text_1: Scans cut heart attack rates and save lives, major study finds
text_2: This brief news release describes a single positive finding from the 4,000-patient SCOT-HEART study:  roughly half of patients with stable chest pain who were randomized to receive computed tomography angiogram (CTA) and standard care had fewer heart attacks over 5 years than those who received standard care alone. But there’s a flaw in the headline and first sentence of the release. This study shows zero difference in deaths, and as the authors acknowledge in the published study, the entire difference between the groups was driven by non-fatal heart attacks. Another problem with the news release is that these benefits are expressed in dramatic relative terms, instead of the much more modest (and helpful) absolute terms. Readers are left with little guidance regarding what may account for the slight drop, and if this really represents a “major” reduction as claimed by the lead author. Finally, readers would have been better served if a discussion of alternative screening methods, conflicts of interest, and potential downstream costs and risks had been included. As a positive, the release mentions the potential to avoid invasive testing via angiogram, which has a very real death rate. What may really be at issue here is whether roughly $1 million scanners are truly better than the non-invasive tests we already have. It remains unclear which patients benefit most from these tests, whether the scans provide actionable information (or simply lead to further confirmatory tests), and what will be their true costs.