This story covers a provocative commentary on the use of cognition-stimulating medications by healthy people.
The commentary, published in the journal Nature, raises a topic that’s significant to people as individuals and to society as a whole. While clearly biased in favor of wider use of the drugs, the commentary clearly meets the test of "reportability" in mainstream media.
The news report does a credible job of summarizing the authors’ main points and gathering independent assessment to put it in context. It included an important balancing perspective from a bioethicist, who said: "It’s a nice puff piece for selling medications for people who don’t have an illness of any kind."
The report’s most significant shortcoming is that it never made clear that there is no good data to support the assumption that the drugs improve cognitive outcomes.
As the ratings below show, the report would have been better if it had mentioned costs more explicitly, and put the issue in the context of other methods people can and do use to enhance brain function.
The article does a reasonable job in covering the major points made in the commentary. Unfortunately almost 20% of the article is devoted to specific information about the drugs rather than the myriad of issues raised by the commentary. The space would have been better used with a more complete discussion of the ethical and societal issues raised by the commentary.
The article fails to report the prices of these drugs, which range from negligible [generic stimulants] to very high [Provigil].
The commentary itself does not cite data about the benefits. Indeed, the paper is in part a call for more research to determine the benefits and harms of various brain-boosting drugs.
Having said that, there is a significant flaw on the reporter’s part. The authors of the commentary are clear in their view that the drugs provide a valuable enhancement to cognitive function in healthy individuals. The reporter mirrors that view with statements such as "[the drugs] can help other people focus their attention and handle information in their heads" and "Lab studies show it can also perk up the brains of well rested people."
While it is true that the benefits of drug use are not quantified in the commentary, the reporter actively provides the readers with qualitative information on the value of drug use.
The reporter does an excellent job of mentioning the potential harms, including addiction and the heart problems linked to amphetamines.
It also discusses the potential harm of social inequality, if these drugs become easily available to those who can afford them but not to others.
On the one hand, the reporter earns points for mentioning the 2001 [!] research which the authors of the commentary cite. But the reporter loses points for failing to emphasize that this commentary, which clearly advocates wider use of these drugs, is based on very little research. We give it a satisfactory score because of the weight of the balancing quote from a bioethicist: "It’s a nice puff piece for selling medications for people who don’t have an illness of any kind."
The story does a good job resisting the temptation to use anecdotes that dramatize the benefits of brain-boosting drugs used by healthy people.
The reporter also refrained from implying that "everybody is going to want to take these drugs."
The reporter interviews two of the paper’s authors and three independent sources, one of whom is sharply negative about the paper and two of whom have more nuanced, ambivalent responses.
The reporter cites the potential conflict of interest of two authors, who have received money from pharmaceutical companies.
While this news report is a summary of a provocative commentary, a more creative and complete approach would have been to look at other ways healthy people stimulate their brains.
One interview subject refers to caffeine, which is obvious and worth mentioning. Indeed, it opens the question of how to draw lines of acceptability when a drug like caffeine is so widely used and unregulated.
Other approaches to brain-boosting that might have been mentioned include those that are common, harmless and based on at least limited data [physical exercise, social relationships, doing puzzles], experimental but commercially oversold [neuroelectric stimulation] and uNPRoven, widely promoted supplements and nostrums, including the many mainstream beverages that include herbs and other purportedly stimulating nutrients.
The article makes clear that a variety of cognition-enhancing drugs are widely available. But it neglects to say that stimulants have additional controls to prevent abuse, including limited supplies per prescription
The article also neglects to say explicitly these drugs are not paid for by insurance companies when used for non-indicated purposes. A brief mention in the last paragraph suggests this, but the article should have stated this plainly.
The reporter does a good job parsing the difference between medical use of these drugs, which is well established, and their use for cognitive enhancement, which is more recent and less widespread.
Because of the number of sources interviewed, it is clear that this story did not rely solely or largely on a news release.
Systematic, Criteria-Driven
Puleeeeease... this 'game changer' weight loss drug causes more nausea and vomiting than a placebo. Some game, some change. My friend Gary would spank you for using the eighth word medical reporters should never, ever use. @garyschwitzer @thackerpd
https://www.healthnewsreview.org/toolkit/just-journalists-writing-tips-case-studies/7-words-and-more-you-shouldnt-use-in-medical-news/ https://twitter.com/OttawaCitizen/status/1361426796126830597
A scary @statnews Op-Ed warns that govt attempts to rein in Pharma may cut off access to "life-changing" drugs.
It takes @garyschwitzer to let us know: the author spent 10 years as Pfizer's public-policy chief. https://twitter.com/garyschwitzer/status/1360325022578053123
.@TranspariMED criticizes STAT op-ed for not disclosing pharma funding of author’s institute - similar to criticism we’ve made of STAT op-eds in the past. @transparify @ThinkTankWatch @icer_review https://www.healthnewsreview.org/2021/02/transparency-watchdog-criticizes-stats-non-disclosure-on-pro-pharma-op-ed/
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