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NEWS: Susan Mayor Robotic prostatectomy transmitted live to engineers to promote collaboration BMJ 2008; 336: 687 [Full text]

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Could you transmit some data?

Gary J. Schwitzer   (1 April 2008)

Robotic prostatectomy transmitted live to engineers to promote collaboration: Unsubstantiated claims presented as evidence

Dr Kirkbride   (1 April 2008)

Could you transmit some data? 1 April 2008
Gary J. Schwitzer, Associate Professor & Director, Health journalism MA program University of Minnesota School of Journalism & Mass Communication Send response to journal: Re: Could you transmit some data?	This was an interesting article about attempts to "encourage developments in robotic surgery." But the story was completely devoid of any data. We learn that robotic radical prostatectomies are much more common in the US than in the UK but we learn nothing about outcomes. We learn that there are ethical issues but none is specified. We learn that a urologist believes robotic surgery has several advantages. But those are not quantified. What does "better results" mean? We learn that "patients recover more quickly" but we're not told how many patients. We learn of "better cancer control" without any definition of that term. Ditto for reported claims of more precision, "less collateral damage, resulting in less blood loss, faster recovery, and fewer complications." No numbers. I'm trying to teach my health journalism students, "No numbers? No story." I hope they weren't reading this week's BMJ "news" section. Gary Schwitzer, Associate Professor, University of Minnesota School of Journalism & Mass Communication, Director, health journalism MA program, Publisher, HealthNewsReview.org Competing interests: None declared
Robotic prostatectomy transmitted live to engineers to promote collaboration: Unsubstantiated claims presented as evidence 1 April 2008
Dr Kirkbride, Consultant Clinical Oncologist Sheffield Teaching Hospitals FT Send response to journal: Re: Robotic prostatectomy transmitted live to engineers to promote collaboration: Unsubstantiated claims presented as evidence	I was more than a little concerned to read this article and particularly by the way that the advantages of robotic prostatectomy were uncritically presented - the statements of Mr Dasgupta appear almost as 'evidence' of benefit. There are assertions of 'better results' which are not further elaborated upon, apart from quoting 'a less tired surgeon POSSIBLY does a better job', a 'usually' reduced length of stay, and, most controversially of all, 'better cancer control after such operations and better maintenance of erections' Claims like these cannot go unchallenged and indeed should never have appeared in the BMJ. No formal trial has ever assessed these outcomes, and indeed the conclusions of recently published meta-analysis stated only that 'compared with retropubic prostatectomy, laparoscopic and robotic- assisted prostatectomy are associated with decreased operative blood loss, decreased risk of transfusion, and similar risk of positive surgical margin' (ref). I note there is no mention of cost made in the article, which, I am afraid, is more promotional material than article in a respected medical journal. Robotically assisted prostatectomy may well have a role to play in treatment of prostate cancer, but only after its value has been properly evaluated, and until then, its proponents cannot make claims such as those quoted in this article. Reference Parsons JK, Bennett JL.Outcomes of Retropubic, Laparoscopic, and Robotic- Assisted Prostatectomy. Urology. 2008 Feb 9;[Epub ahead of print] Competing interests: None declared