The NBC broadcast nicely contrasts the demands that glucose monitoring and insulin shots impose on Type I diabetes patients with the tremendous uncertainty associated with experimental stem cell treatments that might free patients from these daily routines. It summarizes the treatment’s apparent benefits and potential harms, as well as ethical concerns about exporting research on dangerous treatments to countries such as Brazil where patients may not fully understand the risks. If the broadcast has a weakness, it is that it fails to mention the limitations inherent in any small, nonrandomized, nonblinded study with short follow-up that investigates a new treatment in patients with a chronic disease requiring lifelong care. (See “Evidence” above.) Even if the treatments were relatively safe and conducted in the U.S., viewers should understand that such studies are awash in potential biases and should always be approached with caution.
There was no discussion of the cost of this experimental procedure, and although it is an experimental procedure, some attempt could have been made to project costs.
The broadcast states that 14 of 15 patients “seem to be cured because they have not needed insulin shots for as long as three years.” This is the main finding of the research and a reasonable summary of the therapy’s benefit.
The broadcast outlines the harms that this “potentially very dangerous procedure” might cause (e.g. infection) as a result of knocking out a patient’s immune system.
The broadcast explains that 14 of the 15 patients who received the experimental treatment no longer need injections of insulin to control their diabetes. Though the broadcast cites experts urging caution about the safety of the new therapy, no one points out that even if the procedure were safe, the remarkable findings could be the result of chance or bias. As the researchers point out in their published manuscript, these findings will need to be validated in studies that randomly assign patients to both the new treatment and a comparison therapy (such as standard care or a sham), assess their health using clinicians who do not know which treatment each patient received, and conduct tests to explain how exactly the new treatment seems to work. Because there is often a period of remission after the onset of Type I diabetes in which patients appear to improve without extraordinary measures, doctors will also have to follow both groups of patients for a longer period of time. The broadcast, though cautious (and limited by TV’s self-imposed time constraints), does not explain this.
The broadcast balances statements from a cautious but hopeful coauthor of the new research with those of both a concerned academic ethicist and the mother of a young girl who has Type I diabetes.
The broadcast transcript mentions insulin injections, the standard of care for Type I diabetes. In addition, the video shows a seven-year-old girl managing her disease through a daily routine of glucose monitoring and insulin shots–an effective way to illustrate the discipline and hardships the current standard therapy imposes on children with the disease, as well as why new approaches would be so welcome.
The story makes it clear that this is an experimental treatment and not widely available.
The broadcast suggests that this form of stem cell therapy is new. This is true, though experimentation with similar treatments for Type I diabetes go back to the 1990s.
No obvious use of text from the press 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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