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Online program to prevent depression: Solid effort by NPR, though a key limitation was overlooked

Rating

3 Star

Categories

An Online Program May Help Prevent Depression In Some People

Our Review Summary

online computer use and depression testing

The story looks at a study published recently in JAMA that found patients who were at risk of developing major depressive disorder (MDD) were less likely to experience MDD if they engaged in online self-help interventions, within a 12-month timeframe.

The story does a good job of describing the interventions and the bulk of the study design. However, the story doesn’t note that study participants could be on antidepressant medications, nor address whether the use of antidepressants may have skewed the results. The story also would have benefitted from an independent source, and a contextual comparison of this treatment to existing alternatives.

 

Why This Matters

Depression can have a devastating effect on individuals suffering from the disease, affecting not only their quality of life but the quality of life for their loved ones. And those effects have societal impacts as well. For example, the CDC notes that “the economic burden of depression, including workplace costs, direct costs and suicide-related costs, was estimated to be $210.5 billion in 2010.” Research that is aimed at preventing the onset of MDD is important, affects many people, and is well worth covering.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

Cost is not addressed in a meaningful way. The story simply refers to online programs for mental health problems as “low cost.” Given that the online programs used in the study involved generating feedback from online trainers for each session and for each patient, the cost may not be negligible. And it’s not clear whether insurers in the U.S. would be willing to pay for preventive mental health treatment. The research was done in Germany, which has a different health care system than the U.S., but the issue of cost should have been addressed more fully.

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

Satisfactory

The story made clear that patients who participated in one of two online self-help interventions had a 27 percent rate of experiencing major depression disorder (MDD) in the 12 months following the study, compared to a 41 percent rate for those who did not participate in the online interventions. That’s enough to earn a satisfactory rating.

It would have been even better if the story had addressed whether there was any difference in performance for patients who received the “cognitive behavioral therapy” intervention versus the “problem-solving therapy” intervention. And if the study didn’t differentiate between results for the two interventions, the story could have said that. This is significant because it’s not clear to readers whether one approach might have been significantly more effective at preventing the onsite of MDD, or if they had comparable results.

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

Not Applicable

The story does not address potential harms, but there are few potential harms associated with the relevant interventions–other than temporary discomfort, stress or anxiety that can come along with addressing difficult feelings. We’ll rate this not applicable.

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

Not Satisfactory

The story does a lot of things right here: It tells us the number of study participants (406), describes the experimental and control groups, and lays out the broad study design.

But the discussion of limitations fell short, especially since the study itself outlined many to keep in mind. One limitation that felt especially important to include, and which the JAMA paper noted, was that study participants were allowed to take antidepressants. How did the study control for that?

Does the story commit disease-mongering?

Satisfactory

No disease mongering here.

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

Not Satisfactory

The story does tell readers who funded the work, which is great. However, the only source quoted in the article is the lead author of the relevant study. An independent expert opinion would have been extremely valuable.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The study compared online self-help interventions to an online education course about depression, and the story reflects that. The story doesn’t discuss the use of in-person therapy for preventing the onset of MDD, nor does it discuss the use of pharmaceutical interventions.

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

Satisfactory

The story not only makes clear that this preventive approach to online interventions is fairly novel, but that there are significant questions about whether it could be scaled up.

Does the story establish the true novelty of the approach?

Satisfactory

The story establishes this early on, noting that “Similar programs have been used to treat depression, but this may be the first one tested to prevent it.”

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

Satisfactory

The story appears to go beyond any news release on the work.

Total Score: 5 of 9 Satisfactory

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