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Similarly, in Europe, SCs are only viewed by the EMA as a drug if they are unmodified cells used for a biologically different function, or modified cells that have been substantially manipulated (including expansion) (Martìn et al., 2014).
Stem cell therapy (SCT) offers much potential, and raises significant expectations.
Scientific and lay discussion have linked SCT to an extensive spectrum of conditions; however, it is a new and evolving area of medicine that is still largely being investigated.
Analyzing the information available on the web can give an idea of how people develop their understanding and knowledge of health-related issues, such as vaccination or supplements (Maki et al., 2015; Aslam et al., 2017).
We have used an approach used in other similar studies to analyze the information on SCT that is available on the Internet (Maki et al., 2015; Aslam et al., 2017).
45% of the centers specialized in treating 1 specialty, 10% offer 2, and 45% offered between 3 and 18 different specialties.
Of the 78 TCs, 65% were in the USA, 23% in Asia, and 8% in Latin America.The aforementioned subclause is stated commonly by TCs and is considered to be legal authorization to treat with minimally manipulated SCs outside of a clinical trial protocol.In cases where TCs wish to offer treatments with cultured SCs, which have been expanded in the laboratory, the clause no longer applies, and the TC either has to operate according to approved clinical trial protocols (George, 2011), or to perform the procedure outside of the USA/European oversight.Both the FDA and EMA, as well as individual national level agencies, have policies in place for appropriate research and clinical translation of SCs (Bianco et al., 2013a).Despite these regulations, authorities are increasingly concerned about the rise in availability of SC therapies outside the approved indications or regulated clinical trials, with the potential to harm patients (Lau et al., 2008; Turner and Knoepfler, 2016).This study shows a disconnection between information about SCT and what is actually offered by TCs.The study also shows that TCs, potentially acting in a regulatory gray area, have a high visibility on the Internet.With recent scientific advancements, SCT is moving away from the ethical dilemmas surrounding the use of embryos, and toward the efficacy of treatments (Phinney and Prockop, 2007; Robinton and Daley, 2012; Trounson and Mc Donald, 2015).At present, SCs are routinely used as bone marrow transplantation, to treat hematological and immunological cancers and disorders, a practice that has existed for 50 years, and for longer than the term “SCT” been a research topic (Copelan, 2006; Appelbaum, 2007).None of the centers offered SCT based on embryonic cells.Health information quality (JAMA score, measuring trustworthiness) was lowest for TCs and commercial websites and highest for scientific journals and health portals.