Low-hanging fruit this story could have snatched include:
With that being said, we thought the story overall offered an informative account of the study and excelled at providing context. We wish more stories about new treatments made the effort to quote four independent experts.
Brain damage caused by stroke affects millions of patients and their caregivers. These people need accurate, unbiased information when making decisions about care and rehabilitation. Journalists can help provide that information by carefully vetting studies about new treatment approaches and seeking out the opinions of multiple independent experts–like this story did.
The story notes that TMS equipment is expensive and requires specialized training. However, this story didn’t put a dollar figure on the cost of the machine as Reuters did. And neither this story nor its Reuters counterpart attempted to quantify the costs of treatment for patients and insurers.
The story tells us that patients receiving TMS improved “16.3% immediately following treatment and by 22.6% two weeks later.” Fair enough. But it didn’t tell us whether that type of improvement represents a meaningful change in patients’ ability to function and care for themselves. Reuters, by contrast, cautioned that “it’s not clear what the amount of improvement they observed would mean for patients in their daily lives.”
We were also confused by this story’s use of the word “neglect” without defining what the term means clinically. Better to leave it out entirely or give a complete explanation of the meaning, as Reuters did.
Although TMS used for depression is associated with a low rate of adverse effects (mostly headache), we don’t know if other problems might emerge when using it on patients who’ve had a stroke. The story didn’t discuss the potential for adverse effects or mention whether any adverse effects were seen in this study. Any new treatment – however theoretically safe – may cause unexpected harms in such a clinically fragile population. That is one of the limitations of a study of such a small number of highly selected individuals.
We would’ve appreciated some stronger cautions about the very small size of this study (only 20 patients) and the danger of drawing firm conclusions from such a tiny sample. Overall, however, we were impressed with the expert comments that generally sought to restrain expectations for the technology. Examples:
The story didn’t exaggerate the challenges faced by individuals who’ve had a stroke, but it would have been helpful to know how many stroke sufferers experience the “neglect” symptoms discussed in the story. The Reuters piece helpfully explains that about half of stroke sufferers experience these symptoms.
The story had excellent sourcing and included comments from four different experts.
The story says that “neglect” symptoms after stroke are usually treated with cognitive and physical therapy, but that this is “often not enough to make a meaningful improvement.” Later, however, it quotes an expert who says that this kind of rehab alone “could and should be enough to treat this kind of stroke.” Well, which one is it? We’ll give the story credit for addressing this criterion, but wish there had been a bit more clarity on the effectiveness of standard rehab.
The study is described as “preliminary” and the treatment is called “not ready for prime time.” We think readers get the idea that this treatment is not available for stroke rehabilitation outside of a research setting.
The story quotes an expert who calls TMS “a very novel treatment” for stroke, which is accurate. However, the story could have given more details about TMS’s more established use as a treatment for depression. The story alludes to this use, but doesn’t convey that depression is what TMS was originally designed to treat and where it is most frequently employed.
This story was not based solely or largely on a press 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
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