Uneven coverage of web-based suicide prevention program for doctors
Rating
STUDY: NEW DOCS' SUICIDAL THOUGHTS EASED WITH ONLINE THERAPY
Our Review Summary
This is a somewhat uneven account of a study of the use of a web-based therapy program in the reduction of suicidal thoughts in medical interns. While some elements of the story are solid, it is incomplete in some important aspects. The reader is provided with insufficient information on key components of the study design, in the timing of the collection of data presented, and on alternative approaches. While the comments of Dr. Dalechek are useful for context, they do not replace the comments of an unaffiliated expert in the field.
Why This Matters
Just about one physician commits suicide daily in the United States and the risk is highest during the early days and months of training. The use of a simple and generally available web-based therapy for medical interns is an intriguing idea that as the primary author notes needs to be validated in a larger study.
Criteria
Satisfactory
The story says the study involved a free online program developed in Australia. Knowing that it is free may be incentive enough for some individual doctors or their hospitals to look into it — so this is useful information.
Satisfactory
The story has some useful information on the benefits of the online therapy. We are told that, “Overall, 12 percent of interns who got online therapy said they had thought about suicide during the year, versus 21 percent of the interns who received four weekly emails with information on depression and where to seek help” and “that interns who got the sessions were 60 percent less likely to have those thoughts than the other group.” However there is no mention of timeframe or the durability of the benefit over time. The suicidal ideation actually increased in both groups from baseline. (Figure 3 in the manuscript highlights the data collection) The figures provided reflect the numbers of interns who had suicidal ideation at least once during the one year data collection. It is also important to point out that 48% of the medical interns participating had a baseline history of depression. And while suicidal thoughts might have been prevented, we don’t know if the intervention would have any effect on actual suicide attempts or success rates.
Not Applicable
It is hard to imagine harms associated with this approach so we will rate it as not applicable.
Not Satisfactory
On the plus side we are told that 200 medical residents participated in the study. Unfortunately we aren’t told how many in the web based therapy actually participated and completed the sessions. This type of study obviously cannot be blinded to the participants but could be to the data collectors but no information is provided in this regard. The actual participation of both groups was far less than 100%. Only 51% of those assigned to the online therapy actually completed all four sessions.
Satisfactory
The story provides some useful insight into the realities of medical training and in the risk of suicide especially in the early internship months.There does not seem to be any evidence of disease mongering.
Satisfactory
The story provides comments from a psychiatry resident not affiliated with the study who offers an important view from the inside.With that being said, we wish the story had included the views of an expert in the field, commenting specifically on the intervention that’s the basis for the story.
Not Satisfactory
The study in question compared access to a web based therapy plan to emailed reminders of available resources. We would like to have seen some comment on the relative value of traditional individualized “talk” therapy to compare to the web based program.
Not Satisfactory
The story notes that the study, “.. used a free online program developed at the National Institute for Mental Health Research at the Australian National University in Canberra.” but provides no additional information about general availability outside of the study.
The story should have mentioned the name of the online program that was used for the study in the case that any current residents may want to try it for themselves, or perhaps family members or friends of current residents may want to suggest the program if they come across the story.
Not Satisfactory
Web based therapy for depression is not new or novel. Its use in general population is well described in the literature. What is perhaps new is the use of a web based protocol in this high risk group.
Satisfactory
The story does not appear to be based on a news release.
Total Score: 5 of 9 Satisfactory
Comments
Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.
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.