HealthNewsReview.org | Independent Expert Reviews of News Stories | Holding Health and Medical Journalism Accountable |
|
|
Cutting edge nail cure
April 09, 2009
The advantages were unsubstantiated, the harms unstated and the effectiveness exaggerated. Network TV promoting an off-label use. Disease mongering at its worst. A new low. Stay tuned for lower.
Our Review Summary
Everytime you think you've seen the worst use of network TV time on "health" topics, something lower pops up on the screen.
Such was the case with ABC's promotion of an off-label unapproved use of a laser for toenail fungus.
The ad - er, story - told us:
• "About half of all Americans over the age of 50 are struggling with this problem." Struggling? Really? Enough to warrant a $1200 treatment ($120 per toe) that is NOT covered by insurance? This is part of the 16% of the GDP that Americans spend on health care.
• ABC profiled one woman: "Meghan, like millions of Americans, has had her toe fungus for 15 years. It's unsightly, embarrassing. And like others, she suffered in silence, not wanting to talk about it." Millions of us like poor Meghan - suffering in silence? But not silent any longer - thanks to almost 5 minutes of network news time.
• It's just been introduced, but it's already used by many podiatrists, but more testing is needed. But the story didn't give any warnings about such proliferation of non-FDA approved uses of technologies.
ABC said this was "news for tens of millions of you out there right now." So is the fact that we spend 16% of the GDP on health care - much of it on stuff like this.
If you're going to do a story on this topic - and it's hard to avoid given how much Americans spend on it - check out the recent New York Times story for comparison. ABC's segment wasn't even in the ballpark.
Click on Criteria for definitions.
We're told that many podiatrists are already using the laser for toenail fungus. But that doesn't tell us much. We're also told it was just introduced at the American Academy of Dermatology meeting. So which is it: just introduced? Or many already using it? Only 13 clinicians are listed on the company's website as providers.
Costs were covered - $120 per toe - not covered by insurance. But we are suspicious of the claimed 88% success rate and the number of treatments required to attain the level of "success" portrayed in the story. This may not be a one-shot, $1,200 deal.
Classic case of disease mongering. Millions of us have it? Suffering in silence? Gag me.
We're told that the laser maker says it's 88% effective. What does that mean? 88% never have a problem again? 88% get one treatment and that's it? What happens to the other 12%? The network gave almost 5 minutes of airtime to this; they could have given more meaningful evidence. "Success" is not necessarily the same as the proclaimed "cure."
No discussion of any harms. Everything carries a potential harm. What do the studies show?
Is it an ethical use of network news time to give 5 minutes to something that is being promoted for off-label use? Do viewers really understand what that means? The novelty may come at a cost - and the network fawningly went along with all of the claims.
Toenail fungus is big business and as a result a number of approaches have been used and many are still in development. While one company's laser was highlighted others are testing similar devices. In addition, other drugs and approaches are in the developmental stages as well. The promotion of an off label use that has no published study results available raises significant issues.
See comments for "Evidence."
We can't be sure if the story relied soley or largely on a news release.
Two true-believer health care professionals were profiled. No independent source appeared.
The story mentions topical solutions with limited effectiveness. And a prescription drug whose "side effects need to be closely monitored with blood tests." But no such scrutiny was applied to the off-label laser idea. That's an unlevel playing field. Not news - but advertising promotion via network TV.
Total Score: 0 of 9 Satisfactory
The U.S. Preventive Services Task Force is considered the gold standard of preventive health recommendations - including on screening tests. It's a good source for journalists and consumers.
About 70% of the stories reviewed from 2006-9 failed to adequately discuss costs, or to explain how big (or small) are the potential benefits and harms of treatments, tests, products and procedures.
We have documented a disturbing trend of news stories taking an advocacy stance, promoting certain screening tests outside the boundaries of scientific evidence.
Stories on new technologies like Cyberknife, DaVinci robotic surgery systems, and proton beam cancer therapy often fail to scrutinize the evidence and/or to discuss the costs involved.
Rather than suggesting that everyone should be screened for everything, news stories could explain: "All screening tests cause harm; some may do good."
The first 38 network TV network morning health news stories reviewed in 2009 earned an average score of 1.2 stars. 13 of the 38 stories got ZERO stars.
Both TIME magazine and BusinessWeek have published terrific stories explaining the importance of the Number Needed to Treat - or NNT.
Knowing relative risk reduction is like knowing you have a 50% off coupon but not knowing whether it's for a Lexus or a lollipop. Absolute risk reduction tells you what the "coupon" is worth. Read more.
The website NoFreeLunch.org posts "a database of health care professionals who have pledged to accept no gifts from industry and to rely on non-promotional sources of information."
To help journalists cover stories responsibly, we post a list of independent experts who state that they do not have financial ties to drug or medical device manufacturers.
We apply the same ten standardized criteria to the review of every story.
We have about 30 story reviewers. Each story is reviewed by 3 different people.
Gary Schwitzer's seven words you shouldn't use in medical news: cure, miracle, breakthrough, promising, dramatic, hope, victim. Read why.
Our reviewers include two former CNN medical reporters and a former editor of the Washington Post health section.