More Sloppy Headlines on Parkinson's Disease

What's wrong with these headlines--one from HealthDay News and the other from ABC News Radio?

First Gene Therapy Trial Effective Against Parkinson's and New Parkinson's Treatment

A reasonable person would conclude that there's a new treatment involving gene therapy for Parkinson's disease. In fact, the study in question, which was just published in the research journal Lancet, was not even designed to show whether this alleged treatment is effective or not. It is merely a safety study of 12 people designed to show whether the experiment will clearly kill or otherwise injure potential subjects of future experiments.

Now, everybody repeat after me, a safety study (technically called a Phase I clinical trial) is not a dosage study (phase II) or an efficacy trial (phase III). Phase I studies are the first baby steps of figuring out whether to even pursue this line of research in humans. Unfortunately, this gets glossed over time and again in general press reports.

It's entirely possible that whatever suggestive hints of efficacy showed up in this incredibly limited trial were the results of the surgery used to implant the viruses that carried the target genes--and not the genes themselves. The implanting operation uses many of the same techniques as deep brain stimulation, which has already shown some benefits with respect to Parkinson's.

I know, I know. Journalists typically don't get to write their own headlines. But this is playing with the hopes and fears of folks with Parkinson's disease and it's wrong.

In addition, as the AP's Malcolm Ritter reported, the lead investigator of the Parkinson's study Dr. Michael Kaplitt has a financial interest in the company that is developing this so-called treatment. Clearly that's another potential source of bias and a further reason to remain wary about all the enthusiastic press.

Source: MG Kaplitt et al. "Safety and tolerability of gene therapy with an adeno-associated virus (AAV) borne GAD gene for Parkinson's disease: an open label, phase I trial." The Lancet 2007; 369:2097-2105

Sloppy Headlines on Parkinson's Disease

Here's a catchy headline that's guaranteed to get your attention: "Smoking and Caffeine May Protect Against Parkinson's Disease."

It was written by the good folks at the Duke University press office. But it does a disservice to anyone who has Parkinson's disease, or cares for or loves someone with the neuro-degenerative condition.

To make matters worse, it gave journalists permission to use similarly dumb headlines for their copy, like this one from the Miami Herald: "Study: Cigarettes, coffee may help ward off Parkinson's."

How sloppy is the Duke press release on Parkinson's disease? Let me count the ways:

1. Regular readers of The Health Media Watch should pick up right away on the "Mighty May" in this title. Whenever you read the word "may" in a health article (or press release) you should always add the phrase "or may not" to the sentence. In other words, "Smoking and Caffeine May or May Not Protect Against Parkinson's Disease."

2. The risk picture is incomplete. "Individuals with Parkinson's disease were half as likely to report ever smoking and a third as likely to report current smoking compared with unaffected relatives," according to the press release. No clue what the absolute risk is of developing Parkinson's disease in one's lifetime as to compared to, oh let's say, LUNG CANCER.

Instead we get just the following dutiful sentence: "Smoking cigarettes and consuming copious amounts of caffeine carry their own risks and should not be taken up in an attempt to avoid developing Parkinson's disease, cautions study investigator Burton L. Scott, M.D., Ph.D., associate professor of medicine."

For the record, about 1 in 100 (or 1%) of people develop Parkinson's disease at some point in their LIFETIME, according to data from the Centers for Disease Control.

But a 68 year-old man who has smoked two packs per day for 50 years and continues to smoke has a 15% chance of developing lung cancer in just the NEXT TEN YEARS (Bach PB, et al. Journal of the National Cancer Institute, 2003).

3. An association does not prove causation. Maybe the folks with Parkinson's were less likely to have smoked because they have less addictive personalities. In that case, smoking would be a side effect of whatever genetic predisposition made you less likely to develop Parkinson's disease. Or maybe, as Maggie Fox of Reuters pointed out in her article, people who are predisposed to developing Parkinson's disease just don't like coffee as much as their counterparts.