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Subject: from BMJ for 3-21-09

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(3) Concern over Google links to worrying medical claims

(Personal view: Google needs better control of its advertisements  
and suggested links)

http://www.bmj.com/cgi/doi/10.1136/bmj.b1083
(Personal view: A Reformation for our times)
http://www.bmj.com/cgi/doi/10.1136/bmj.b1080

Google needs better control of its advertisements and suggested  
links to avoid web pages that contain worrying medical claims, warn  
doctors in an article published on bmj.com today.

Dr Marco Masoni and colleagues at the University of Florence in  
Italy suggest that, as the internet is not well policed and  
regulated, it is up to members of the medical community to be  
vigilant and to suggest improvements.

They recently used Google Italia to search on the keyword "aloe"  
and found sponsored links to websites recommending aloe arborescens  
for the prevention and treatment of cancer and offering it for sale.

AdWords is "Google's flagship advertising product" and was its  
"main source of revenue in 2007." Through it, users can create  
advertisements, choose their own key words, and decide which Google  
queries their advertisements should match. Google decides on  
placement on its pages of search results: which advertisements to  
show and in what order.

But Google's automated matching to search terms sometimes places  
inappropriate advertisements. For example Google Guide (which is  
neither affiliated with nor endorsed by Google), says: "In  
September of 2003, adjacent to a New York Post article about a  
gruesome murder in which the victim's body parts were stashed in a  
suitcase, Google listed an ad for suitcases. Since that incident,  
Google has improved its filters and automatically pulls ads from  
pages with disturbing content."

But the authors argue that Google filters must be improved further.

Google has often said that it wishes to enter the healthcare arena  
in many ways, say the authors. "We think that a necessary first  
step for Google is to improve its filters and algorithms so as to  
prevent possible harm to its users," they conclude.

"We are experiencing a healthcare reformation," says Joanne Shaw  
from NHS Direct in a second article. "The internet has brought the  
canon of medical knowledge into the hands and homes of ordinary  
people, and this should be welcomed and encouraged as good for  
patients and doctors alike." It is true that the internet may be a  
further source of alarm for the worried well, but equally it  
encourages early presentation and action that could improve  
survival and reduce complications from long term conditions, she  
writes.

Furthermore, the internet does not diminish the role of doctors but  
casts them as expert advisers rather than authoritarian figures  
with exclusive guardianship of special knowledge denied to ordinary  
people.

Many doctors already act according to those principles, and many  
patients will continue to want a more traditional style of  
relationship with their doctors. But people who look to the  
internet as a legitimate tool to help them with their health may  
already be in the majority and this is something for us to  
celebrate, she concludes.

Contacts:
Dr Marco Masoni, Faculty of Medicine, University of Florence, Italy
Email: <m.masoni [bat] med.unifi.it>

Joanne Shaw, Chair, NHS Direct NHS Trust, UK
Email: <joanne.shaw [bat] healthstrategy.org>
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