This example of thorough reporting provides a valuable service by warning readers of the shaky basis and likely harms of Lupron treatment of children with autism. Part of a series by the Chicago Tribune.
Stories on similar contentious topics too often settle into “he said, she said” duels that stick readers with the task of trying to decide whom to believe. By contrast, this story highlights the fact that not all medical journal articles are equal: there are solidly-based reviews of the evidence and then there are reports that proclaim bold conclusions despite questionable methods and spotty data. These reporters thoughtfully weighed the claims and clearly point out which side has the strong preponderance of evidence.
As one quote underscores, autism “has become a cottage industry of false hope, and false hope is no gift to parents." Without faulting this piece of solid reporting, it is worth noting that false hope is not spread only by a few “bad apples.” Though it is an issue beyond the scope of this story, the more common threat comes from those in the mainstream who push medical interventions beyond the evidence base… and weak reporting that fails to challenge those claims.
One hopes the effect of this report will be to raise the level of healthy skepticism of “breakthroughs” and “cures” of all varieties. On the other hand, readers might conclude merely that they need to keep an eye out for a few renegades; that would be the wrong lesson.
Nowhere is “Buyer Beware” a more essential credo than in health care. This story equips readers to be wary of providers who have professional credentials and authorship of medical journal articles, yet lack evidence to justify the interventions they impose on their patients.
The story says that the providers charge $12,000 for tests and then Lupron treatments costs about $5,000 to $6,000 per month. It also points out that insurance companies may balk at covering the treatments.
The story appropriately questions whether Lupron offers these children any benefits.
The story notes the pain of injections and lists harmful effects of Lupron treatment including delayed puberty, interfering with bone development, heart health, and other effects on sexual development and health.
Both sides of this debate can point to journal articles. The reporters properly distinguished between high-quality reviews that take a broad look at the available evidence and articles that base conclusions on questionable methods and data.
Though this story was not about autism per se, it offers a valuable reminder about the vulnerability of patients and families who are struggling with difficult health challenges.
The story did quote several independent experts and referred to prominent reviews of the evidence related to autism, heavy metal exposure and hormonal treatment. It spelled out the business model of the providers: their chain of clinics and “franchising” arrangements with some providers.
The story points out that there is no cure for autism and that therapy for behavior and communication issues is commonly recommended.
The article notes that Lupron is approved to treat precocious puberty and is also used to treat some cases of prostate cancer, endometriosis and to chemically castrate sex offenders.
The story notes the treatment is based on an uNPRoven hypothesis, has limited availability and the drug is not approved for this use.
The reporters interviewed the proponents of Lupron therapy as well as several independent experts critical of the practice.
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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