In a story reported before the study results were even presented at a scientific meeting, researchers suggest that key differences seen using functional magnetic resonance imaging may be a key diagnostic tool for autism. The story headline suggests the test is a "new hope" for diagnosing the disorder. The reader is then provided with a series of conflicting statements about the value of the test and its relative prospects as a diagnostic method. While the story does provide a balance of opinion by quoting two additional experts, the enthusiasm displayed in the opening paragraph and headline make this a less than desirable report.
Parents of children with autism, and adults who are living with autism, are an active, growing community looking for concrete treatments and preventative measures. There are many researchers trying to find cures and early detection methods, but there are nearly as many untested therapies that are giving people false hope.
At a minimum, the reporter could have found out what a typical fMRI scan costs for someone without insurance and for someone with basic insurance. It also could have found out what one of the machines costs a hospital to purchase and, perhaps, how many are acutally in use nationwide.
It talks about the potential benefits, but it doesn’t quantify them. There were 30 children in the study with autism and 14 without. It does not make it clear whether all 30 children showed differences in their brain activity patterns or some fraction of them. Instead of a he said/she said between experts, the research may show that all children, no matter where they are on the autism spectrum, show a clear difference in brain activity compared to chilldren without autism. This is what the story indicates, but it doesn’t make it clear. It also does not even attempt to estimate how many people might benefit from this.
It makes a pass at this by saying the screening may inadvertently detect other brain problems and lead to misdiagnoses, but it doesn’t develop the theme. Although fMRI does not use ionizing radiation, the procedure is long and the subject’s head need to be restrained for the scans to be taken, In addition, the scan itself produces a good deal of noise (loud thumping) requiring the subject to wear protective earphones. And, the test will take up to one hour to complete.
Mixed bag. The first quote introduces one hesitation in the story. The researchers say, "If we could do this with other markers, we could probably identify people early on…" Two graphs later it says, "But another expert pointed out that the study is extremely preliminary." So preliminary, in fact, that it does not appear to have been published in a peer reviewed journal, which is one thing that isn’t clear from the article. Still, the overall sense of the story is that the evidence is preliminary and needs more study.
Unlike most autism stories, which tend to spend a lot of time talking about the exponentially larger number of kids with autism every year and the horrors that the disease brings to a family, this article was straight forward. We all know what autism is, even if we haven’t lived with a family member who has that diagnosis, and here is what a group of researchers is trying to do to pin down what exactly is going on inside an autistic child’s brain.
The idependent sources were well chosen and well quoted. The researchers themselves are given the proper context, for the most part, too. The story does not identify conflicts of interest. One could see if one of the researchers had an interest in an fMRI machine manufacturer, but everyone involved and not involved seems to agree that we are a long way from a marketable product.
The reader would have benefited from a brief discussion on the current gold standard approach to the disgnosis of autism. While structural and functional diagnostic studies are used in research, they are not commonly applied in routine clinical care. The failure to compare existing methods to the study method does not allow the reader to appreciate how far from the norm the testing procedure is. There could have been more discussion of other diagnostic techniques that are in experimental trials or past techniques that have been tried and discarded.
The story makes it clear several ways that this is early research and would require further development before a detection protocol was available.
There’s no context for what similar research has come before, and what competing research is out there. Even though the reporter did the right thing by talking with two outside experts, there should have been some clear statements in here about how much fMRI has been studied in relation to autism and whether other diagnostic tools have been studied.
Since independent sources are quoted, it does not appear that the story relied solely on a press release.