This story demonstrates why it’s so important to seek out independent perspectives in health news. Readers of the competing Post coverage on this story — which featured no such perspective — will come away with a fairly superficial understanding of this new drug’s impact in the treatment of double chins. They won’t learn, for example, that people with loose skin under their neck could end up looking worse than they started after treatment and be in line for a $5,000 neck lift. The Times also delves into the numbers and helps readers understand the research that formed the basis for approval. It carefully describes and quantifies potential benefits as well as harms. An excellent 5-star effort.
Like it or not, lifestyle drugs are big business. So it is not surprising that a “treatment” for double chins has been developed. The FDA approved Kybella based in part on the recommendation of its dermatologic drugs advisory committee. Critical to that approval is a clear understanding on the part of the patient as to the risks and potential benefits of this treatment for a cosmetic condition.
The story notes that the price has not yet been set, which we’ll call good enough for a Satisfactory rating. It could have noted whether insurers are likely to pay for the treatment.
The story provides a good deal more information on the benefits seen in the clinical trials than does the corresponding Washington Post coverage. We are told, “The pooled results from both trials found that 68.2 percent of patients who got the drug saw at least a one-grade reduction in fat, compared with 20.5 percent of patients who got sham injections. Grading was determined by clinical examination and answers on a standardized form. Sixteen percent of patients who received the real injections saw a reduction of two grades in under-chin fat. Only 1.5 percent of the placebo group saw that level of improvement.” We would have liked to have seen some detail about what a two-grade change in under-chin would look like, however.
And while the story does focus extensively on one patient’s anecdotal success story, it also notes that not every patient is a good candidate for treatment. Example: “If a patient has excess fat and loose skin, Dr. Rohrich said, ‘you’ll have a crepey neck and need a neck lift’ after fat is reduced with the shot. Neck lifts can cost $5,000 or more.”
The story does a great job in not only providing a listing of potential harms, it also provides information on their frequency and impact on the subjects in the clinical trials.
The story describes the clinical trials forming the basis for approval in more detail than the Post story, although it could have explained the outcomes a bit more clearly. (What does a “one-grade reduction in fat” mean?) The story gets extra credit for providing significant detail on who is and isn’t a good candidate for the procedure.
The story does not appear to overplay the incidence of fat chins.
This story provides comments from two experts in the field not associated with the clinical trials or the drug company. Compared with the Post’s news-release based coverage, this yields additional depth and perspective regarding patient selection and potential harms. The story also notes that one quoted source is a paid consultant to the company.
The story points out that liposuction is an alternative.
The story notes that the treatment will be available in late summer after doctors are trained to give the injections.
The story says that the drug is the first nonsurgical way of reducing double chins. We wonder if diet and exercise would also be considered nonsurgical treatments for at least some cases of double chins. But we can find no literature to support that idea. Perhaps it’s too obvious an idea for anyone to have studied it?
The story is full of independent reporting.
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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