if you’ve ever tried searching Google or Bing for rare disease symptoms, you know that this is not effective 

Physicians are trained to arrive at a medical diagnosis by starting with the potential causes that are most common. The adage is “When you hear hoofbeats, think horses—not zebras.” This is logical and effective if a patient has a common condition, but the diagnosis of an orphan condition requires a different approach. The National Organization for Rare Disorders estimates that it takes an average of 9 years for a rare disease patient to get an accurate diagnosis.

This means that many patients, caregivers and physicians are online searching for answers, using search engines and forums. But, if you’ve ever tried searching Google or Bing for rare disease symptoms, you know that this is not effective. Enter Radu Dragusin from the Technical University of Denmark and a few colleagues who have launched a new search engine dedicated to the diagnosis of rare diseases called FindZebra.com.

Their study published in the International Journal of Medical Informatics shows FindZebra outperforms Google. The research explains that the algorithms of popular search engines (such as Google) favor websites that have a number of other websites linking back to them. These links validate that the information has been found useful to others. But by its very nature, information on rare disorders is typically scarce and has fewer backlinks.
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the site owner has control over how their internal site search provides results and those results, like any other messaging, need to be compliant 

We recently reviewed this FDA warning letter sent on January 29, 2013 to Medical Doctors Research (MDR), a nutritional supplement manufacturer.

The letter cited a variety of issues, but the one that caught our attention was the reference to the search within the website. MDR included a site search functionality where someone could enter a keyword and it provides results from the pages within that website. The FDA letter notes: “In addition, typing the key word ‘cancer’ or ‘diabetes’ into your product search field located on your website brings up your product lists to include Fitness tabs for Men, Longevit – E and others, implying your products are intended for use in the diagnosis, cure, mitigation, treatment or prevention of such diseases. Your products are not generally recognized as safe and effective for the above referenced uses, and therefore, the products are ‘new drugs’ under Section 201(p) of the Act [21 U.S.C. § 321(p)].”
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There have been some big changes in Google search results for pharmaceutical keywords in the last few weeks. Google has taken the next step in evolving the search results to include more information from their “knowledge graph.” They have changed both the design of the results page and how the medication information is provided for brand/generic name searches.

The previous design showed a brief description of the drug from the National Institutes of Health and links to the prescribing and risk information. The new design (see below) gives the drug information an expanded space on the top right and changes the information provided.

For nondrug searches, Google has also added other types of reference information directly to the search results pages to expand the original scope of the knowledge graph. For example, they’ve added live stock quote information, travel reservation information and enhanced restaurant listings.
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We tested out the new interface design for our clients' campaigns and found that most of them were not affected by the change at all. 

On May 16, 2012, Google released a change to the way search results pages are designed. They call this new design the Google Knowledge Graph. It integrates information from Wikipedia and other (music, movies, reference) databases for which they have licensed the rights. Currently, the change is only on English language searches and hasn’t been rolled out into all the international flavors of Google.

Why the redesign?
Google has described the Knowledge Graph as “semantic search,” meaning that the engine isn’t just looking at individual keywords and phrases, but learning more about the multiple meanings of these searches (disambiguation) and hopefully providing more real answers than in the past. They have spent a lot of time modifying the algorithm itself to recognize multiple meanings based on their own past search data, and this is another layer in that effort.

How are pharmaceutical-related searches affected?
Considering the media coverage of this change, we expected to see changes in all the search results pages. We found that very few were affected for our clients. We tested out the new interface design for our clients’ campaigns and found that most of them were not affected by the change at all. Google thinks that this change has only affected 10-20% of searches.

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The placement of the related disease searches on the page is prominent 

In February Google announced a new enhancement to their search results for health symptoms. We have known for a long time that Dr. Google is one of the first places people go to investigate whether a symptom is worth a trip to the doctor to investigate or not. This change in how the results are displayed tries to use the data from the National Institutes of Health, Wikipedia, and others, to determine the most common diagnoses that are associated with their symptom.

“Our data shows that a search for symptoms is often followed by a search for a related condition. To make the process easier, now when you search for a symptom or set of symptoms, you’ll often see a list of possibly related health conditions that you can use to refine your search,” writes Roni Zeiger, MD, Google’s Chief Health Strategist, on their blog.

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Recently there has also been an integration of Google+ content into search engine results pages 

Google has been an important part of the health research process for patients and healthcare providers for many years. This year Google is shaking things up with a list of new products and innovations that will affect both the paid and organic search strategies of pharmaceutical companies.

Google+
Google started allowing businesses to create Google+ pages/profiles and visitors to opt into specific “circles” in order to receive specific posts and updates. An example might be using circles to customize messages for patients, healthcare providers and caregivers. The Google+ platform could integrate well with a segmented marketing strategy, and Google+ now has a network of 100 million users worldwide.

However, one reason for pharma to wait to create Google+ pages is because the commenting capability cannot be suppressed or controlled the way it can be on YouTube. Note that just like Facebook (850 million users), a Google+ page requires resources to add content, monitor comments and interact with users. Roche is the only biopharmaceutical company we have seen who has taken advantage of Google+ with placeholder company and career pages.

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We have yet to see how much data will be lost; Google suggests it should be a minority 

This week Google announced that it is making a change to how Google Analytics (GA) reports keyword level data. Google announced this as a change intended to protect the privacy of the user data of people who are logged into their tools while searching.

Basically, Google explains the change as separating the keyword level data from searches into two groups: one for those who are not signed into Google’s universal login for all its products and one for those who are logged in. Google will remove/suppress/protect the keyword level data from the search results pages for those people who are logged in, and those keywords will be listed within the organic search reporting of GA as “not set” or “not provided.” Everything else from searchers who are not logged in will still be reported, as will all data from paid search campaigns.

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dog with a long tail

Rare disease patients and caregivers are the epitome of long-tail searchers 

Although the vast majority of time spent online is spent on long-tail sites — or sites with an overall reach smaller than 1.5% of the internet population — the majority of ad dollars are spent on short tail sites, according to comScore. What an interesting disconnect between audiences and marketers.

A CONTEXTWEB study of 1,000 ad campaigns across 18,000 publisher sites during the second half of 2010 discovered that ads placed on long-tail sites lifted click rates by 24% — a big lift compared with larger web properties. The research identified that “health” had a 43% lift in click-through rates for long-tail ads.

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this may increase or decrease the impressions of your Paid Search ads and the resulting the Click-Through-Rate 

On September 8, Google Instant was launched, showing search results as the user types the query. You don’t have to finish typing or hit enter to see results. In fact, after typing one letter, results appear. This predictive search tries to anticipate what users are looking for and save time.

If you haven’t already tried it, go to Google.com to see how it works (it hasn’t been rolled out to the Google search boxes in toolbars). You can turn off Instant search – which I did after a few days since I found it to be distracting. Some industry pundits are predicting that this is the future of search and in a few years we won’t remember searching any other way. However, others are skeptical. It will be interesting to see how this evolves.

Impact on Paid Search
It’s interesting to start to type in a search query and as you continue, see the different Paid Search ads appear. According to Google, a Paid Search ad impression is counted in three different ways:

• Any click on the page: If a user begins typing, then clicks anywhere on the page (whether that’s for an ad, a spell check or related search), an impression is counted.
• Search selection: If a user clicks the search button or presses enter or selects one of the predicted queries, an impression is counted.
• Three-seconds: If a user stops typing and does nothing for three seconds, an impression is counted.

Depending on how your campaign is set up, this may increase or decrease the impressions of your Paid Search ads and the resulting the Click-Through-Rate (CTR).
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Spelling diabetes is one thing. Spelling immune thrombocytopenic purpura is something else altogether. 

Pamela Todd, Content Strategist at Siren Interactive, contributes this post:

Search matters — especially when it comes to healthcare.  The PEW Internet Project reports that 75%-80% of Americans have searched for health information online. And significantly, this information-seeking usually begins at a general search engine.

Among the most active searchers are those with a disability or chronic disease, who have a continuing need for information and support — like those with rare disorders. Why is search so important to patients and caregivers in the rare disorder community?

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