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Deep in brain, shocks help Parkinson’s symptoms

Rating

5 Star

Deep in brain, shocks help Parkinson’s symptoms

Our Review Summary

This article about the benefits and risks of deep-brain stimulation treatment for Parkinson’s disease does a solid job of balancing positive study findings with negative ones. It provides adequate opportunity for a skeptic to air his concerns.

Still, there is some room for improvement.  The story could have done a better job of putting the findings into the context of previous research, and could have better described the weaknesses of the research itself, including a small sample size, limited duration and the fact that the most positive findings, of four additional hours of "on time," were based on self reports.

Overall, though, sound reporting.  And it’s good to see a newspaper devote more than 1,000 words to a story like this these days!

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

The story reports that the procedure costs about $120,000.

But we wish it had given the price of the many drugs and treatments used in conventional therapy for Parkinson’s disease. As a consequence, the reader is led to believe the cost comparision is $120,000 vs. $0. In fact it’s $120,000 vs. some other number, perhaps a higher one. Some comparison would have been useful. 

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

Satisfactory

The story does an adequate job of quantifying the benefits, using hard data to indicate the duration of the study, the number of patients involved and the most signficant outcome.

The reporter also does a good job of quantifying the side effects, which it does with even more specificity. 

 

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

Satisfactory

The story mentions the "much greater risk of serious adverse side effects" in the same sentence that delivers the positive results. Placing the "bad news" of side effects right alongside the "good news" of improvements is a best practice for which this reporter should be commended.

Later in the story the reporter lists these side effects and provides data on the number, severity and duration of the side effects. The story also mentions the death that resulted from the surgery. 

Yet the story fails to mention that the study found consistent, if small, loss of cognitive function in the stimulation group. It also fails to mention that the long-term effect of the sugery is unknown, and that this study, lasting just six months, cannot help answer that question. 

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

Satisfactory

The news article is based on a randomized controlled trial published in the Journal of the American Medical Association.

The study is fairly small and some key outcomes, including the most dramatic, are based on self-reports. It was only six months long, and the efficacy of the treatment over time is still unknown.

The story should have reported these caveats. On balance, however, the story earns a "satisfactory" rating under the "evidence" criterion.  

Does the story commit disease-mongering?

Satisfactory

The story begins and ends with an anecdote illustrating what appears to be a "dramatic" improvement. But that outcome is based on self-reports rather than a medical assessment. Still, it falls short of disease mongering.

The reporting of the patient’s story did not reflect whether she had side effects. Given the fact that the study shows the risk of serious side effects is about 4 times higher with the surgery, we wish this angle had been reported.

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

Satisfactory

The reporter interviewed one patient with a self-reported positive outcome, and four medical specialists.

  • Of the four physicians, one simply provides demographic data. 
  • Two of the remaining three are positive about the procedure. 
  • The remaining source, a skeptic, is given a reasonable amount of space to express his concerns. 

The reporter–eventually, in the last phrase of the story–mentions that the research was paid for partly by the maker of the deep-brain stimulation device. 

On balance, the sourcing of this story is acceptable. 

Does the story compare the new approach with existing alternatives?

Satisfactory

The story makes it clear that the alternative to surgery is a cocktail of medications, which have their limitations.

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

Satisfactory

Although the article does not make a clear statement about availability, it does imply that deep brain stimulation is available in at least some hospitals, has been in use since at least 2005, and is applied to a variety of conditions.

The story says that only 2 percent of patients get the surgery, while 15 percent are eligible. It would have been useful to know if availability played any role in this discrepancy.

Does the story establish the true novelty of the approach?

Satisfactory

While the lede implies the surgery is exotic, later in the story the report makes clear that it is done with some regularity and is being studied for use on other conditions.

The reporter includes specifics: About 15 percent of Parkinson’s patients may qualify for the surgery, yet only 2 percent of patients get it.

Ideally this information would have been placed higher in the story so Parkinson’s patients and caretakers understand the limited applicability. 

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

Satisfactory

Based on the number of sources cited, it’s clear this story didn’t rely solely or largely on a news release.

Total Score: 10 of 10 Satisfactory

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