Media Doctor Australia Featured Articles

Electronic brain stimulation used to treat Parkinson's disease may also boost memory (rated 3.5 stars)

This story demonstrates that balanced and informative health news doesn't need to be long. The story makes it quite clear this research is preliminary and needs extensive follow up, and it provides links to the article in the New England Journal of Medicine and related stories about memory research. There is no promise of a radical breakthrough for diseases like Alzheimer's, just that this research that may one day lead to a new treatment.

Emergency treatment target 'saving lives' (rated 4.5 stars)

A small number of studies have shown that overcrowding in hospital emergency departments are not only inconvenient and unpleasant but lead to adverse outcomes, including higher rates of readmission to hospital and death. These were observational studies. There have been no large randomised trials of programs to reduce waiting times. The study described here falls somewhere between these ideals as it was a prospective study, but hospitals differed in the date the 4-hour rule was introduced. The story reports the study well, covering the intervention, its cost, study methods and reporting the outcomes in both relative and absolute terms.

Scientists want kids with three parents to help eradicate genetic disease (rated 3 stars)

This story does not explore treatment options for those with mitochondrial disease, nor does it evaluate the evidence associated with the technique of transplanting mitochondrial DNA. There is also a sense that this technology is here, in Sydney, ready to be used - should the government amend legislation to allow it - despite this research still being in its infancy and quite some way from even being tested in clinical trials.

And are Australian scientists the ones doing this research - it's not clear but it would seem that most of this research is being done in the UK.

The right diet - by prescription (rated 1.5 stars)

This story presents a number of viewpoints about the complex links between diet and health. But there is an apparent lack of skepticism and no independent comment on claims that are made.
It is important to remember that many claims have been made about diet and disease over a long period but few have translated into clinically significant benefits.

For instance, anti-oxidants were touted as the answer to heart disease and cancer but properly controlled clinical trials have documented no benefit and even slight harm.

Here, a respected scientist tells us that he is forced to sit down to a weekly meal of liver pate as a supply of vitamin B12, because he is 'particularly susceptible to folate deficiency'. He seems to measuring his own DNA damage and correlating this with his diet, which sounds a bit like a high tech form of hypochondria. But maybe there is another angle - the blood test developed by the scientist was commercialized by the 'Reach100' company in 2007 and at that time it cost $650. The clinic website does not mention the current price but states that they offer a 'new approach to preventative and anti-ageing medicine'.

Another scientist interviewed for the story is studying the adverse effects of glycation products (where a sugar is stuck onto a protein in the body, or in food) and extols the virtues of unprocessed foods.

The problem here is that two respected scientists and a skilled journalist do not guarantee a great story. The story fails to point to the gap between these types of basic research and the reality of whether they make an important difference to people. What is missing is the right amount of skepticism - either from the journalist or independent expert informant.

Study puts the squeeze on vascular disease (rated 3 stars)

Although it sounds like an important and simple way of testing for peripheral vascular disease (PVD) there is a lot of information lacking in this story, The study was a meta-analysis, where the results of lots of studies on the same topic are pooled and analysed. And it was published in The Lancet which is a highly respected journal. So the signs point to the evidence being good. But we aren't told this directly, and we don't know if there are better ways of testing for PVD or just how accurate this test is. It's obviously cheap and accessible - almost everyone's had their blood pressure taken in the GPs office but could this become a test which could be a separate cost, and how many arms does one GP need to take 2 BPs simultaneously?

Hair test for breast cancer on the horizon (rated 2.5 stars)

This appears to be a story drumming up interest in a company's early development of a new breast cancer screening test. While the new method may eventually become a screening test but there is a very long way to go. The story does not mention how many false positives the test would give. There are considerable risks from a test that tells healthy women they have breast cancer as they will require further testing, sometimes invasive, to establish the correct diagnosis. Not to mention the fear and anxiety that goes along with that

Breakthrough in diagnosing genetic disease (rated 2 stars)

This entire story is reproduced, albeit with a bit of rearranging, from the original press release. It's hardly independent journalism and in any other situation would be plagiarism. It's not something we see a lot of in Australia but perhaps it's a sign of the times as pressure increases on journalist and news outlets to produce more and more often for online publications.

Deep sequencing is becoming a very popular tool these days, especially as it's price has reduced dramatically in the last two years. There is talk of the "$1,000 genome", because this is now all it costs to get the genome of an individual sequenced (though price increases the "deeper" you wish to sequence).

"Harms of treatment" would relate to false positives/negatives inherent within the technology, as well as in the understanding of the disease itself (eg, if there is 100% penetrance of a mutation or not) - though new technologies are always criticised in this respect until they "prove themselves" in society.

An independent expert - not the one supplied in the press release - would have added another dimension to the story. There is no mention of when this technology may be more widely avaiable for diagnosis, nor the costs associated with this or who will pay for it.

We do acknowledge the subject of this story is a tough area to cover well in the media - not only because it's a diagnostic technique, but because deep sequencing technology produces so much data that the only way to really communicate the results is in how many cases researchers can identify previously-known mutations in the DNA they're sequencing. This results in an output that is either a categorical "yes" or "no" for being able to diagnose specific mutations, thus making it hard to critique for correct interpretation of the evidence. The claims of being able to diagnose 25% more in the future are because they have all the information there, but there is most likely a poor understanding of the mutations/polymorphisms that have been identified in these cases.

Stem cell treatment reverses blindness (rated 4.5 stars)

The journalist on this story has done a good job and there is exciting potential in these results. However, considering the inconclusive conclusions along with the small number of patients (2) in the study, the headline, "Stem cell treatment reverses blindness" is inaccurate and doesn't match the story content. This is no reflection on the journalist, as the headline is put in by a sub-editor after the story is written and the journalist usually doesn't see it until it's published.

One important omission is that the story states both conditions in the experiment were untreatable. While this is true for these study participants, the story failed to distinguish between "dry" macular degeneration (the untreatable type these patients had), and "wet" macular degeneration, which is treatable to at least some extent with existing drugs.

While the story doesn't state explicitly that the study treatment is not available in Australia, it is clear the results come from very early experiments taking place in the US and that more research into safety and efficacy is needed.

The quantification of the benefits is vague, despite the researchers cautioning they could not tell whether improvements were due to the treatment, co-treatments or a placebo effect.

UK midwife harvesting afterbirth then selling as 'health' pill (rated 1.5 stars)

There is no attempt to provide evidence of the efficacy and safety of this product and no independent expert comment. It's interventions like this that give CAM a bad name.

Vaccine tested for deadly bacterial meningitis strain (rated 4 stars)

This is a comprehensive story about an important new vaccine. The only information missing was any side effects and the potential cost .

New hope in diagnosis of rare disorder (rated 3.5 stars)

An interesting story discussing the potential the new test may have if it reaches market but details are little light. As with most stories about new tests, this lacks information about false positive and false negatives (ie wrongly diagnosing or missing a diagnosis). Virtually all tests do this to some extent but it's rarely discussed in news stories, especially for genetic tests which have a false air of infallibility.

Psychosis treatment makes light work of weighty side effects (rated 1 star)

This story presents an overly optimistic description of a program that has been running for some time, without sufficient supporting information on quality of evidence, sources, cost, availability and adverse outcomes. It is also not clear from this story just what this "radical new treatment" actually is. There is nothing new or radical about prescribing statins or metformin or about giving advice about diet and exercise.

Risks of taking aspirin for heart disease may outweigh benefits (rated 2.5 stars)

The strengths of this story are that it contrasts the benefits and harms of a commonly used drug - low-dose aspirin to prevent heart attacks and strokes. For individuals at high risk of these events (particularly those who have already suffered an event) the benefits outweigh the harms. This story covers the results of a study in a healthy population, where the benefit to harm ratio is sometimes less clear-cut. The discussants make it clear that this ratio varies by individual and this is a strength. The story also clearly quantifies the benefits in terms of how many patients have to take aspirin so that one will benefit, but it does not state how many of these individuals will suffer harm in the form of bleeding. This was clearly stated in the study abstract. It is unfortunate this discussion did not include the type of research evidence. This was not a new study but a meta-analysis of randomised controlled trials involving people who had not previously experienced a heart attach or stroke. While this is a robust attempt at clearly communicating a complex concept, it falls short of covering the whole story.

French breast implant ruptures '16 times worse' (rated 2.5 stars)

This is a shortened version of a story published in The Times in the UK. It provides statistics on the failure rates of a popular but faulty breast implant. It highlights the lack of regulation of this medical industry and the devices themselves. The research is limited to a case series and it is very hard to judge the validity of the results. In addition, it does not describe the clinical consequences of rupture. The report has not been peer-reviewed and apparently has been 'submitted' to a journal. It is unusual for researchers to highlight work at this stage in the publication process, as it can compromise their chances of success. Aside from the limitations of the reporting of the research, the main weakness of this story is a complete failure to put the subject in an Australian context. This was an opportunity to speak to Australian plastic surgeons, to find out how often the implants have been used and to inform affected women of their options.

Spray hope for pot addicts (rated 2.5 stars)

The main point of the story seems to be to publicise an upcoming study investigating whether a cannabinoid spray helps addicts stop using cannabis. The study lead provides no evidence to support the statement on why this product is likely to help with cessation. There is no information to judge the quality of the planned study (eg, design, size, duration, outcome - what does 'quit' mean scientifically?) and no information on how people can find out more about participating - a big miss for potential recruitment. Importantly, there is no independent comment on the study and no information on the side effects or potential costs of the drug (in a study, it is likely the spray would be provided free of charge). This is an interesting topic that could have been covered so much better.