evaluating news Archives - Headache and Migraine News

7 February 2013

Migraine Triggers: Don’t Believe the Headlines (and the myths)

James Discoveries & Stats, Information 3

Every once in a while headlines go flashing around in the media that give a completely wrong impression. For example, I’ve recently seen these headlines:

Migraine triggers may not cause severe headaches

Report: Migraine triggers may not be so potent

Migraine “Triggers” May Not Cause Migraines After All

What impression do you get from these headlines? First, you might think,”Oh, we used to think that certain ‘triggers’ (ie chocolate, weather, MSG) caused migraines, but now with new research we know that they don’t!”

Migraine Triggers? What do the headlines say?

Worse, someone might think,”Oh yeah, I have a coworker like that. She blames everything for her headaches. Maybe now she can start taking some responsibility.”

Now if you’ve only read the headlines, you’re going to be surprised about what the articles are actually about.

The actual study

Yes, there was an interesting study done, published by the journal Neurology (ahead of print on the 23rd of January 2013 – Provocation of migraine with aura using natural trigger factors). The study was small (just 27 patients), and studied only 2 “triggers” – bright/flickering lights and exercise. Although patients said that these were triggers for them, only a few reported migraine attacks after exposure (a few from exercise, none from bright lights).

That’s it? Yup.

Of course, this raises a whole boatload of questions. How long after the exposure were patients monitored? What type of bright/flickering lights? How much exercise? Of course, the study answers these questions – but that’s not the point.

The point is – what does this really tell us about migraine triggers?

Well, there’s one thing that the study suggests. The triggers that some patients report may not always immediately trigger a migraine attack.

That’s it. And that’s not a big news story.

Migraine Trigger Myths?

Are we just believing myths about triggers? Let’s take a quick look at a few…

MYTH: A “migraine trigger” is something that causes a migraine. Actually, a trigger could “cause” an attack, in the sense that you wouldn’t have had the attack at that time if it weren’t for a certain trigger. But actually, no one knows the “cause” of migraine, and to call a trigger a cause is, in the opinion of this author, an over simplification.
MYTH: We used to think that various things “triggered” migraine attacks, but now we know better. Actually, the trigger controversy is nothing new. For many years doctors and researchers have debated about how much influence triggers, particularly common triggers (ie chocolate, bananas, flickering lights…) have on migraine. They have debated about whether it’s better to avoid them or not.
MYTH: Everyone with migraine has to fear the same triggers. Nonsense! Triggers are different in everyone. Though there are things that commonly trigger migraine attacks, those things may not be a problem at all for some people.
MYTH: If X is a trigger for you, X will always result in a migraine attack. Absolutely untrue! Let’s say raw onion is a migraine trigger for you. That does not mean that every time you eat raw onion you will get a migraine attack. That may be true for some people, but not others. It’s likely that a number of triggers are working together – once you’re exposed to too many for you, an attack begins. So on a good day with few triggers, X may not lead to any problems.
MYTH: Avoiding triggers will cure migraine. Not only will it not “cure” migraine, avoiding triggers will not always mean you won’t get any attacks. Migraine isn’t that predictable. In many cases avoiding triggers can lead to fewer attacks – in rare cases no attacks at all. But there are no guarantees.
MYTH: A migraine trigger will always immediately result in a migraine attack. Actually, there’s a lot of disagreement over this one, particularly when it comes to food. Sure, an attack will often come almost right away. But some believe that triggers could impact you a day or even several days later. That makes it very hard to study exactly how triggers work. What if exposure to trigger X on Tuesday leads to a migraine on Wednesday – but only if you’re also exposed to Y on Wednesday? See the problem?

There was a good point that some have tried to make from this study (and I’m not blaming the study itself for the headlines). That is, many migraineurs assume that certain things will always trigger an attack, and so they avoid things that could help them. This may relate to nutrition, but it’s especially true of exercise. The benefits of moderate exercise, done properly, are in most cases going to far outweigh the problems. There are ways to minimize exercise headache and migraine.

Sure, they headlines did their job – they grabbed attention. But for so many who don’t bother to read the information carefully – particularly people who “know someone with migraine” – the headlines can be very misleading.

While we’re on the topic, here are 12 ways to Evaluate Migraine News. And more information about tracking down migraine triggers.

4 October 2008

12 ways to Evaluate Migraine News

James Tips 4

I’ve read hundreds of news stories on migraine, cluster headache and other types of headache. I’ve listened to the radio, heard podcasts, watched TV and read magazines. And I’ve learnt two things. News stories can be helpful. But sometimes they can obscure the truth more than they reveal it.

Below are 12 ways to evaluate news stories, especially those about migraine or headache. This is especially helpful when your Aunt Zelda mails you an article she clipped out of her local newspaper, informing you that at last there’s a cure (ie you no longer have any excuse to lie around sick)!

One disclaimer. You’ll notice a lot of these tips are negative. Don’t get me wrong – I appreciate good journalism, and of course I’m including here your evaluation of blogs like this one. Just because an article does something wrong, almost never means you should discount it completely. It might mean you should question conclusions, or check more sources (I like to see at least two or three sources and usually some more background before I report on something).

Very few of these things make me totally discount the whole story, although I admit a at least one or two make me pretty annoyed.

Be suspicious of "too-good-to-be-true" or miraculous claims
Be extra suspicious if you read about the suppressed or newly-discovered treatment that will soon sweep the world. It may be true – I hope it is, but experience shows two things. First, it probably isn’t so. Second, if it’s that newly discovered there are probably years and years of testing ahead before it will be available to you. Keep your eyes open, watch for progress, look up other sources, and be patient.
Try to find information beyond TV, radio, and headlines
TV and radio are notorious for giving us little bits of information, but not going into more depth. If you’re really interested in a topic, go to the library and pull out some books, magazines and journals. Or, surf the web for credible information from a variety of sources.

In the same way, headlines are often very misleading. Read the rest of the article, and look for facts.
Realize that the same story from the same source is recycled and reused many times
"But I heard the same thing on CNN! And on FOX! And on CBC! And in the Times, and the Sun!" Yeah, me too. And you might find that they all had suspiciously similar wording. The reason is, they all got the information from one source and just recycled the story.
There’s nothing wrong with that – however, just remember that just because it’s often repeated does not mean it’s true! Count all those similar articles as one, then look for more in-depth information, sources, and background.

You may wonder why I often send you to other websites in my articles. It’s because I never want you to rely on one source – look at the same thing from many points of view. Good sources with good research can disagree.
Watch out for the words "press release"
Often a drug company or maker of a supplement will come out with a "press release" that makes great claims for their new migraine or headache treatment. That’s fine, but remember that there’s bias here in favour of the people trying to sell you something. They may even quote studies (that they might have funded) – but you can bet they’ll overlook studies that aren’t so positive.
Analyze the research
Where was it done? how many people? was it "controlled"? were the subjects only from a certain country, or economic class, age, or gender? I could write a whole article on how to do this, but for now just realize that the value of studies varies drastically. For example, a study of 12 women in a clinic in New York is a lot different than a study following 234 men and 344 women over 12 years. One study is also different than a "meta-study", which collects data from several studies. The Cleveland Clinic has some good tips on evaluating studies and trials.
Don’t get too excited about personal stories
"I feel like I have my life back, and I’m so grateful." "It is great that he is enjoying his life now." "Her agonizing migraines had stopped their monthly, miserable appearances."

Have you heard quotes like these in news stories? Me too. They’re great – they add that human interest element, and give hope. However, realize that this is one person out of millions. It may turn out that there are very few people who will benefit from whatever the treatment is. Don’t make the jump from one person to millions with migraine.
Be suspicious of words like "cure"
I did a survey of migraine news reports over the past 5 years. Of the reports that made claims of a cure for migraine, 95.2% were actually talking about what I would call a treatment. In fact, many of the articles went on to explain that the so-called cure only helped a percentage of migraine sufferers, or only decreased the number of attacks.

The other 4.8% of articles weren’t talking about a cure either – they were talking about websites that claimed that they had a cure – scams, in other words. None of the news articles were actually talking about a real cure for migraine! No wonder your family and friends are confused.

To make matters worse, many of these treatments have since fallen out of favour with new research.

I have to admit, this one really drives me crazy.
Remember that statistics can be deceiving
I love statistics. They’re fascinating. Often very helpful. But often not.

Statistics can contradict each other. Depending on how the study was done, and how you report it, you can often make them say what you want. Statistic usually do tell us something, but ask yourself what that is. News stories often tend to jump to conclusions beyond what the data is suggesting.
Don’t jump to conclusions
Oh yes, don’t you jump to conclusions either! But you already knew that, right? 😉
Check the date
In this day and age when you can check news stories from the 1800s on the Internet, be sure to find out when the story was printed, and when the study (if there is one) took place. Sometimes a news story will report on a study years old, which is fine (many are overlooked!), but you need to know that. If the story is old, check to see if there have been any updates on the treatment.

Check the sources
Where did this information come from? Where was the study done? Was it published in a recognized medical journal? Who funded it? Can you check with the information on the website of the source (university, etc)?
Watch out for old-fashioned words
The world of migraine research is changing fast, and so is terminology. Be cautious when you hear terms that are confusing. The classic is the term "migraine headache". What’s that? Well, it does exist – it’s a symptom of migraine disease, but often it’s mistakenly used instead of the term "migraine". Migraine is not a headache!

Another example is "visual migraine". What’s that? It’s an old term for – well, that’s the problem, sometimes it’s used for different things. (read more about terms like eye migraine and ocular migraine here) Are they talking about retinal migraine? Migraine with aura? Migraine aura without headache?

I don’t totally discount stories using old terms. For whatever reason, some of the world’s top experts still use them. But it is reason to double-check and make sure the person talking has the credentials to say what they’re saying.

Be careful out there. There’s a lot of information, a lot of claims. We need to ignore the bad and find the good.

I only have 12 tips – I probably could have had 15 or 20. What have you learnt about deciding if a news story is worth your time? Share a comment!