It begins well, saying, “A new look at the medical evidence shows zinc supplements may take the edge off the common cold. But not a whole lot.” That’s a more realistic assessment of the evidence than the more enthusiastic beginning to the WebMD story on the same subject. At the same time, this story could have done a better job providing details from the review and quantifying the benefits in a transparent way. We also wish it had brought in some outside perspectives, which could have offered some important insights.
But let’s not lose sight of the strong points: for the second straight day, Reuters Health (and this same reporter) led with caution while others trumpeted findings. Note how the WebMD had an early quote, “This is great news.” And the NY Times’ first sentence said it “may be the next best thing” to a cure. To quote the title of an evidence-based health care column in the Times, “Really?”
Although most of us view the common cold as a mere nuisance, the infection can have serious clinical and economic impact. The common cold is responsible for a large number of lost work days, lost school days and physician visits. Over $400 Million is spent annually in the US for over the counter remedies. Unfortunately, the common cold is also responsible for significant number of prescriptions for antibiotics despite the fact that antibiotics do not work against viral infections. The common cold can also trigger ear infections, sinusitis and worsen lung disease. The Cochrane review of published studies assessing the value of a number of different zinc products as both preventives and for treatment provides a new look at a long standing question; Do zinc salts provide any benefit in the treatment or prevention of the common cold? Stories about such a sought after treatment should take an appropriately critical and cautious look at the evidence.
The story says that the supplements can be bought “for a few dollars,” which is more than the WebMD story noted. Even better, though, this story talked about the costs in work days missed and lost productivity from the common cold.
The story provided fewer numbers than the WebMD story, and we wish it had presented some of the evidence in absolute terms. The story seems to want it both ways. While the story opening does provide the reader with some understanding of the uncertainty of the review results, the quotes from one of the study authors appear to provide an endorsement that is well beyond that in the study conclusions. For example, the story notes, “The bottom line: After seven days of treatment, those taking the supplements had less than half the chance of still being sick.” What is left unsaid is that the authors of the paper rated the evidence for that conclusion as low and “Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.” Far from the declarative statement in the story.
The story didn’t quantify the potential harms, but did discuss the side effects. This story says, “Singh said the side effects of zinc lozenges, which can be bought for a few dollars in any drug store in the U.S., come down to bad taste and some cases of nausea.” The full listing in the article includes constipation, diarrhea, abdominal pain, dry mouth and oral irritation. Because the story downplayed the side effects in a story that is essentially encouraging long-term zinc use, we rate this unsatisfactory.
The story did a better job than the WebMD story on the same topic of walking readers through the review. It says, for example, high up, “The new review is based on 13 trials with 966 participants who either took zinc or a dummy treatment at the beginning of their symptoms. Another two trials found that zinc helped stave off colds, but the quality of that research was low.The bottom line: After seven days of treatment, those taking the supplements had less than half the chance of still being sick.” The story also says, “Exactly how well zinc works is a matter of future research, and the one day estimate may well change, the researchers note. They add it is currently unclear what dose and particular formulation of the supplement will be most helpful.”
The published article is 58 pages long, so it is not surprising that a story can’t do it all in reporting on the results. For example, the story suggests that 13 trials were included in the review. That is true but not all of the trials were included in the each analysis due to different reporting methods. People who took zinc preparations are said to have had symptoms that lasted about a day shorter than those who took a placebo, which is based on six of the trials. The paper notes a mean reduction of about one day. That is a subtle but big difference. The story also notes that people taking zinc products had less severe symptoms, which was based on five of the trials and not 13. A bit more attention to the detail would have provided readers with a better understanding of the review methods.
Nonethless, we’ll give it the benefit of the doubt, as the overall tone of the story drove home the uncertainties: “may take the edge off the common cold…but not a whole lot.” … “I think one can give it a try,” said the researcher who led the new work. “But giving zinc over a long period of time for prevention should be be done very carefully.” All appropriate caveats.
No disease-mongering. We appreciated that this story gave information about the financial and clinical impact of the common cold.
Our posted criterion doesn’t allow us to give a satisfactory grade to a story that relies on just one source, even a source as smart as Dr. Meenu Singh, the author of this study.
The story didn’t compare zinc to alternatives, which is a shame. People take many different drugs, supplements and home remedies to fight colds. We wish that even a few words had been given to the evidence for those treatments as well. We would have liked to have seen some comment on the best ways to protect yourself and your family from getting a cold besides zinc products. A few words about hand hygiene and keeping your hands away from your eyes, mouth and nose would have been helpful to the readers
This story, unlike the WebMD story, made it clear exactly what the review looked at and where those supplements could be found. “Singh said the side effects of zinc lozenges, which can be bought for a few dollars in any drug store in the U.S., come down to bad taste and some cases of nausea. The researchers did not study nasal zinc remedies, however.In 2009, the U.S. Food and Drug Administration warned Matrixx Initiatives to stop selling its widely used supplement Zicam after more than 130 users reportedly lost their sense of smell.”
The story talked about how this review fits into the growing amount of research around zinc.
The story didn’t rely solely or largely 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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