Editor’s Note: This letter is printed in its entirety as it was received, except for standard proofreading. The uses of “you/your” in the letter refer to Mobility Management Executive Editor Laurie Watanabe. Proofreading changes/additions are noted in brackets.
I am writing in response to your article “Sunrise Medical Launches RGK in North America.”
I was [struck] by the statement: “We believe in the clinical evidence, which says a highly customized ultralight manual chair that is built to fit the individual rider results in optimal function and quality of life.” Let’s break this down for the purpose of clarity.
The statement makes an explicit reference to clinical evidence that supports the claim, yet no mention or citation is made to said evidence. The key term here is “built to fit,” as it is meant to distinguish from other approaches used to “fit to the individual,” including adjustments and measurements made during an evaluation. As a result, I must deduce that evidence exists that differentiated the means by which “fit” is achieved.
Relatedly, “optimal function” and “quality of life” are the stated outcomes. This suggests that these outcomes would have been measured within the “clinical evidence” comparing “built to fit” from other approaches to achieve fit. These are tough constructs to measure, but can be measured with validity using appropriate methodology.
Sunrise Medical chose to make this statement, and you chose to include it in your article. I am working on the assumption that you have fact-checked the article. I’m doubting that you would print “Lima beans are evil” simply because I staked that claim (which I firmly believe, by the way), but unless you have seen said evidence, you did the same thing.
So, please accept this Letter to the Editor as a request for the clinical evidence that Sunrise claims exists. I must ask, because I searched and came up empty. Many articles study quality of life in the context of wheelchair use, and some even considered wheelchair design — zero studied the claim that you stated.
Indeed, studying QOL [quality of life] is nontrivial especially when assessing mobility equipment, so I applaud those who have tackled this issue. Making unsubstantiated claims belittles their work, and that is unacceptable.
I have long advocated for the seating and mobility field to segue away from unsubstantiated claims and a profound lack of applicable and meaningful performance testing. Studying wheelchairs in their contexts of use is not easy, but that does not mean that people can make up claims and freely state them, especially in an article that provides a cover of legitimacy.
Sunrise is not alone in staking performance claims that are not accompanied with attribution to the source. It is not hard to find manufacturer unsubstantiated claims about frame materials, incremental mass, propulsion efficiency, vibration damping and cushion performance (to name a few). These claims are easily refuted by synthesizing actual science, but continually dominate the beliefs because unsubstantiated claims are given legitimacy. I believe that my request for the evidence is a fair means to determine if Sunrise made an unsubstantiated claim and you offered legitimacy in quoting this claim.
I believe that the wheelchair users and clinicians would greatly benefit if we focused on value. Value is defined as performance as a function of cost, and, often, must be evaluated from an individual perspective. This means that we should report performance and cost to the user, and let him or her decide the value within their lives. For example, I would like to drive a Porsche [Cayenne] EV, but I own a Kia Soul EV.
I believe that manufacturers will never focus on value, in part because we have allowed an industry to grow based upon unsubstantiated claims of performance. This has benefited a few, while resulting in a marked disparity of technology access. I believe that we have one realistic hope: that payers will begin to care about value, rather than focusing on cost. Users and clinicians stand to benefit, but they do not have the power to invoke change. We only need one payer to embrace value. Then the others will join in because they will save money and provide value to their beneficiaries. Now that would be a useful topic for you to cover.
Stephen Sprigle, Ph.D, PT
Rehabilitation Engineering and Applied Research Lab
Georgia Institute of Technology
Editor’s Reply: The referenced article was a news story published in our eMobility newsletter on Aug. 11, 2022. It was a “spot news” story, a timely announcement of breaking news housed in the news section of our Web site.
Breaking news stories are not designed to be comprehensive or analytical. In these situations, reporters are messengers. Our job is to report in a timely, accurate way without personal bias. We need to verify that the news source is legitimate, and then accurately report what was said or what happened, regardless of whether or not we agree.
If I were writing a news story about lima beans, and Dr. Sprigle said, on the record, “Lima beans are evil,” I would write, “Stephen Sprigle said, ‘Lima beans are evil.’” My job is to accurately print and attribute his quote. My job is not to agree, disagree, or censor his words according to my personal opinions.
In the case of RGK, I was sent a press release by a member of Sunrise Medical North America’s marketing department who is one of my regular editorial contacts there.
After determining that the press release was legitimate, I accurately quoted its content without personal bias. In doing so, I met my professional obligations as a journalist.