This Reuters story pulls readers in with the idea that, one day, people might reduce migraine pain with a smartphone-connected tool. The report highlights a new Neurology journal study of Nerivio Migra, a battery-powered device that uses low-intensity electric shocks to the skin, a method called “transcutaneous electric nerve stimulation” (TENS) and which theoretically blocks pain signals in nerves to reduce the severity of migraines. Similar devices have been FDA-approved for use on the head, which doesn’t necessarily mean they work — only that they’re relatively safe to use — and this study tried TENS on patients’ upper arms (a more discreet location) to see if it had any effect.
The story carefully hedges the benefits of the therapy, and it’s a wise move: only 71 middle-aged people were studied, most of them women, and not all of them received the actual treatment due to its double-blind setup. We do wish the projected cost of the treatment had been included, as well as a discussion on migraine treatments in general.
There’s no totally effective treatment or way to prevent migraines, and sufferers will be eager to read news about potential new treatments. For this reason, any news stories on this treatment must be cautious and not oversell the benefits, which are still experimental at this point. This story did a good job keeping the tone moderate.
This was one downside to the story: There’s no information about the cost, either for the Nerivio Migra or similar treatments. We found that Cefaly — a TENS device that’s FDA-approved for use on the forehead — costs roughly $350, according to the company’s website.
The story does a nice job laying out the results. Readers are not only told how effective the treatment was measured to be at certain shock frequencies, but also how the placebo arms of the study fared, too.
The side effects are minimal but worth mentioning — and this story doesn’t lay them out. Some users can be allergic to the sticky pads of a TENS system, and those with heart conditions, metal implants, epilepsy, or other neurological conditions might be poor candidates for it.
The story does a decent job here. It mentions a few shortcomings of the study, including how placebo patients often stopped their treatments before the recommended time of 20 minutes had passed. The report also explains how the study didn’t address long-term pain relief, i.e. beyond two hours. It’s also clear that the study was company-funded.
However, there was some background information we wish had been included: Although two TENS devices were approved for migraine in 2013 and 2014, both approvals were based on small studies with questionable randomization. The current study seems to fit that same pattern of poor evidence quality, and we wish this news story had dug into that. It is possible the weak placebo setting was distinguished from the therapeutic setting by the patients, who stopped the former more often. And for this reason, if patients knew which treatment they were on, then the results are falsely skewed, as well.
We didn’t find any disagreeable or fear-stoking language. The story would have been stronger if it had also discussed the prevalence of migraine sufferers in the general population.
The story included cautionary comments from a neurology researcher, which helps balance and contextualize the study’s results. The story also disclosed that the study was “company-funded” and that the study’s lead author is “an advisory board member for Theranica, the company developing the device.”
We only get a passing mention of drugs, and there are many available. Quickly fleshing out the efficacy of those drugs versus this TENS technique would have gone a long way in helping migraine sufferers who may be desperate to try the most effective, affordable, and least invasive treatment.
The story establishes that TENS was already available for use on the head, but uses a researcher’s words to carefully note that it remains to be seen if TENS on the arm is a reliable stand-alone treatment that doesn’t need to be paired with drugs. It also makes it clear that the technology is still being tested.
Readers are told how most TENS therapy for migraines applies to the head, not the upper arm (as this devices is designed for), so this would be a somewhat new way to use the treatment.
The story did not rely on the news 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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