Interesting postpartum depression study results reported in the Guardian, but have they actually been published?

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

We were glad that this short story mentioned the societal cost estimate for depression but still find it lacks any “cost” for the therapy under discussion.

For the clinical trial, the researchers used an existing system of Lady Health Workers who are specially trained to do the intervention, so the cost would be whatever it cost to add this training and time to their work. (Likely minimal.)

So, we think the story should have added a line or two acknowledging that it was a relatively affordable intervention where it was implemented–in Pakistan–but is likely to be of widely varying costs depending on where it’s used. In the U.S., for example, cognitive behavioral therapy typically requires 8-12 weeks of visits to a professional who charges between $180 and $250 per hour in the United States, according to Consumer Reports. Some of this might be covered by some insurance.

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

Not Satisfactory

Here’s what the story said about benefits. The figures reported are in italics, sometimes in numbers and sometimes as percentages.

“The study, one of the largest randomised control trials to be held in the developing world, followed women diagnosed with depression mid-pregnancy in 40 communities in rural Pakistan. Within a year, more than half of the women in a control group (58%) were still depressed, whereas only a quarter of the mothers who had been treated with CBT reported depression.

“Returning to the women and their children seven years later, researchers found that the treated mothers were still significantly less likely to be depressed than the control group.”

The first paragraph of this passage was detailed and useful. But, considering that this story is all about the 7-year follow-up, there was not enough information on what was measured (in the second paragraph). What does “significantly less likely” mean, numerically? Had that been expressed in numbers or percentages, we’d have likely rated this Satisfactory.

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

Not Satisfactory

The story does provide some important details on the initial study:

The study, one of the largest randomised control trials to be held in the developing world, followed women diagnosed with depression mid-pregnancy in 40 communities in rural Pakistan.

However, it doesn’t give us adequate information about the follow-up study on maternal outcomes. It states that it is based on research led by Sonia Bhalotra, of the Institute for Social and Economic Research, ISER, at the University of Essex, and that’s about it.

We could not find any publication of this presumably new research by Bhalotra. What we did find was a media briefing indicating that this research was recently presented at a conference–which indicates it should be considered preliminary until published. This point should have been stressed in the news story.

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

Not Satisfactory

The story does not quote anyone independent of this study; this would have been very useful to include considering this is unpublished data (as far as we can tell).

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

Not Satisfactory

The story didn’t address availability.

As explained in the original clinical trial, the researchers used an existing system of Lady Health Workers who are specially trained to do the intervention, making the treatment available in an area where it normally wouldn’t be.

But even in nations with more resources, spotty insurance coverage and lack of providers limit access to this type of care. The story should have at least touched up on the availability issue. This is an area an independent source likely could have given some context on.