Each tells the tale differently, with different context and subplots. This HealthDay story nicely frames the meaning of this line of research by hammering home its early stage and unanswered questions.
There’s a need for additional effective, well-tolerated treatment options for uncontrolled asthma, and this study provides early evidence—to be confirmed in future research—of a drug that’s sometimes given to such patients but is not currently approved by the FDA for that use.
This article provides great details about the meaning of this research, and it consistently reinforces the idea that “at this stage there is no definitive answer whether Spiriva should or shouldn’t be used in asthma.” We appreciate the repetition of the study’s limitations, as these concepts can seem nonintuitive — 210 sounds like a lot of people, 14 weeks sounds like a long time — and thus the quality of evidence can be tricky to understand by readers outside the world of medical research. The firm emphasis in this story sets an appropriate tone that’s unavoidable.
The story also explains why it would be important to have another option like Spiriva on the table for these patients, even if the benefits weren’t better than those of Severent.
We suggest some other points that seem to be missing, such as costs and quantified benefits and harms.
Costs aren’t discussed and should be.
The benefits observed in the study were not quantified. As with harms, the story didn’t tell readers how often events occurred.
Harms in the study aren’t quantified. How often did they occur? It tells us that the long-term safety needs to be studied, and it gives us good points about safety concerns that have been raised about Severent. (The AP article we reviewed mentions the safety concerns that have been raised about Spiriva.)
We think safety information from this study, including the rates of serious events, could’ve been mentioned if not quantified.
From the article’s headline to its last sentence, it firmly emphasizes the preliminary quality of this research. We give it a shout-out for prominently establishing the study’s early stage, providing wonderful context about the small sample size and follow-up period, identifying why future research is needed, and bringing those caveats home by concluding that right now there are no definitive answers and these new results do not constitute an all-out recommendation for its use in asthma.
As with the AP article, this story could’ve been clearer about the importance of randomization, blinding, and placebo controls, and there’s no explanation of the crossover design, obscuring the study’s duration and who received what when. However, the HealthDay article is not misleading about the duration, unlike the AP story that presents 14-week data on a 52-week timescale without acknowledging that an extrapolation was done.
The headline itself specifies “some asthmatics,” and the first sentence goes further in identifying the population affected by this research. So no disease-mongering here.
The article cites an independent source who was not, apparently, related to the study. The funding of the study was also mentioned.
The AP article we reviewed digs into further conflicts of interest for the study investigators. As an aside to our review, that article also probes the controversy over the fact that a drug company didn’t donate some of the drugs used in this study.
By the nature of the study, an unapproved therapy was compared to existing alternatives.
The headline and early sentences establish that Spiriva is available for COPD. It‘s not clear about the availability of Severent, one of the comparator regimens used in the study.
The story is specific about Spiriva’s mechanism of action and lack of indication for asthma.
We haven’t found evidence that the article relies on a news release.