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Focus is on deep brain stimulation to treat disorders

Rating

3 Star

Focus is on deep brain stimulation to treat disorders

Our Review Summary

The story reports on deep brain stimulation (DBS), a potential new treatment for obsessive compulsive disorder (OCD). DBS has been used to treat movement disorders such as Parkinson's disease, and recently it had been used in people with treatment-resistant depression.  The story reports that this new treatment for OCD is still in early clinical trials and notes that it does not yet have FDA approval. There is speculation that the device may be approved for "humanitarian" reasons.

The story mentions that DBS is for a very small group of people with treatment-resistant OCD. The story notes that this would mean other therapies, such as medication and cognitive or other behavioral therapies would have already been tried without success prior to consideration of DBS. It would have been informative for the reader to get data on the proportion who respond to more standard treatments. The reader could be left thinking – this medication didn't work – time to go to DBS.  In fact, patients would need to fail mutiple standard treatments prior to trying this treatment.

The story gives an overview of a small trial of DBS in patients with treatment-resistant OCD and depression, but it does not discuss the trial design, nor are we told if these's patients OCD symptoms improved. The story only mentions that 50% of this group (of 18 people with OCD and/or depression) scored higher on a memory test,  an intermediate outcome, rather than focusing on overall response. The story does note that results from the study were presented at a conference, meaning they have not been peer-reviewed in a published journal.  (See our primer on some of the flaws in trying to interpret such presentations.) The story relied heavily on one patient's anecdotal experience of reduced OCD symptoms and improved memory. 

The story does not mention potential harms of the device or harms of the surgery to implant the device.  There is so little long-term experience with these devices that we really don't know all the the harms.

The focus of the story was on impact on memory, but there was no discussion of the impact on the other symptoms experienced by the patients (do they get better? worse?), so the picture is incomplete  The cost of this treatment is also not mentioned. Estimated costs of the device and the operation to implant the device would be available as it is currently approved for the treatment of Parkinson's disease. 

The story provides multiple perspectives on this experimental approach for OCD.  A patient, clinician, neurosurgeon, and a researcher involved in a clinical trial provide perspectives on this approach for people who have debilitating OCD and have exhausted all traditional treatment options.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story does not mention the cost of this treatment. Estimated costs of the device and the operation to implant the device would be available as it is already used in the treatment of Parkinson's disease.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The story provides no quantitative benefit of deep brain stimulation for severe symptoms of obsessive-compulsive disorder except to say "two-thirds of the patients scored 50 percent higher on memory measures after deep brain stimulation."  But readers are not told how reliable or significant those measures are.  The story instead relied heavily on one patient's anecdotal experience of reduced OCD thoughts and behaviors and an improvement in memory.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

The story does not mention potential harms of the device or harms of the surgery to implant the device. The story states that deep brain stimulation would be used "only in extreme cases" but we are not told why.  There is so little long-term experience with these devices that we don't know all the the harms.  Certainly infection is one of the more serious concerns, but this is not mentioned. 

 

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

The story gives an overview of a small trial of deep brain stimulation,  but it does not discuss the trial design, nor are we told how these patients' obsessive-compulsive disorder improved. The story only mentions that 50% of this group (of 18 people with OCD and/or depression) scored higher on memory tests. The story does note that results from the study were presented at a conference.  But it does not explain whether they been peer-reviewed in a published journal. Additionally, they don't place these findings into context with other studies and they emphasize an intermediate outcome (memory) rather than focusing on overall response.

Does the story commit disease-mongering?

Satisfactory

The story gives accurate prevalence data and amplifies that by giving the number of individuals severely affected or disabled.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

The story provides multiple perspectives on this experimental approach to obsessive-compulsive disorder. 

Does the story compare the new approach with existing alternatives?

Satisfactory

The story mentions that deep brain stimulation (DBS) is for a very small group of people with treatment-resistant obsessive-compulsive disorder. The story notes that this would mean other therapies, such as medication and cognitive or other behavioral therapies, would have already been tried without success prior to consideration of DBS. That said, it would have been much more informative for the reader to get data on the proportion who respond to more standard treatments. The reader could be left thinking – this medication didn't work – time to go to DBS.  In fact, patients would need to fail mutiple standard treatments prior to trying this treatment.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The story reports that this is a new experimental approach to obsessive compulsive disorder still in early clinical trials. There is speculation that the device may be approved for "humanitarian" reasons, but the story does mentions that it does not yet have FDA approval. It would have been more helpful if they told the reader whether it was only available in research protocols or for clinical use, and if it was covered by insurance.

Does the story establish the true novelty of the approach?

Satisfactory

The story reports that this is a potential new approach for obsessive-compulsive disorder. Deep brain stimulation (DBS) has been used to treat movement disorders such as Parkinson's disease, and some treatment-resistant depression.

Does the story appear to rely solely or largely on a news release?

Satisfactory

Multiple independent sources are cited in this story. It does not appear the information relies solely or largely on a news release.

Total Score: 6 of 10 Satisfactory

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