Barney Frank is Awesome

He really needs to teach every other Democrat how to do this:

At Least One Guy Gets It...

(click to embiggen)

In search of a credible search engine

The internet is obviously a wonderful source of information. Unfortunately, a lot of that information isn't actually true.

The misinformation isn't usually intentionally malicious. It's just the byproduct of every dumbass with a computer having the ability to put their own mistaken beliefs on the web. Some of the resulting misinformation is more widely-believed than the actual truth, and this leads to problems.

Google is really a very good search engine. I use it all the time, and generally the first few results you get from a Google search are decent enough. But not always.

Recently, I've been contemplating how much better searching would be if the results for certain kinds of searches were sorted not by popularity, but by credibility. Far too often have I encountered search results where the misinformation heavily outranked the truth.

Well, as it turns out there are at least two search engines out there who claim to promote credible information on searches related to health care (but nothing much else at this point). Since bad healthcare information dominates the internet, and since that misinformation can actually have pretty severe consequences for people who believe it, health information seems like a great place to start.

Today I'm going to examine these two new search engines and compare their results to Google on a number of health issues. Let's see how they work.

The following search engines will be used:

• Bing - this is Microsoft's recently-renamed search engine, that they stupidly choose to call a "decision engine." I don't know what that means either. Wikipedia (itself not exactly the most credible source) describes its "Bing Health" search services as follows:

  Bing Health (previously Live Search Health) is a health-related search service as part of Microsoft's Bing search engine. It is a search engine specifically for health-related information through a variety of trusted and credible sources, including Medstory, Mayo Clinic, National Institutes of Health's MedlinePlus, as well as from Wikipedia.

• hakia - I just discovered this one last night. It's still in beta, but does make a very concerted effort to provide credible information. As they describe it, hakia gets librarians to submit credible sources, and require a source to be peer-reviewed, lack commercial bias, have current information, and not be controlled by outside parties for it to be considered credible. At this point, their credible search element is limited to health and environmental information.
• Google - really needs no introduction.

I'll be using a few different health-related search terms to see how these three compare. They are:

• diabetes - basic, easy one to start with.
• vaccine ingredients - simple enough, just give me accurate information on what's in vaccines.
• swine flu - because big stories draw scammers.

I'll submit each of those italicized search terms to the three engines, and let's see what we end up with. I'm only going to deal with the top five results from each, because that's where the vast majority of people are going to end up.

Test #1 - diabetes

Google - The first five results (discarding ads, duplicates from the same domain, and news results) are pretty good. At the top is the American Diabetes Association, with WebMD, a journal of diabetes, and NIH information in the top five.

Unfortunately, this site ranks third, and it's little more than a marketing site for the pharmaceutical company GlaxoSmithKline. Pretty blatant conflict of interest there.

Bing - Bing separates its results out into different categories (like "Diabetes Symptoms," "Diabetes Prevention," etc). I'm just going to use the top-level stuff that doesn't have a subheading, and again ignore the ads at the top.

Bing does okay here. The top results is from the Mayo Clinic, who clearly have partnered with Microsoft here. Second is the ADA. Third is Wikipedia's article on diabetes, which is not exactly what I'd consider a credible source (Wikipedia articles are a great example of popular ideas winning out over true ones). GSK's little propaganda site is up there too.

hakia - A search at the default hakia.com domain brings up a special diabetes page. All the information seems pretty good, with the ADA, Mayo Clinic, and some other fairly respectable sources of information available. Notably absent are GSK's site and Wikipedia, which is nice.

Clicking on the "credible" tab for results gives us several PubMed articles, as well as a couple of top results for the Northwest Coalition for Alternatives to Pesticides. Which is a decently reality-based page, but probably not what you're actually looking for if you just search for "diabetes."

Verdict! - They're all pretty decent, actually. hakia is maybe a tiny bit ahead for keeping out GSK and Wikipedia, but loses points for relatively useless "credible" results. Let's call this one a tie.

Test #2 - vaccine ingredients

This one is going to be interesting. There's a large antivaccination contingent on the internet, so getting accurate information about what's actually in vaccines is tricky.

Google - It's not pretty. The top two results are both antivacine sites, publishing lists of dubious quality to try to scare people away from vaccines. Lots of talk of thimerosol, which crazy people insist causes autism despite tons of evidence to the contrary.

The third result is the CDC, which is the only credible source in the top five. Then it's back to the antivaccine propaganda. Just below the CDC, we even get Rense.com. One look at that site should be enough to show just how credible their information is.

Bing - Holy crap. Google's results were already horrible, but Bing's are even worse. Rense has moved up to the top spot, with the even more batshit-insane Whale.to taking up third place. The entire top 10 is utter crap, except for the CDC at number 8. Horrible results.

hakia - Well, the "Web Results" are still incredibly bad. But hakia does put the "Credible Sites" right next to them.


So we have batshit insanity right next to very good stuff. It would be nice if the credible stuff actually showed up in the general "web results" too, but perhaps that's something that will come about at a later stage (note that hakia is still in beta). Additionally, hakia's credible results are poorly-ranked. They skew towards overly-specific when people are looking for general information. Again, this is something that might be worked out later.

Verdict! - They all suck, but hakia sucks slightly less than the others. Bing is actually even worse than Google, despite their claim to provide credible health information.

Test #3 - swine flu

Google - Not too bad. The CDC's excellent swine flu portal is in the top position, with the rest of the top five rounded out by Wikipedia, a mostly-reasonable but ad-heavy medical portal, the World Health Organization, and Medline. Wikipedia's presence is probably okay in this case, because of H1N1's newsworthiness.

Bing - Again we get the Mayo Clinic at the top, with Wikipedia following close after. Then some stuff from the Guardian which is pretty reasonable.

But right after that we get a really stupid blog, which has a lot of bad information (like telling you to disinfect your shoes, which is just dumb) and appears to be a veiled attempt at selling you an herbal supplement. It's a scam site part of a network of identical scam sites, plain and simple.

Overall, the Bing results for swine flu appear to be about 20% credible and 80% scams and bullshit.

hakia - Pretty good! The credible results are indeed very credible, though they once again suffer from not being particularly relevant. The normal results are also pretty credible, and there's nary a scam to be found. The normal results do skew a little newsy at times, but overall not too bad.

Verdict! - Google and hakia both win this round. They avoided nonsense and provided good information. hakia's "credible search" is still giving good, but often irrelevant results, but their normal search made up for it. Bing was fine for two links and then turned to crap.

Results

I had intended to do a couple more test searches, but this is getting lengthy and there's a pretty clear pattern emerging.

Basically, when it comes to health information your best options are either Google or hakia. Google has a lot of bad stuff mixed in, but the top few results are usually decent. hakia has a way to go before it's truly useful, but the credible results it delivers are certainly credible. They're just not necessarily very relevant. If it works out the kinks, maybe by the time it's out of beta it'll be something quite good.

Bing, on the other hand, sucks really hard. I'm not sure how a search engine that goes out of its way to provide credible health information managed to provide worse information than Google (which makes no such attempt), but it did. Avoid this one.

Also notable is that all our engines did pretty badly with the vaccine ingredient search. This was not the least bit surprising, and is actually the reason why I chose that term. Faced with the tons of stupid out there, hakia seemed to do the best. Dealing with these sorts of controversial topics may be the most difficult test of a search engine, so hakia's relatively good performance may signal good things on the way.

Of course, it's necessary with any search engine to use your own critical thinking skills and actually sort out what's true from what's not. Even the most credible and well-respected sites can contain errors, and no search engine is going to be able to make the final call for you.

Hopefully we can reach a point where a simple health-related search can bring back mostly-credible results instead of mostly-nonsense results. There's still a way to go, but it's good to see some people trying.

Swine Flu: What to do, and not do

There's a lot of news about swine flu right now, and for good reason. While it's impossible to know at this point whether this will lead to a flu pandemic, the potential does exist.

There's a lot that's still unknown about this flu strain, but there are some basic things that people can do--and other things people should avoid--at this point. I'm not going to offer medical advice, since I'm not qualified to do so, but most of this stuff is pretty simple.

Let's start with what you can do to protect both yourself and others. Most of these should be obvious, but they're worth repeating anyway.

1) Wash your hands. Use hot water and soap. A quick splash is not enough, you need to spend a bit of time. Recite the alphabet to yourself while doing it, and by the time you're done that should be about enough time. If you're unable to get to a sink for whatever reason, you could carry around some Purell or a similar product to sanitize your hands.

2) Cover your mouth if you cough or sneeze. But don't sneeze into your hand! If you have a tissue, use that and then throw it away immediately. Don't keep a used-up disease rag in your pocket. If you don't have a tissue, then cough or sneeze into your elbow, like this:


Yeah, you might gross up your inner elbow, but it's better than getting gunk on your hands and then spreading it to others, or sneezing unimpeded and spewing germs all over the room.

3) Learn about the flu. As with any fast-moving and poorly-understood disease, there's going to be a ton of bad information out there. Inoculate yourself against it with good information.

Here are some good resources:

• The Center for Disease Control's Swine Flu page - Good general clearinghouse.
• Pandemicflu.gov - Also handy if you're still worried about Avian Flu!
• The World Health Organization's swine flu page - Another good clearinghouse for information.
• Effect Measure blog - A blog written by epidemiologists and public health officials. Provides better context and analysis than simple press releases.
• H5N1 blog - One of the better "flu blogs" out there. Is covering H1N1 (swine flu) extensively.

Most of these sites also provide a lot of links if you want even more information.

4) Don't kiss any pigs. This is just a good rule in general.

So, those are a few simple things that you can do to cut your own risk and the risk you might pose to others if you happen to get infected. Now on to things you really should not do.

1) Don't go to work/school/public events if you're sick. Going out in public while sick doesn't mean you're tougher than the disease, it means you're a jerk who doesn't care about making everyone else sick. Unless you really want to be known as the guy/girl who spread disease to all your friends, just stay home.

2) Don't stick your hands in your mouth, eyes, or nose. Again, obvious. Even if you think your hands are clean, the mouth, eyes, and nose provide an easy way for diseases to get into the body. Best just to avoid them.

3) Don't listen to quacks. You're going to see a lot of scammers offering totally ineffectual "cures" over the next few weeks. There will be spam emails trying to sell you imaginary medicines, there will be people offering the insanely diluted liver of a diseased duck as a medicine, there will be holistic "healers" and homeopaths aplenty offering you products that are nothing more than a placebo. Don't waste your money.

4) Don't blame Mexico. I include this only because I've already seen people trying to use this outbreak to grandstand about illegal immigration (Google "swine flu" + immigration and you'll find lots of examples). That's utterly absurd. This outbreak could have started anywhere, and viruses don't care one bit about political borders. People who try to tie this to immigration are playing politics in the stupidest possible way.

5) Don't panic. Panic never helps, and there's no reason for it anyway. While H1N1 has the potential to become a pandemic, it's impossible to know how it will turn out at this early stage. There's a lot more we don't know about this flu strain than there is stuff we do know, so don't freak yourself out by jumping to conclusions that aren't based on fact.

As always, these lists are incomplete. But these are easy things to do, and they're good ideas even when there isn't a potential pandemic looming on the horizon.

The truth about Massachusetts' universal health program

So, every couple of months I decide I'm going to do a big, well-researched post on the Massachusetts "universal" health care system and its many failings.

This desire is typically brought on by hearing some politician or public figure praise the Massachusetts system as being "proven to work," or suggesting it should be used nationally. At this point steam starts coming out of my ears in a comical fashion and I decide to write a post that will show everyone just how misled they've been.

Then I get distracted playing video games or something.

Lucky for me, Physicians for a National Health Program have done the dirty work for me, and prepared an extensive report citing the many reasons why Massachusetts would be a crummy model. It is absolutely worth a read.

Of if you're lazy, at least have a look over their press release.

If you're too lazy to even do that, here's part of the executive summary:

The reform has been more expensive than expected, costing $1.1 billion in fiscal 2008 and $1.3 billion in fiscal 2009. In the face of a state budget crisis in fall 2008, Gov. Deval Patrick announced that he will keep the reform afloat by draining money from safety-net providers such as public hospitals and community clinics.

While the number of people lacking health insurance in Massachusetts has been reduced, several recent surveys demonstrate that substantial problems in access to care remain in the state. While the new health insurance improved access to care for some residents, many low-income patients who previously received completely free care under the state’s old free care program now face co-payments, premiums and deductibles that stop them from getting needed care.

In addition, cuts to safety-net providers have reduced health resources available to the state’s remaining uninsured, as well as to others who rely on safety-net providers for services in short supply in the private sector. These safety-net services include emergency room care, chronic mental health care, and primary care. The net effect of this expensive reform on access to care is at best modest, and for some patients, negative.

By mandating that uninsured residents purchase private health insurance, the law reinforced the economic and political power of health insurance firms. Thus, the reform augments the already high administrative costs of health care. Moreover, the agency that administers the new law (the “Connector”) adds an extra 4 to 5 percentage points to the already high overhead of private health insurance policies.

The reform failed to reduce overreliance on expensive, high-technology services. Indeed, some of its provisions such as changes in Medicaid rates and cuts to safety-net providers (who do more primary care) have further tilted health spending toward expensive, high-technology are.

A solution is also offered, though you're going to have to go at least read the report to find out what it is (hint: it rhymes with "Pringle slayer").

Now I'm off to go play video games. Later, chumps!

A less good quote

From John McCain, here (pdf):

Opening up the health insurance market to more vigorous nationwide competition, as we have done over the last decade in banking, would provide more choices of innovative products less burdened by the worst excesses of state-based regulation.

Yes, let's model healthcare after the banking industry. It's doing just great.

Update: What's Palin's take on healthcare? I was able to dig that up too.

Reporter: Do you agree with Senator McCain's attitudes towards health insurance deregulation?
Palin: In what respect, Charlie?
Reporter: My name's Frank.
Palin: I can see Russia from my house!