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Transcript of Joel Gurin Keynote from “Trust or Consequence: How Failure to Disclose Ad Relationships Threatens to Burst the Search Bubble”

Joel Gurin, Executive Vice President, Consumers Union

Other Speakers:
Beau Brendler, Consumer Reports WebWatch

Note: This is an edited transcript of the proceedings.

Beau Brendler: So I’d like to now introduce Joel Gurin, the Executive Vice President of Consumers Union, publisher of Consumer Reports magazine. At CU, Joel oversees content development and publishing, fundraising, new product development and strategic planning. He joined CU in 1991 as science editor of Consumer Reports. He became editorial director in 1994 and executive vice president in 1997. Consumers Union administers Consumer Reports WebWatch, as you know.

As editorial director for CU, Joel was the chief editor of Consumer Reports magazine, which now has a circulation of 4 million. Joel also oversaw the launch of Consumerreports.org in 1997. It has become one of the most successful paid content sites on the Web, with close to 2 million active paid subscribers.

As Consumer Reports’ science editor, Joel directed coverage of healthcare, medicine, the environment and nutrition. From 1981 to 1990, Joel was also a founding editor and later the editor-in-chief ofAmerican Health Magazine. One of the fastest-growing magazines of the 1980s, American Health was also the first health magazine ever to win the National Magazine Award for general excellence.

Joel is also the author of four books on health, medicine and nutrition. And I think his speech will do a lot to tie together the themes that we’ve been talking about today and into the afternoon. So please welcome Joel Gurin.

Joel Gurin: Thank you.

Thanks very much and thank you all for coming today. It really strikes me that there is just a tremendous amount of collective expertise in this room today, and we really appreciate all of you coming with us to talk about how we can make the Web better for the people who use it. You all represent, really, some of the best thought leaders in the industry, and if we’re all going to try to improve the way the Web operates and the way it serves consumers, I think this is a really excellent place to start. So thank you.

We’re talking a lot today about issues of transparency and disclosure, so I want to do my own full disclosure. I am not an expert on the Web in the way that you all are. But I’m really here to represent the perspective of the consumer and also to give you the perspective of our own organization, Consumers Union, which publishes lots of different things, including Consumer Reports on Health and, Steve [Barrett], thank you very much for that nice endorsement of our Health newsletter. And also we’re the organization that has started Consumer Reports WebWatch three years ago, which we’re very, very proud of.

We started WebWatch with a mission, which is to try to make the Web more consumer friendly and more trustworthy as an information source. And as you’ve been hearing in the last two sessions, there’s still a lot more work to do.

This conference is really focused on two of the most compelling kinds of consumer Web sites: search engines and health sites. And there really are a lot of similarities, I think, between the two. Both are used by consumers to find information that can be incredibly important in their lives. Both have the potential to open up really new worlds of knowledge for millions of people and help them in all kinds of new ways. But both kinds of sites are still being operated in ways that can be confusing at best and deceptive at worst.

So, really, one of the key messages of this conference is that we need to do a better job to bring consumers unbiased information online in a useful and trustworthy way. Well, I’m going to talk about both search engines and health sites; I’ll talk about how the two are connected. I’m going to focus especially on health, though, because it’s a fairly new area for us. It’s an area that, as you heard before, I’ve had a lot of experience with, as Beau just told you. And I’ll talk particularly about some of the issues that just came up in that really excellent discussion we just had about the importance both of transparency and information reliability; how do you balance the two, and how do you look at the importance of both.

And if you stick with me through this presentation, I can promise you all a dancing pill at the end and you’ll just have to wait and see what that is.

I’m going to step back a little bit from the two excellent presentations that we just heard from Jørgen [Wouters] and from Peter [Goldschmidt], who I think really gave you a lot of real in-depth detail and insight into the issues around search engines and health sites. I want to step back and talk about the big themes and the big issues that really matter most from the viewpoint of the consumer.

If you think back to that video we showed at the very beginning, you heard a lot of real people out there, talking about their real experiences — not very happy. What I want to do here is bring it back to the issues that are making people unhappy, or worse, in the world of search and health sites.

My own experience, when I started working on this speech, I went to learn a little bit more about search engines and how people are using them. So I decided to do something that I never tried before, I actually decided to Google “Google.” If you’ve ever done this, if you look at this, you actually get about 240 million responses in about a tenth of a second. Which definitely told me a lot more about Google than any normal person would ever need to know.

If you go through here, you can find sources on Google’s business model, on their search technology, a whole bunch of games that you can play using Google. So I’ve now found out that you can use Google to automatically create surreal poetry, to figure out which historical figures are the most popular. You can do a Google smackdown pitting Genghis Khan against Attila the Hun, and you can generate full-color images based on the words that you find in Google searches. There is even a site that actually will let you display Google pages in a mirror image, backwards.

Well, this little exercise really told me a couple of very important things. First, it showed me that a lot of people using Google definitely have too much time on their hands. But it also showed just how much interest and attention and usage the search engines have generated. I mean, you think about this – 237 million search results. That is a lot of results. And just for comparison, that’s about 7 or 8 times more than the results that you get if you do a search on George W. Bush. So this tells us that Google is more popular than the president, or something.

But it really shows that search has become of great interest to people and also that it’s a universal tool that’s really incredibly easy to use. Now, a decade ago, if you had thought of the idea of getting 200-plus million searches on anything, in any period of time, even a lifetime, let alone a tenth of a second, this would have seemed like some kind of fantasy. Well, now consumers can get more information than they can possibly use on any subject with no effort and in no time at all.

That seems like a great thing, but there’s really a trap here. And the trap is that it is so easy to do an extensive search that you can become inundated with information before you have a chance to figure out what’s going on. Before you can figure out which sources are really useful and trustworthy and which ones are not.

Now, at Consumer Reports WebWatch, we’ve been studying search engines and the way people use them for three years now. And you can read all about this on the site, we’ve got a really excellent presentation, I think, from Jørgen, summarizing some of the work. Beau introduced the WebWatch team this morning. I really want to credit and thank all the WebWatch team, many of whom are here today, who have just done an incredible job in generating so much important information. I also want to thank Beau, who has just done a remarkable job as the director of WebWatch, and also Chuck Bell, who’s here, our programs director, who saw the need for this project early on and secured the funding to launch it. And also, of course, we’re very grateful to The Pew Charitable Trusts and the John S. and James L. Knight Foundation for their ongoing support. At Consumers Union, we really feel this is some of the most important work we do and we’re very proud of the work that these folks have done over the last few years.

Well, let’s step back from all that information that Jørgen gave you this morning and talk about what are the basic things that we know about search engines from all of this research? Well, the first major finding is a simple one and that is that most people who use search engines just know a lot less about how they work than the people in this room do. And I want to go back and talk about some of the research findings and highlight what some of the human experience has been for people trying to use search.

So, as you’ll remember, in April 2002, when we were just starting WebWatch, we published the results of a national poll of Web-savvy adults. And these are people who had all been using the Internet for at least six months, so they weren’t complete newbies to the Web. Well, in that first survey, 60% of these people, more than half of them, had no idea that search engines take money from advertisers in any way that affects their search results. And some of our later studies, which you also heard about, also showed that about half of Web-savvy users really don’t understand how search engines make their money. This is kind of striking. This is a huge number of people; it’s really a lot of ignorance among, really, a very savvy and well-educated population.

Well, we were surprised by this finding, so we did then this second in-depth study, which you also heard a little bit about. We hired a company, we actually used anthropologists, we used trained anthropologists here to study how people are using the Web. We sent them out to four cities – Providence, Phoenix, Kansas City, and Raleigh-Durham. They sat down with 17 people in these cities and they just watched them use the Web and see what happened in their daily lives.

And in this study, we chose people who actually did not know a lot about how search engines worked in the beginning. And then, after a while, we told them about paid placement and about paid inclusion and all of this. They were not happy. When they understood the game, they got very angry. They told us they felt betrayed, they told us they felt depressed. They realized – you know, they felt foolish. They realized that they just didn’t know what words like “sponsored link” meant or what “featured results” really meant. And they didn’t like it when they found out.

This study also showed how important clarity and disclosure are, that they’re really good for consumers and they’re also good for search engines themselves. Because people in this study, when they understood what was going on, they had a much higher impression of the search engines that really had been straightforward with them, that had clear disclosure and a much lower impression of the sites that didn’t. And those other sites, they actually, many times they said, you know, I’m just not going back to that site again. And I think you heard that a little bit in the videos today from some of those people.

Well, we have kept looking at search engines since that study. We’ve looked really at not only the study that we did last year, but the updatethat you just heard about this morning. And it’s really not a very great picture. We think it’s a real problem that search engines are not becoming more clear, but in many cases are really becoming less clear. We think that, as consumers figure this out, they’re really going to become as angry as some of the people that you saw in the videos or some of the people we talked to in our first study.

Now, we have definitely seen some positive steps from search engines that are seeing the risk of a corrosion of consumer trust. For example, Google, as we’ve talked about today, has never used paid inclusion. And last year, actually, as we were doing our study, both Ask Jeeves and MSN announced that they would stop using paid inclusion and they did. So that’s a good thing. But you also see changes going in the negative direction. So those same two sites – Ask Jeeves and MSN – have also become worse at disclosing what they do, as many other search engines have.

And we’ve really seen what you can consider I think a lot of backsliding just in the last year, the kinds of phenomena that Jørgen talked about – people labeling paid placement and paid inclusion less clearly. I have a slide that sort of summarizes some of our key findings. The key findings really, to put it all together, are: Disclosure headings and links are becoming less visible; paid placement hyperlinks are vanishing; paid inclusion hyperlinks have been removed, really, from many sites that had them; and paid inclusion is still prevalent.

So, how do you add this all up? What do consumers make of this, what do we make of this? The bottom line really is this: We have the most powerful information machine that has ever existed in human history, and it’s just not trustworthy enough. Tens of millions of consumers, maybe hundreds of millions of people by now, are using search engines all the time for a wide range of needs. Most of them don’t know how to find the best information there or how to sort out the valuable sources from the pretenders. So we have a vast information pipeline that’s really becoming badly corroded. And that is really a bad thing, ultimately, both for consumers and for the businesses that serve them.

Now, more consumers probably use search engines than use any other kind of Web site, but health sites are very close behind. These are sites that really have to be trustworthy. I mean, the difference between good and bad medical information here can literally be a life or death issue. But it’s very hard for consumers to tell the difference on the Web.

Here’s how you have to picture this. Imagine that you walked into a health clinic for help with, I don’t know, severe pain of some kind. Someone comes out to treat you, they’re wearing a white coat, you don’t know whether they’re a doctor, you don’t know whether they’re an alternative healer who’s going to give you some herbal remedy, or maybe they’re a drug company representative. You have no idea who you’re being treated by.

This is really exactly the same kind of situation that consumers face when they look at health information online. There’s a ton of information, but you really can’t always tell the source or how reliable that source is.

So we’ve actually done – you heard from Peter about the study that we did with HII [Health Improvement Institute], but I want to share with you also some additional information that we have about health Web sites. This comes from our own internal market research studies, but I can share some of the headlines with you today. So here are some of our key findings.

One, more than 90 million people now use the Web for health information, and other estimates have gone between about 90 and 100 million. The Pew [Internet & American Life] estimate is now almost identical to this one.

Speaker: Americans?

Joel Gurin: Americans, yes. People now are researching specific conditions, nutrition, prescription drugs or drug interactions, weight management, exercise and fitness, I think pretty much in that order. So it’s really a wide range.

And nearly – this is an interesting connection now between search and health – about two-thirds of online health researchers are using search engines to find health sites. So that’s really the way –search engines are really kind of the gateways into health information for a lot of people.

But when people start a health search by going to a search engine, they can get confusing or misleading results. The California Healthcare Foundation and RAND did a study several years ago and they found that people looking for health information online have only a one in five chance of getting relevant information on the first page of search results. Now, it may have gotten a little better since then, but if you look at some current sites, you can see what the problem what the problem is.

Here’s an interesting one. If you Google “arthritis,” you’ll get 15 million results. And even the ones on the first results aren’t very clear or useful. Now, this arthritis.com is actually the second listing that shows up under sponsored links. This promises – on Google, when it shows up, it says this is going to give you answers you can trust. Well, look at the very bottom and you’ll see of course that this is sponsored by Pfizer.

And through some very interesting fluke, I guess, this site doesn’t say anything at all about the recent warnings on Celebrex and Bextra, which are two Pfizer drugs for arthritis that have been flagged for very serious safety problems. If you do click through to the Pfizer site, they’ll tell you something about it there and it’s fairly straightforward. But if you’re looking for answers you can trust, your biggest questions right now would really be on the safety of arthritis drugs, and you’re not going to find anything on this site because of the sponsor and who creates it.

Now, also if you go to Google and you look at “arthritis,” you’re going to find a whole bunch of sponsored links for all kinds of stuff – and, remember, about half of people using Google or any search engine don’t know, really, what sponsored links are, so they don’t really understand necessarily that these are ads.

So what are you going to find there? Well, you’re going to see ads for dietary supplements for arthritis. You’ll see a wonderful ad for a treatment based on emu oil – this comes from Australia. There’s an ad for a company that makes hip replacements. There’s an ad for a book that claims that sex and alcohol are the best way to treat arthritis; that’s kind of interesting anyway. At least someone on there has a sense of humor.

Then you get to this very interesting thing. This is a really interesting site that also shows up as a sponsored link on Google. This is very clever, because you look at this and this looks like this comes from, I don’t know, some National Institute of something, right? It’s designed to look like a clinical evaluation of the best arthritis treatments, but really, as you explore this site, what this is really about is selling, quote, unquote, “natural treatments for arthritis online.”

So it is very easy, very easy for any user to get lost in a sea of really misleading, unreliable and unhelpful health information as you start to use search. Sorry, do you have a question?

Speaker: Does looking at the source code reveal any of this regarding paid placement, paid inclusion?

Joel Gurin: You know, I wouldn’t really know the answer to that. It does show up as a sponsored link. It does show up as a sponsored link on Google, it’s flagged as a sponsored link. So it’s not deceptive in that sense. But the question or the issue is that many people really don’t differentiate between sponsored links and regular listings as far as we can tell from our own research. And if you were to just track this, you could easily feel this was just like a straightforward medical site and not realize that it’s really an ad site for natural supplements and remedies on arthritis. Yeah?

Speaker: Yeah, I was just going to say, I think the issue is it’s not clear who sponsored it, right?

Joel Gurin: It’s not clear who sponsored it. It’s really not even clear really what it is. It’s just not clear what it is. It’s U.S. Medical Research Product Research Division. I mean, what is that? And you have to really start looking through it and saying, Oh, it’s all about glucosamine and chondroitin and stuff like that.

So now, if you go to Google and search for “depression,” actually, you get a similar kind of thing as you get from arthritis. And I’ll talk about this site in a minute. But you’ll actually — in this case, you’ll get like 36 million results, more than double what you get for arthritis. If you were not depressed when you started, you would be by the time you tried to figure out what was going on.

This is another interesting site. This is actually the second listing to show up. And, by the way, this one and the Pfizer site that I showed you on arthritis, they are not sponsored links. These are showing up in regular search results and they are the second-highest result. So these are really – even someone who knows the difference between sponsorship and non-sponsorship would very quickly go to these, because they’re showing up in the regular listings.

Well, this is the second one that shows up when you go and look at depression. This one is depression.com. This one is run by Glaxo-SmithKline. This is a drug company that has taken a lot of heat recently, I’m sure a lot of you know, because they apparently hid research results about the risk of Paxil, which is one of their drugs.

But this site, which also talks about all the information you need, this is the page within the site on depression.com that talks about antidepressant medication. So you would go here, one would naturally assume you’re in this site, you’re going to find out about the wide range of antidepressants; there’s at least half a dozen that are in common use. You would get some information on comparing safety and efficacy, etc. You would be wrong.

What you would get here, in fact, is just information about Wellbutrin and Paxil, which happen to be the two drugs that are made by Glaxo-SmithKline. So that’s interesting. There’s also an ad up at the top for an antidepressant with a low risk of sexual side effects, which is Wellbutrin, made by the people who run this site.

But you actually are not at a great risk. If you’re searching for depression information, there’s very low risk that you’re going to end up not knowing about all the many other drugs that are being sold as antidepressants, because they all have sites of their own. So if you go again to the first results page on Google, you’ll see sponsored links from Pfizer, which makes Zoloft, and from Eli Lilly, which makes a drug called Cymbalta. And you will find all kinds of very clinical-looking sites that promote a whole variety of alternative remedies.

So people are selling stuff all over the place and it’s really mixed in with good medical information in a way that’s very hard to sort out. I see another question.

Speaker: Yeah, in the previous Web page, I noticed that it was a dot-org Web page and not a dot-com Web page, which basically – doesn’t that say dot-org? Which would have basically implied that it was a non-commercial Web site. Which makes that even more devious.

Joel Gurin: You know, that’s very interesting. Thank you, I hadn’t noticed that, and I’m now very curious about this site. When I get back I’m going to do more research on this. If you look at it, they have a ton of links to natural remedies. But that’s a good point, I hadn’t noticed and that merits a little bit more of a look. Thank you.

So, where does this all leave us? So what we know is we know that more than 90 million Americans are looking for health information online. And what we conclude is that most of these people are probably really pretty confused.

I want to go back again to some of the research results from our market studies which show this confusion. When we asked people about how they viewed health Web sites, just in some of our own internal research, we had about two-fifths, almost half, saying they felt they had to be very careful using online health information. A third said that the content is influenced by advertisers. Only a quarter believe that most sites are very reliable, and another quarter said it’s really very questionable.

So people seem to be sorting out health information online by looking for well-known names or going to a site they’ve used before or going to a site that friends or relatives have recommended. And we saw in our studies, about two-thirds of people said they used one of those ways of finding a site.

Now, for sites with big names in health, that is not necessarily bad news. I mean, trust seems to generate more trust online. But if you step back and look at the whole picture, these findings are really showing us that health Web sites as a whole face a very significant credibility gap.

Now, think about this. This is health information. This is the most important personal information probably that any of us will ever use and millions of people really just feel that they simply cannot trust most of what they find online. And they have good reason for feeling that way.

So this is ultimately an issue not only for the credibility of health sites, it’s an issue for the credibility of the Web. If the Internet is really going to become the valued, trustworthy information source that we all want it to be, this is really a problem we have to solve.

So how do you solve it? Well, as you heard from Peter this morning, the first step toward trust really is transparency. Sites have to be clear about who runs them, who owns them, where they get their information.

And the study that you heard about really did rate the sites, I think, in a really pioneering way on a lot of these criteria and looked at the 10 criteria again, just as a reminder, that Peter talked about just a little bit earlier.

This study really did have some good news for consumers. As Peter said, the top 20 sites as a whole rated excellent on average, on identity, on advertising and sponsorship disclosure and on privacy. And six of the top 20 sites, including WebMD and MayoClinic, were rated Excellent. That’s all very good. And there are certainly a lot of really, really top-quality health sites out there.

But what we know we’re not able to measure in this study is the fact that we’re looking here at the top 20 most-trafficked sites. A lot of the sites that people are going to go to are not going to be anywhere near those top 20. This is particularly true, again, because so many people are finding health information through search. You go to a search engine, you type in the name of the disease, you’re going to get a lot of disease-specific sites, including ones like the ones I showed you on arthritis and depression, that are not in the top 20, because they’re not put together as good general health information sites. They’re just out there. Some of them may be highly valuable. Some of them may be highly questionable. It’s very, very hard for consumers to sort it out.

Well, what we’ve been doing, as you know, what we do at WebWatch, is we like guidelines. And we hope to get people to sign onto them, because we think ultimately it’ll be everybody’s interest to operate in a way which gives consumers more trust in the Web overall, and with these kinds of sites in particular.

So the voluntary guidelines which we encourage and invite everyone to sign onto we feel have been a very important first step. And we really believe that following these best practices is not only the right thing to do for consumers, it’s ultimately good marketing.

We’ve also begun to develop special recommendations and guidelines for search engines and we’re starting to do that for health sites, as well. We’d actually be very interested in your ideas for guidelines that you think sites – that should be part of these recommendations for health and for search.

But what we have found overall so far is that we’ve had some resistance, unfortunately, from these quarters in signing on even to the basic guidelines that those 200 sites have done. Only one search company, as Beau mentioned, Overture, has signed onto our overall guidelines. But we have had a little bit more luck with health sites. A number of them have taken the WebWatch pledge and WebMD and MayoClinic are among those, and we’re very appreciative of that.

I also want to talk about the power of these guidelines and explain a little bit about why we’re putting so much time and energy into doing this kind of standard-setting. We had an experience in our study of health sites that you heard about that really showed us the power of this approach. One site, called drugs.com, tested so poorly in so many ways that we were about to give it the equivalent of a Not Acceptable rating that you see sometimes in Consumer Reports magazine.

Well, we found out that that site is owned by a group of New Zealand pharmacists. We got in touch with them. We told them what we thought was wrong with their site. And in eight hours, they responded and said that they would address the problems that we pointed out. In 24 hours, we got a message that everything had been fixed – and it was. Well, that’s a very rapid response from one of the top 20 most-trafficked health sites and it really gives us a lot of faith that this kind of approach – of setting standards, holding sites accountable and asking people to engage with us in that kind of dialogue – can be very, very helpful.

So I want to take a few minutes, in the spirit of encouraging more Web sites to do some self-reflection, to talk about some of our new Consumer Reports WebWatch recommendations, first for search engines and then for health sites.

So our guidelines for search engines include just a couple of very, very basic points. They’re a bit obvious, but I think as you get into the details, they really become meaningful.

First, the sites should really tell users who’s supporting the sites. Search engines should provide a comprehensive list of their major advertisers and content sponsors. They should especially highlight those relationships that would influence search rankings. The list should be highly visible and should be updated often.

Second, tell us how it works. Search engines, we believe, should really explain how they rank and prioritize their listings. Even though this often relies on a lot of complicated and proprietary algorithms, we think there are ways to get basic information out there that consumers can understand. Talk about the criteria that are used for relevancy, technology that’s used and how payments from advertisers affect the listings.

They should certainly explain terms like “paid placement” and “paid inclusion” simply, clearly. And they should explain also that the first sites that are listed are not necessarily the best, which I think a lot of people assume they are.

And, finally, show us what’s paid for and what’s not. Sites should label paid search results clearly and conspicuously. And, as you’ve heard, we’ve looked at this in some detail. We like the idea of using a term like “paid advertisement,” as newspapers and magazines do, because that’s something that’s really in common currency. And sites should also explain search results that come from a business partner or a third party and should say whether those results come from pure search or whether they’ve been paid for.

We also think that search engines can do a lot more to help consumers find health information that’s good, in particular. So many people go to search engines to look for online health information that the search engines are almost becoming de facto health portals. And I think there is a real opportunity, and even an obligation, to help people find better health information and advice through the search engines. Google has taken a step in this direction;, they have a policy now on online pharmacy ads. They’ve required now for the last year all their online pharmacy advertisers and affiliates have to be part of the Square Trade Licensed Pharmacy program. We think that’s a good first step.

And we think that search engines could actually take the same idea and apply it to other kinds of health sites beyond pharmacies. For example, what would happen if Google and Yahoo! and the others decided that they would only accept sponsored links from health sites that really follow best practices? A lot of these sponsored links would disappear and the ones that were left would really have a much higher quality of information for consumers.

Now, the problem with all of this, and it’s a big one, is really agreeing on what best practices mean for health sites. You may know there are about 20 different sets of guidelines out there now, all from different organizations. And that’s really a little bit too much of a good thing. With all of that going on, it’s hard to hold sites accountable for doing business in the best possible way.

But there are some common themes. Most of the guidelines agree that health sites should provide basic disclosures and transparency as a critical first step. And we’ve begun to put together a set of guidelines that we hope sites will follow, and that really comes out of the study that Peter told you about today. So here’s what we think some of these sites should do. Again, I think this is kind of a clear crystallization of some of the key points.

One is to be clear about the site’s identity, with clear statements about who owns the site, the physical address where it’s produced and what its mission is.

Second, to identify experts and expert content. Sites ought to byline their content or at least show in some way that it’s been produced by qualified people and reviewed by health experts.

Third, date-stamp content and correct errors. This question came up before about currency. I think this whole question of, you know, what do you do when Vioxx is taken off the market is a big question. There’s got to be some way that sites really look at those, not only errors, but also just updating information.

And, finally, be clear about relationships with other sites, organizations and advertisers. If the site is sponsored by a drug company, be upfront about it. And the site should be very clear about what its purpose and whether it has a point of view.

Well, all of this would help, but it doesn’t solve the problem that we were just talking about a little bit before, which is about the quality and reliability of the information. And I think Pfizer.com, which we talked about, is a very good example. I mean, they’re very clear about who they are, they’re very transparent. We’re Pfizer.com, we’re run by a giant drug company, this is who we are, this is what we do. But you wouldn’t exactly go there for unbiased information on how their drugs compare to other treatments. I mean, that would be like going to United.com to find the best fare on Jet Blue or something like that. It’s not what you would expect that site to be able to do.

So, clearly, information reliability is a very, very important part of this. And it is extremely difficult, I think, if not impossible, to evaluate sites for the quality of their information [unintelligible].

However, if you’re building a site from scratch, we believe it is possible, or if you’re working on an existing site, it is possible I think for people who are developing health sites to do it in a way that really ensures a very high quality of information.

And this is actually a segue to the last thing I want to talk about just for a few minutes, which is to tell you about some of the work on health information that we’re doing at Consumer Reports.

You know that we are, of course, an information publisher and one that’s done a lot of work in the health arena. And we have recently developed some health sites of our own. I’d like to take this opportunity, with so many industry leaders and thought leaders in the room, to tell you about what we’re doing, because I think it’s work you should know about. I’d like to share some information and insights there. We’re also hoping that some of our own work at Consumer Reports could be in some way a model for what could be done elsewhere, as well.

Now, our work in health really stems from the concept of evidence-based medicine. Which is a phrase that you’re going to hear more and more about, I think, in medical research circles. A lot of medical organizations are now really working to pull together all the relevant research evidence on a given medical topic, use expert analysis to figure out what the most important findings are and then really put together a comprehensive set of information and recommendations that consumers can use.

This is a huge job, but it’s something that we are working with a partner to try to approach in this new site, which is ConsumerReportsMedicalGuide.org. This is a site that we just launched last month. It’s a paid subscription service. We’ve designed it to be a single reliable source for research-based information on medical problems, treatments and drugs.

Now, we did not come up with all of this ourselves, because this is outside of our scope. But what we’ve done here is we’ve partnered with the British Medical Journal Publishing Group, which has really been a pioneer in working on evidence-based medicine. Some of you may know they publish a book called Clinical Evidence, which goes to about a half a million doctors in the U.S., which is really a compendium of looking at research from all over the world and saying, okay, what do we believe are best practices and treatments for different kinds of diseases and conditions, based on the best available research. That’s become a very important source book for doctors.

What we’ve done is we’ve translated it into a form that can be used by consumers. We’ve started with about 60 medical conditions. We’re going to be adding more, and we’ve also added a database of 900 drugs from the American Society of Health Systems Pharmacists.

So this is at least one approach to answering that question of how do you ensure the quality of information online? How do you work with a trusted source through another trusted source to really bring together information that is research-based and follows some basic guidelines about the quality of information?

This is also, by the way, done at a 6th grade reading level, but with a level of depth and interactivity that we think will be very helpful to people at any educational level and it’s gotten very good response from consumers so far.

The next one I wanted to talk to you about is Consumer Reports Best Buy Drugs, or CRBestbuydrugs.org. This is a free site – the Medical Guide is subscription-based — and it’s foundation-funded. We launched it last December. There are some brochures and material which I see a lot of you have already taken outside and hope you find it of interest.

But this is also another approach to using evidence-based medicine, to sort out, in this case, how can people find lower-cost drugs that are equally effective as the ones that may cost twice or three or four times as much. And here the evidence base is a multi-state research project called the Drug Effectiveness Review Project, which has pulled together drug information, again, from all different kinds of sources. We worked with them to make this accessible to consumers.

We’re also very gratified because Forrester has just issued a report on our site and other drug comparison sites and they said, quote, “Consumer Reports sets a high standard for helping consumers with prescription decisions”, unquote – and they said we could quote them. So that’s very nice.

So we feel we’ve gotten actually a tremendous public response to this. And, again, it’s a different evidence base than the Medical Guide, but it’s the same idea of taking a well-processed and well-created medical database and working with that.

And then, finally, look at our last slide, we’ve started to use the Web to try to change the medical marketplace through awareness and advocacy. Now, this is the home page of Prescription for Change. This is an advocacy site where we’re enlisting people to help push for legislation to make drugs safer and make information about them more easily available.

Now, since last fall, more than 100,000 people have helped us in this online campaign. And they’ve sent more than 400,000 emails to Congress and their state representatives. This is on issues like the clinical trial registry – you know, to have an open registry of information about drug trials. That’s something we’re pushing for very hard and we found that it’s really hit a nerve with consumers.

And the last thing I want to show you and tell you about is the fact that we have found, as I’m sure many of you have, that if you want to reach consumers on the Web, it helps to be a little bit clever about it. So over there you can see a little preview there, the dancing pill movie.

This is – I have to tell you, this is one of my favorite things thatConsumer Reports has ever done. What happened is that somebody in our Texas office – an advocate named Kathy Mitchell – had the inspired idea to create a song that was a parody about the drug industry and use this song to get people interested in the issues. So she went to one of our most used consumer sources, which is a band called the Austin Lounge Lizards, and got them to create a song called, “The Drugs I Need,” and found a company to do an animation for it. And then we started making it available over the Web.

Well, this thing has become a major, like a monster hit. It’s been written up in The New York Times, it’s been featured on JibJab. It’s been shown on the “Today Show.” We estimate that more than one and three-quarter million people have seen this thing online now. And it has been a very, very effective way to reach people, start to educate them and engage them in a serious issue.

So I’d like to show you this, really because I just sort of can’t resist it and just to have a little fun before lunch. So, do we have the DVD working? Can the pill dance? Let’s see.

[Video plays]

So, what can I say? It’s all about using the Web to reach people, change the marketplace, have some fun at the same time. That’s what we’re trying to do at Consumer Reports and at WebWatch.

Thank you very much. If there are any quick questions, I’d be happy to take them, and then we should all get out to lunch. Yes?

Speaker: [unintelligible]

Joel Gurin: Beau, you’re really more familiar with that, too, you want to speak to that?

Beau Brendler: [unintelligible] — you have been saying is that those are part of the nature of the way people are making money on the Web and we’re not against that. It’s just, the issue that we keep hitting on is disclosure, so we would just like to see those kinds of things more clearly disclosed.

Joel Gurin: I would say one of the things that we’ve learned over many years as information publishers at Consumer Reports is that what you think you are being clear about is not always clearly understood. So you know this in publishing all the time. You can put something out there, you can label something, you do anything and people may not really get it. And I think the finding from our study is not necessarily even so much that people hate the idea of any kind of advertising, they just want real transparency about what it is, and even terms that we all use all the time are not always clear to consumers. Which is I think a somewhat different kind of issue.

Anything else? Okay, have a good lunch and enjoy. See you afterwards.