May 30th, 2012
Reality Check: Do Reporters Spin Trial Results?
Harlan M. Krumholz, MD, SM
Do reporters spin trial results – or do some reporters just not understand the science well enough to report results accurately?
I was thumbing through Nature Reviews/Cardiology when I happened on this headline in the section on Research Highlights: Vorapaxar beneficial in setting of prior MI, but not in patients who have experienced stroke. This long headline caught my attention because I thought that TRA 2P-TIMI 50, the trial that is being reported, was positive at the cost of a substantially higher risk of bleeding.
Vorapaxar is a novel antiplatelet drug that Merck inherited from Schering-Plough. It selectively inhibits the actions of thrombin. TRA 2P-TIMI 50 showed that in patients with a history of MI, stroke or PVD, vorapaxar produced an absolute 1.2% reduction in the composite of death from cardiovascular disease, myocardial infarction or stroke – and a 1.7% increase in moderate or severe bleeding and a 0.5% increase in intracranial bleeding.
With the disappointing TRACER study, which showed that in patients with acute coronary syndrome, this drug did not produce a significant reduction in a composite of death from cardiovascular causes, myocardial infarction, stroke, recurrent ischemia with rehospitalization, or urgent coronary revascularization and did significantly increase intracranial bleeding – this drug seems unlikely to garner much support.
In this context, the headline seems to be a little misleading. Is that really the major message from this trial? How do you know which research summaries you can trust? I’d also like to hear from anyone who thinks I misinterpreted this trial.
4 Responses to “Reality Check: Do Reporters Spin Trial Results?”
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I never cease to be amazed at how often the actual journal article differs from the interpretation/spin put on it by the newspapers. Some journalists spend enough time to read the report to include all the caveats in the article in question, while others seem to cherry-pick from the abstract. I once had to tell a patient that the “National Enquirer” is not a medical journal.
It works in all directions: (some) authors, editors, backers, drug companies, and various iterations of the press are influence peddlers. I strongly urge all to read the statistical discussion of The Million Women Study by the U of Capetown’s Samuel Shapiro as he reviews the categoreis of causality errors built into a supposedly flawless study (so comparable to what is published everywhere). His list of generally accepted causality errors in that study include time order, information and detection bias, internal and external consistency, and biologic plausibility. No conflicts. http://www.thepmc.org
The AMA used to hold educational conferences for medical journalists when it had an office in NYC. No longer. Too many cubs doing general reporting now. And others often write the headers.
Recent stories on HDL Rx., for example, really missed the point. So–
Authors: In addition to your summary conclusions, add a line that says what one may not conclude from your data if “cold” pre-readers have had some doubts.
Do Ducks swim? The reporters always flavor their stories to get people to read them. Media reporting is not the same as peer reviewed journal authoring. If it was, the media would go out of business. I saw an article today published in the NYT (a “reputable” newspaper).The flavor of the article was exercise can hurt you. If you want to attract attention, remember it is “man bites dog” that will do it.