Health News Review

Overall, a good story, but women trying to make decisions would have been helped by a few more comparative details.

Our Review Summary

Many currently available birth control methods are effective, but only when they are actually used. A new study shows that methods such as the IUD and hormonal implants, which require no further attention once they are in place, are substantially more effective than methods that require daily attention, such as taking a pill. This story emphasizes the difference in effectiveness without providing much context about how contraceptive decisions are made, which involves weighing effectiveness against other factors such as side effects, cost, and future pregnancy plans.


Why This Matters

Preventing unwanted pregnancy is a critical health issue, for women, men, and the society at large, with current estimates of 3 million unplanned pregnancies per year in the U.S., of which half result from failure of birth control methods.  Women have many options for birth control, and reliable evidence about the relative effectiveness of each method is an essential factor in making decisions about contraception.


Criteria

Not Satisfactory

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

There is no discussion of the costs of long-acting methods (IUDs, implants, and long-acting injections) compared to alternatives such as the birth control pill, patch, or ring, although there is acknowledgement that insurance may not cover long-acting methods.  It only briefly addresses IUDs and implants with this line: “can cost patients several hundred dollars if not paid for by insurance.”

Satisfactory

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

Satisfactory

The report clearly quantifies the difference in failure rates of the various methods, which range from less than 1% for long-acting methods to about 5% (after 1 year of use) and 9% (after 3 years) for the pill and patch. There is no consideration of other benefits aside from prevention of pregnancy, which can be an important factor in choice of method for some women. For example, the oral contraceptive pill can lessen menstrual cramps, and some IUDs also treat excessively heavy periods.

Not Satisfactory

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

Not Satisfactory

No mention is made of side effects that may accompany long-acting contraceptive methods, nor of those associated with the birth control pill/patch/ring. While effectiveness in preventing pregnancy is a paramount concern, women also weigh side effects in making a decision about which method to use.

Satisfactory

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

Satisfactory

The report notes that the study involved a cohort of 7500 women ages 14 to 45 who were initiating or changing birth control methods and who sought to avoid pregnancy for at least one year.

Satisfactory

Does the story commit disease-mongering?

Satisfactory

No disease mongering at play here.

Satisfactory

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

Satisfactory

An independent expert is cited and makes clear that effectiveness, while important, is only one factor in a woman’s decision about a contraceptive method.

The potential for conflict of interest is adequately addressed, noting that one of the researchers is involved in training doctors on how to use one of the implantable methods.

Not Satisfactory

Does the story compare the new approach with existing alternatives?

Not Satisfactory

Mixed bag:

The story does a good job of comparing alternatives from the standpoint of effectiveness.  However it neglects any consideration of how they compare in terms of side effects and cost.

 

Satisfactory

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

Satisfactory

The higher cost of IUDs and implants can be a significant barrier to availability, as can access to health care providers trained to insert these devices. The story briefly mentions cost issues and lack of insurance coverage for these two options, but it is not clear how often lack of access to care affects availability.  We’ll give the story the benefit of the doubt on this criterion.

Satisfactory

Does the story establish the true novelty of the approach?

Satisfactory

Older studies have looked retrospectively at the effectiveness of different contraceptive methods, but this study provides a prospective look at how well they work in the real world, among typical users. The novelty is that this study was prospective, allowing more reliable measurement of outcomes such as pregnancy, and that it involved a large, diverse population of U.S. women.  The story appropriately referred to the confirmatory nature of the study and how it gives doctors “new ammunition to recommend these (long-lasting) methods.”

Satisfactory

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

Satisfactory

The report does not appear to rely on a press release.

Total Score: 7 of 10 Satisfactory


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