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Globe story on experimental autism treatment is all anecdote, no data

Tracking the risks and rewards of transcranial magnetic stimulation

Our Review Summary

Mental health symbol Puzzle and head brain concept as a human face profile made from crumpled white paper with a jigsaw piece cut out on a rustic old double page spread horizontal wood background.

This is a story about John Elder Robison, and his book “Switched On: A Memoir of Brain Change and Emotional Awakening.” In the book, Robison discusses his experience as a person with Asperger syndrome undergoing transcranial magnetic stimulation (TMS) as part of a research study. The story includes quotes from him and a doctor on the TMS research team.

This story is lacking because of its reliance on the anecdotal experience of one person. There’s no data. No broader perspective. No independent voices. No pushback at all on the statements and claims made.

While we understand that this story is supposed to be a profile of one person’s experience, that doesn’t absolve it of responsibility to evaluate whether the claims are likely to be true or broadly representative of what others can expect.

 

Why This Matters

The need for treatments that can help people with autism is clear–effective, proven therapies are lacking. As such, this story offers hope to those with autism spectrum disorder and their families. But in doing so, it runs the risk that the hope isn’t really backed up by evidence. Though Robison believes the treatments have helped him, it is very difficult to assess whether TMS is responsible.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

There is no discussion of costs. The exact number of sessions necessary, the duration of treatment and the repeat treatments through time are not discussed, either. But, an idea of cost is important–this treatment is unlikely to be covered by insurance, and readers given hope by this story will want to know how much it may cost.

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

Not Satisfactory

While Robison refers to improvements in his life, there is no discussion of how long the effects last, what changes occurred and how they actually benefited Robison. And, while personal anecdotes are powerful, they don’t provide evidence that can be used to assess the likelihood of benefit or harm in general. A discussion of the research in this area should have been included.

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

Not Satisfactory

The story does describe harms that affected the man highlighted in this piece. While that’s important for understanding his story, the descriptions provided do not help the reader determine how common these harms may be nor the severity of the negative aspects identified. Studies of TMS for the treatment of other disorders–for example, depression–could have been cited to establish common risks and side effects.

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

Not Satisfactory

There is no evidence provided except for anecdotes. If there isn’t any substantial research on this topic, the story could have said so. At the very least, the story could’ve described the larger results of the study that Robison took part in.

Does the story commit disease-mongering?

Satisfactory

There is no disease mongering. There are no well proven, effective treatments for autism spectrum disorder.

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

Not Applicable

Given that this is primarily an interview with a book author, we’ll rate this N/A. However, a source who is independent of the book author (the only other person quoted is one of the research doctors), could have provided important perspectives on the treatment being discussed anecdotally.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

There is no discussion of alternatives–either of alternative treatments the patient received, or of general options for people with autism.

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

Satisfactory

It is clear that transcranial magnetic stimulation is available because it is used to treat depression. It is also clear from the story that TMS’s use for treating autism is still not routine or even necessarily recommended.

Does the story establish the true novelty of the approach?

Satisfactory

Though TMS isn’t new, its use for autism should still be considered novel. As the story states “TMS is not yet recommended as an autism treatment.”

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

Satisfactory

This story was obviously written from an interview of the author and his doctor. It did not rely on a news release.

Total Score: 4 of 9 Satisfactory

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