Monday, October 26, 2015

Questioning Health News

Sometimes I wonder why I bother to watch the short health segments on the local television news.  They usually strike me as simplistic or condescending – like the one a few days ago telling me that the best way to avoid a cold this winter is frequent hand-washing, duh! Or the only sure way to lose weight is to eat less and exercise more, duh2!

Every once in a while, though, they make me think, even when the topic has no bearing on my personal situation.  The other day they ran a story telling how more doctors have been recommending a combination of Vitamin B6 and an antihistamine to pregnant mothers with severe morning sickness.  (Suspicious as I am of any supplement, I had to pay attention.)  I could not find the original broadcast but this Baby Center website confirms that information:  “Vitamin B6 and doxylamine have often been used in combination to treat morning sickness. In fact, the FDA has approved this combination for nausea and vomiting during pregnancy under the brand-name Diclegis. Your practitioner may write you a prescription for it or have you take the over-the-counter combination.”

What started me thinking was a statement by one of the interviewed doctors later in the story describing how she would first recommend safer alternatives:  ginger and acupuncture.  Are these really effective treatments, and if not is a doctor behaving ethically when making such recommendations?

First things first.  The National Institute of Health (NIH) reviewed several studies to find if ginger really can relieve nausea.  They found one acceptable study on its use for morning sickness and this study did favor ginger over placebo, but they conclude that its effectiveness for nausea in general is “still a matter of debate.”  The University of Maryland Medical Center found in two small studies women taking 1g of ginger every four days “felt less nauseous and did not vomit as much as those who got placebo.”  It gives some relief but is not a cure.  UMMC adds:  “Pregnant women should ask their doctors before taking ginger and not take more than 1g per day.”

Acupuncture is another story.  NIH has reviewed many studies finding “acupuncture appears to be a reasonable option for people with chronic pain….“However, clinical practice guidelines are inconsistent in recommendations about acupuncture.”  There is no mention of it being effective or even tested for morning sickness, and even for those problems where it shows some effectiveness many researcher saw “no difference between the effects of actual and simulated acupuncture.” 

Of the two, ginger may work, but there is no evidence that acupuncture is effective.  The question follows about the ethics of recommending a treatment with no track record.  This becomes tricky when you consider the placebo effect, which involves administering a pill or shot with no medicinal value or applying a treatment or test with no direct effect, that relies on the patient’s belief system to promote healing.  As this Forbes article explains, doctors do not agree among themselves what course is proper and where to draw the line that may violate either ethical standards or trust in the doctor-patient relationship.  One point to consider, of course, is the cost of a placebo prescription.  Ginger is fairly inexpensive but Harvard Health reports:  “Acupuncture treatments range from $65 to $125 per session. Private insurers usually don’t pay for it, nor do Medicare or Medicaid.”

Critical thinking drives us to ask these kinds of questions of seemingly innocent statements on the news.  Perhaps if enough people begin asking, it will force journalists to be less passive and dig a little bit deeper before passing along all their tidbits and leaving it up to the viewers to sort out fact from fiction from misinformation.  Shouldn’t they consider it to be their job?

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