An occasionally irregular blog about orthodontics

The accuracy of orthodontist’s websites in the UK: dear oh dear..

The accuracy of orthodontist’s websites in the UK: dear oh dear..

The accuracy of Orthodontist’s websites in the UK: Dear oh dear…

When I signed off the last blog on self ligating brackets I wrote that I was concerned with the accuracy of orthodontist’s websites  particularly with relevance to claims being made for certain methods of treatment.

I did not know, at this point, that the British Dental Journal was going to publish a paper on this and this has appeared in the latest issue. As a result, I am going to blog about this and not on “the development of outcomes in orthodontics”, I will do this later.

images-18The quality of orthodontic practice websites

 J Parekh and D Gill

British Dental Journal 2014; 216: E21

DOI: 10.1038/sj.bdj.2014.403

 

 

What did they do?

This was a simple paper.  They investigated the accuracy of orthodontist’s websites. They used a simple methodology and they simply entered “orthodontic practice” into Google, Yahoo and Ask search engines and they recorded the top ten unique websites found by each engine. They only included those practices based in the UK.

They then compared the content to the General Dental Council (the UK Dental Regulator) guidelines on ethical advertising (found here). The GDC published this document in 2012   to provide advice to practitioners on the content of their website, with one aim being to advise that any claims made for the effectiveness of  treatments are supported by evidence. They also graded the websites using the LIDA instrument which measures  accessibility, usability and reliability (found here)

What did they find?

When they measured the websites against the GDC criteria the average score for compliance was 63%. When they looked at LIDA scores the mean score was 72%. When they looked at the claims made for treatments. They found that 11 websites (37%) made claims regarding self ligating brackets that were not supported by current clinical research.

They concluded that in general websites adhered poorly to the GDC guidelines and most of the issues were concerned with absence of publishing a complaints policy. They also pointed out that they were concerned with the high proportion of practices making claims about treatment that were not supported by scientific research

 What did I think?

I thought that this was a very interesting publication that addressed a contemporary problem. I am a little concerned that the sample of websites is rather low and I am not sure if the search engines will have ranked certain websites that have a high number of hits.  But if we take these factors into consideration, this paper does still present some interesting data.

It is now over a year since the GDC published their guidelines and while it is hoped that they are having an effect, there is no doubt that this process is slow. This is particularly important when one of the most common reasons for complaints against healthcare professionals is lack of information about proposed treatments etc. The authors also point out that complaints about advertising are increasing. There is a clear need for practitioners to update their websites. The authors also point out that it is very easy to let websites and their content become “fallow” and this paper may encourage practitioners to review their content.

However, the most concerning results of this paper are concerned with the claims made for the efficacy of treatments. In their conclusions they state

Any claims from practices regarding the efficacy of their treatment must be founded on a sound evidence base and clinicians should consider reporting the source of such statement.

They pointed out that the misleading claims that they found were concerned with self ligating brackets. Importantly, it is now established that there is a lack of evidence underpinning many of the claims. In fact, it would be very surprising to find a single orthodontist who is not aware of the research that has been published over the last few years. It is, therefore, surprising to see the high proportion of sites making claims that are outdated or against the available evidence. This is clearly misleading for our patients.

I carried out a similar exercise to the investigators and put in the following search term into google “fast self ligating orthodontic UK”. Here is the results of the search. Have a look for yourself. http://goo.gl/6GJr0y

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There Are 7 Comments

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  1. Jayaram Mailankody says:

    The website publishers are not under oath to publish “The truth, the whole truth and nothing but truth”. Someone has said, ‘there are half-truths, lies and statistics’- seeing the cyber-world, he would have added ‘hyper-lies’! Maybe we have to take them ‘with (more than)a pinch of salt’!

  2. Arun Madahar says:

    Hi, my name is Arun and I am a registrar at the Royal London and Colchester hospitals.

    My MClinDent thesis titled ‘the quality of information on the internet regarding orthodontic treatment modalities ‘ is due to be completed by the summer.
    Along similar lines we have done an in depth analysis over 120 orthodontic practice websites and general information websites derived from the first 2 webpages of 5 search engines.We have used Discern,LIDA and JAMA assessment tools to do a thorough analysis of each website.
    We collected data as to the type of orthodontic treatment modality advertised: conventional fixed, functionals, Invisalign ,self ligating, six month smiles, lingual orthodontics .

    Initial results indicate the poor quality of information derived mainly from websites produced by general cosmetic dentists or practices as compared to specialist practitioners. The information we examined relates to validity, reliability , indication of source, usability, access ability , evidence based , conflict of interest and readability. We have also developed a prediction model to help ascertain the quality of a particular medical or dental website.

    A number of websites I came across scored highly and have to be commended for the great quality and layout of information open to the public . However other websites were heavily marketed, dubious and misleading. This is obviously a concern and can lead patients to inappropriate delivery of care.

    I look forward to publishing and sharing my thesis with all in due course.

  3. Jayaram Mailankody says:

    The website publishing is a relatively new medium. The publishers of website are not under oath to publish “Only truth, whole truth, and nothing but truth”. Maybe regulations/ethical considerations need to be implemented in this sector.

    • Kevin O'Brien says:

      Hi, yes the publishers of the websites are not responsible for the content. However, the orthodontist’s who are making the misleading claims are potentially acting unethically and unprofessionally.

  4. Peter Jones says:

    I would have thought you would have supported the orthodontists more as currently it is getting more and more difficult to make the business model work.

    As highlighted in a previous reply, private general dentists are most guilty of this with thier STO treatments, yet you use this paper/topic to push your agenda of anti self ligation. You have threatened to out the ‘self ligating’ users but STO GDP’s get off scot free can you please exain your inconsistencies?

  5. Jayaram Mailankody says:

    The General Dentist offering Orthodontic treatment is going to increase in future, as orthodontic appliances are becoming ‘fully programmed’, more use of CAD-CAM aligners, lesser skills required as majority of the processes are ‘outsourced’. So the era of made-easy, quick-fix solutions will appeal to the patients as well as GDPs. Orthodontists will be called upon to deal with severe, complex and mutilated malocclusions(Like Cleft-lip/palate) only/largely.

  6. Hi Kevin,
    There does seem to be plenty of BS out there. It’s a problem when practice websites are developed by web copywriters who invariably repeat the copy and the wonder claims from the manufacturers. Then we even fall into the trap of believing it ourselves as it’s on our own website! However, practice owners should take overall responsibility for what is said on their sites, in light of the recent guidelines etc. This can be quite a task when content is updated on the site or posted on Social Media by an enthusiastic member of the practice or web team, eager to drive patient interest often without the owner realising. Of course, it is a disservice to patients and counter-productive to exaggerate claims of clinical efficacy in the absence of firm scientific evidence or worse when the evidence refutes the claims. I have actually enjoyed revisiting and editing our content and removing any lingering BS, which has made me feel much better! Thanks for the insight.
    Best wishes, Ben

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