This was a so-so account of a study that compared acupuncture to using an eye patch for treatment of a certain type of “lazy eye” known as anisometropic amblyopia. It was better than the competing HealthDay coverage at describing the design of the study and quantifying the benefits that can be expected from acupuncture. It noted that children treated with acupuncture had an improvement of a little more than 2 lines on a vision chart — a practical characterization of the effects that was not provided in the rival report. But the coverage shared gaps with HealthDay when it came to discussion of the costs and availability of acupuncture. This story also failed to point out that the researchers might stand to benefit financially from a patent on vision-related acupuncture sites — a conflict that was disclosed in the original research paper and should have been included in this news story.
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.
A source in this story cited time and expense as two factors that might decrease the attractiveness and accessibility of acupuncture. However, it never attached figures to these concerns. We think the story should at least have mentioned the cost of a typical office visit to an acupuncturist.
The story did a better job than the competing coverage of quantifying the extent of the benefit observed with acupuncture. It explained that children in the acupuncture group had their vision improve by about 2.3 lines on the vision chart, compared with about 1.8 lines in the patch group. (HeathDay, by contrast, merely said that vision “improved markedly” in the acupuncture group.) It also explained that the amblyopia was considered “resolved” in 42% of acupuncture and 17% of patch patients. (The HealthDay we also reviewed described these patients less precisely as “successfully treated.”) Lastly, this story noted that the benefits of acupuncture were much less pronounced after 25 weeks than they were at 15 weeks, whereas HealthDay only mentioned the 15-week outcomes.
This study did not report significant adverse effects with either the patch or with acupuncture. In our view, however, this does not absolve the story from at least mentioning the potential for harm with both treatments. The patch, for example, has the potential to cause new onset amblyopia in the stronger eye. And acupuncture might be painful, cause infections (though rarely), and disrupt a child’s education due to the need for frequent treatments.
The story did a good job of describing what happened in this experiment and pointed out a number of key limitations. Importantly, it explained that the children receiving acupuncture were told to do an hour a day of vision exercises in addition to the acupuncture — something HealthDay neglected to call attention to. In addition, it cited the small size of the study; the lack of other research on acupuncture for amblyopia; and the significant time, travel and expense of acupuncture as factors to keep in mind when interpreting the results. We wish it had also called attention to the significant placebo effect that is possible with acupuncture and which may have affected the outcome of the study.
This story brought perspective from two independent experts who helped put the results in the appropriate context. Unfortunately, it didn’t point out that some of the study investigators may have a financial incentive to promote acupuncture because they are trying to patent needle placement sites related to vision. The competing coverage also failed to identify this conflict.
The story weighs some of the pros and cons of acupuncture compared with the traditional patch therapy. It notes that the patch has the advantage of being inexpensive and that it can be worn at home, making it more convenient.
Like the competing HealthDay coverage, this story noted that acupuncture may not be widely accepted in some areas. But it also never cautioned that it might be impossible to find a trained acupuncturist in many places in the U.S. It should have pointed this out and emphasized the need to check for accreditation/licensing when choosing a practitioner.
While we can’t vouch for this story’s contention that amblyopia has been successfully treated with acupuncture in the past (the studies which apparently show this are in Italian and Russian), we think it’s important that the story at least mentioned this previous research and noted that there is some scientific basis to believe that acupuncture might be therapeutic.
Since the story quotes two experts not affiliated with study, we can be sure it wasn’t 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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