Health News Review

The overarching question in our mind is why/whether results in 14 people after two treatments in two months is newsworthy. Especially when results of a study on a competing technology in more people over longer time were ignored.

Our Review Summary

The story is based on a presentation from a “Late Breaking Research Session” at the annual meeting of the American Academy of Dermatology.  The presentation was one of 15 conducted within a 2 hour time period (an average of 8 minutes per presentation).  So how/why was this one selected for news coverage? We are especially bewildered since a poster at the same meeting (Poster 5300) provided information on the use of a competing microwave device for hyperhidrosis.  The poster presented 6 month data for 27/31 enrolled subjects.  Why then report on a 2 month study in 14 subjects presented presumably in 8 minutes? Fort those who are interested, here are the study results.


Why This Matters

We wish the story had provided some discussion about what is normal sweating and what is considered excessive.

Are stained armpits when you meet the new in-laws or give a talk before a large audience a sign of a problem?

And does an 80% reduction in sweat in people considered to have a problem enough to make a difference for them?

This context was lacking.

The problems of reporting on talks at scientific meetings have been documented.  We wish more news organizations would learn from past mis-steps.


Criteria

Not Satisfactory

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story seems to excuse itself from this issue by saying the researcher “did not estimate costs.”  Well, that’s not good enough.

The story explains that the technology is already approved for eyelid lifts.  Even though that’s a totally different ballgame, what does that cost?  Use of new technologies is not free – and stories promoting efficacy claims shouldn’t give researchers a free ride on the cost issue.

It took us just seconds to find cost estimates online.  One plastic surgeon wrote: ” rough pricing guidelines: Axillary treatment: Botox (~6 months): $600-995; Ultrasonic therapy (permanent): $3800 Hands OR Feet: Botox (~6 months): $400-895.”

Not Satisfactory

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

Not Satisfactory

We are given relative estimates of sweat reduction after treatment – but no context to judge the scope.

What does an 80% reduction of sweat in a person with excessive sweating amount to?  Does that bring them back to near “normal”?  – Which, of course, raises questions about “What is normal?”

 

Not Satisfactory

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

Not Satisfactory

The story states that “some in the study reported temporary tenderness, redness, numbness and bruising.” That’s all it said.

That raises more questions than it provides answers.

  1. How many is “some”?
  2. How temporary is “temporary”?
  3. What is the ultrasound doing that is causing these issues?  What’s known/unknown about the mechanism?
Satisfactory

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

Satisfactory

We’ll give the story the benefit of the doubt for reporting “small study” in the subhead and later, “the study was small and the findings are preliminary.”  And at the end:

This study was presented at a medical conference. The findings should be considered preliminary as they have not yet undergone the “peer review” process, in which outside experts scrutinize the data prior to publication in a medical journal.

Still, the overarching question in our mind is how/whether results in 14 people after two treatments in two months is newsworthy.

And we are troubled by the story allowing the researcher to talk about early data from his next study which isn’t even completed yet, much less published or peer-reviewed.

Not Satisfactory

Does the story commit disease-mongering?

Not Satisfactory

We all sweat.  How much is excessive?

What pushes someone from the estimated 97% who are “normal sweaters” (by inference in the story) into the 3% who “suffer” from excessive sweating (stated in the story)? Primary focal hyperhidrosis is not defined simply by “excessive sweating.”  In order for the diagnosis to be made other criteria need to be met.  Suggesting excessive sweating is enough to put a person into the elite 1-3% of the population with the condition is a bit of over reach.

Where does that 3% estimate come from?

Other estimates we found in a quick web search put the estimate at less than 1%.

When does this become a problem worthy of ultrasound treatment over several months’ time?

Satisfactory

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

Satisfactory

A weak satisfactory grade on this.

Two dermatologists were quoted besides the researcher:  one really didn’t add much.  The other has a connection to a competing technology for hyperhidrosis.

And the story did note that the researcher received a grant from the company making the technology.

Not Satisfactory

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story added a list of other treatment alternatives at the end of the story.  We wish it had also provided some comparison of effectiveness.  Oddly, it listed the cost of a competing technology but not the cost of the ultrasound which was the focus of the story.

But most odd – and the reason we give this an unsatisfactory score – is that at the same dermatology meeting, data were presented on the use of a competing microwave device for hyperhidrosis – with longer term results and in more patients!

Not Satisfactory

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

Not Satisfactory

The story never does state the availability of the technology for people with hyperhidrosis.  It does state that the FDA has approved it for eyelid lifts.  Are many dermatologists (or others) trying it for hyperhidrosis?

A simple few additional words would have clarified the issue.

Not Satisfactory

Does the story establish the true novelty of the approach?

Not Satisfactory

The headline says “new procedure” but we quickly found online references going back at least 6 years about other ultrasound research for hyperhidrosis.  Some broader context about other uses and past attempts in this field should have been referenced.

Satisfactory

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

Satisfactory

It does not appear that the story relied on a news release.

But we must admit, we wonder about the rationale for picking this study out of the hundreds being reported on at the annual meeting for a story.

Total Score: 3 of 10 Satisfactory


Comments

sarah posted on March 26, 2012 at 10:58 am

Of course Dr Nestsor “did not estimate costs” – it’s a rare physician who knows what any treatment they do costs! Try asking your doctor what a procedure costs next time s/he orders one!

It’s sad that publications have transferred their loyalty and focus from their readers to atracting advertisers and increasing “hits” or page-views. Follow the money, when you can ….

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