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Marketing of Low Volume Robotic Cardiac Surgery Programs via the Internet and Public Reporting Avenues
Sugam A. Bhatnagar, Abdulla Alabagi, Robert Poston.
University of Arizona, Tucson, AZ, USA.

OBJECTIVE: Marketing of robotic cardiac surgery via that internet and voluntary public reporting is an appropriate response to growing demand for less invasive procedures. However, the value of this information to the public depends on transparency. For robotic cardiac surgery programs defined as active vs. inactive, we compared the content and quality of information on websites and the % programs that publically report their results to the The Society of Thoracic Surgeons (STS).
METHODS: A national database was queried for cardiac surgical volume of programs that performed at least one major robotic cardiac procedure (CABG, mitral valve repair) within the last 10 years. The websites of these hospitals were analyzed for the content and quality of data regarding these procedures.
RESULTS: Within the last 10 years, 372 programs have performed robotic cardiac surgery, distributed amongst programs that are active (i.e. >50 robotic cases in 2011, n=24), low volume (between 1-49 cases, n=136) and currently inactive (n=212). Out of 372 total programs, 100% (n=24) of active, 52% (n=71) low volume and 47% (n=100) of inactive programs contain information about robotic cardiac surgery. Institutional superiority was claimed in 88% of active programs, 18% of low volume programs. Eight inactive programs (4%) contained egregious and inaccurate claims about superiority (Table 1). The percentage of active programs that volunteered to report to STS website was significantly higher than those that were inactive (30 vs. 40% reporting, Fisher test, P=0.018) and showed a trend towards increased Overall Composite Score (96.16 ±1.138 vs. 96.62±1.138, P=0.16).
CONCLUSIONS: Internet marketing of robotics was noted to be widespread and often provides information of poor quality. Inaccurate or incomplete information about robotics increases the risk that patients are misdirected about this procedure.

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