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Nothing much works for morning sickness, study finds

Rating

2 Star

Nothing much works for morning sickness, study finds

Our Review Summary

We usually like it when stories approach an issue from a suspicious, "show me the evidence" perspective. But in this case, the story’s doubtful take on treatments for morning sickness just isn’t backed up by solid reporting. Unlike the NPR story we reviewed, this story did not attempt to provide a thorough analysis of the Cochrane Library’s review of morning sickness research. headline and lead misstate the main findings of the study being covered, and the story glosses over important details about how that study was conducted. What’s more, a quote and much of the content appear to have been taken from a press release issued by a journal publisher about the study. 

 

Why This Matters

Skepticism about medical treatments needs to be supported by a thorough evaluation of the evidence and balanced reporting of different views. Otherwise it’s no better than the mindless cheerleading for new treatments so prevalent in health journalism today.  

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

There is no discussion of costs here. We think that it is just as important to tell people about the costs of treatments that have little scientific support. Should people be spending money on expensive therapies or even low-cost vitamin treatments if there is little proof that they work?

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

Not Satisfactory

Too vague. The story tells us the study authors "found some benefit" for acustimulation over three weeks, but it provides no details about the extent of this benefit or how it was measured. Elsewhere, the story says a study found that "women who suffer morning sickness are less likely to develop breast cancer." This information is next to useless without an estimate of the size of the benefit in absolute terms. Lastly, the story ends by telling us "most experts" recommend common-sense steps like getting enough rest, eating small meals, and avoiding strong smells. This is undoubtedly reasonable advice, but it sounds incongruous after the rest of the story just emphasized the lack of evidence supporting all the other different approaches. Why should women trust the advice of these unnamed "experts" on the basis of no evidence at all?  

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

Not Satisfactory

This story did discuss potential harms associated with the use of ginger and anti-vomiting drugs. But it didn’t characterize them very well (ginger "actually made many women sick," the story tells us) or attempt to quantify how often they occured. The story also didn’t mention that review authors found little discussion of potential harms in the studies they looked at. This is an important conclusion that should have been passed along to readers.

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

Not Satisfactory

This story, like the competing NPR piece, overstates the main conclusion of the study authors. The headline states that "Nothing much works for morning sickness" and the lead claims there are "no effective treatments" for morning sickness. These statements are oversimplications of the evidence. The study authors concluded that there was little evidence from high quality studies to support currently used treatments. So it would have been more accurate to say that we just don’t know whether these treatments are effective or not. Unlike the NPR study, though, this story provided very little detail about how the study authors conducted their review of the evidence. We learn that they analyzed 27 clinical trials including 4041 women, but that’s about the extent of the discussion. We think the story should have included more information about:

  • the design of the included studies and whether they were randomized and included a control group.
  • characteristics of the patients, including the severity of their morning sickness
  • what measures the authors used to assess benefits
  • the limitations that prevented the review authors from pooling the results of the different studies in a larger combined analysis. The NPR story was particularly good on this point.

Does the story commit disease-mongering?

Not Satisfactory

We’ll flag this story for inadvertent disease-mongering. The story gives a description of very severe morning sickness, known as hyperemesis gravidarum, and says the condition "requires medical treatment and can cause blood clots and damage to the infant." While this is true, the story failed to mention that  the review authors specifically excluded studies that enrolled patients with hyperemesis gravidarum from their analysis. Based on the story, readers might get the impression that there are no effective treatments for this very serious condition, which is not necessarily the case.

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

Not Satisfactory

The only expert quoted in this story is one of the authors of the Cochrane group study being covered. This would not normally qualify as an independent perspective, but since the Cochrane collaborative is by definition an independent source reviewing the combined studies, one could argue this category should be ruled not applicable for this story. On the other hand, experts do sometimes disagree about whether the methodology used by Cochrane reviewers is appropriate, so it can also be argued that adding another voice would have added context and value for readers.  

A toss-up here, but we’ll err, as we usually do, on the side of high standards and call this one unsatisfactory.  

Does the story compare the new approach with existing alternatives?

Satisfactory

The story mentions a number of different treatments used for morning sickness and emphasizes the lack of good evidence to support any specific treatment.

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

Satisfactory

As with the competing NPR story, we think it is clear that the Cochrane review covered widely available treatments.

Does the story establish the true novelty of the approach?

Not Applicable

The novelty of the therapies discussed in this article isn’t really in question, so we’ll call this one not applicable.

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

Not Satisfactory

This story quotes directly from a news release about the study. It attributes the quote to "a statement" but does not make it clear that this statement was part of a news release. Reporters ask questions all the time via email, and readers may assume that the researcher simply provided the reporter a statement in response. There’s no evidence that any other sources of information were sought for this report. In addition, the text of the story hews very closely to that of the press release and provides very similar details. We think that’s unsatisfactory.

Total Score: 2 of 9 Satisfactory

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