Direct to Consumer Advertising via the Internet, a Study of Hip Resurfacing

Abstract

DeclarationB.O. has received funding from Zimmer Inc. to partially cover costs of attending a conference to present the results of this study. IntroductionPatient use of the internet for information on health continues to grow.1,2 Such information can influence the patient/physician relationship, 3 and can also lead to patient harm. 4 Direct to Consumer Advertising (DCTA) via the internet continues to increase in importance. 5,6 DCTA can put pressure on health care professionals to provide specific treatments not currently available, or which are expensive. The aim of this advertising is to persuade the patient to use the product and criticisms of this type of advertising includes poor explanation of risks, outcomes etc. In addition, the quality of the information of this website is not often accredited by organisations such as HON (Health on the Net). Whilst such advertising is not permitted in the United Kingdom (UK), access to internet sites outwith the UK is still likely to influence patients as research suggests that patients are not influenced by country of origin of websites, even when the information they seek may be very country specific. 7Of particular interest is the recent trend towards increased use of DTCA in orthopaedic implants/devices. 8 Whilst a number of studies have looked at the quality of health related information on the web, this has been directed towards disease where our knowledge is relatively well established. Hip resurfacing is an evolving technology 9,10,11 and as such generates much discussion on the web. Further, it is an operation advocated for young patients 9,10,12 who are the most likely to seek health information on the Internet.3 It was the aim of this study to identify a method for measuring quality of health information on the Internet and to use this to identify the quality of hip resurfacing websites. Method Websites with Hip Resurfacing InformationThe top six internet search engines (Yahoo, MSN, Google, AOL, Ask Jeeves and Lycos) 13 were used to identify websites containing information about hip resurfacing. We used the following key terms "hip resurfacing", "hip surface replacement" and "Birmingham hip". People are most likely to visit the first 10 results generated by a search page 7,14 and as such the first page of each search engine result (containing 10 website links) was assessed. Sponsored links on the first page were also assessed. As Google is the largest and most widely used search engine, 13 the first two pages of results generated were assessed. Websites were excluded if they were; duplicated, Abstract Background and Aims

Surfing for mouth guards: assessing quality of online information

“…Ogunwale et al. (44) reported a strong, positive correlation between the score of every website in each assessment category (credibility, usability, currentness, total content and disclosure/bias) and the total score for that website.…”

“…Further studies are therefore needed to confirm this relationship to find out whether there is any relationship between reliability and accuracy scores. Ogunwale et al (44) reported a strong, positive correlation between the score of every website in each assessment category (credibility, usability, currentness, total content and disclosure/bias) and the total score for that website.…”

“…Further studies must therefore validate the scoring systems proposed in this study. One possible change to the reliability score questionnaire (Table 1) is to include the item 'presence of a third-part certification/independent quality level': for example, the use of the HON certification as used in Ogunwale et al (44).…”

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“…Moreover, robotic prostatectomy is not the only medical service that has been found to be inappropriately marketed. A number of studies have shown misleading and incomplete information aimed at consumers regarding orthopedic procedures, 31,32 HIV antiretroviral medications, 33 and mesothelioma. 34 …”

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“…This direct-to-consumer advertising is gaining popularity in orthopedic surgery [7,8]. Therefore, patients should have access to sites that provide them with independent, high quality and realistic information [8,10]. Clearly, there is a role for independent organizations, e.g.…”