Sunday, October 15, 2006

Truth in Advertising?

Found on a hospital's website advertising their speech therapy services:

"Our speech pathologists are trained in the leading treatments for dysphagia. Deep Pharyngeal Neuromuscular Stimulation (DPNS) and Vitalstim are offered at our facility. Both of these methods have been proven to be highly effective in the treatment of dysphagia." (emphasis mine)

I guess their definition of "proven" must be different than mine.

I can understand saying that VitalStim has been "proven", seeing as the company touts a 98% improvement rate, and claims that "it's the only dysphagia therapy backed by compelling clinical data." The problem with these claims is that the research they are based on -- the initial study by Marcy Freed -- was so flawed as to be virtually useless. Apparently there is other data as well, which was submitted to the FDA when seeking clearance for the VitalStim device, but as far as I know this data has not been published (at least not in a peer-reviewed publication); if it were that impressive, don't you think they would have published it?

But how anyone can claim that DPNS is "proven" is beyond me. There is no peer-reviewed research. (I believe there is a case series report, but nothing that "proves" it works). And it's not like it's a brand-new approach anymore. The originator of the technique supposedly has data, but once again, why hasn't it been published?

The majority of the evidence used to support these two techniques is anecdotal. Which, granted, has its place, but scientifically, anecdotal evidence is not "proof."

If I were a patient, I would want to know if a therapy that I was paying good money (and time) for was based on little more than anecdote. Not to say that I wouldn't continue such a therapy (well... on second thought, for something as aversive as DPNS, maybe I wouldn't!), but I would want to know. As therapists, we have an obligation to our patients to use their time and money well, and to be forthcoming about our limitations. We should also be well versed enough in the research and scientific basis for our practices that we avoid making wrong or misleading statements such as the one above.


Blogger Sarah said...

Wow, that really is a bold statement!

You probably already know this, but the absence of published data may be due to proprietary concerns. Sometimes even data given to the FDA isn't published for those reasons. VitalStim and DPNS both require several expensive hours of training. To be useful (not to mention actually publishable), published data would need to include rationale, methods and procedures (at least). The owners of the methods have been less than forthcoming about all of these things... even to those that pay for the course, as far as I know. As long as people still pay to take the course, they really have no reason to publish (beyond those silly little moral reasons...)

7:28 PM  

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