This article about the benefits of nasal irrigation helps introduce readers to an often overlooked treatment for sinus congestion. It generally is successful at doing so. As the sources suggest, for many people this is an excellent first treatment for sinus congestion and headaches.
However, the article falls short of several health reporting best practices which make it less credible, complete, balanced and useful.
None of these shortcomings creates a public health hazard or undercuts the fundamental value of the story. But they demonstrate the importance of using reporting best practices even when an article is not controversial and the treatment featured potentially effective and benign.
It would have been simple and useful to cite the costs of the device, the spray equivalent, and the solution.
The story does not provide sufficient data about the outcomes, instead summarizing with the words "effective," "safe," and "inexpensive."
The key study of 28 people showed a 30 to 40 percent improvement in systems.
The story does not mention the side effect of nasal irritation, post-treatment dripping and saline occasionally getting trapped in the inner ear. While these are rarely serious, they should have been noted.
The article cites three studies published in medical journals.
But detail on the key study, appearing in the Annals of Family Medicine report, is insufficient. That study addresses the efficacy of irrigation most directly, but it is summarized without data.
The study was only partially blinded, was based on questionnaires adminstered weeks after irrigation had been undertaken, and involved a treatment group of only 28 people.
While the story emphasizes how unpleasant chronic nasal congestion is, it does not exaggerate its seriousness.
The main source cited is Diane Heatley, whose objectivity is compromised by her ownership of a company that sells a nasal irrigation system. Other sources round out the piece, but over-reliance on Heatley harms the objectivity.
Authors of the published article in Annals of Family Practice would have been better sources.
Two independent medical sources discuss mainly antibiotic overuse.
The story also leads and ends with anecdotes from satisfied patients.
One of them claims to have gotten relief from migraine headaches. Irrigation does not treat migraines, but migraines are often thought to be sinus headaches. In all likelihood the patient got relief via irrigation from her sinus headaches, which she thought were migraines. This story could easily confuse readers who believe irrigation can relieve migraine headaches.
The article makes clear that saline sprays, antibiotics and over-the-counter nasal sprays are also used to treat sinus congestion. Exploring how use of irrigation can reduce incidence of antibiotic overuse is particularly valuable.
Mentioning the efficacy and side effects of each alternative treatment would have added value, however.
The story didn’t explicity discuss availability, but neti pots and nasal irrigation devices are easily available at drug stores, "alternative treatment" retailers and on the Internet.
The story reports that the tradition of use is very old, that adoption in the U.S. is low but beginning to gain popularity.
There is no evidence the article was based on a press release.
An October 2006 press release announced the release of a new product in the SinuCleanse line, sold by primary source Diane Heatley.
Systematic, Criteria-Driven
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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