To the Editor: The front-page article in the Sydney Morning Herald on 7 June this year1 highlights the problem of premature media coverage of a scientific presentation,2 potentially causing distress and confusion. Without being subjected to full peer-review and unavailable for analysis in its full published form, such data should not be presented to the public as scientific fact, and should not be sensationalised so as to encourage patients and doctors to change management. A small single-centre observational study is regarded as Level 4 evidence and cannot be used to recommend a change in management. At most, such data might be considered hypothesis-generating and used as the basis for a properly conducted clinical trial.

In a meta-analysis of 70 000 "high risk" patients, antiplatelet therapy, mainly with aspirin, reduced rates of stroke, myocardial infarction and vascular death by 25%.3 Aspirin also reduced by almost half the rate of graft occlusion after coronary bypass surgery.4 The press article has confused such patients and may lead to their discontinuing life-saving therapy. It cites Bertouch as stating that 75 mg of aspirin "might be more appropriate". There are no data, either from the Prince of Wales study or any other, to support the contention that 75 mg of aspirin causes less bleeding than 100 mg or 150 mg. The press release describes the research as a "world-first study", and Dr Bolin is cited as stating that "we were unaware that really low-dose aspirin had the same risk". However, as early as 1991, the Swedish Aspirin Low-Dose Trial showed that even 75 mg of aspirin produced more bleeding than placebo (P = 0.04).5

As a result of the Sydney Morning Herald article, patients are asking their doctors to make a judgement on ceasing their aspirin therapy, which might prove fatal, or reducing the dose from 100 or 150 mg to 75 mg, which is not supported by evidence and is not even a dose available in Australia. At a time when it is difficult enough to convince patients to take medication which is of proven benefit, both the press and the research community have a responsibility to the public to avoid recommendations which are not evidence-based and which detract from our efforts to reduce the mortality from Australia's biggest killer — cardiovascular disease.