If it had spent a little more time quantifying the potential benefits of this screening, and if it had discussed any of the potential harms, it would have earned a higher rating.
MRIs are being touted as a breakthrough screening for a range of conditions, with promises that “early intervention” will save lives and eliminate suffering. For this to be true, studies have to be properly designed and have to target the right population of patients. The study in question here does neither well, and the story does a decent job capturing the uncertainty around the study’s findings.
The story deserves high marks for noting the high costs of an MRI. “This test costs no more than a standard MRI, which runs around $1,500, Hirsch noted.”
The story starts off with a very vague description of the study’s findings, saying, “The researchers found no differences in the activity in the hearing area of the brain between the two groups. However, in the language comprehension area, there was significantly more activity among typical children than among children with autism, Hirsch’s group noted.” What would be considered significant when comparing one group of 12 to another group of 15? The story does provide a bit more specific information later saying, “To further test this screening approach, another group of 27 autistic children, aged 5 to 17, underwent fMRI and the researchers were able to identify 26 of them as autistic.” We felt this was inadequate and also misleading. As the story goes on to point out, the brain differences that were found may not be exclusive to autism. There’s a chance, in fact, that were the study group much larger that there would have been many other subjects who had the same brain activity but were not otherwise diagnosed as autistic.
There are no harms quantified or even mentioned, which is disappointing. The harms from an inaccurate diagnosis of autism or any other disorder can be real and devastating.
The story notes the limitations of the study several times and in several ways. For example, it says, “For one, this study was done in school-aged children, many of whom were actually teenagers, so it is impossible to know if these differences in neuroimaging would also be found in younger patients, Adesman pointed out.” We would have liked more details about the correlation between clinical symptoms and the fMRI findings.
The story avoids disease-mongering and takes care to acknowledge that there are different shades of autism along a spectrum. “For one, it is not known whether this technique can identify autism across the entire spectrum of the disorder.”
HealthDay continues its laudable tradition of listing the story’s sources at the end of the piece.. We thought the quotes from independent experts were great and provided some strong context.
The story does not go into much detail about the alternatives to MRI screening, but it does say that most chlidren are diagnosed by a clinician, not through any biological screening or brain scan.
The story makes it clear that using MRIs to diagnose autism is an uNPRoven approach. The author of the study says, “This is not the diagnostic that you can package and send to all community health centers in the United States. This is an announcement that this can be done,” she said. The story could have pointed out that the validity of the testing would be dependent on the expertise of the radiologist, as reading functinal MRI is different from traditional MRI.
The story shows that there is still a lot of work to be done before MRIs could be used as a novel screening device for autism.
The story does not rely on a news release.