Research Letter |

Failure of an Internet-Based Health Care Intervention for Colonoscopy Preparation: A Caveat for Investigators

Aarti Kakkar, MD1; Brian C. Jacobson, MD, MPH2
[+] Author Affiliations
1Hallmark Health Medical Associates, Boston, Massachusetts
2Section of Gastroenterology, Boston University Medical Center, Boston, Massachusetts
JAMA Intern Med. 2013;173(14):1374-1376. doi:10.1001/jamainternmed.2013.6477.
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Internet-based tools for health care delivery are proliferating. We examined the effectiveness of an online instructional video aimed at improving bowel preparation prior to colonoscopy. We hypothesized that an educational tool explaining the importance of preparation, the precolonoscopy diet, and how to administer the bowel purgative would lead to improved bowel preparation. However, what we learned during this randomized clinical trial of 2000 patients was that there may still be considerable limitations to reliance on the Internet for health care interventions.

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Why not mail a video?
Posted on June 3, 2013
Marco D. Huesch
University of Southern California; Duke University
Conflict of Interest: None Declared
I understand the appeal of using the internet for (i) cheap surveillance (e.g. of trends, using social media microbloggers like Twitter), (ii) cheap recruitment (e.g. of human subject survey participants, e.g. ClearVoice Research, Amazon's Mechanical Turk) and (iii) cheap information provision (e.g. the present thought-provoking article)In theory, using the internet can reduce the marginal cost of education, perhaps even to zero. But mightn't a patient value a cheap instructional video as much or more? And be able to use it more easily?I'd be fascinated to see a follow-up study that tried the video approach and maybe also some behavioral economics approaches. Say, send the DVD for free, and offer patients a small cash reward if they return it at time of procedure?
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