The story did a great job evaluating the evidence, providing outside voices, discussing alternatives to marijuana smoking, and presenting both the benefits and the potential harms. It could have done a better job discussing possible costs, availability and conflicts of interest. From the headline to the last sentence, this report avoided overstatement of the applicability of the potential benefit and used clear incisive language that left the reader with a good understanding of the study and its implications.
This topic lends itself to jokey, pun-filled writing, but this story played it straight. Chronic pain can ruin lives, and a breakthrough with an alternative approach would be important news. As this story makes clear, until some larger studies with fewer limitations are undertaken, we are far from the point where marijuana can be considered a safe and effective treatment for chronic pain.
It is less surprising that neither story discussed costs, given that so few stories do. But sample costs could have been obtained by calling any of the numerous medical marijuana outlets in states where it is legal.
Both stories did a decent job of quantifying the benefits.This story provided more details, though, including the differences in patient experiences between the three different concentrations of marijuana. It also repeated this important bit of information: "There was also no difference in the quality of life or mood scores that participants reported when they were on any of the four treatments." The story also does a great job of pointing out that the treatment duration of five days in each dosage phase is too short to judge utility for chronic pain, which is a long-term affliction.
Neither story actually quantified the harms, but they both noted there were side effects. This story did a better job, though, by noting that the only dose that seemed to work also seemed to produce the most side effects and by raising the issue of long-term safety concerns. It also was the only story to answer the question that readers surely would have when reading about an illegal narcotic being used as medicine. Did these patients feel high as a result? This story says that most did not. Because of the additional information and context, the rating here is satisfactory.
This story, unlike the competing WebMD piece, establishes in the first sentence — even in the first three words — that this was "a small study." It then discusses the limitations of the study at several points. The second sentence says, "The pain reduction was "modest" – less than 1 point on an 11-point scale for the strongest marijuana – and patients reported no overall difference in their quality of life based on what they smoked." The writer elegantly and succinctly described the study design — a complex randomized cross-over trial with double blinding and delved into an important feature of the study, that the subjects in retrospect may have been able to detect during which phase of their experience they inhaled placebo versus the most potent drug.
This story avoids disease mongering, and, in fact, goes beyond that to note how few people actually suffer from the type of chronic pain that was the subject of the study: "About 1 to 2 percent of adults in the U.S."
The story quotes two outside experts, one of whom is completely independent from the study and the journal, Dr Andrea Hohmann. Beyond that, we would bet that the reporter spent more time interviewing Dr. Mark Ware, the lead researcher, or at least asked tougher questions. Because Ware is more measured in this story than in the WebMD story. He even goes so far as to say, "What about long-term safety issues?" he asked. "These need to be considered before the drug becomes prescribable." As with the WebMD story, it would have been nice to see who funded the research. Unlike the WebMD story, this one did not point out the conflicts of interest of Dr. Henry McQuay.
This story talks about a range of treatment options and even has the study’s lead author suggesting, that "these patients should also be getting behavioral and physical therapy."
Strangely, neither story we reviewed pointed out that marijuana is illegal in most states and in Canada, where the study took place. The story could have, at a minimum, mentioned which states have medical marijuana laws or talked about whether any other countries currently allow cannabis to be sold in pill form the way it was used in this study.
The story alludes to the fact that this study "supports a limited number of trials that have suggested marijuana may be helpful for people suffering from chronic pain," indicating that the treatment is not very novel at all. It would have been nice to see more context around that. The WebMD story provides a little more information in this regard. If the news release is to be believed, "This is the first trial to be conducted where patients have been allowed to smoke cannabis at home and to monitor their responses, daily". That could have been made clear.
The story goes well beyond the release. Here’s the release.