Acceptable evidence in health advertising

To avoid misleading the public, claims made in advertising about regulated health services must be supported by acceptable evidence.

The framework below can be used by anyone (a business or individual) advertising a regulated health service (including registered health practitioners, business owners, organisations or corporate entities) to assess if there is acceptable evidence for a claim made in advertising.

The Australian Health Practitioner Regulation Agency (Ahpra) and National Boards’ approach to assessing evidence to support claims is consistent with the wider scientific and academic community.

There is an important difference between acceptable evidence for claims made in advertising and the evidence used for clinical decisions about patient care. When treating patients, practitioners must obtain informed consent for the care provided and are expected to discuss the evidence for different treatment options. In advertising, the claims are generic, and practitioners are not available to clarify whether a treatment is appropriate for an individual patient.

Factors for assessing if evidence is acceptable

In general, evidence is assessed as ‘acceptable’ where a body of evidence rates highly against the following factors (see here for more information on what is acceptable evidence):

• Source: Is the evidence supporting my claim from a publicly accessible and reliable source?
• Relevance: Does the evidence directly support my advertising claim? Is it about the patient population targeted by my claim?
• Inclusion: Have I considered relevant studies on this topic, including negative and neutral findings?
• Level: Was the study well-designed and appropriately selected to answer the research question/s?
• Quality: How was the study conducted? How much uncertainty is there? Have chance, bias and confounding factors been considered?
• Strength: Does the evidence show a meaningful effect that supports my advertising claim?

The framework above should be used when assessing advertising claims about the benefits or effectiveness of a treatment.

Issues to consider about study design

Study design is an important aspect to consider when assessing if claims are supported by acceptable evidence. The evidence required for a therapeutic claim will depend on the specific claim made in the advertisement.

A well-conducted systematic review of relevant randomised control trials (RCT) represents the highest level of evidence where it considers all studies on a given topic and the review is systematic, it can be reproduced and is representative of all the evidence. Where a systematic review is unavailable, it is important that relevant sources of evidence are considered (not selective sources which are not representative).

There are specific issues that need to be considered in making a judgement about the quality of a specific study design. More information on assessing three common study designs can be found below:

• systematic review
• RCT or pseudo-RCT, and
• cohort or case control study.

Examples of unacceptable evidence for advertising claims

Examples of unacceptable evidence could include a comparative study without concurrent controls or a single case study. Such evidence has a higher risk of biased (or inaccurate) findings as a consequence of the study design.

The following types of studies will generally not be considered acceptable evidence for advertising claims:

• studies involving no human subjects
• before and after studies with few or no controls
• self-assessment studies
• anecdotal evidence based on observations in practice
• outcome studies or audits, unless bias or other factors that may influence the results are carefully controlled, and/or
• studies that are not applicable to the target population.

Glossary of terms and resources

An explanation of terms and why they are important when assessing if evidence is ‘acceptable’, and helpful resources, are on the Glossary of terms and resources page.

Factors for assessing if evidence is acceptable

Issues to consider about study design

Glossary of terms and resources