The article on maternal kisses for boo-boos is clearly a fake, but I’m not sure what it’s trying to teach us

A number of people sent me this article over the weekend. “Maternal kisses are not effective in alleviating minor childhood injuries (boo-boos): a randomized, controlled and blinded study“:

Background: The practice of maternal kissing of minor injuries of childhood (boo-boos), though widely endorsed and practised, has never been demonstrated to be of benefit to children.

Objective: To determine the efficacy, if any, of maternal kissing of boo-boos in toddlers.

Design: Randomized, controlled and double-blinded study of children with experimentally induced minor injuries. Control arms included both no intervention group and ‘sham’ (non-maternal) kissing. Children were blinded to the identity of the kisser in both the maternal and sham control groups.

Setting: Outpatient research clinics in Ottawa, Canada.

Participants: 943 maternal–toddler pairs recruited from the community.

Measurements: Toddler Discomfort Index (TDI) pre-injury, 1 and 5 minutes post-injury.

Results: One-minute and 5-minute TDI scores did not differ significantly between the maternal and sham kiss groups. Both of these groups had significantly higher TDI scores at 5 minutes compared to the no intervention group.

Conclusions: Maternal kissing of boo-boos confers no benefit on children with minor traumatic injuries compared to both no intervention and sham kissing. In fact, children in the maternal kissing group were significantly more distressed at 5 minutes than were children in the no intervention group. The practice of maternal kissing of boo-boos is not supported by the evidence and we recommend a moratorium on the practice.

Let’s start with the fact that I am 99.9% sure this is satire. They randomized kids to get injured by luring them under tables with candy. They let strangers kiss the boo-boos. They used words like “boo-boos”. They were funded by a (fake) device company that sells ointments and bandaids. It’s ridiculous, start to finish.

But this was printed in an otherwise real journal, with no warning. That actually made me consider it for a minute. Sure, other journals, like BMJ, do Christmas issues (which I was featured in not once, but twice), but it’s a whole issue, and it’s widely marked as special. This was just slipped into the journal without notice.

So… it’s satire. I still don’t get the joke. Is it that this is clearly a terrible study and something that big-bad pharma would write? Is that the funny? It’s not working for me.

Was this meant to show how evidence-based medicine is a failure? Given the piece, I might think that was the intent. But that’s also strange. I could pick this study apart and explain why it’s not worth following in a second. There are better ways to show that “research” has limits. This doesn’t prove EBM is wrong at all. No one who really understands research says that you need an RCT for everything.

Or is it something else? Am I missing the joke? Please let me know.

@aaronecarroll

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