1. Testing a New Product Message for Medtronic’s Reveal Plus Insertable Loop Recorder Julie Gilbert May 19, 2003

2. Meet Margie Wert

3. How the Reveal Plus Works

4. Persons who faint due to cardiac causes are at increased risk for sudden death. Those who faint, due to cardiac causes, have a six-month mortality rate of greater than 10%. New England Journal of Medicine, September 2002 Significance of the Condition

5. Statistics on Fainting 1 million people in the U.S. faint each year. 70,000 people have recurrent, infrequent fainting episodes that are undiagnosed and improperly treated.

6. World’s only implantable cardiac monitor Captures heart rhythm data to help determine if fainting is due to cardiac causes (or not) Medtronic’s Reveal Plus Insertable Loop Recorder

7. Research Question Would promoting the message,“patients with cardiac syncope (fainting) are at greater risk for cardiac death,” cause cardiac physicians to more frequently refer for or implant the Medtronic Reveal Plus insertable loop recorder?

8. Research Hypotheses New message would alter current practices New message would be credible with audience New message would be more compelling than current product message

9. About the Survey Target audience: Cardiologists, implanting cardiologists and electrophysiologists 4400 invitations mailed to physicians pre-registered for 2003 American College of Cardiology convention Computer and Palm Pilot-based survey instrument

10. 85 usable surveys gathered Sample included mostly cardiologists (limited number of implanting cardiologists and electrophysiologists) Results

11. To rule out cardiac syncope (in the appropriate patient group) how frequently do you refer or implant an insertable loop recorder? Always……..9% Often……...31% Sometimes..41% Never……..19% Identifying Current Reveal Plus Use

12. Respondents read statements from study published in New England Journal of Medicine. 97% replied – YES. The potential risk for sudden death in patients with cardiac syncope would alter how how patients were tested/monitored. Could the Study Affect Behavior?

13. Would the potential risk of death cause you to more frequently refer or implant an insertable loop recorder? Respondents Indicated New Attitudes Toward Reveal Plus Use Projected Behavior Current Use Always20%9% Often53%31% Sometimes27%41% Never0%19%

14. “Reveal Plus – the right tool to help clearly and definitively rule out cardiac syncope, cardiac death.” 91% - indicated it was credible Was the Draft Message Credible?

15. Most Compelling Messages Which statement is most compelling? 1.Helping to rule out cardiac syncope and cardiac death 2.Provides critical information to better understand your patients’ risk 3.The gold standard for diagnostic monitoring (current product message) 4.Long-term monitoring for a more complete picture 5.The essential tool for patients at increased risk for arrhythmias 61% - indicated statements 1 and 2 (statements based on fainting study) were most compelling.

16. Answering the Research Question Would promoting the message,“patients with cardiac syncope (fainting) are at greater risk for cardiac death,” cause cardiac physicians to more frequently refer for or implant the Medtronic Reveal Plus insertable loop recorder? For this small sample, yes.

17. Recommendations Repeat the study at other conventions attended by cardiac physicians Explore additional research options (e-mail, phone) to gather data from cardiac physicians In addition, examine effective media for delivering messages and information to cardiac physicians

19. Questions?