Sites touting surgeries are one-sided, says study

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The drug industry gets a lot of grief over its online communications to consumers, but a study has found that sites posted by doctors and hospitals and touting surgeries are often dreadful—and far less tightly regulated.

Among the findings of the article "Direct-to-Consumer Internet Promotion of Robotic Prostatectomy Exhibits Varying Quality of Information" in the April 2012 issue of Health Affairs, is that many of the websites surveyed posed a number of problems. Among the findings were that 42% of the surveyed sites failed to mentions surgical risks, and the majority of the sites were written at college reading levels, when experts generally recommend consumer-facing information to be written for the typical eighth-grader, according to the Flesch-Kincaid scale. They also found that the majority of the websites included unsupportable medical claims.

The study, which used the procedure robotic prostatectomy as a test case, found the websites by Googling as a potential patient would. They also used the top search terms for the procedure, based on Google Insights Search Tool, and stuck to the first page of results to mimic typical patient behavior.

The authors say that the impact of these lapses is significant. The websites they studied provided “misleading, unbalanced and exaggerated claims” that portrayed robotic prostatectomy, which is described as minimally invasive and uses a small incision, as preferable to the more traditional open prostatectomy. The writers found that in a survey of 400 men that 24% who went the robotic route regretted their decision, compared to the 15% who pursued the open approach. The writers think “unrealistic expectations may account for some of this disparity.”

The study found the sites studied noticeably tilted towards the positives of the surgery and buried or ignored the potential downsides. Authors say it makes sense when put in context: the FDA is in charge of the pharmaceutical industry's communications, but the FTC is in charge of everything else, including hospital and physician communications. They say this division of labor places a greater burden on the FTC, which “could not possibly regulate all advertising in the United States." That could account for its looser definition for what constitutes unacceptable, misleading advertising, compared to the far stricter FDA. Moreover, where pharmaceutical industry advertisers and agencies are well-versed in the FDA's requirement that side effects and contraindications be included in its communications, doctors and hospitals are only barred from misleading consumers.

The authors caution that more government oversight and stricter regulations are not the solution. Instead, they propose that medical societies and the FDA establish a set of guidelines that can walk healthcare providers and organizations through what constitutes balanced, patient-appropriate communications.
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