CMPI has concerns about those searches. They dropped a report into the inbox titled “Insta-Americans: The Empowered (and Imperiled) Health Care Consumer in the Age of Internet Medicine.”

The group presented a look at searches for Crestor, a cholesterol medication; Avandia, a diabetes drug; teen suicides and Selective serotonin reuptake inhibitor (SSRI) drugs; and autism and vaccines.

“The Web is home to many important sources of authoritative medical information including the National Institutes of Health, its related National Library of Medicine and medical specialty group web sites,” said CMRI. “However they are rarely the sites that show up or are seen first.”

Peter Pitts, a former FDA associate commissioner and contributor to the CMRI report, criticized the heavy presence of lawyers, attorney referral services, herbal alternative treatments, and information websites run by people and groups “ideologically opposed to pharmaceuticals.”

Interesting stuff, to be certain. But when this kind of report drops over the transom, so to speak, from a new source, we’re always curious about who’s passing these juicy tidbits along.

A search on Google for Pitts shows his associate commissioner position as being for external relations at FDA. In other words, a marketing position.

An odd choice to head up something called Center for Medicine in the Public Interest. We had the naïve expectation a doctor or similar professional would be running the show. Curiouser and curiouser, we decided to poke this soft underbelly a little more.

A link from Counterpunch proved interesting. Pitts and CMPI vice-president Robert Goldberg both worked for the FDA, as have other members of CMPI.

Counterpunch writer Evelyn Pringle, writing about the FDA and the scandal around Avandia’s potential for elevating the risk of heart attacks and death from cardiovascular episodes, discussed the attempts to discredit the Cleveland Clinic and its researcher who published the Avandia findings, Dr. Steven Nissen.

Pitts defended FDA spokesman Douglas Arbesfeld in June 2007, a month after Arbesfeld attempted to discredit Nissen and the Avandia study with the media. Arbesfeld was disciplined by the FDA for his actions under the role of FDA spokesperson.

Pringle called CMPI “a whole nest of ex-(pharmaceutical industry) moles who served the industry in one capacity or another in the Bush Administration’s FDA.” One current CMPI advisor, Daniel Troy, a former chief counsel for the FDA, helped get preemption in place for the drug companies.

“This “assertion of preemption” says that, as long as the FDA has approved a drug and its label, private citizens in state courts cannot sue the drug company for failing to warn about a product’s serious health risks, even in cases where it can be shown that the company concealed studies that revealed the risk from the public and the FDA,” wrote Pringle.

Now, we have our issues with Google, especially on the topic of privacy, the purchase of DoubleClick, and the potential for one company to be able to tap information on roughly 85 percent of the Internet-using public. We’re curious about CMPI’s motives in doing this study.

The issues CMPI raises regarding search results have been the kinds of topics Google continually tweaks its algorithm to rank appropriately. Our searches for Crestor and Avandia found links to side effects, warning/recalls, and other relevant topics atop the search results, but under the AdWords box which had a lawyer ad for Avandia and a third-party cholesterol remedy ad for Crestor.

While the safe option would be to say “ask a doctor for advice,” we have to note a couple of instances where Google’s search proved successful in helping someone with a medical condition when conventional approaches, including doctor’s visits, did not.

Dilbert creator Scott Adams suffered from a strange affliction that seemed to tie a throat affliction to a hand affliction. Through Google, Adams discovered a rare neurological condition called a spasmodic dysphonia that matched his symptoms.

A specialist confirmed what Google revealed to Adams, who was treated successfully. One has to give Google credit for pulling together the details Adams needed, when he needed them.

Similar cases have been noted elsewhere. Google isn’t an MD, and certainly isn’t perfect when it comes to clinical diagnoses. But throwing a blanket of mistrust over it for healthcare searches isn’t an appropriate course of action either.

Which isn’t much. I put that out there so others won’t have to.

I also make that disclaimer in advance of what is a grander, more important topic: To what extent is the so-called "Googlization of reality" affecting our understanding of the world around us? The answer may not be so available and everybody with a stake in it will give you different answers.

If you took the Internet’s word for everything, you might believe that Ron Paul is a Republican frontrunner or that the elephant population has tripled in the past six months (see Stephen Colbert’s "wikiality" social experiment).

Clearly, information on the Internet (even Google) isn’t perfect, and knowing your source is paramount, hence my opening disclaimer.

The Center for Medicine in the Public Interest (CMPI) is a medical industry thinktank, fronted by former Bush Administration FDA officials. CMPI released a study this week outlining the perils of relying on Google for prescription medication information.

“What we found was not only disturbing, but dangerous to public health,” said CMPI vice president Robert Goldberg. “For millions of Americans, Google has replaced the family physician. People trust, and make decisions, based on the information they find online. With few exceptions, the information we found appeared legitimate but had no medical authority whatsoever. In many cases, we found lawyers posing as medical experts.”   

For searches on keywords like "Crestor side effects" and "Avandia side effects" CMPI found:

• 65% of the first three pages of search results came from sites which were biased or contained unverified information.
• Almost half of the first three pages of search results belonged to lawyers and attorney referral services seeking plaintiffs for class action lawsuits.
• Zero official regulatory pages or professional medical organizations appeared in the inventory of results.

Crestor is a cholesterol medication made by AstraZeneca and Avandia is a type 2 diabetes drug produced by GlaxoSmithKline.

Many of the results also referred to "unmoderated" patient forums, sites selling or promoting "alternative medicines" or were sites run by, as CMPI describes them, "anti-pharmaceutical activists."

All of these concerns and findings are published in a 33-page paper entitled "Insta-Americans: The Empowered (and Imperiled) Health Care Consumer in the Age of Internet Medicine." Similar concerns were voiced about selective serotonin reuptake inhibitors and their (Internet) relationship to teen suicide rates and links between vaccinations and autism.

"Much like our email boxes are filled by ‘spam’ urging us to collect millions from Nigeria or confirm our banking information from phony Ebay or Bank of America security sites, a lot of the medical ‘information’ on the Web is designed to sell, deceive or frighten, rather than inform," said Goldberg.

Citing a Pew report, CMPI 113 million Americans search for health information, but three quarters rarely check the sources of the information.

According to Peter Pitts, CMPI President and former Associate Commissioner for External Affairs for the FDA, "it is important to remember that not everything online is true. The Internet has made it easier than ever before for charlatans and quacks to spread fear and misinformation. Mark Twain wrote: ?’Beware of health books. You might die of a misprint.’ The same can now be said of the Web."

And that can really affect pharmaceutical sales. Because doctors were afraid of lawsuits and patients were afraid of, you know, death, Avandia prescriptions had declined by 60 percent as September 2007.

Of course, it could also have something to do with the black box warning the FDA put on Avandia about increased heart problems. If you use a less targeted keyword, like simply "avandia," you’ll find that official government warning (and one for Crestor, too), along with official pharmaceutical company pages, scores of lawyer-sponsored AdWords links, pages from WebMD, the Mayo Clinic, the New York Times, USA Today, and a group called Public Citizen which runs a site called WorstPills.org.

Pitts and Goldberg aren’t especially fond of that last group, and single out Dr. Sidney Wolfe, who runs the site, as a source of misinformation about Avandia. Wolfe joins several others with lots of letters behind their names on the site’s About page. Maybe it’s because Wolfe has a close relationship with Ralph Nader, that CMPI labels them an anti-pharmaceutical activist group. Who knows?

But Wolfe’s opinion of Avandia match a Cleveland Clinic doctor named Stephen Nissen, whose May 2007 New England Journal of Medicine article about the drug CMPI cites as a "common source of misinformation." Dr. Nissen’s viewpoint however is echoed by a Toronto endocrinologist in this more recent (December 2007) USA Today article.

So why fixate on these drugs in particular? You could present a number of theories. CMPI is partially funded by the pharmaceutical industry, the Lilly Endowment (connected to Eli Lilly) being one of the largest contributors. Patients shying away from pharmaceuticals is bad for business.

A clue could be in reporter Evelyn Pringle’s article about Avandia, the FDA and CMPI. Pringle labels CMPI as "a home for industry hit men who served in the Bush Administration’s FDA." Pringle explains in detail Pitts’ and Goldberg’s association with Manning, Selvege & Lee, a PR firm representing many pharmaceutical companies, including AstraZeneca, and with FDA spokesman Douglas Arbesfeld, who has a close relationship with GSK.

But I’m sure that has nothing to do with their opinion on what is misinformation and what isn’t.

The extra-cynical of us might also notice CMPI’s definite stance against regulation of the health care industry and any type of universal health care. Those cynics might get really crazy and suggest that by advocating a greater reliance on your doctor and the drugs he or she prescribes rather than moonbat alternatives cuts down on the perception that there are flaws in the health care industry in its current privatized state. Plus, with obesity rates the way they are, diabetes medicines are big, big money.

But that’s just crazy right?

Well, anyway, CMPI says to check your sources, especially those sources found on Google, the nation’s most popular search engine, where most online health research begins. Sometimes people manipulate the information to suit them.   
 

But you might also conclude that a variety of sources is a good thing. I could be wrong. After all, I did all my research for this article on Google.