Genetic testing for baldness

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The segment states that the test costs $149.

However, the test is not as reliable as would appear and additional costs should be considered. A man with no evidence of hair loss and a positive test result will require a visit to a dermatologist and a set of confirmatory tests. The costs of the confirmatory tests, minoxidil or finasteride treatment and the degree of benefit should have been included in the discussion.

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

Not Satisfactory

The spokesman cites figures connecting certain gene variants with either a 60 percent increased chance of baldness or an 85 percent reduced chance of baldness. 

This is not correctly stated, and it causes a false impression of efficacy. The positive predictive value of 60 percent means that the test when positive is correct 60 percent of the time.  Conversely, the negative predictive value of 85 percent means that when the test is negative, it is correct 85 percent of the time.

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

Not Satisfactory

The test itself, a cheek swab, is risk-free.

But the segment should have mentioned the potential harm linked to false positives or false negatives–the chances of which are not specified.

A false positive or negative could result in unnecessary expenditures and psychological impacts. A 20-year-old could overtreat his hair and worry about a baldness "clock ticking" when in fact he retains his hair–and vice versa. 

Since one justification given for the test is the psychological impact of baldness, this is a significant omission.

In addition, the reality is that minoxidil and finasteride are only marginally effective in some men.   Both drugs have side effects that are not noted in the report. 

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

Not Satisfactory

The company spokesman cites figures linking chance of baldness to genetic features, but it does not provide a source. We have no idea what these data are drawn from–independent tests, company estimates, etc. 

Does the story commit disease-mongering?

Not Satisfactory

The segment implies baldness is a condition requiring treatment. This is not necessarily true.

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

Not Satisfactory

The segment draws on two highly self-interested sources, a spokesman for the company that markets the test, and a doctor who sells it to patients. 

The reporter also interviews an independent dermatologist, who provides some context to explain the shortcomings of a single-gene test.

The host interviews an independent dermatologist who discusses baldness treatments. Both the reporter and the host contribute some caveats the other sources do not. 

But no one was interviewed about issues that were in the works this same day – and for some time prior. 

On the same day this segment aired, it was announced that the company that makes HairDX, along with a dozen other California firms, had been sent cease-and-desist orders by the State of California earlier in the month. The state is investigating whether these genetic tests constitute a medical procedure, whether they can be sold directly to the public, what kind of quality control and licensing should apply, and other issues. On the day this segment appeared, HairDX announced that it would no longer sell its product directly to consumers via the Internet, and that in California or New York it would sell exclusively through physicians.

Spending more time with knowledgeable independent sources likely would have turned up some of these issues.