Advertisement by medical facilities as an opportunity of APOE genetic testing in Japan: a website analysis

Abstract Background : The APOE -ε4 allele[s] is a strong risk factor for Alzheimer’s disease (AD). Its significant opportunity route includes out-of-insurance APOE testing services provided in medical facilities in Japan via their website advertisements. Therefore, there is a concern that adequate self-determination of whether to undergo APOE testing may be spared depending on the content of website advertisement descriptions. Methods : In this study, we searched medical facility websites in Japan advertising APOE genetic testing as one of their services. The defining features of the advertisements were manually assessed based on deemed-preferable features that we prespecified in the aspects of legal regulations or other applicable guidelines published by related societies. Results : We identified 220 medical facilities that had created advertisements for the provision of APOE genetic testing on their websites. Of these, 85% were small clinics, and the remaining 15% were outpatient departments of large hospitals. The median cost of APOE testing (when clarified) was US$ 123.1 (in 143 JP¥/US$). Contact information, details, and costs of testing were described on most of the websites. Meanwhile, features’ explaining APOE as a risk gene,’ ‘notes on interpreting APOE results,’ or ‘explaining examination methods (e.g., blood sampling) were described to a variable degree depending on individual facilities. ‘Notes on genetic testing’ or ‘genetic counseling’ were hardly referred to, and ‘specialists with appropriate expertise’ were considered to participate in clinical practice in approximately one-third of these facilities providing APOE testing services. Conclusions : These results suggest that self-determination on taking out-of-insurance APOE testing at some medical facilities in Japan may possibly be influenced in an inappropriate manner. Further discussion might be warranted on how and to what extent information on APOE testing should be provided to patients on the website of medical facilities advertising the test in order to support the well-informed self-determination of patients.