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To date, there has been little research with digital direct-to-consumer (DTC) communication regarding pharmaceutical products (eg, product websites), so this study was designed to measure perception and recall of Important Safety Information (ISI) in websites viewed on desktops and smartphone devices. A quantitative survey was conducted with 1600 self-identified asthma patients. Participants viewed 1 of 4 mocked-up websites for a fictitious asthma product in either a desktop or smartphone format that varied in the way in which risk information was presented and accessed. The “websites” were embedded in survey software that enabled behavior to be tracked and facilitated presentation of questions designed to assess memory and user experience. Statistically significant differences in likelihood of interacting with, and memory of, the ISI were observed across the 4 different presentation formats—2 typical of existing website formats and 2 representing alternative formats—for both desktop and smartphone media. The traditional formats consistently outperformed the alternative formats overall, but when analyses are restricted to the subset of participants who view ISI, elements of one of the alternative formats proved to be superior. Digital presentation of different formats of risk information has a significant effect on recall and recognition of ISI associated with pharmaceutical products, and the interactive nature of digital material adds a layer of complexity to assessing the performance of the various formats.

4 Background: Research investigating Pts’ preferences in treatment (tx) decisions for advanced (NSCLC) has generally been limited to smaller, single-country studies or anecdotal reports, and has rarely included Cgs’ perspectives. Methods: A 30 minute online or phone survey was conducted 28 June to 9 August, 2011. Survey participants (SP) included NSCLC Pts (n=245) or Cgs of NSCLC Pts (n=251) treated in the prior 12 months. A 1:1 non-paired sample of Pts and Cgs was sought in the US (n=295), France (FR; n= 100) and Germany (DE; n=101). FR and DE data were weighted to better reflect the age distribution of NSCLC in those countries, then combined. Results: For NSCLC SP, 64% were ≤65 years; 52% were male; 13% current smokers; 64% former smokers. Disease was localized in 21%, advanced in 73% and unknown in 6%. Tx was ongoing in 54%, and in 15% and 31% respectively tx was completed < 3 or 3-12 months previously. SPs elected tx to maintain independence (90%) and to control the cancer (89%); 81% were willing to continue tx indefinitely to maintain disease control. Although 69% of SP were greatly concerned about chemotherapy side effects, 60% were willing to endure significant side effects to live longer. SPs were comfortable asking their doctor questions (84%), and 68% were comfortable asking questions if they disagreed with recommended tx; 58% of SPs usually deferred tx decisions to the doctor. Comprehension of the tx plan was higher upon tx initiation (71%) than at diagnosis (46%) or at time of initial explanation by the doctor (62%). Many SPs (77%) relied on the nurses to help them understand their condition/tx. Among SPs in whom tx was discontinued (n=230), the most common reported reasons for stopping were that the cancer decreased in size (41%) or had stopped growing (28%). Only 14% believed tx was stopped because the cancer was not responsive, while 13% believed the cancer was gone. Conclusions: This large 3-country survey characterized factors important to the NSCLC SP in determining motivations for tx including a desire to control the disease and willingness to continue treatment for disease control if there was an acceptable risk/benefit balance. The survey also indicated a possible misapprehension on the reason(s) tx was halted.

Objective. —To evaluate the persistence of effects on health and development at age 5 years of the Infant Health and Development Program, an early childhood intervention that was provided to low-birth-weight (LBW) premature infants from neonatal discharge through age 3 years. Design. —Randomized, controlled, multicenter trial, stratified by two LBW groups: lighter (≤2000 g) and heavier (2001 to 2500 g). Setting. —Eight socioeconomically heterogeneous clinical sites. Participants. —Of 985 eligible infants weighing 2500 g or less and at 37 weeks' or less gestational age, 377 infants were randomly assigned to the intervention group and 608 to the follow-up only group. About two thirds of the infants in each group were in the lighter LBW stratum, and one third were in the heavier LBW stratum. Intervention. —The intervention group received home visits (from neonatal discharge through age 3 years) as well as center-based schooling (from 1 to 3 years of age). Children in both groups received pediatric surveillance. Main Outcome Measures. —Cognitive development, behavioral competence, and health status. Results. —At age 5 years, the intervention group had full-scale IQ scores similar to children in the follow-up only group. However, in the heavier LBW stratum, children in the intervention group had higher full-scale IQ scores (3.7 points higher;P=.03) and higher verbal IQ scores (4.2 points higher;P=.02). No significant differences between intervention and follow-up only groups in cognitive measures at age 5 years were noted in the lighter LBW infants. The intervention and follow-up groups were similar in behavior and health measures regardless of LBW stratum. Conclusion. —The early childhood intervention provided in the first 3 years of life had effects on heavier LBW premature infants' IQ and verbal performance at age 5 years that were not observed for lighter LBW premature infants. The intervention did not affect health or behavior at age 5 years in either LBW stratum. (JAMA. 1994;272:1257-1262)