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Potential TAVR risks understated on hospital websites
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Many US hospital websites include information on the benefits of transcatheter aortic valve replacement, but details on possible risks are less common, according to a new report in JAMA Internal Medicine.
Researchers evaluated websites of 317 hospitals listed in the American College of Cardiology and Society of Thoracic Surgeons Transcatheter Valve Therapy Registry. They also collected information from the 2013 American Hospital Association annual survey on the characteristics of each hospital.
“We were struck by the amount of marketing that surrounded [TAVR]. Since people commonly seek out health information online, we assessed the content available regarding the known risks and benefits of TAVR on hospitals’ websites,” Mark Neuman, MD, MSc, assistant professor of anesthesiology and critical care at Perelman School of Medicine at the University of Pennsylvania and a senior fellow in the Leonard David Institute of Health Economics, said in a press release.
Overall, 262 hospitals had website pages that included information on TAVR. The majority (81.3%) were nonprofit/nongovernment hospitals. Most (81.7%) had a major teaching affiliation. More than 97% of the hospitals that presented online information about TAVR were located in urban areas, and 69.8% had more than 400 beds.
All but two of the Web pages describing TAVR indicated one or more benefits of the procedure compared with open AVR. The benefits most frequently mentioned included a less-invasive procedure (95.4% of all websites), faster recovery (47.7%), no need for cardiopulmonary bypass (45.8%) and better quality of life (45.4%).
At least one risk of TAVR was detailed on 26.3% of Web pages. The risks most frequently mentioned included stroke or transient ischemic attack (18.3% of all websites), vascular complications (13.7%), death (11.8%) and unknown long-term durability of the replacement valve (10.7%).
Numerical quantitative information was more likely to be available when websites addressed the benefits of TAVR. Ninety-seven websites quantified one or more term relevant to benefits compared with 12 sites that quantified any term related to risks (P<.001).
“Our findings suggest that Web-based advertising of TAVR to the public by hospitals may understate the established risks of this procedure and provide little context for the magnitude of those risks to inform patient decision making,” Mariah L. Kincaid, BS, Lee A. Fleisher, MD, and Neuman wrote. Hospitals may promote appropriate use of TAVR by presenting more balanced information regarding TAVR’s risks and benefits.”
Disclosure: The study was supported by a grant from the National Institute on Aging and the Foundation for Anesthesia Education and Research. The researchers report no relevant financial disclosures.
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