June 15, 2017 Read Original Story

Small, unpublished study on new knee pain procedure needed more scrutiny from NBC News

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Rating

‘Cool’ New Knee Procedure Eases Arthritis Pain Without Surgery

Our Review Summary

Knees crippled by osteoarthritis sideline millions of Americans. While most folks seeking help are offered such treatments as physical therapy and steroid injections, this story describes another option: using radio frequency to “mute” the nerves in your knee that transmit the pain signals to your brain.

The story does a good job discussing side effects, and discussing costs of treatment. But when it comes to discussing the evidence, the story falls short. It doesn’t explain that the one study mentioned is an abstract of a talk given at a meeting, which is considered preliminary. Nor does it provide any specifics on how much the new technique relieved pain compared to the control group, or how that was measured. From what we can tell, there’s really not much high-quality data on this procedure–despite the FDA approval.

Why This Matters

The FDA approved this treatment earlier this spring, and that means its use could spread rapidly, making accurate stories about it all the more important. (Approval is no guarantee of safety of effectiveness.)

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

Costs are indeed addressed.

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

Not Satisfactory

Although the story makes clear that the process relieves pain, it offers little in the way of quantification. According to the one study mentioned, by how much did it help? How was that measured? That is particularly important here, as this procedure appears to reduce—but not necessarily eliminate—pain. The story does use verbs such as “eases” and “reduces,” but then it focuses on one patient who, after the procedure, seems to be pain-free. The text later does a good job of indicating that the pain reduction is relatively short-lived, lasting 6 months to a year.

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

Satisfactory

Risks are identified.

However, we think it would have been worth pointing out that there is little scientific literature about applying this old technology to a new part of the body. So, it’s unclear what the eventual risks are.

Also, the article is not quite clear what radiofrequency ablation is doing: killing nerves, for at least 6 months. There could be permanent loss of nerve sensation, or maybe the nerves will grow back years later, either normally or in an altered state (which has happened in some other medical and surgical situations).

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

Not Satisfactory

The story gives short shrift to details of the one study it cites, which compared the effect of cooled radio frequency ablation with steroid injections. In reality, the study has some issues. The story should have made it clear that this was a relatively small industry-funded study that hasn’t been published nor peer-reviewed and also wasn’t blinded (meaning participants knew which treatment they were getting).

Does the story commit disease-mongering?

Satisfactory

Osteoarthritis in the knee can be debilitating and the story didn’t disease monger its severity or prevalence.

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

Not Satisfactory

The story has several independent sources. However, the story missed a potential conflict of interest. According to ProPublica’s Dollars for Docs database, one of the story sources consults for at least two major medical device companies that make products similar to the “Coolief” system described in the story. That source also received small amounts of cash (for food and beverages) from Halyard Health, which makes the Coolief system.

Does the story compare the new approach with existing alternatives?

Satisfactory

The text mentions treatment options and compares the radio frequency procedure with one of them.

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

Satisfactory

Recent approval by the Federal Drug Administration means that the technique is not yet widely available, the story notes.

Does the story establish the true novelty of the approach?

Satisfactory

This use of radiofrequency treatment on arthritic knees does appear to be relatively new, although the technique has been employed to cope with a variety of other painful conditions, including trigeminal neuralgia, cancer pain, and spinal pain.

Although radiofrequency therapy is over 60 years old, it is not used very often, apart from some procedures by cardiologists to rewire the heart’s electrical system.

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

Satisfactory

The story did not appear to rely on the news release.

Total Score: 7 of 10 Satisfactory

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