This story includes appropriate caution about jumping to conclusions that folic acid can indeed prevent some cases of autism, as well as the size of any potential effect. It does a better job than the Reuters Health story of explaining why a study of women in Norway may not be relevant to women in the US. But the Reuters Health story probably does a better job of telling readers how small the underlying autism risk is in Norway. This LA Times blog post, though, graded slightly better than a CNN blog post on the same study.
Stories that may encourage millions of people to change behavior in order to possibly, but not certainly, affect a small risk, should proceed with caution. But since folic acid supplementation is already strongly recommended to reduce the risk a baby may be born with spina bifida or other neural tube defects, reporting on this research is important, even if any potential benefit appears to be relatively small and tentative.
Not applicable. No discussion of costs, but since folic acid supplement pills cost only a few cents each, the omission is not important.
This story reports both the raw data differences in autism risk between the folic acid and non-folic acid groups (a 2-to-1 difference) and the much smaller 39 percent difference the researchers reported after adjusting for education and other maternal characteristics. However, by stating the overall absolute risk of a child with autism as 0.13% instead of about 1 in a thousand, readers of this story may not get as good an understanding of the absolute risks as readers of the Reuters Health story we also reviewed.
This is a tough call.
The US Preventive Services Task Force and other expert bodies state that there is no evidence of potential harm from recommended levels of folic acid supplementation. But there are hypothetical, yet plausible concerns about harmful effects of getting too much folic acid, especially an increase in cancer risk. This is why many countries have not embraced mandatory folic acid fortification of the food supply. The story could have mentioned this.
The point is that there are always potential harms. This is not a risk-free substance. Stories may not always find the time/space to delve into hypothetical/plausible potential harms, but we wish they would.
This story is cautious in its language, emphasizing “link…association…more likely” and avoiding cause-and-effect inferences. It includes details about possible factors besides folic acid supplements that could explain differences (such as education, smoking, whether the pregnancy was planned) and that researchers adjusted their results to try to account for those factors. This story also has a clear discussion of the underlying differences between autism risk in Norway and the US and how caution should be exercised in applying study results from one country to the other.
The story mentions the puzzlement about why rates of autism appear to be rising in the US, thus giving readers a sense of how much remains unknown about potential causes or responses.
Unlike the Reuters Health story (which quoted two independent sources), this one does not include comments from an independent source, just a quote from a journal editorial (and that quote doesn’t directly address the quality of the evidence). The competing CNN.com story (also a blog post), reviewed a day earlier, had three independent sources.
There are no broadly-recommended ways to reduce autism risk.
It is clear that folic acid supplements are widely available and have long been recommended for women considering pregnancy.
The story reports the long-standing recommendation that women considering pregnancy take folic acid supplements and that many common foods are already fortified with the vitamin.
But it could have noted that at least one other study has documented an association between folic acid use and reduced autism risk. The JAMA paper on which the story is based cites several prior reseach efforts showing association with folate in early pregnancy and severe language delay or autism.
The story does not appear to rely 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
Comments
Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.
Our Comments Policy
But before leaving a comment, please review these notes about our policy.
You are responsible for any comments you leave on this site.
This site is primarily a forum for discussion about the quality (or lack thereof) in journalism or other media messages (advertising, marketing, public relations, medical journals, etc.) It is not intended to be a forum for definitive discussions about medicine or science.
We will delete comments that include personal attacks, unfounded allegations, unverified claims, product pitches, profanity or any from anyone who does not list a full name and a functioning email address. We will also end any thread of repetitive comments. We don”t give medical advice so we won”t respond to questions asking for it.
We don”t have sufficient staffing to contact each commenter who left such a message. If you have a question about why your comment was edited or removed, you can email us at feedback@healthnewsreview.org.
There has been a recent burst of attention to troubles with many comments left on science and science news/communication websites. Read “Online science comments: trolls, trash and treasure.”
The authors of the Retraction Watch comments policy urge commenters:
We”re also concerned about anonymous comments. We ask that all commenters leave their full name and provide an actual email address in case we feel we need to contact them. We may delete any comment left by someone who does not leave their name and a legitimate email address.
And, as noted, product pitches of any sort – pushing treatments, tests, products, procedures, physicians, medical centers, books, websites – are likely to be deleted. We don”t accept advertising on this site and are not going to give it away free.
The ability to leave comments expires after a certain period of time. So you may find that you’re unable to leave a comment on an article that is more than a few months old.
You might also like