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Read Original Story

Blood therapy

Rating

3 Star

Blood therapy

Our Review Summary

This story on platelet-rich plasma [PRP] therapy for tendon injuries is an unusual, instructive example of health news reporting: It falls considerably short on two essential best practices but is nonetheless reasonably accurate and responsible in the impression it conveys. It’s also engaging and well-written.

The story basically says the following:

  • PRP for sports injuries is promising, and just gaining some acceptance in the U.S.
  • Those who do the treatment believe it to be effective and low-risk
  • It has applications for both professional athletes and regular people with painful soft-tissue injuries
  • It’s not well-studied and hasn’t been widely adopted

Its key flaw is balance: It over-emphasizes the enthusiastic assessments of patients and practitioners, downplaying the lack of research and unknowns about the procedure. The flaw is one of emphasis, not omission. 

The reporter could have avoided this with a few actions:

  • Stating more plainly and prominently the lack of human research showing the procedure to be safe and effective, and its long-term effects unknown. This is a major point, requiring more than implication
  • Including some detail about and from that thin research record [see below] and European medical use/approval
  • Asking for a few details about the people whose outcomes have been less successful, and for practitioners’ thoughts about which patients might make the best candidates for the procedure
  • Finding one dissenter who is unsold on the benefits or wisdom of PRP.  In science, when there is not solid evidence, it would seem that having a doubter seems an appropriate balance.

Readers seeking this additional information should check out this 2008 literature assessment Current Review of Musculoskeletal Medicine

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story includes some information on costs, but we question the accuracy of it.

It says injection with a special syringe costs $250, and that the doctor’s consultation and injection are likely to be covered by insurance. It says some insurers won’t cover the $250 cost.

But the reporter may be underestimating the total costs. Other sources quote the cost of PRP at $400 to $600, with some as high as $2,000.

It appears the $250 out-of-pocket estimate is best-case. The reporter should have said this and included a price range, especially if it turns out none of the costs are covered by insurance.

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

Not Satisfactory

The story includes no data on benefits. 

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

Not Satisfactory

The story allows practitioners to emphasize the procedure’s safety–by, among other things, stating that it involves injecting the patient’s own platelets into the site of the injury, thus avoiding rejection as a risk.

But it should have plainly stated that the safety of the procedure has not been established in clinical trials, and that it carries at least minor risks of infection, misapplication and the procedure not working. 

It should also have said that the long-term effects of the treatment are not known. 

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

Not Satisfactory

The report is based only on anecdotes and practitioners’ broad-brush assessments of their clinical experiences.

There is nothing inherently wrong with this, but the report should have been more explicit about the lack of clinical trials on this application of PRP therapy.

While it mentions that at least one research study is underway, it should have clarified other key facts: 

  • Most published research into soft-tissue use of PRP has been in animals. One small study was published in a sports medicine journal in 2006. 
  • A 2008 literature review concluded the practice shows promise but a lack of research makes it impossible to assess benefits and risks. It clearly states that outcomes appear to be highly dependent on patient and injury selection. 
  • The statement that PRP is "FDA approved" for use on healing bone is incorrect. The FDA does not approve procedures, only devices. The FDA ruled that the devices used to inject PRP into bone are substantially equivalent to a device currently on the market, clearing the way for the marketing of the new device. It made a similar ruling on the centrifuge that permits smaller quantities of blood to be spun to separate platelets for therapeutic use. 
  • Further, the reporter should have inquired into research European medical bodies have used to justify its use for soft-tissue injuries. Approval of the procedure is implied but not clarified.  

Does the story commit disease-mongering?

Satisfactory

The story does not exaggerate the severity of the soft-tissue injuries treated here.

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

Satisfactory

Sourcing is good, in number and variety. Sources include:

  • Two patients who are pleased with their outcomes
  • A sports physician who used PRP on a professional football player and one middle-aged golfer, and is conducting a research study
  • A national expert who has been using PRP on tendon injuries for four years and doing PRP on soft tissue for ten
  • A trauma doctor who has been using PRP to treat fractures for two years and has not used it for soft-tissue injuries.

With a treatment lacking solid research, it’s good practice to find a dissenting opinion. That would have been a useful addition.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story mentions, in the context of patient anecdotes, the other approaches used to heal soft-tissue injuries: rest, rehab and cortisone shots.

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

Satisfactory

The story implies that PRP therapy is not widely available. It mentions that a knowledgeable sports physician learned about its use in Europe second-hand.

Of the physicians interviewed, the one who has been using it the longest has been doing so for 10 years, only four for soft-tissue injuries; another physician has been doing it for two years but never used it on a tendon injury.

Ideally the story would have said explicitly how many doctors and/or medical centers do PRP therapy for soft-tissue injuries. But all things considered the story earns a "satisfactory" rating

Does the story establish the true novelty of the approach?

Satisfactory

The story accurately implies that the treatment is done rarely in the U.S. but is used more more liberally in Europe.

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

Satisfactory

There is no press release linked to this article. It seems the story was triggered by a discussion with a local sports physician who treated a professional athlete. 

Total Score: 6 of 10 Satisfactory

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