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Topical Gel Catches Up With Pills for Relief


4 Star

Topical Gel Catches Up With Pills for Relief

Our Review Summary

This story about topical gels that contain pain relief medication similar to ibuprofen makes a strong showing when examined point-by-point. Nevertheless, readers may end up with a skewed impression because of the personal anecdote and opinion that open and close the story. The headline and lead, as well as the last words of a story, can carry a lot of weight. The meat of the story includes a comprehensive overview of the medical evidence, but then there are phrases such as, “She raved about the stuff” and “for immediate relief of my tennis-related muscle pull, the cream was handy and helpful.” All the careful statements of fact in the body of the story may well be drowned out by the personal comments.

This story includes something we see too rarely: it points out that much of the available medical evidence comes from clinical trials on ideal patients. These patients have simple problems and aren’t being treated for other serious conditions, and there is little information about how these medications work and what risks they may present to more typical patients, who often are dealing with multiple health conditions and taking several drugs that could interact.


Why This Matters

One strongly-worded claim or conclusion can brush aside a page full of facts. This story has a well-constructed middle that is overshadowed by opinions highlighted at both its beginning and end.


Does the story adequately discuss the costs of the intervention?


The story says that the average copayment for a month’s supply of some of the topical NSAID medications is around $30. It would have been nice to include the cost of comparable oral medications.

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

Not Satisfactory

Although the story explains the available evidence comparing topical NSAIDs to oral pain relievers, highlights the limited number of direct comparisons, and carefully states the general consensus of experts, all of this solid reporting is undermined by a focus on personal anecdotal evidence over quantifiable benefits. Indeed, the reporter claims one medication provided immediate relief, a statement at odds with clinical trials that conclude that it usually takes hours for patients to feel the pain-relief effects of topical NSAIDs.

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


The story summarizes the reported side effects of topical NSAIDS. What’s more, the reporter points out that the potential risks in people who have other health problems or are taking other drugs have not been well studied. That insight is something we see too rarely.

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


The story refers to a number of clinical trials and systematic reviews of the evidence. It highlights areas where evidence is lacking or inconclusive. It would have been helpful to point out that in placebo-controlled trials, almost as many people who received the placebo reported pain relief as did those who got the active medication. The story could have mentioned that the systematic review it referred to was published by the Cochrane Collaboration and also the sources of the other clinical trial reports, so that interested readers could more easily locate the original articles.

Does the story commit disease-mongering?

Not Satisfactory

The story does not exaggerate the common pains these drugs are intended to treat, but the personal anecdotes and opinions highlighted at the beginning and ending of the story are unrepresentative of the typical experiences reported by participants in clinical trials and create a powerful impression that is at odds with the evidence.

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


The story includes quotes from several experts and points out that two of them have accepted consulting fees or research support from pharmaceutical companies.

Does the story compare the new approach with existing alternatives?


The essence of this story is an attempt to compare topical NSAIDs with pills and other pain treatments. As noted above, though, the story does not mention that most people with minor pains feel better after awhile even if they don’t take any pain relief medication. It also should have mentioned that the difference between placebo and active treatment groups in the clinical trials is often slim.

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


The story reports that only three topical NSAIDs (nonsteroidal anti-inflammatory drugs) are approved for sale with a prescription in the United States, while several brands are sold over the counter in Europe.

Does the story establish the true novelty of the approach?


Part of the focus of the story is that NSAIDS have been around for a long time but only recently are being given a more serious scientific reassessment. As the story says, "But a number of new controlled trials and meta-analyses like Dr. Moore’s suggest that topical Nsaids are as effective as their oral counterparts for treating osteoarthritis in the knee and hand as well as musculoskeletal injuries like soreness and tendinitis."

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


The story includes several experts and mentions multiple studies.

Total Score: 8 of 10 Satisfactory


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