Direct-to-consumer website promotion of robotic prostatectomy

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A paper in Health Affairs – “Direct-To-Consumer Internet Promotion Of Robotic Prostatectomy Exhibits Varying Quality Of Information” (subscription required) – adds to mounting questions about the marketing and promotion of this technology.

A team of researchers analyzed claims made in online promotions of robotic surgery for prostate cancer. Excerpts of the paper:

“We found that many sites claimed benefits that were unsupported by evidence and that 42 percent of the sites failed to mention risks. Most sites were published by hospitals and physicians, which the public may regard as more objective than pages published by manufacturers. Unbalanced information may inappropriately raise patients’ expectations. Increasing enforcement and regulation of online promotions may be beyond the capabilities of federal authorities. Thus, the most feasible solution may be for the government and medical societies to promote the production of balanced educational material.

Many people probably understand that they should not put stock in health information found on user-generated websites. However, it is not as obvious that sites published by members of the medical community may also be subject to concerns about quality, completeness, and bias. Although these publishers may have conflicts of interest, their public reputation and medical background may imply to many people that they are balanced and objective.

Overall, there was a wide range in the tone and presentation of the web pages we reviewed. Some pages used a direct, informational tone; others used excessively ornate prose about the wonders of life without cancer, with fairly little substantiative discussion of robotic prostatectomy. One site directly stated that there were no risks associated with robotic prostatectomy, then proceeded to list a number of risks lower on the page. We found information of poor quality presented on many sites in our sample, not just those that might be considered outright advertising.

As advertising shifts from traditional media to the Internet, the regulation of advertising content becomes increasingly difficult. The amount of print and broadcast advertising is limited by the high cost of these media. In contrast, Internet promotion expands the opportunities for inexpensive, direct-to-consumer marketing. Thus, the volume of material promoting specific medical procedures, devices, and drugs may be impossible for any single entity to monitor. Proposals to increase regulation of direct-to-consumer medical care promotion may also be limited by legal and ethical considerations associated with restricting free speech.

Instead of creating new regulations and strengthening enforcement, it may be more feasible for the FDA and medical societies to promote the creation of responsible, balanced educational material. These organizations could produce and distribute guidelines intended for physicians and hospitals that describe how to develop educational materials in a balanced and patient-friendly manner. Additionally, specialty societies could provide template descriptions of risks and benefits to help doctors describe the medical products and procedures they use.”


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