Monday, February 28, 2005

The Times of India and AIIMS cure heart disease

The reporting of medical news in the media has always left a lot to be desired. An excellent example of this is the story which the Times of India carried on its front page on 25 Feb 2005. This was headlined, "AIIMS scripts stem cell success story." While I must admire the writer's alliteration skills, the story just carries the tall claims made by the All India Institute of Medical Sciences, New Delhi, without bothering to verify them.
Stem cells used to be the media's favourite medical story in 2001 when the NIH first released their report, Stem Cells: Scientific Progress and Future Research Directions. There was a lot of hype about how these cells would transform medicine as we know it, and these cells ignited the public imgaination as well, so that stem cell research became a "hot area" in medicine, and stem cell researchers became front page celebrities. Stem cell research attracted millions of dollars of funding, and entered the vocabulary of the well-informed lay reader ( which is quite remarkable, when you remember that even most doctors were quite clueless about these cells uptil 2001 !) Unfortunately, none of these claims withstood the passage of time, so that serious researchers moved away from the glare of the media, and went back to their labs to try to convert the potential locked up in stem cells into something which would be clinically useful for their patients. They all agreed that it would take a number of years before stem cells could be used for actual treatment, because so much more needed to be learnt about them.
Now the AIIMS claims to have
marked a global first by pioneering stem cell medicine by the "injection method", placing the institute right at the top of the world's medicine map.
I wish this were true, but it's not !
In their anxiety to scoop the rest of the press,
"here is an exclusive story only in the Times of India"
the reporter has relied solely on a lengthy exclusive interview with Dr Venugopal, the institute's director. Unfortunately, the story is just a concoction of hype , hope and plans for the future.
The lead paragraph describes
Ishika, a 7-month old baby with cardiac myopathy, who has had stem cells injected into her heart. As she flashes a toothless smile, her mother hopes that Ishika's will be another success story of stem cell research at AIIMS.
Is this the stuff of front page medical reporting ? A mother's hope ? What happens if Ishika does not do well ? Will the Times report this failure on its front page too ?
The next paragraph is
about a 70-year old stroke patient is also set to be injected with stem cells to improve his condition.
However, only a crystal ball can tell us whether he will really improve or not.
Finally, the story reports a
path-breaking study conducted from February 2003 to January 2005, where 35 cardiac patients were given stem cell treatment and monitored,
and
the statistics speak for themselves.

Actually, the study is not even path breaking. Stem cell injections to improve heart function were first done in France way back in 2000 and the world leader today is Germany , where the first studies were done in 2001. If you subscribe to New Scientist , how stem cell injections have been used for treating heart disease has been racily reported in their 25 September 2004 issue, in an article titled , Don't go breaking my heart.
If the reporter had bothered to do her homework, she could also have read the well-written article, CELL THERAPY: Renovating the Heart in Science magazine. This well-balanced article provides a very good historical overview, tempers the promise with the practical real-life clinical problems, and also highlights the risks associated with this treatment. ( These include life-threatening problems such as arrhythmias and the risk that the stem cells may develop into cells other than heart muscle cells). Reading the TOI article which describes stem cells as "magic cells", one would think AIIMS has discovered the elixir of life all by themselves, when in reality they have not even been the pioneers in the field.
Secondly, when the results claim that "56% of the affected areas injected with these cells have shown improvement", you know that statistics are being used to mislead. While the number sounds very accurate , reliable and therefore trustworthy, every cardiologist know that it's impossible to be so accurate. Heart muscle function is assessed by echocardiography, and it's impossible for this tool to provide this sort of accuracy.
Unfortunately, the journalist has broken all the basic rules for reporting. She has not bothered to determine if the study was published in a respected peer reviewed medical journal - after all, such a major breakthrough, if it were true, would be the lead article in Science, Nature and the New England Journal of Medicine ! Also, she has not bothered to interview other doctors, or ask them for their opinions - one of the cardinal principles of reporting !
Even simple common sense would have caused her to pause before filing her story. If it's so simple and effective, then why aren't all doctors all over the world doing this for their patients ?
Medical stories are too important to be treated so shoddily. Readers respect the Times of India, and TOI stories are supposed to be trustworthy. Such shabby reporting creates a lot of harm, for both patients and their doctors. It creates false hopes, which may never be fulfilled. You can imagine the avalanche of patients who will be flocking to the AIIMS; or who will be carrying the cutting to their doctors, demanding a "stem cell injection " for treatment !
It also damages the credibility of the newspaper - and of institutes like the AIIMS. If they cry wolf too often, no one will take them seriously the next time, or respect their research.

3 comments:

  1. Good work. I had my doubts about the TOI piece as well, but you put the concerns across very well.

    ReplyDelete
  2. Dear Doctor,

    Stem cells could benefit the patient if the cells were cultivated from the patients own body, preferably his own umbilical chord. Otherwise the patient risks genetic contamination as cells can exchange genetic information within themselves. However such stem cell therapy would be prohibitively expensive. Maybe in case of accidental injuries where tissue regeneration would be ordinarily difficult, stem cell therapy could prove to be very useful.

    Regards,
    Jagannath.

    ReplyDelete
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    ReplyDelete

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