There’s been a lot of news coverage and a lot of marketing claims about the alleged benefits from products containing probiotics. The study reported on is from the well respected Cochrane organization. A Cochrane review is comprehensive and rigorous, meaning that the conclusions are important and can change medical practice.
But this story included only the perspective of the lead author of the study with no independent perspective. And, in including a claim about possibly soothing stomachs (in the headline) and soothing “fickle bowels” (in the lead), it stepped outside the boundaries of evidence.
Many claims have been made about probiotics for prevention of gastric upset or for the treatment of bowel conditions. Although this study reported positive outcomes, it is important to recognize that what was observed was benefit in treating acute diarrhea and that does not necessarily extrapolate to other preventive issues related to bowel health. Diarrhea, for which the benefits of probiotics were reviewed, causes substantial sick days and deaths in developing countries.
There was no discussion of costs. Because we always think cost is important – even if it doesn’t amount to much – we wish the story had included some cost estimates for probiotics-containing products. Does it add much to the cost of yogurt and other products?
The story was clear that outcome studied was the duration for a bout with acute diarrhea. However by opening the story with mention of possible ability to ‘soothe fickle bowel’, this piece plays into the marketing of benefit from probiotics beyond treating the condition studied. In addition, the story gives only relative risk reduction for the risk of prolonged diarrhea – reduced by 59%. But 59% of what?
The story mentioned that there were “no negative side effects” in the literature review. So, for that, we’ll give it a satisfactory score. But a broader perspective on this issue could have addressed the potential for harm in hospitalization-associated diarrhea.
The story is based on a review of the literature published by the Cochrane organization; the story mentioned that the outcomes reported derive from 63 different studies.
It would have been informative to help readers understand a little more about the quality of the evidence that was reviewed.
The story did not engage in overt disease mongering.
No independent sources were cited in this story – only the lead author of the study.
There was no comparison with other treatments for acute diarrhea. A variety of over the counter medications are available to help improve symptoms, and simple dietary changes (avoiding dairy, for example) can also improve symptoms.
The story listed several different types of products containing ‘probiotics’, indicating that they may normally be found in some products while others represent supplemented products.
The story pointed out that this current review follows on the heels of a previous review published in 2004.
We can’t be sure of the extent to which the story relied on a news release. We do know that only the lead author of the study was quoted.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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