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The Latest Advance Against Acne

Rating

3 Star

The Latest Advance Against Acne

Our Review Summary

This article descibes a treatment for persistent acne called Isolaz. By combining suction with a laser, it offers an approach different from the usual drug, topical or laser-based treatments.

The article falls short of key health journalism best practices:

It focuses on two anecdotes from patients satisfied with their treatments, and interviews two physicians with obvious commercial interest in the treatment.

It describes the research in vaguely positive ways, allowing a quote from an independent doctor to summarize it by saying "the science is sound." Even in a short story like this, some information about the nature of the studies and the findings should be included.

It fails to mention that the device is being marketed heavily and slickly to dermatologists and patients without substantial references to published research.  

The story is generally credulous in tone rather than skeptical. A reporter finding two enthused patients, two commercially motivated and enthused doctors and vague claims of efficacy would do better to dig deeper. The result is that the article feels more like a rewritten press release rather than a work of journalism done with the reader’s interest in mind.

For instance, it turns out the only clinical study cited in company literature was conducted by a consultant to the maker of the device, and it focuses exclusively on use of the device for hair removal and something it calls "skin rejuvenation." 

While chronic acne is not a dangerous disease, it has serious psychological effects. People with this skin condition, as the reporter mentions in the first paragraph, are surrounded by commercial products that promise cures but rarely deliver.

They deserve a more diligent report on yet another "breakthrough" treatment.

One additional observation: This story was first published as a blog entry on the USNews website in February. It was published in the print version of the magazine on June 9. This is a practice common at USNews (though the editor says that in this case the time between blog and print article is unusually long). Web-first publication is becoming increasingly common industry-wide.

One assumes the story was updated and rechecked before it was published in print.  

But it’s worth raising the question of whether the credulous view, breezy tone and failure to dig into research is a result of the story’s provenance. Blog entries are usually written faster than print stories, and receive less editing.

The key question is, are blog entries destined to provide a lower level of public service due to how they are created? Or is there some way to embed best practices in the new medium?

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

The story reports the price as between $150 and $500 per session, and reports that insurance generally won’t cover it. The story elsewhere says that five sessions are considered a mimimum, and regular follow-ups may be required.

It would have been useful to do the math for the reader–between $750 and $2,500 for the minimum treatment, plus continuing costs.

The price should also have been reported much earlier in the story, to help readers frame the role the treatment could play in their lives.  

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

Not Satisfactory

The article does not quantify the benefits of the treatment in detail.

It says the device "has been shown to yield high rates of acne clear-up" with patients for whom topical treatments did not work.

A physician who offers the treatment estimates that it works "in about 90 percent" of his patients.

A patient says her skin is "100 percent better."

None of these formulations helps a lay reader figure out how effective the device has been shown to be when studied carefully.  

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

Satisfactory

The story reveals that the treatment has brief side effects such as swelling and reddening, none serious or lingering.

It also mentions the concerns about use with dark-skinned patients, for whom the laser might cause changes in skin pigment.

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

Not Satisfactory

The only evidence supporting efficacy and safety of the technique is breezily mentioned as "several small studies" that confirm anecdotal reports.

Verbal assessments of the efficacy are provided by two physicians and two patients.

FDA marketing clearance is mentioned but no evidence from those trials is cited. 

 

Does the story commit disease-mongering?

Satisfactory

The story overdramatizes the struggles and success of the two quoted patients with chronic acne.

Since the machine presumably would be most useful on those with serious cases for whom other treatments fail, however, the reporting does not engage in egregious disease mongering. 

The article veers toward overselling the treatment with an artful but hyperbolic sentence: "The two-pronged process both stuns and deactivates hyperactive oil glands and kills the bacteria they nourish, quashing the source of the breakouts in one 20-minute swoop."

This story just barely earns a satisfactory rating for this criterion.  

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

Not Satisfactory

Sources include a physician who led a study on Isolaz, a physician who treated (apparently with success) one of the patients quoted, and a third doctor portrayed as a skeptic who believes the science is sound.

Two patients who are satisfied with their treatments are also used as sources.

The story would have been more balanced had it quoted doctors and/or patients who had less success with the treatment.

Any doctor who has invested in one of these machines–and seeks to build a cash-only business that is not limited by insurance reimbursements–is not a disinterested source of information about the treatment’s efficacy. The story should have mentioned this. 

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The first paragaph of the article whisks through the usual treatments for acne, but only as a list of failures.

The story would have been more valuable had it reported first-line treatments for chronic acne–as well as on Accutane, which (at least for boys) is often successful at treating the most serious acne cases.

The story certainly should have mentioned the use and benefits of various common laser treatments.  

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

Not Satisfactory

The story does not indicate how widespread the use of Isolaz is. Readers wouldn’t know whether a typical dermatologist would offer this, or whether they would need to go to a specialized skin care center.

Does the story establish the true novelty of the approach?

Satisfactory

The article reports that the device received marketing clearance in 2006.

It also reports that Isolaz is the only acne treatment that combines suction with laser. This appears to be true. The article should have mentioned though that laser treatment alone has been used for a number of years. 

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

Not Applicable

There does not appear to be a press release associated with this story.

Total Score: 4 of 9 Satisfactory

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