Evidence map›Paper›PMID 32535075›Full record

ArticleUrology2020

Direct-To-Consumer Internet Prescription Platforms Overlook Crucial Pathology Found During Traditional Office Evaluation of Young Men With Erectile Dysfunction.

Robert H Shahinyan, Arash Amighi, Alson N Carey, Dar A Yoffe, Devyn C Hodge, Matthew E Pollard, Justin J Nork, Jesse N Mills, Sriram V Eleswarapu

Abstract read
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In one paragraph

Article in Urology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed
4.1field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 37 citations in OpenAlex.

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  9. Review
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  11. Testosterone replacement therapy in the era of telemedicine.International journal of impotence research · 2022
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Robert H ShahinyanDivision of Andrology, Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA.
Arash AmighiDivision of Andrology, Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA.
Alson N CareyDivision of Andrology, Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA.
Dar A YoffeDivision of Andrology, Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA.
Devyn C HodgeDivision of Andrology, Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA.
Matthew E PollardScott Department of Urology, Baylor College of Medicine, Houston, TX.
Justin J NorkUnited States Naval Hospital, Guam.
Jesse N MillsDivision of Andrology, Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA.
Sriram V EleswarapuDivision of Andrology, Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA. Electronic address: SEleswarapu@mednet.ucla.edu.
University of California, Los Angeles · USBaylor College of Medicine · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine comorbidities in young men with erectile dysfunction (ED) who are increasingly targeted by direct-to-consumer (DTC) internet platforms that sell phosphodiesterase-5 (PDE-5) inhibitors without comprehensive clinical evaluation; and, further, to characterize the portrayal of DTC platforms by popular news media.

methodsWe retrospectively reviewed all men age ≤40 evaluated for ED at an andrology clinic during January 2016-March 2019 to obtain demographics, exam and lab findings, and treatments. Five news sources were analyzed during the study period to characterize whether articles about DTC platforms were positive, critical, or balanced/neutral.

resultsWe identified 388 patients, with age 29.5 ± 5.0 years, 15% rate of obesity, 20% prediabetes or diabetes, 54% dyslipidemia, and 20% hypogonadism. Serum lab findings associated with subfertility were found in 11%. Semen analysis was conducted in 64 men, of whom 40% were abnormal. Varicoceles were found in 35%. PDE-5 inhibitor was prescribed to 328 men (88%). Off-label empiric therapies included clomiphene (32.9%) or aromatase inhibitor (12.1%). Testosterone replacement was initiated in 9.7%. Analysis of news coverage revealed 18 articles, of which 61% portrayed DTC platforms exclusively in a positive light.

conclusionOffice consultation identified young men with significant comorbidities that would be missed by DTC platforms, which employ only questionnaires for health screening. DTC platforms present themselves as medical authorities without following AUA Guidelines, yet garner mostly positive press coverage. Patients engaging these platforms may falsely believe they are receiving adequate medical assessment. Urologists may do well to incorporate telemedicine to enfranchise young men with evidence-based evaluation.

Indexed as

AdultComorbidityDiabetes MellitusDyslipidemiasElectronic Health RecordsElectronic PrescribingErectile DysfunctionHumansHypogonadismInternetMaleObesityOffice VisitsOff-Label UsePenile ErectionPhosphodiesterase 5 InhibitorsPhosphodiesterase 5 Inhibitors

Identifiers

PMID32535075
OpenAlexW3034456819

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.