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Marketing versus evidence: Which helps patients decide?

Posted Jul 01 2014 4:43pm
Gary Schwitzer summarized a study a couple of weeks ago .  Perhaps it should be required reading by Dr. Stifelman and others at NYU Langone Medical Center .

Meantime, a paper published in the journal Surgical Innovation – “ The impact of marketing language on patient preference for robot-assisted surgery ” – describes a little experiment.  38 patients were asked to make two treatment decisions between robotic surgery and conventional laparoscopic surgery. One time, the robotic procedure was described as a “state-of-the-art, innovative new technology” – the marketing frame.  The other time it was termed a “promising new technology, which has not been used extensively and with research regarding its safety and effectiveness ongoing” – the evidence-based frame.  The methodology used is more thoroughly explained in the paper.

The results?  No surprise
  • With the marketing frame, 20 of 38 chose the robotic approach.  Of those, 12 switched to conventional laparoscopy when the evidence-based frame was used.
  • 17 of 18 who chose conventional laparoscopy in the marketing frame made the same choice when the evidence-based frame was used.
  • Among the 13 patients who made discordant treatment decisions under opposing frames, the robotic approach was significantly more likely to be chosen under the marketing frame.
The researchers conclude
“Our findings suggest that marketing strategies unrelated to the presentation of potential risks and benefits of a surgical technology may influence patient preference…This effect may be contributing to rising trends in the number of robot-assisted surgery procedures performed.”
They point out that “the evidence in favor of robot-assisted surgery is controversial” and “Robotic surgical systems typically cost between $1 million and $2.5 million, with $100, 000 to $200,000 in annual maintenance fees.”

Take home message:  “When patients are confronted with decisions regarding their care, they have a number of resources available to them.  Some of these resources misrepresent evidence relating to risk and benefits.”
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