At first glance, this story about elderberry extract seems to satisfactorily address the key elements of our criteria. But closer analysis reveals that the story is a mishmash of evidence and anecdotes presented in a way that undercuts the science and is likely to confuse readers. By highlighting hopeful anecdotes in the lead and close, while burying a skeptical take on the evidence in the middle, the story fails to draw an accurate picture of the available science.
Overall impressions are the ones that last. Stories about medical treatments should do more than just refer to evidence or merely alternate between positive and skeptical comments. Stories should present information in a way that helps readers grasp the gist of the science, rather than devaluing clinical evidence by giving personal anecdotes greater prominence.
The brand of elderberry extract mentioned in this story sells for about a dollar a dose at Walgreens. By our calculations, the daily use recommended by the manufacturer and apparently followed by the family highlighted in this story would cost a family of four about $1500 dollars/year.
While this story reports a specific claim of shortened flu symptoms, it also tosses in several vague claims about less severe and less frequent unspecified illness. The family that’s the focus of the story seems to take elderberry to prevent illness, but the story doesn’t tell us if elderberry has ever been shown to do that. Overall, the presentation is more likely to confuse than inform readers.
We’ll give the story credit here for making it clear that raw elderberries are poisonous. However, the story is about commercially-prepared elderberry extract, not raw berries. There was no discussion of possible harms of extracts. While the few clinical trials of elderberry extract did not report adverse events, the story could have at least noted that supplements are exempt from most FDA regulations. The lack of inspections and independent quality control checks means that consumers are almost entirely dependent on the internal procedures of manufacturers. Thus, there is no independent guarantee that the potentially poisonous elderberries are being properly prepared.
This rating is a close call. The story does report that the one study of an elderberry extract it mentions was small, in contrast to the much larger studies of antiviral medicines approved by the FDA. The story also includes a quote from a physician saying there is not enough research about whether elderberry extract works in children. That being said, the story does not address whether or not there is research on the product in adults. That’s a question worth raising, since the father of the children cited in the piece says he and his wife take the product, too. In addition, we’d point out that the most powerful sections of a story are the beginning and the end. This story both opened and closed with anecdotes supporting elderberry extract use. That presentation is likely to drown out the cautionary statements in the body of the text.
While the studies of the effect of elderberry extract on the flu have looked at treating people who are sick, the story highlights daily use intended to prevent illness. The story does not address this disconnect between the matter of treating people who are ill and dosing everyone with elderberry extract.
We will give this story a passing grade here because it does include a quote from a physician skeptical of elderberry extract. However, there is no mention of whether the trials of elderberry extract have been done by independent researchers or just manufacturers or others with a financial interest in the results. At least one study we’re aware of cites Razei Bar, a manufacturer of elderberry extract, as its sole sponsor.
We’ll rate the story satisfactory here since it does mention two approved antiviral drugs. However, it doesn’t include any references to proven methods of reducing the risk of catching or spreading a virus, such as frequent and thorough hand washing, eating a healthy diet, getting enough sleep, and staying home when sick. An extra sentence would have been sufficient to provide this important context.
It seems clear from the story that elderberry extract is readily available.
The story refers to elderberry extract as an ancient herbal remedy, so there’s no attempt to frame this as a new discovery. That being said, the intro claims that elderberry is getting “fresh attention” this cold and flu season. Is that true? We don’t see what — other than the experience of the Brennan family in Glen Rock, New Jersey — is new here.
The story appears to be based on some original reporting.
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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