A few key issues were missed:
Finally, it would have been ideal if the story had briefly mentioned the major treatment options for a patient with major depression who fails the first treatment: change in medication or combinations of medication, psychotherapy with or without medication, and neurostimulation such as TMS or ECT. An independent expert perspective could have helped with this.
Although drugs can be effective for many patients with depression, they can cause a host of adverse effects and don’t work for everyone. Electroconvulsive therapy (ECT) can be helpful for some patients who don’t respond to medication, but it too carries a risk of adverse effects, including confusion, memory loss, and harms related to the anesthesia. TMS has the potential to be a safer, less invasive alternative to ECT for patients who don’t respond to antidepressant drugs.
The story doesn’t discuss the cost of the TMS machine or the cost of a typical course of treatment. This is a significant oversight considering that many health insurance plans offer limited coverage for mental health expenses. Does a patient who pays out of pocket have any hope of affording TMS treatment? The article doesn’t say.
The article describes the percentage of patients who benefited from TMS in absolute terms and tells us that 12 patients would need to be treated with TMS to achieve 1 treatment success. These descriptions give readers a realistic idea of how likely a patient will be to benefit from TMS.
An even clearer approach would have been to say that 13 of 92 (14%) benefited from TMS and that 5 of 98 (5%) benefited from sham treatment. The other critical missed opportunity is to remind readers that these are remission rates in those who failed at least 1 prior treatment. For patients who have never been treated for depression, remission rates are much higher with any first-line treatment.
The story notes that people in the TMS and sham treatment groups were equally likely to experience side effects including headache, discomfort at the TMS site, and eye twitching. The story could have pointed out that we don’t know much about long-term adverse effects of this treatment, and that a short-term study of 190 subjects has limited ability to identify rare but potentially serious adverse effects.
The story gives a satisfactory summary of what happened in this placebo-controlled trial and why it represents an advance over previous research. It provided good detail regarding the researchers’ efforts to develop a sham treatment that would mimic a real TMS treatment session. Although the story states that the optimal length of TMS treatment "is not yet clear," we think the story could have been a bit stronger in cautioning about the short duration of the study and lack of long-term outcomes data.
This story doesn’t resort to disease-mongering.
As noted above, the story relied on a single source who was also lead investigator on the study being covered. It failed to note that this source has received research grants from, and is an advisor to, several different companies involved in the manufacture of TMS-related technology. To avoid the appearance of any conflict of interest, the article should have disclosed these ties.
This story doesn’t do enough to describe the treatment options for a patient with major depression who fails the first treatment: These options include a change in medication or combinations of medication, psychotherapy with or without medication, and neurostimulation such as TMS or ECT. This type of information could have been obtained from an independent expert.
The story states that TMS is approved by the FDA for the treatment of depression, but this characterization may give the impression that TMS is more widely available than is actually the case. TMS is cleared for use only in patients with major depression who don’t get better after treatment with an antidepressant medication. Also, while we couldn’t locate data as to how widely available TMS treatment is, it is safe to say that most practitioners don’t have a TMS device in their office. Obtaining access to the machine and trained operators is likely to be a challenge for many patients, especially those in rural areas. The story should have pointed out these important restrictions on the treatment’s availability.
The story does not attempt to portray TMS as more novel than is appropriate and notes similarities between TMS and a more established treatment approach known as electroconvulsive therapy.
This story doesn’t appear to have lifted any copy directly from an NIH news release about the study. Since it included only one expert source who was also the lead investigator on the study, however, we can’t say for sure how much the story relied on the release. We’ll call it not applicable.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
Comments
Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.
Our Comments Policy
But before leaving a comment, please review these notes about our policy.
You are responsible for any comments you leave on this site.
This site is primarily a forum for discussion about the quality (or lack thereof) in journalism or other media messages (advertising, marketing, public relations, medical journals, etc.) It is not intended to be a forum for definitive discussions about medicine or science.
We will delete comments that include personal attacks, unfounded allegations, unverified claims, product pitches, profanity or any from anyone who does not list a full name and a functioning email address. We will also end any thread of repetitive comments. We don”t give medical advice so we won”t respond to questions asking for it.
We don”t have sufficient staffing to contact each commenter who left such a message. If you have a question about why your comment was edited or removed, you can email us at feedback@healthnewsreview.org.
There has been a recent burst of attention to troubles with many comments left on science and science news/communication websites. Read “Online science comments: trolls, trash and treasure.”
The authors of the Retraction Watch comments policy urge commenters:
We”re also concerned about anonymous comments. We ask that all commenters leave their full name and provide an actual email address in case we feel we need to contact them. We may delete any comment left by someone who does not leave their name and a legitimate email address.
And, as noted, product pitches of any sort – pushing treatments, tests, products, procedures, physicians, medical centers, books, websites – are likely to be deleted. We don”t accept advertising on this site and are not going to give it away free.
The ability to leave comments expires after a certain period of time. So you may find that you’re unable to leave a comment on an article that is more than a few months old.
You might also like