This story offered an informative but flawed summary of a study that tested acupuncture to treat a form of “lazy eye” known as anisometropic amblyopia. It was at its best when describing why the trial, despite its positive results, provides only preliminary evidence that acupuncture is an effective treatment for this condition. On the downside, it offered only a vague description of how the researchers assessed the treatment effects in this study, making the discussion of benefits much less meaningful than that provided in the competing coverage from WebMD. The story also failed to completely characterize the costs and availability of acupuncture, and didn’t explain that the research team might have a financial incentive to promote the effectiveness of acupuncture.
Amblyopia — a condition which causes reduced vision in one eye because the eye and brain are not communicating properly — is a leading cause of vision impairment in children. Treatment is most successful when the condition is identified and addressed at an early age, but older children can also benefit from patching therapy which forces the weaker eye to work harder and communicate more effectively with the brain. Older children may resist wearing an eye patch, however, and it is possible that using a patch will lead to new problems in the better-functioning eye. This study suggests that acupuncture may be a safe and effective alternative to patching for older children with amblyopia. Now additional research will be needed to confirm whether the benefits of acupuncture are real and sustainable over the long term.
The story mentions that acupuncture may not be be covered by many insurers, but it never provides even a ballpark estimate of what a typical office visit for acupuncture would cost.
The description of benefits in this story is not sufficiently detailed. It states that overall visual acuity “improved markedly more” in the acupuncture group compared with the patch group. But it never tells readers how visual acuity was measured and makes no attempt to quantify the difference. Later, the story states that lazy eye was “successfully treated” in nearly 42% of the acupuncture patients but only 17% of the patch patients. Again, though, it never offered a definition for “successful treatment,” so readers have no way to gauge the importance of this result. The story should also have acknowledged that the results favoring acupuncture were much small after 25 weeks than they were after 15 weeks. Thirty percent of the patch group would have been considered “treatment successes” after 25 weeks compared with 42% of the acupuncture group — a difference that was not statistically significant.
The story states that neither treatment produced significant side effects in the study, which is accurate. It also goes into some detail about the potential adverse effects reported previously with patch treatment, but it doesn’t mention any of the drawbacks of acupuncture that patients might encounter outside of a study. Notably, the frequent treatments required by the study protocol might require taking children out of school and cause disruption to their education as well as the parent’s employment. The researchers were able to avoid this by scheduling all appointments after school, but parents outside of a study might not have this much flexibility. We’ll call this a satisfactory, but more detail would have been useful.
The story provides a reasonably accurate account of the experiment with appropriate caveats about limitations. The story introduces notes of caution early on about the small size of the study and the need for additional research. It also acknowledges that the study was of relatively short duration and that the results may be dependent upon the specific skills of the acupuncturist and may not be reproducible with other practitioners. Unlike the WebMD coverage, though, this story never mentioned that the acupuncture group also had to do an hour per day of near-vision activities on top of the acupuncture and similar to what the patching group was told to do. In addition, the story probably should have mentioned that acupuncture, like many conventional medicines, is known to produce a significant placebo effect. Thus, although the acupuncture seemed to work about as good or better than the patch therapy, we can’t be sure if the children in the study were responding to a real effect of the acupuncture or some other aspect of the treatment such as the time spent with caregivers or the therapeutic ritual. Had the study included a group of children receiving an identical sham acupuncture therapy (that is, needles placed randomly instead of in strategic acupuncture locations), we’d have greater confidence that the effects reported are real.
The story repeats statistics provided in the study regarding the worldwide prevalence of amblyopia. These figures do not appear to overstate or exaggerate the impact of amblyopia.
The story deserves praise for seeking out comments from two experts who provide valuable perspective on the results. Unfortunately, though, the story didn’t point out that the researchers in this study have filed a patent application for vision-related acupuncture points. This constitutes a significant potential financial conflict that should have been disclosed to readers.
The story notes that standard treatment for younger children with amblyopia involves eyeglasses or contact lens designed to correct problems with focus. Patch therapy is useful for older children, according to the story, but may be tougher for children to adhere to and has potential adverse effects.
While the story notes that acupuncture is more widely accepted in certain geographical areas than others, it doesn’t convey how difficult a time people would have finding a skilled acupuncturist across broad swaths of the country. This is especially important considering that the treatment was given 5 times a week and would be impractical if significant travel time was required. It also should have mentioned accreditation for acupuncturists and how to choose a practitioner.
The story cites previous research suggesting that acupuncture may improve blood flow to the eye and has other potentially beneficial physiologic effects. And while it quotes one expert who says he is unaware of any previous studies of acupuncture for eye conditions, another source points out that acupuncture has been tested for glaucoma and myopia without much success. Readers get the appropriate impression that this is a novel approach to the treatment of amblyopia, but not totally uNPRecedented.
This story was not based on a news release.
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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