This CBS Early Show segment on the three-year-old WalkAide medical device manages to put a check next to nearly every item on a list of Health Journalism Worst Practices.
1. It is full of loaded, technically incorrect language: new, revolutionary, miracle. The device is none of these. Twice the segment refers to the device as a "miracle in a box." It’s not even in a box.
2. The segment makes two statements that are technically correct as worded but broadly misleading through implication:
It says the device is "a promising development in restoring full function" to people once confined to a wheelchair. [Reality: It can temporarily improve the gait of some patients with foot drop syndrome.]
It says it can "restore mobility to patients with multiple sclerosis, cerebral palsy and traumatic brain injuries." [Reality: It can improve the mobility of patients who are already mobile, and only a fraction of the patients with the conditions listed can be helped by it.]
3. The segment does not report on any research done on the device, or even indicate whether there is any. The evidence of effectiveness cited is a single anecdote.
4. The segment does not mention potential harms, contraindications or limitations. People with pacemakers can’t use it; neither can pregnant women. One cannot wear it while driving.
5. While the segment celebrates the patient as a determined young woman who has earnestly undertaken eight years of rehab, it fails to make clear that she is [therefore] an outlier with untypical results.
6. No independent expert was interviewed to provide some perspective and reality check.
7. The whole "I had to snowboard again" conceit is just a foolish stage show, a clinically irrelevant fatuity. Indeed, the device cannot possibly function when the patient’s feet are strapped into a snowboard.
All that said, the WalkAide appears to be a useful device for some people with foot drop–not new, not a revolution, not a miracle, but a device that can help improve the quality of life for some patients. It can help them walk more normally, perhaps reducing risk of falls, joint damage and muscle atrophy. It may help make their limbs healthier and stronger–though this has not been proven.
The WalkAide cannot help the paralyzed rise miraculously from their wheelchairs any more than a circus-tent preacher can. Yet the report implies this, almost cruelly misleading "the many Americans who have lost the ability to walk."
Why would a TV network, medical correspondent, producer and host do this in front of millions of people?
The correspondent does an excellent job citing the patient cost [$5,000] and noting that Medicare pays for the device under some conditions, and that some private insurance companies cover it on a case-by-case basis.
The story cites no data to verify the treatment’s effectiveness.
The segment mentions none of the potential harms of the device, which include a failure to help some individuals.
It may lead to irritation and burns; some patients have reported not being able to use it for this reason. The consequences of long-term use on nerves and muscles are unknown.
The device is not recommended for those with heart disease, seizures, pacemakers or pregnancy. It can’t be worn while driving.
Aside from the story of the young woman featured, the segment provides no evidence the device is safe or effective.
It does not appear that rigorous clinical trials documenting outcomes across a patient population have been done. The reporter should have mentioned this.
The story suggests the device can help people who have had spinal cord injuries, a stroke, brain injury or who have MS or cerebral palsy. The device can help only those who have foot drop as a symptom of these conditions. This exaggerates the prevalence of the conditions treatable by this device.
The correspondent interviewed nobody aside from one very satisfied patient.
The story refers to other approaches to foot drop only in passing and to dismiss them as inadequate–braces, metal, plastic, joints, etc.
It fails to mention the most common approach to foot drop, an orthotic and continued rehab. Surgery is useful in some cases.
It fails to mention other devices in development.
The segment should have been more clear on availability. But by citing price and Medicare coverage it accurately implies availablity for clinical use. It minimally earns a "satisfactory" rating.
For the record, it is available by prescription from certified providers.
The segment calls the device new and revolutionary. It is neither.
New? The WalkAide has been on the market since 2006. It was approved for marketing by the FDA under a process that requires it to be substantially similar to an existing product.
Revolutionary? Electrical stimulation to help people move limbs with limited or no mobility has been in development since the 1960s.
Brain-machine interfaces–devices that allow people to control limb movements with their brains–are currently in development. Now that’s revolutionary.
We can’t be sure if the story relied on a news release. But why did the story run at this time? How did they find this extraordinary young woman and why did they choose to run the story like an infomercial?