This broadcast news segment reports on transdermal direct current stimulation (TDCS) as a potential treatment for chronic pain.
It makes clear that the trials are continuing and that the possibly encouraging results are preliminary. It also acknowledges that the mechanism by which pain relief occurs remains unknown.
The report does two things particularly well: It places this treatment in the context of other clinical approaches to chronic pain; and it provides some interesting, even amusing history.
The story falls short in one significant way. It should have included an interview with an independent expert to provide context. The effect of the piece is to imply universal enthusiasm, and that’s unlikely to be the case.
As a side note, it’s worth pointing out that some people who left comments on the CBS website about this story had questions about where they can get the treatment. This is a useful reminder that a report about a experimental approach not yet available should be absolutely clear that the approach is not yet on the market.
Those viewers who wrote into the CBS site may have been swayed by language used in the story like "hope…breakthrough…promising" – three of our seven suggested "words you shouldn’t use in medical news." Only a suggestion – but it is sick people who gave us those suggestions and we weigh their suggestions carefully.
The reporter says "That’s the hope…whatever the cost." No cost was discussed. Granted, this is early research on an experimental approach. But it was given network news time. Our rule of thumb is: if it’s not too early to project possible benefits, it’s not too early to project possible costs. If the story can use words like "breakthrough, promising, hope" to describe this very early research and project those words onto an unsubstantiated potential market of 1 in 4 Americans suffering from chronic pain or 1 in 10 having it for over a year, then we suggest it’s time to talk costs.
The segment makes no attempt to quantify the benefits of the treatment.
But the report makes clear that the trials are early and the benefits not proven. This would make a specific citation of benefits unnecessary–even potentially misleading–just as the single positive patient anecdote may be misleading.
The segment says there is some tingling and a sunburn-like lingering effect linked to the treatment.
While this is accurate, TDCS is relatively new and the real side effect profile is unknown at the moment. There may well be cognitive and motor reflex effects with repeated use.
A simple statement that there may well be other unrecognized side effects would have put this into context.
The story is based on a continuing multi-center trial and on the results of two previous, small trials of targted applications of TDCS. While this is not high quality evidence, the story makes clear, repeatedly, that this is preliminary evidence only.
The story opens with an extraordinary anecdote, exaggerating both the severity of chronic pain and the potential of the treatment to help.
Yet it states that up to 1 in 4 Americans suffer from chronic pain, and 1 in 10 have it for over a year.
The number of people who suffer the kind of pain as the featured patient is likely much smaller than these figures imply. The segment should have stated this. The true prevalence of chronic pain is unknown. It depends on the definition used and the population surveyed.
Both sources interviewed are interested parties. At least one of them is a clinical investigator for the trial, the other his colleague at the same institution.
The reporter should have interviewed at least one independent expert on chronic pain for some context.
In addition, the only subject interviewed reports a positive outcome.
The reporter does an excellent job at the end of the piece describing the wide range of treatments used for serious chronic pain–and that multiple approaches are often required.
He also makes clear that TDCS would be one treatment to add to the arsenal, not a breakthrough that would make other options obsolete.
The segment states that transdermal direct current stimulation (TDCS) is still in clinical trials.
The segment makes clear that while this particular application of electrical stimulation is novel, it has been in development and used for other purposes for many years.
The segment does not appear to be influenced by the press release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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