Loren J Smith, Saeed Arefanian, MD, Jeffrey Blatnik, MD. Washington University School of Medicine in St. Louis
Introduction: Robot-assisted general surgery (RAGS) procedures have been growing in use and demand. Internet information about robotic surgery has similarly expanded, enhancing consumer access to information. Increasingly patients are taking an active role in their healthcare decision-making often consulting the internet for information upon which to base their decisions. The goal of this study is to analyze data from a survey of online information on RAGS to assess the type and quality of information available. Understanding the preconceptions created by readily-available internet resources can help physicians bridge the gap between patient perceptions of best medical care and effective treatment for specific concerns.
Methods: Nine search terms encompassing four categories of general surgery with the largest increase in robotics were entered into the three most-frequented search engines. Sites meeting the inclusion criteria were screened using a 114 dichotomous question internet screening rubric (ISR). The ISR evaluated sites based on 12 categories of comprehensiveness and 17 categories of content thoroughness. Secondary financial gain was uncovered using The Open Payments Search Tool. Descriptive and statistical analyses include median, interquartile-range, Chi-square, and the Mann-Whitney U Test.
Results: Sites providing RAGS or selling the da Vinci account for 85% of informational results. Many RAGS providers (68%) receive secondary financial gain. The median comprehensiveness score is 4 of 12 (IQR=2). Discussion of risk, disadvantage, complication, and financial consideration are often absent (medians=0). In contrast, benefits and advantages predominate (63% cited 3+ surgical benefits (0-6) and 72% cited 4+ patient benefits (0-8). 25% of sites specify RAGS as the sole surgical option. There is no statistical significance in disclosure parameters between hospitals and private practice, however, there is a slight credibility advantage to private practices (p=0.03). Only 50% of sites describe the robot as an instrument used in surgical procedures with 49% describing how it works. 35% neglect to state that the surgeon controls the robot and 60% fail to contextualize RAGS as a type of MIS. 84% of sites omit financial discussion completely.
Conclusions: The results underscore the promotional nature of information regarding RAGS, with the majority of informational sites directly or secondarily benefiting. The lack of depth and comprehensiveness demonstrates a trend toward superficial information over depth of content, often at the expense of a balanced assessment of the risks inherent in surgery. As a result, patients who investigate RAGS on the internet may conclude it is associated with non-supported benefits and outcomes.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95211
Program Number: P700
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster