Robotic surgery presented biased

In mid May, an article was publishe in the Journal for Healthcare Quality, "Robotic Surgery Claims on United States Hospital Websites". It got fairly big media attention, discussed as "Hospitals Misleading Patients" (here and here as well).

The study provided the analysis of "400 random U.S. hospital websites as of June 2010. Data was collected on the presence and location of robotic surgery information on a hospital’s website; use of images or text provided by the manufacturer; use of direct link to manufacturer website; statements of clinical superiority; statements of improved cancer outcome; mention of a comparison group for a statement; citation of supporting data and mention of specific risks." It got to some interesting results:

"Forty-one percent of hospital websites described robotic surgery. Among these, 37% percent presented robotic surgery on their homepage, 73% used manufacturer-provided stock images or text, and 33% linked to a manufacturer website. Statements of clinical superiority were made on 86% of websites, with 32% describing improved cancer control, and 2% described a reference group. No hospital website mentioned risks."

They concluded that:

• Many hospital websites overestimate the benefits and underestimate the risks of robotic
  surgery, potentially misinforming patients and encouraging them to undergo robotic surgery.
• The prominent placement on a hospital website and the use of emotional appeal obscures
  the lack of support for clinical claims.
• The widespread use of manufacturer-provided images and text raises concerns about conflicts of interest. Stock materials, produced for advertisement purposes, can be understandably one
  dimensional, even claiming that robotic surgery is the ‘‘most effective’’ or ‘‘ideal’’ therapeutic option for patients. 

And some recommendations:.

• Hospitals should be conscientious of their role as a trusted medical adviser, and ensure that information provided on their website represents the best available evidence.
• Hospitals should make it transparent when they are using materials provided by a manufacturer and avoid endorsing brand-name medical technologies. 
• If hospitals are unable to provide patient-friendly, objective information about a certain treatment option, they should direct patients to a third-party source of information and encourage patients to learn about alternatives.
• Hospital websites should present balanced medical information, accurately stating risks and benefits.

FDA has recently started to look into these issues, and primarily aims to improve the clearance procedures. Naturally, some voices raised in favor of robotic surgery, urging for better information sharing. Due to the recent installation of data-collection boxes with certain da Vinci robots and the wide-spread use of the system, we should see large-scale, evidence-based studies on robot surgery benefits rolling out in the near future.

Source: J. for Healthcare Quality