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Open Access 01-12-2018 | Research

Online advertising and marketing claims by providers of proton beam therapy: are they guideline-based?

Authors: Mark T. Corkum, Wei Liu, David A. Palma, Glenn S. Bauman, Robert E. Dinniwell, Andrew Warner, Mark V. Mishra, Alexander V. Louie

Published in: Radiation Oncology | Issue 1/2018

Abstract

Background

Cancer patients frequently search the Internet for treatment options, and hospital websites are seen as reliable sources of knowledge. Guidelines support the use of proton radiotherapy in specific disease sites or on clinical trials. This study aims to evaluate direct-to-consumer advertising content and claims made by proton therapy centre (PTC) websites worldwide.

Methods

Operational PTC websites in English were identified through the Particle Therapy Co-Operative Group website. Data abstraction of website content was performed independently by two investigators. Eight international guidelines were consulted to determine guideline-based indications for proton radiotherapy. Univariate and multivariate logistic regression models were used to determine the characteristics of PTC websites that indicated proton radiotherapy offered greater disease control or cure rates.

Results

Forty-eight PTCs with 46 English websites were identified. 60·9% of PTC websites claimed proton therapy provided improved disease control or cure. U.S. websites listed more indications than international websites (15·5 ± 5·4 vs. 10·4 ± 5·8, p = 0·004). The most common disease sites advertised were prostate (87·0%), head and neck (87·0%) and pediatrics (82·6%), all of which were indicated in least one international guideline. Several disease sites advertised were not present in any consensus guidelines, including pancreatobiliary (52·2%), breast (50·0%), and esophageal (43·5%) cancers. Multivariate analysis found increasing number of disease sites and claiming their centre was a local or regional leader in proton radiotherapy was associated with indicating proton radiotherapy offers greater disease control or cure.

Conclusions

Information from PTC websites often differs from recommendations found in international consensus guidelines. As online marketing information may have significant influence on patient decision-making, alignment of such information with accepted guidelines and consensus opinion should be adopted by PTC providers.

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Macready N. Cancer patients connect on the internet. J Natl Cancer Inst. 2012;104:267–8. https://doi.org/10.1093/jnci/djs130.CrossRefPubMed

Sidana A, Hernandez DJ, Feng Z, et al. Treatment decision-making for localized prostate cancer: what younger men choose and why. Prostate. 2012;72:58–64. https://doi.org/10.1002/pros.21406.CrossRefPubMed

Maddock C, Lewis I, Ahmad K, Sullivan R. Online information needs of cancer patients and their organizations. Ecancermedicalscience. 2011;5:235. https://doi.org/10.3332/ecancer.2011.235.PubMedPubMedCentral

Wald HS, Dube CE, Anthony DC. Untangling the web-the impact of internet use on health care and the physician-patient relationship. Patient Educ Couns. 2007;68:218–24. https://doi.org/10.1016/j.pec.2007.05.016.CrossRefPubMed

Johnson PT, Chen JK, Eng J, Makary MA, Fishman EK. A comparison of world wide web resources for identifying medical information. Acad Radiol. 2008;15:1165–72. https://doi.org/10.1016/j.acra.2008.02.010.CrossRefPubMed

Hartzband P, Groopman J. Untangling the web - patients, doctors and the internet. N Engl J Med. 2010;362:1063–6. https://doi.org/10.1056/NEJMp0911938.CrossRefPubMed

Ziebland S, Chapple A, Dumelow C, et al. How the internet affects patients’ experience of cancer: a qualitative study. BMJ. 2004;328:564. https://doi.org/10.1136/bmj.328.7439.564.CrossRefPubMedPubMedCentral

Chen X, Siu LL. Impact of the media and the internet on oncology: survey of cancer patients and oncologists in Canada. J Clin Oncol. 2001;19:4291–7.CrossRefPubMed

Jin LX, Ibrahim AM, Newman NA, et al. Robotic surgery claims on United States hospital websites. J Healthc Qual. 2011;33:48–52. https://doi.org/10.1111/j.1945-1474.2011.00148.x.CrossRefPubMed

10.

Pronovost PJ, Miller M, Wachter RM. The GAAP in quality measurement and reporting. JAMA. 2007;298:1800–2. https://doi.org/10.1001/jama.298.15.1800.CrossRefPubMed

11.

Holcombe RF. The ethics of marketing cancer. J Cancer Policy. 2015;3:1–2. https://doi.org/10.1016/j.jcpo.2014.11.001.CrossRef

12.

Narang AK, Lam E, Makary MA, et al. Accuracy of marketing claims by providers of stereotactic radiation therapy. J Oncol Pract. 2013;9:57–62. https://doi.org/10.1200/JOP.2012.000693.CrossRefPubMed

13.

Palmer D, Hedberg T. The ethics of marketing to vulnerable populations. J Bus Ethics. 2013;116:403–13. https://doi.org/10.1007/s10551-012-1476-2.CrossRef

14.

Varian Medical Systems. Summary of 2016 final Medicare payment rules 2015. https://www.varian.com/sites/default/files/resource_attachments/2016_Final_Medicare_Payment_Rules_Rad%23_10405.docx_.pdf (Accessed 9 Jan 2017).

15.

Shah A, Ricci KI, Efstathiou JA. Beyond a moonshot: insurance coverage for proton therapy. Lancet Oncol. 2016;17:559–61. https://doi.org/10.1016/S1470-2045(16)00171-6.CrossRefPubMed

16.

Halperin EC. The proton problem. Lancet Oncol. 2013;14:1046–8. https://doi.org/10.1016/S1470-2045(13)70443-1.CrossRefPubMed

17.

Jarosek S, Elliott S, Virnig BA. Proton beam radiotherapy in the U.S. Medicare population: growth in use between 2006 and 2009: data points # 10. Rockville: US Agency for Healthcare Research and Quality; n.d. 2012.

18.

Basto M, Cooperberg MR, Murphy DG. Proton therapy websites: information anarchy creates confusion. BJU Int. 2015;115:183–5.CrossRefPubMed

19.

Patel S, Kostaras X, Parliament M, et al. Recommendations for the referral of patients for proton-beam therapy, an Alberta Health Services report: a model for Canada? Curr Oncol. 2014;21:251–62. https://doi.org/10.3747/co.21.2207.CrossRefPubMedPubMedCentral

20.

American Society for Radiation Oncology. Model policies: proton beam therapy 2014. https://www.astro.org/uploadedFiles/Main_Site/Practice_Management/Reimbursement/ASTRO PBT Model Policy FINAL.pdf (Accessed 4 Jan 2017).

21.

National Health Services England. Guidance for the referral of patients abroad for NHS proton treatment 2011. https://www.england.nhs.uk/wp-content/uploads/2014/09/guidance-referral-pat-abroad-nhs-proton.pdf (Accessed 4 Jan 2017).

22.

Department of Health (United Kingdom). National PBT service development Programme – value for money addendum to the strategic outline case 2012. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213045/national-proton-beam-therapy-service-development-programme-value-for-money-addendum.pdf (Accessed 4 Jan 2017).

23.

Institute for Clinical and Economic Review. Proton beam therapy final evidence report 2014. https://icer-review.org/wp-content/uploads/2014/07/pbt_final_report_040114.pdf (Accessed 4 Jan 2017).

24.

The Royal Australian and New Zealand College of Radiologists. Position paper on particle therapy 2015. http://www.ranzcr.edu.au/documents-download/document-library-2/document-library-4/3971-20151118-position-paper-on-particle-therapy-final (Accessed 4 Jan 2017).

25.

Aarhus University. The Danish National Center for particle radiotherapy 2012. https://www.rm.dk/siteassets/om-os/a_udbud/dnu_partikelterapi/det-nationale-center-for-partikelterapi-2012.pdf (Accessed 4 Jan 2017).

26.

Health Council of the Netherlands. Proton radiotherapy 2009. https://www.gezondheidsraad.nl/sites/default/files/proton_radiotherapy200917E_0.pdf (Accessed 4 Jan 2017).

27.

National Comprehensive Cancer Network. NCCN guidelines for treatment of cancer by site n.d. 2017. https://www.nccn.org/professionals/physician_gls/f_guidelines.asp. (Accessed 4 Jan 2017).

28.

Skarsgard LD. Radiobiology with heavy charged particles: a historical review. Phys Medica. 1998;14(Suppl 1):1–19.

29.

Particle Therapy Co-Operative Group. Facilities in operation. 2016. https://www.ptcog.ch/index.php/facilities-in-operation (Accessed 4 Jan 2017).

30.

Particle Therapy Co-Operative Group. Facilities under construction. 2016. https://www.ptcog.ch/index.php/facilities-under-construction (Accessed 4 Jan 2017).

31.

American Medical Association. AMA code of medical ethics’ opinion on physician advertising. Am Med Assoc J Ethics. 2010;12:376–7.

32.

AMA Council on Ethical and Judicial Affairs. Code of Medical Ethics. Chicago: American Medical Association; 2016.

33.

Olteanu A, Peshterliev S, Liu X, Aberer K. Web credibility: features exploration and credibility prediction. Berlin, Heidelberg: Springer; 2013. p. 557–68. https://doi.org/10.1007/978-3-642-36973-5_47.

34.

von Elm E, Altman DG, Egger M, et al. Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ. 2007;335:806–8. https://doi.org/10.1136/bmj.39335.541782.AD.CrossRefPubMedPubMedCentral

35.

Robertson CT. New DTCA guidance — enough to empower consumers? N Engl J Med. 2015;373:1085–7. https://doi.org/10.1056/NEJMp1508548.CrossRefPubMed

36.

Boden WE, Diamond GA. DTCA for PTCA — crossing the line in consumer health education? N Engl J Med. 2008;358:2197–200. https://doi.org/10.1056/NEJMp0801433.CrossRefPubMed

37.

Kontos EZ, Viswanath K. Cancer-related direct-to-consumer advertising: a critical review. Nat Rev Cancer. 2011;11:142–50. https://doi.org/10.1038/nrc2999.CrossRefPubMed

38.

Glatstein E. The return of the snake oil salesmen. Int J Radiat Oncol. 2003;55:561–2. https://doi.org/10.1016/S0360-3016(02)04204-9.CrossRef

39.

Glatstein E. Intensity-modulated radiation therapy: the inverse, the converse, and the perverse. Semin Radiat Oncol. 2002;12:272–81. https://doi.org/10.1053/srao.2002.32433.CrossRefPubMed

40.

Peeters A, Grutters JPC, Pijls-Johannesma M, et al. How costly is particle therapy? Cost analysis of external beam radiotherapy with carbon-ions, protons and photons. Radiother Oncol. 2010;95:45–53. https://doi.org/10.1016/j.radonc.2009.12.002.CrossRefPubMed

41.

Iversen G. Proton therapy: progress with a price tag. 2014. http://proton-therapy.org/dotmed_progress_sept_2014.html (Accessed 17 May 2017).

42.

Contreras J, Zhao T, Perkins S, et al. The world’s first single-room proton therapy facility: two-year experience. Pract Radiat Oncol. 2017;7:e71–6. https://doi.org/10.1016/j.prro.2016.07.003.CrossRefPubMed

43.

Verma V, Mishra MV, Mehta MP. A systematic review of the cost and cost-effectiveness studies of proton radiotherapy. Cancer. 2016;122:1483–501. https://doi.org/10.1002/cncr.29882.CrossRefPubMed

44.

Verma V, Shah C, J-CM R, et al. Cost-comparativeness of proton versus photon therapy. Chinese Clin Oncol. 2016;5:56. https://doi.org/10.21037/CCO.V0I0.11097.CrossRef

45.

Rubenson D, Kapp DS. Getting real about NCI-designated cancer center advertising. Nat Rev Clin Oncol. 2017;14:195–6. https://doi.org/10.1038/nrclinonc.2017.28.CrossRefPubMed

46.

Vater LB, Donohue JM, Park SY, et al. Trends in cancer-center spending on advertising in the United States, 2005 to 2014. JAMA Intern Med. 2016;176:1214–6. https://doi.org/10.1001/jamainternmed.2016.0780.CrossRefPubMedPubMedCentral

47.

Rosenthal E. Ask your doctor if this ad is right for you. New York times 2016. https://www.nytimes.com/2016/02/28/sunday-review/ask-your-doctor-if-this-ad-is-right-for-you.html.

48.

Vater LB, Donohue JM, Arnold R, et al. What are cancer centers advertising to the public? Ann Intern Med. 2014;160:813–20. https://doi.org/10.7326/M14-0500.CrossRefPubMedPubMedCentral

49.

Suit H, Kooy H, Trofimov A, et al. Should positive phase III clinical trial data be required before proton beam therapy is more widely adopted? No. Radiother Oncol. 2008;86:148–53. https://doi.org/10.1016/j.radonc.2007.12.024.CrossRefPubMed

50.

Mitin T, Zietman AL. Promise and pitfalls of heavy-particle therapy. J Clin Oncol. 2014;32:2855–63. https://doi.org/10.1200/JCO.2014.55.1945.CrossRefPubMedPubMedCentral

51.

Leeman JE, Romesser PB, Zhou Y, et al. Proton therapy for head and neck cancer: expanding the therapeutic window. Lancet Oncol. 2017;18:e254–65. https://doi.org/10.1016/S1470-2045(17)30179-1.CrossRefPubMed

52.

Mishra MV, Aggarwal S, Bentzen SM, et al. Establishing evidence-based indications for proton therapy: an overview of current clinical trials. Radiat Oncol Biol. 2017;97:228–35. https://doi.org/10.1016/j.ijrobp.2016.10.045.CrossRef

53.

Liao Z, Lee J, Komaki R, et al. OC-0143: a Bayesian randomisation trial of IMRT vs. PSPT for locally advanced non-small cell lung carcinoma. Radiother Oncol. 2017;119:S65. https://doi.org/10.1016/S0167-8140(16)31392-5.CrossRef

54.

National Comprehensive Cancer Network. Prostate Cancer NCCN Guidelines (Version 2.2017) 2017. https://www.nccn.org/professionals/physician_gls/pdf/prostate.pdf (Accessed 24 May 2017).

55.

Terashima K, Demizu Y, Hashimoto N, et al. A phase I/II study of gemcitabine-concurrent proton radiotherapy for locally advanced pancreatic cancer without distant metastasis. Radiother Oncol. 2012;103:25–31. https://doi.org/10.1016/j.radonc.2011.12.029.CrossRefPubMed

56.

Verma V, Iftekaruddin Z, Badar N, et al. Proton beam radiotherapy as part of comprehensive regional nodal irradiation for locally advanced breast cancer. Radiother Oncol. 2017;123:294–8. https://doi.org/10.1016/j.radonc.2017.04.007.CrossRefPubMed

57.

Ishikawa H, Hashimoto T, Moriwaki T, et al. Proton beam therapy combined with concurrent chemotherapy for esophageal cancer. Anticancer Res. 2015;35:1757–62.PubMed

58.

Kagei K, Tokuuye K, Okumura T, et al. Long-term results of proton beam therapy for carcinoma of the uterine cervix. Int J Radiat Oncol Biol Phys. 2003;55:1265–71.CrossRefPubMed

Title: Online advertising and marketing claims by providers of proton beam therapy: are they guideline-based?
Authors: Mark T. Corkum
Wei Liu
David A. Palma
Glenn S. Bauman
Robert E. Dinniwell
Andrew Warner
Mark V. Mishra
Alexander V. Louie
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: Radiation Oncology / Issue 1/2018
Electronic ISSN: 1748-717X
DOI: https://doi.org/10.1186/s13014-018-0988-z

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Online advertising and marketing claims by providers of proton beam therapy: are they guideline-based?

Abstract

Background

Methods

Results

Conclusions

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Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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