Physicians recommend radiation as first-line treatment for facial pain, but where’s the data?

Does the news release adequately discuss the costs of the intervention?

Not Satisfactory

We know surgery has many costs involved but none of them are discussed in this news release. The release mentions performing a “cost-based analysis” at the end but this is insufficient to give credit here.

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

Not Satisfactory

There are no numbers to back up the claims in the release. The release does not share information about the actual scores from patients in this study. In addition to providing data on the EuroQOL 5-Dimension questionairre scores before and after treatment, the release should have also provided information about what constitutes a meaningful change in the EQ-5D score.

Does the news release adequately explain/quantify the harms of the intervention?

Not Satisfactory

It would be most useful to know why radiosurgery is typically a “second line treatment to be used following the medication” and so one wonders if this is due to the harms involved with this type of surgery which can include fatigue, skin problems, and difficulty swallowing, none of which are mentioned in the news release. At a minimum, if there weren’t any side effects among the patient volunteers, the release could have stated that there weren’t any. Additionally, since the treatment involves radiation and radiation can promote cancer, the study should have mentioned this and why or why not it is an issue with this specific treatment.

Does the news release seem to grasp the quality of the evidence?

Not Satisfactory

The two questionnaires, the EuroQOL 5-Dimension and Patient Health Questionnaire 9 were administered before and after the radiosurgery. Before and after comparisons of self-reported outcomes are among the lower forms of evidence.

Limitations of this type of evidence should have been noted. Many patients could have been improved by factors not directly related to the surgery and we won’t know this without a control or comparison group. Though the piece does describe the study and what it measured (quality of life and depression), it doesn’t explicitly state that these findings aren’t compared to other treatments. Moreover, it isn’t clear what treatments patients in this study had previously or were currently taking at the time of the radiation treatment. For example, had they tried an anti-seizure medicine that is commonly used for trigeminal neuralgia and were they still taking it? One could then have asked if taking it at baseline, were they able to stop it? So while the information provided is helpful, other key pieces of data are left out and their absence makes it hard for the reader to put these results into context.

Does the news release identify funding sources & disclose conflicts of interest?

Not Satisfactory

The release doesn’t name the funder of the study. There’s also no mention of potential conflicts of interest, other than that Dr. Chao does the procedure.

Does the news release compare the new approach with existing alternatives?

Not Satisfactory

Although the release comments on medicines used for treating trigeminal neuralgia, their mention focuses on very severe side effects. However, no information is provided about the use of these medicines in the patients participating in this study. Only by directly comparing different forms of treatment can one determine their relative benefits. It is also worth mentioning that some patients will have spontaneous improvement, so it isn’t clear if it was the radiation treatment, or just the passage of time that helped.