The problem with first-person reporting of unproven interventions

Houston Chronicle reporter Craig Hlavaty recently treated readers to a first-person account of getting an intravenous (IV) vitamin infusion inside a van parked outside his house.

The article, “Feeling the drip, drip, drip of the mobile IV craze,” related how a needle was inserted into his arm, “just where a tattooed lightning bolt strikes.”

Hlavaty extolled the cool rush of liquid into his veins:

After a few minutes, a great euphoria hits and my entire body feels at ease. I have a desire to hear early period Neil Young in an almost post-orgasmic haze. It’s at this point I remark on how plush the seats in the van are.

Mildly entertaining, perhaps. But is it good journalism?

The article didn’t probe much into whether these $179 infusions can help people or cause them harm.

It did parrot the infusion company’s unsupported marketing claims about helping everything from hangovers to cancer.

The piece departed from the Chronicle’s history of strong health care journalism, recently exemplified by an investigation with ProPublica of quality issues in the Baylor St. Luke’s Medical Center heart program.

“To me, this reads like an advertisement, something I would not expect to see in the Houston Chronicle,” said Ruth SoRelle, a retired medical writer who spent two decades reporting health and science stories at the paper.

Our publisher, Gary Schwitzer, wrote about the downsides of first-person reporting on health interventions, which often have a favorable tilt and might —  as Hamilton Nolan wrote on Gawker — cause “stories from the wider world” to go untold.

Feeling like Nicholas Cage

In this case, the reporting betrayed nary a hint of skepticism.

Hlavaty gushed that the mobile IV business is “part of a health trend that’s been used by celebrities, cancer patients and people just wanting to kill their hangovers via the influx of vitamins.”

He observed that as he stepped out of the van “the trees are greener, the early evening air is cooler and my feet almost bounce in running shoes. I feel like that Nicolas Cage GIF from ‘Con Air’ when he steps off the prison bus, with the wind blowing hair back and a close-eyed smile appreciating the moment.”

To his credit, Hlavaty did interview a dietitian (erroneously referred to as a doctor), who provided mild caveats such as “studies are still out on treatments like this.”

But he pooh-poohed the view that healthy people can get sufficient nutrition from food, asking “what’s the fun in that doc?” and quoting the owner of the mobile IV business laughably asserting that “it would have to be a full-time job prepping, supplementing, eating and drinking.”

“Really irresponsible reporting”

Some HealthNewsReview.org contributors expressed dismay via email that a news organization would put precious editorial resources into promoting an unproven product.

“Overall, I think this is really irresponsible reporting,” said University of Florida journalism professor Kim Walsh-Childers, PhD, who criticized the “snarky approach to a serious health topic.”.

“I would argue that it’s ethically questionable for a newspaper, in essence, to encourage people to substitute unproven IV injections of anything as a way of compensating for poor diet, overuse of alcohol and lack of adequate sleep,” she said.

The old vitamin hoax

While Hlavaty portrayed IV vitamins as trendy, they’re in fact an “old hoax,” said Mayo Clinic Health System internist Ed Ward, MD.

“There is no scientific evidence IV vitamins benefit anyone (other than the seller of the vitamins). Like other alternative-medicine/nutrition/snake-oil scams they are popular simply because of placebo effects and marketing,” Ward said.

He pointed to a 2013 review of the evidence on the web site Science-Based Medicine, which called vitamin infusions “health care theater” with no medical justification.

While the story reported the infusion company official’s claim that infusions are a “prevention” tool, Kaiser Health News recently reported there’s no conclusive evidence that dietary supplements prevent chronic diseases.

The story mentions “preliminary studies are showing that these treatments can be effective for people that have sepsis, a serious blood infection,” but sepsis is generally seen in hospitalized patients. You can check out our coverage of the evidence behind using Vitamin C infusions for sepsis.

An expensive euphoria

Unexplored were any potential harms, such as sick people avoiding appropriate treatment and well people believing that infusions can negate their unhealthy behaviors.

The safety of chugging massive quantifies of supplements isn’t always clear.

As Kaiser reported, preliminary positive studies can fuel “irrational exuberance” about possible benefits, leading people to take supplements for years until more rigorous research shows they do no good, or might do harm. For example, beta carotene has been linked to greater lung cancer risk, and vitamin E may increase the risk of prostate cancer.

University of Chicago internist Adam Cifu, MD, said IVs themselves carry a small risk of mild side effects such as a local infections, bleeding, and a superficial blood clot in a vein, and a “very small risk” of bad side effects such as bacteria in the blood or an allergic reaction.

As for the purported buzz, Dan Mayer, MD, a retired professor of emergency medicine at Albany Medical College, suggested the anti-nausea drug Zoran in the infusion could cause central nervous system effects that might be misinterpreted as euphoria. He said a liter of fluid can make a somewhat dehydrated person feel better, “maybe even a bit ‘euphoric.’”

Euphoria is subjective, and there are cheaper ways to get it, said Cifu: “I get euphoric eating a good plate of pasta.”

“It’s not about us”

SoRelle said as a journalist she turned down offers of free procedures — such as an MRI — on ethical grounds. “It would be like being the food writer and taking free food,” she said.

But first-person reporting also isn’t a substitute for evidence. While some people might enjoy a more personal and conversation style, Walsh-Childers said she’s no fan unless a journalist has a unique story.

“In other words, if something happens to the journalist that no one else experienced or would have been likely to experience, then sure, tell that story. But if it’s something other people are experiencing, I prefer for journalists to stay the heck out of the story. It’s not about us – it’s about the public,” she said.

Mary Chris Jaklevic is a reporter-editor, HealthNewsReview.org, and can be reached on Twitter @mcjaklevic.

Image credit: Shutterstock.com

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