Health News Review

One of our reviewers wrote, "WebMD apparently was phoning it in on this one." Read why.

Our Review Summary

There was no independent perspective or interview of any kind conducted for this story. And the lack of expert feedback shows in the mediocre evaluation of the evidence, vague discussion of benefits, and failure to provide important context about previous research in this area. Perhaps most troubling, the story did not mention that the study being covered was funded by the manufacturer of the probiotic supplement being tested–one of several reasons for readers to look cautiously on the findings.


Why This Matters

It would be nice to offer parents an effective evidence-based treatment for infant colic–a  condition typically characterized by at least 3 hours of crying at least 3 days per week during the first few months of life. Although many will consider this trial to be proof of probiotics’ effectiveness (an impression bolstered by WebMD’s incurious coverage), a small study such as this one can never conclusively establish a treatment benefit. Failure to discuss this uncertainty leaves readers with only half the story.  


Criteria

Not Satisfactory

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story did not mention how much treatment with this probiotic costs. A month’s supply costs about $40 according to one Internet retailer–information that easily could have been included in the piece.  

Satisfactory

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Satisfactory

The story reports the number of minutes per day that children cried in the probiotic and placebo group — a reasonable characterization of the main findings. Although we’ll award a borderline satisfactory, we wish the story had avoided some of the following vague language:
 

  • The story states that L. reuteri is a bacterium which "improves digestion" — a phrase which is meaningless without further explanation. L. reuteri has been shown to reduced the duration of diarrhea caused by viral infections and may increase the number of bowel movements in constipated infants. If this is what is meant by "improved digestion," then the story is accurate, but we doubt most readers will make this connection. 
  • The story states that L reuteri reduces the level of "harmful E. coli bacteria." This is a simplistic description which invites confusion between garden variety E. coli bacteria which are normally present in the human gut and the highly infectious strains implicated in food recalls. To be clear, E. coli is a normal and natural denizen of the human intestine and is not necessarily "harmful" as suggested by the story.  
Not Satisfactory

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

Probiotics are generally regarded as safe for healthy children. Nevertheless, the mechanism through which these bacteria work are not well understood, and there have been reports of severe infections attributable to probiotics in critically ill or immunocompromised patients. We don’t necessarily think the story needed to get into this level of detail about potential adverse effects, but some comment about the general safety (or lack thereof) of this probiotic strain should have been provided

Not Satisfactory

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

This one was close, but ultimately unsatisfactory in our opinion. Although the study provides a reasonable explanation of the intervention, the measures, and the main results, it failed to discuss the limitations of a study which included just 50 patients. Small, early studies often report dramatic benefits from a new therapy (especially when they are industry-sponsored); the benefits seen in subsequent larger studies is usually less impressive for a variety of reasons. Had the study contacted an independent expert for a comment on the findings (another deficiency discussed below under the "Sources" criterion), they likely would have provided this context.  

Satisfactory

Does the story commit disease-mongering?

Satisfactory

The story did not exaggerate the effects of infant colic.

Not Satisfactory

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

A real shortcoming. No independent perspective was provided nor were the researchers themselves interviewed for the story. In addition, the story failed to point out that the study was funded by probiotic manufacturer BioGaia.   

Satisfactory

Does the story compare the new approach with existing alternatives?

Satisfactory

The story notes that there is no known cause or cure for infant colic. However, the story should have noted that colic goes away on it’s own after several weeks, and is not a "disease", therefore may not need treatment. A close call, but satisfactory.

Not Satisfactory

Does the story establish the availability of the treatment/test/product/procedure?

Not Satisfactory

Not enough information here. The probiotic tested in this study is actually a commercially available product distributed by the study’s sponsor, BioGaia–information which was never provided to readers. (More on this later under the "Sources" criterion below.) Moreover, the story attributed the benefits observed in the study to the Lactobacillus reuteri species of probiotic; it should have pointed out that the researchers tested a specific commercial strain of L. reuteri known as Lactobacillus reuteri DSM 17 938. Different strains of the same probiotic are known to produce widely varying effects, so the reduction in crying observed in the study might not be seen with other strains of L. reuteri.     

Not Satisfactory

Does the story establish the true novelty of the approach?

Not Satisfactory

The story failed to mention important background here. The study reported on was actually a follow-up to a previous open label study (the researchers knew which children were getting what treatment) conducted by these same investigators and which also found a benefit for L reuteri on colic. The fact that this second, blinded trial has confirmed the previous findings should increase our confidence that something real is happeneing here. Still, as previously noted, larger, independent studies will be needed to conclusively establish a benefit for probiotics on colic.   

Not Applicable

Does the story appear to rely solely or largely on a news release?

Not Applicable

We couldn’t find any evidence that this story relied on a news release. Considering that nobody was interviewed, however, the best we can do is call it not applicable.

Total Score: 3 of 9 Satisfactory


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