as lifestyle changes, another drug, surgery, or no treatment)? If you’re only hearing about the potential benefits, ask what the harms are, and how often do they occur?
Don’t be fooled by health-related ads and news stories that ‘spin’ a company’s product or treatment with misleading statements.
Additional Reading
For more on this topic, check How to See Through the Hype in Medical News, Ads, and Public Service Announcements. It’s my review of the book “Know Your Chances―Understanding Health Statistics” by Steven Woloshin, Lisa M. Schwartz, and H. Gilbert Welch.
BTW: you can read the book online for free at PubMed Health, part of the U.S. National Library of Medicine.
News Story Review Criteria
The HealthNewsReview.org criteria consist of 10 different elements that they think should be included in all health care news stories and all health care news (press) releases:
1.Does the news release adequately discuss the costs of the intervention?
2.Does the news release adequately quantify the benefits of the treatment/test/product/procedure?
3.Does the news release adequately explain/quantify the harms of the intervention?
4.Does the news release seem to grasp the quality of the evidence?
5.Does the news release commit disease-mongering?
6.Does the news release identify funding sources & disclose conflicts of interest?
7.Does the news release compare the new approach with existing alternatives?
8.Does the news release establish the availability of the treatment/test/product/procedure?
9.Does the news release establish the true novelty of the approach?
10.Does the news release include unjustifiable, sensational language, including in the quotes of researchers?
Learn more about the News Story Review Criteria on the HealthNewsReview.org website.
