Beta-blockers used by musicians, athletes, students to enhance performance

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

 There was no discussion of costs.

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

Not Satisfactory

 The story provided anecdotes about performance anxiety relief from the use of beta-blockers such as indicating that ‘it decreases tremors and steadies nerves’.  While descriptive, this type of information does not inform the reader about the amount of benefit that might be expected. Where are the numbers?  Where are the data?  Where’s the evidence?

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

Not Satisfactory

Mixed bag, but a confusing one so we give it an unsatisfactory score. The story indicated that beta blockers ‘can cause problems for those who use them for non-medical purposes’ and that ‘no catastrophic events have been reported’.  This is both contradictory and inadequate.  

The story quoted one doctor who "recalled seeing a fellow doctor pass out while giving a speech because he had taken a beta-blocker for stage fright."  We believe it is just as inadequate to cite anecdotes – and not evidence – for harms as it is for benefits. How OFTEN does this occur? 

The story could have given much more helpful detail on the common side effects of low heart rate, low blood pressure (and its consequences), fatigue, sexual dysfunction, and several other side effects people might experience if they took beta blockers frequently.

Instead, the overall impression – steered by the weight of rosy anecdotes – was that this is a choice without negative consequences.

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

Not Satisfactory

 The story provided a number of anecdotes about the use of beta blockers to alleviate performance anxiety.  Although it did mention that this class of medication has not been studied in healthy individuals, this was swamped by the sheer volume of personal testimony.  The use of the personal narrative in this way is misleading as it suggests that it is an adequate substitute for an actual demonstration of safety and effectiveness, which it is not.  The one study it cited was 19 years old and was done in 32 people.  Is that the best evidence there is? 

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

Not Satisfactory

 While numerous musicians were quoted in this story about their perceptions about the use of beta-blockers, the actual clinical perspective about this use for the medication was inadequately represented in this piece.

By our count, generally positive promotional comments were represented in 6 interviewees – one of them even speculating on someone who couldn’t take the pills 46 years ago because they weren’t available with that person wondering if the pills could have saved the person’s career.  Generally negative comments came from two interviewees.

Forget about balance.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

 While hailing the benefits of beta-blocker use for management of performance anxiety, there was no discussion of alternative methods, such as cognitive behavioral therapy, or even comments from other performers about how they deal with these problems.