How our leading newspapers misreport medical news...a story involving biliary stenting
Today's TOI and the Express Service have made a big deal about a report from PGI Chandigarh, where the Gastroenterology department has treated 18 patients of type II malignant biliary obstruction with unilateral metal stenting without injecting contrast into the biliary tree during the stenting. The big deal is obviously not the metal stenting per se, but the fact that since the stenting was performed without contrast injection into the biliary system, the incidence of cholangitis and infection after the procedure was 0%. This has been reported in the Journal of Gastroenterology & Hepatology, which is the official journal of the Asian Pacific Association of Gastroenterology, one of the minor and less important journals in the field.
The titles of both newspaper reports are sensationalistic to say the least. One is titled "New Hope for Cancer Patients" and the other "New Treatment For Cancer Patients with Jaundice". New hope? New treatment? Just because infection was prevented by avoiding the injection of contrast into the biliary tree, that becomes the New Big Thing? Jeez!
There is also a footnote on the use of brachytherapy to treat these tumors, which is also not a new method, something a simple Pubmed search would have unearthed.
The newspapers never exercise due diligence. If the concerned reporter had cross-checked with the available literature or with another gastroenterologist or gastroenterology department, he/she would have figured out the importance (or lack of) of this issue. But journalists and the press are not the only ones to blame. Obviously the press was contacted and a "press report" or its equivalent was issued to obtain the requisite publicity...
2 Comments:
This is regarding the comments made in inner visions 05/23/2004- 05/29/2004 on the new method of unilateral metal stenting in type II hilar malignant biliary obstructions.
Treatment of complex hilar strictures is a difficult problem especially to gastroenterologists. Dr. Bhavin is not aware of the number of deaths occurring due to resulting cholangitis in these patients undergoing ERCP even in experienced hands. I don’t know whether Dr. Bhavin is a gastroenterologist or not. If he is not, he is justified in underestimating the importance of this procedure. The problem is so difficult that majority of endoscopists prefer not to do anything in such patients or get a drainage done by radiologists which is not a preferred method over endoscopy. This procedure is not just no-injection of contrast and avoiding infection. The procedure is new, as this has not been reported in literature and the way the metal stent is put across the hilar stricture without visualizing the duct and stricture. Kindly go through my original article published in May issue of Journal of Gastroenterology and Hepatology 2004. Putting metal stent is no problem, it’s an easy job done, however, without contrast there is no report in literature.
Regarding intraluminal brachytherapy for bile duct tumour, is not a new thing, however, no center in our country is doing this by endoscopic route. To my knowledge the only center that is doing intraluminal brachytherapy is SGPGI, Lucknow, that too through percutaneous route. The information was spread with the intention of making the public aware so that they are benefited and not misled by inexperienced physicians/ gastroenterologists/ endoscopists.
Dr. Virendra Singh
Associate Professor Hepatology,
PGIMER, Chandigarh.
8:21 PM
Fair enough. The last sentence in my post was probably unwarranted.
The problem is the way the lay press reports medical news of any kind. Such news is always blown up beyond proportion and considering the tremendous lack of any kind of knowledge and ability to understand technical reporting of any kind among the lay public, such news reports just don't serve the purpose they were probably meant to.
9:36 PM
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