Of four stories we reviewed on this study (Washington Post blog, NPR, Los Angeles Times as well), two were blog pieces – this one and the Washington Post entry. This CNN effort was better in most ways than the opinionated blog from the Washington Post. It earned points for sticking to the evidence and providing independent perspectives about the value of antibiotics for treating childhood ear infections. We also applaud the story’s focus on shared decision-making between doctors and parents when managing ear infections. A bit more detail on costs and harms would have added value to this excellent story.
Wanting the best for a child with an ear infection doesn’t necessarily mean opting for the most aggressive treatment. As Dr Richard Rosenfeld puts it in this story: “Medicine is about gray zones and balancing the risks and benefits. Parents and doctors need to understand what the benefits and what the downside of treatments are.” While the research discussed here confirms that antibiotics are likely to be beneficial for certain children with ear infections, no study can take the place of a careful consideration of individual circumstances. According to Rosenfeld: “It’s an opportunity for a conversation with your pediatrician.”
This story did not discuss the costs of antibiotic prescriptions to the individual or costs of policies on our health care system and society. We think it should have.
Although a bit more detail would have been useful on the findings from both studies, the story does provide an account of the absolute rate of symptom relief after 7 days for antibiotic (80%) and placebo-treated (74%) patients, which is the expectation for this criterion. It also provides valuable expert commentary on how parents can put these benefits into context vs. the risk of harm and the likelihood of spontaneous recovery in children who don’t receive antibiotics.
Although we’re tempted to give this story a pass for providing a detailed list of potential harms and a better explanation of why limiting antibiotic use can be beneficial (it can “increase the chance the future use of antibiotics will be effective”), the expectation here is that the story will provide a quantitative estimate if available. These figures were easily obtainable from the original studies, and should have been provided.
This story takes a much more careful approach to examining the evidence than the competing Washington Post blog. Examples:
The prominence of the independent voices in this story is a real strength of the coverage. It was nice to see lengthy comments from Dr. Richard Rosenfeld, who literally wrote the book (or at least edited it) on evidence-based treatment of ear infections. There’s also input from a doctor who is a stronger proponent of early antibiotic use.
The story adequately describes the rationale supporting watchful waiting, which is the primary alternative to antibiotics for an acute ear infection.
The availability of antibiotics to treat ear infections is not in question.
The story correctly characterized the novelty of the research: it establishes that antibiotics are more effective for infants and toddlers with a conclusive ear infection diagnosis, and supports current U.S. guidelines for providing immediate antibiotics to such children.
The story features comments from two independent experts, so we can be sure it’s not based on a news release.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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