As I was innocently driving down the FL Turnpike, for the Cleveland Clinic (restarting a cardiovascular clinical trial), I was assaulted by a story on NPR about how a progesterone gel was used to reduce premature births in women 'diagnosed' with a 'short cervix.' First, I think some of the girls on my basketball team should be diagnosed with 'short stature' and maybe we can get some kind of intervention. The conversion of physical characteristics into pathology is, itself, a pathology. But that isn't the part that got me.
In the course of the report, they stated that women with short cervix had rates of premature delivery of up to 50% and those that used the progesterone gel had a 45% reduction in premature births. Sounds great. So the story goes on to 'highlight' one woman who entered the trial and was in the group that had the active cream and delivered a full-term baby. The quote from NPR was the therapy 'worked.' Huh? How would they know she wasn't going to go to full-term without the drug? Huh? Science reporting is the only thing lazier than science itself. I mean, NPR? What are they trying to prove, that they are just as bad as commercial outfits?
Well, I had to look at the real numbers, to see what the likelihood of pre-term delivery in the study was and it was 23% of 229 women (in the control arm), meaning around 52 births. Also means the majority of women with the diagnosis of 'short cervix' don't have premature babies. And in the treatment arm (same number of women, I think), about 32 women have pre-term deliveries, despite the drug. So that means the drug 'prevented' about 20 pre-term births out of 229 total births. I mean not bad, but hardly earth shattering, especially for the horribly misleading commentary about the woman who they followed.
Good news for the pharmaceutical company is that soon all the women in the US with 'short cervix' will get this drug, even though the vast majority will not benefit and there will still be lots of pre-term births. Oh, and we will all pay the millions necessary to implement the therapy. But that's the way we apparently like it.