This USA Today story covers a video and a conference talk about a wrist gadget that Microsoft researchers designed for Emma, a person with Parkinson’s disease — an ailment for which there is no cure and affects 10 million people worldwide and 1 million in the US (60,000 people in the country are diagnosed each year).
The video shows how the vibrating device (named the “Emma Project”) appears to calm the woman’s hand tremors enough to write and draw at a basic and recently unattainable level. It’s an undeniably heartwarming story, but this story overplays its hand. Seeing is not believing when it comes to a medical intervention; many factors, including a placebo effect, can make an intervention seem like it works when it doesn’t.
Also, just because it seems to work for one person doesn’t mean it will for others, or to the same degree. This work is, in effect, a non-study with a sample size of one. There’s not enough here to show the device does or does not work; all we know is that it appears to for this woman. A fairer headline would have left no room to potentially mislead readers, i.e. “Microsoft shows off watch that quiets one woman’s Parkinson’s tremors.”
Microsoft has a lot of attractive bait to dangle in front of writers: A cool-looking wrist gadget; a simple and seemingly innovative solution to a vexing problem; and a heartwarming positive outcome for a Parkinson’s disease patient. But a minimally significant burden of proof is absent in the form of a controlled study, and so the story serves merely as a promotional megaphone for a tech company.
No price is discussed, but since it’s made clear that the “Emma” watch is a one-off prototype, we’ll mark this one as “not applicable.” However, it would have been useful to mention the price range of smart watches.
It appears the “Emma” watch helped a patient regain some of her hand control, enough to draw her name (which was presumably impossible “for ages,” according to the patient) and a cleanly drawn square (when her pre-watch attempt was squiggly). But how much are the watch and its vibrations actually helping and for how long — we don’t know, because there’s no control group. It’s a sample size of one, and what’s shown in the video may very well be a placebo effect without either the patient, designer, or anyone else knowing.
Only a well-designed research study could responsibly attempt to determine the benefits of this device or its durability, but there doesn’t appear to be one. The story should have made this point very strongly.
No harms are discussed, and there’s no study to suggest what those might be. But presumably the physical harms here would be minimal, given that thousands if not millions of people wear vibrating smart watches without any known ill effects.
As we discussed above, the story needed to strongly point out that a study size of patient makes for very weak evidence. And that when larger controlled trials studies are done, the evidence can be tricky to assess–studies have shown the ability of placebo to stimulate the release of dopamine and improve symptoms, at least temporarily.
There’s no scary language in this story, and we’re told about 10 million people have the disease.
Readers sorely need the voice of a scientific and medical expert or two, especially one who’s well-versed in treatment methods for Parkinson’s, to assess the concept of this watch and any related research that speaks to its novelty (or lack thereof).
The Microsoft video embedded in the story states that there is no cure, and the story notes how the watch is not a cure. However, there’s no mention of any alternative treatments, and many exist. Some of the first-line medications (levodopa, dopamine agonists, anticholinergics) are very effective in controlling tremor. For patients with resistant symptoms, treatment with second-line medications (clozapine, amantadine, clonazepam, propranolol, neurontin) can be used. In patients with disabling refractory tremor, neurosurgical treatments including thermocoagulation and deep brain stimulation offer tremor control.
The story states the device is just a prototype. More could have been said about what this means, but it’s enough to rate satisfactory.
The story seems to imply that using vibrations to treat symptoms of Parkinson’s is a groundbreaking new concept. (The embedded video by Microsoft is even more suggestive, with one of its researchers saying, “I’m on to something, I’m on to something” after using the device).
However, vibration therapy is an idea that researchers have kicked around for at least a decade — for example, vibrating shoe soles to help patients walk faster and with more control, and a vibrating chair for “whole-body” therapy to treat multiple symptoms. Perhaps a vibrating watch-type device is a novel advancement, but at this stage, the research is far too preliminary to know.
The story makes clear that its genesis came from a video and talk at the “Build 2017” conference in Seattle.
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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