Research by medical student shows that online information sources are not always as comprehensive as expected
Should hospital websites warn patients about the risks of surgical procedures, or is that information better conveyed in person by a medical professional? Mariah Kincaid, an M.D./M.P.H. student at the School of Medicine, discovered that few hospital websites provided information on the risks of a procedure called transcatheter aortic valve replacement (TAVR).
That’s a complicated name for a minimally invasive procedure that delivers a collapsible replacement valve through a catheter instead of open-heart surgery. Once the new valve is inflated, it takes over the work of the damaged valve.
Getting a new valve through a catheter sounds a lot better than open-heart surgery, but both have risks. Transcatheter aortic valve replacement is only approved for patients who can’t tolerate the traditional open-chest procedure or are at very high risk for complications during the surgery. Kincaid’s research letter, published in JAMA Internal Medicine, focused on how hospital websites informed their patients of their risks—if they did so at all.
Kincaid and researchers at the University of Pennsylvania’s Perelman School of Medicine reviewed the websites of 262 U.S. hospitals, looking for information on risks and benefits of TAVR compared to open-heart surgery.
They found that 99 percent of the hospitals described at least one benefit of TAVR, usually the lower degree of invasiveness. In contrast, only 26 percent of the sites mentioned any of the risks known to be associated with the procedure, such as stroke.
Why is this important? Patients frequently seek out health information on hospital websites, and that influences how they assess the risks and benefits of a procedure.
Kincaid did the study as part of her Applied Learning Experience—a practicum and seminar required of M.P.H. students—under the guidance of Assistant Professor Libby Bradshaw. She is quick to point out that websites are only one small measure of how hospitals present information to patients.
“While searching online is an increasingly common way that patients obtain medical information, patients will often receive information from a multitude of sources, including a face-to-face discussion with their physician,” she says.
“Since we did not evaluate the quality of information from other sources, such as conversations that might take place in person with a cardiologist or surgeon,” she says, “we can’t predict how patients are being educated about TAVR’s risks and benefits through other methods.”
Although patients may ultimately receive balanced information, Kincaid notes that hospitals could help promote reasonable expectations and appropriate use of TAVR by presenting both risks and benefits of the procedure on their websites.
