What are Cancer Centers Advertising to the Public? A Rapid Review of the Literature

Facilities that provide cancer care are increasingly promoting their services directly to the public through advertisements. In the past few years, cancer center advertising has received criticism for making unsupported claims about survival, omitting risk information, and using emotional language. Although there is a large body of evidence regarding the content, impact, and regulation of pharmaceutical advertising, there is little known about that of cancer centers. This study aimed to assess the evidence regarding advertising by facilities that provide cancer care. The author conducted a rapid review of publications that analyzed the content of cancer center advertising published before February 15, 2013. Only two peer-reviewed studies were selected for inclusion from 353 publications identified by the review. Both were cross-sectional studies and reported the use of emotional appeal and patient testimonials as advertising strategies. While the number of studies found was too small and their methods and quality too variable to allow for any confident conclusions to be made, this study identified a considerable gap in the literature. Descriptive studies of the content of cancer center advertising are needed to move the debate forward and inform studies measuring the impact on the public. Understanding the messages conveyed through cancer center advertisements and their effect on the population are of high public health importance, as such messages have the potential to affect health costs, patient preferences and expectations about treatment, and the provider-patient relationship

Defining Natural History: Assessment of the Ability of College Students to Aid in Characterizing Clinical Progression of Niemann-Pick Disease, Type C

Niemann-Pick Disease, type C (NPC) is a fatal, neurodegenerative, lysosomal storage disorder. It is a rare disease with broad phenotypic spectrum and variable age of onset. These issues make it difficult to develop a universally accepted clinical outcome measure to assess urgently needed therapies. To this end, clinical investigators have defined emerging, disease severity scales. The average time from initial symptom to diagnosis is approximately 4 years. Further, some patients may not travel to specialized clinical centers even after diagnosis. We were therefore interested in investigating whether appropriately trained, community-based assessment of patient records could assist in defining disease progression using clinical severity scores. In this study we evolved a secure, step wise process to show that pre-existing medical records may be correctly assessed by non-clinical practitioners trained to quantify disease progression. Sixty-four undergraduate students at the University of Notre Dame were expertly trained in clinical disease assessment and recognition of major and minor symptoms of NPC. Seven clinical records, randomly selected from a total of thirty seven used to establish a leading clinical severity scale, were correctly assessed to show expected characteristics of linear disease progression. Student assessment of two new records donated by NPC families to our study also revealed linear progression of disease, but both showed accelerated disease progression, relative to the current severity scale, especially at the later stages. Together, these data suggest that college students may be trained in assessment of patient records, and thus provide insight into the natural history of a disease