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All you need to read in the other general journals

BMJ 2008; 336 doi: (Published 22 May 2008) Cite this as: BMJ 2008;336:1156

US regulators should investigate television adverts for drug eluting stents

At the end of last year, direct to consumer advertising of drugs in the US entered new territory when the manufacturers of the Cypher serolimus eluting stent launched a television advertising campaign. At least one expert has called on the Food and Drug Administration (FDA) to investigate the content, which implies that a serolimus eluting stent can open up your life as well as your coronary arteries. Middle aged adults swim, fish, and jog, while a voice-over says “when your arteries narrow, so does your life” and “it’s time to open it.”

Although the advert mentions a few potential complications of stent placement, such as heart attack or stroke, it doesn’t cover the full list, which includes coronary artery rupture, emergency coronary artery bypass, and death. The regulatory rules governing broadcast advertisements may be weaker than those governing print advertising, but even a 60 second television commercial is supposed to include a “fair balance” of risks and benefits, he writes. The FDA should take a close look and decide whether the campaign meets the basic requirements for non-deceptive advertising. If not, it is little more than “a bold experiment in interventional psychology”—testing just how far patient preferences can influence highly complex technical decisions about the best interventional treatments for coronary artery disease.

Pros and cons of ultrasound for breast cancer screening

Women trust mammography even though it has a relatively low sensitivity—it picks up only about half of all breast cancers. The combination of mammography and ultrasound detects more cancers, according to a recent landmark study (11.8/1000 women screened v 7.6; difference 4.2, 95% CI 1.1 to 7.2). Should screening programmes add ultrasound to standard mammography?

Probably not, says a linked editorial (p 2203). Mammography and ultrasound together produced substantially more false positives than mammography alone. Less than 9% of the women who had biopsies prompted by …

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