This story explains that researchers at the Cleveland Clinic are searching for a first patient for a trial testing whether deep brain stimulation (DBS) might be helpful in improving the outcome of physical therapy in disabled stroke patients.
It provides little solid evidence that such a procedure would lead to a positive clinical outcome. Nevertheless, the story suggests that this serious invasive brain surgery might work and the headline describes it as potentially “groundbreaking.” The story also overlooks that the costs per patient would seem prohibitive for the volume of people who might seek it out.
Later in the story, things get a little less breathless: We find out there are harms associated with this surgery, including some that might not yet be known.
As this Time Magazine story points out, around 800,000 Americans suffer strokes each year and half of those are disabled by these events. A procedure that might improve their quality of life would be a boon to public health. DBS carries significant risks, is expensive, and this story provides little evidence to support its enthusiastic claims.
While this story admittedly is announcing a new procedure never tried in human stroke patients, it conveniently glosses over the sheer complexity of what is being proposed–intricate brain surgery for stroke patients–a procedure that inevitably will cost tens of thousands of dollars, and that if successful will actually only be an adjunct to aid in subsequent physical therapy following a stroke. Given that the story says that annually, nearly half of stroke patients will be disabled — 400,000 — the cost of using this procedure on even a portion of those represents a staggering public health cost.
Human trials have not yet begun. The story discusses rat research:
“But for 10 years, Machado and his team have been studying the effects of DBS on rats. They found that rats with strokes who received DBS had more proteins in the brain that are associated with brain plasticity—and twice as many synapses or connections between nerve cells compared to rats with strokes who did not undergo DBS.”
But no data were provided to explain what “more proteins” means – how much more? In how many of the rats? What is the significance of twice as many synapses? So the discussion of the animal research is almost meaningless.
Nonetheless, we’ll grade this Not Applicable since it’s clear there are no human data to report. However, this does raise the question of why this pre-trial announcement is newsworthy in a national news outlet.
Near the end, the story does mention that “DBS is a type of brain surgery, and comes with risks like bleeding, infection and need for more surgeries” so it earns a Satisfactory rating. It also points out some harms may be unknown. But we would have been happier if the risks were not buried in the last paragraph of the story by which point, odds are, some people would have stopped reading.
While the story is raising the hopes of stroke patients, it actually provides little evidence that the proposed procedure will work or be “groundbreaking” as the headline states. It mentions that DBS has been effective with some Parkinson’s disease patients in eliminating some symptoms of that illness. But it only suggests that in earlier studies in rats, DBS was associated with an increase in proteins in the brain associated with plasticity, meaning that it might be facilitating the brain’s ability to repair stoke damage. The earlier animal studies found DBS was associated with many more nerve synapses, suggesting improved communication between nerve cells. But neither of these findings necessarily mean an improved clinical outcome for patients, which is the hope actually raised by the story.
The leap from animal research to humans–or from use in people with other conditions–is not emphasized strongly enough.
There is no disease-mongering of stroke in the story.
The story only quotes a single source–the head of the clinical trial who will also be the person leading the DBS surgery. There is no discussion about potential conflicts of interest.
The story does point out that the standard treatment for stroke victims who suffer a disability is physical therapy. However, clot busting drugs and other early intervention methods are also being tried as means to improve stroke outcomes.
This story is pretty clear that actual clinical application of DBS for stroke patients is a long way off, given that the first patient on which this will be tried hasn’t been identified yet. So we’ll rate this a marginally Satisfactory, with the caveat that stories like this which raise patient hopes prematurely can do real harm to people and their families. We would have liked it better if the story had spelled out how many steps it will take before this becomes an actual treatment (if ever).
The novelty of the investigation of deep brain stimulation for stroke patients is made clear.
There is no indication that this story relied on a news release. A quick check of the Cleveland Clinic’s website shows no release touting this research project.
Systematic, Criteria-Driven
One sentence from an @npr story about #opioids prompted twitter rage amongst #addiction specialists. I took a closer look at the issue - an insurance barrier called prior authorization - for @HealthNewsRevu. @jonathan_giftos @LarochelleMarc @maiasz https://t.co/QgL8K8zJUD
Comments
We Welcome Comments. But please note: We will delete comments left by anyone who doesn’t leave an actual first and last name and an actual email address.
We will delete comments that include personal attacks, unfounded allegations, unverified facts, product pitches, or profanity. We will also end any thread of repetitive comments. Comments should primarily discuss the quality (or lack thereof) in journalism or other media messages about health and medicine. This is not intended to be a forum for definitive discussions about medicine or science. Nor is it a forum to share your personal story about a disease or treatment -- your comment must relate to media messages about health care. If your comment doesn't adhere to these policies, we won't post it. Questions? Please see more on our comments policy.
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
Research shows some early tumours can produce molecule made from cholesterol which can mimic oestrogen…
About 800,000 people in the United States suffer from a stroke each year. Of those who…
A computerized brain training program cut the risk of dementia among healthy people by 48…