Mayo Clinic and Google Knowledge Panels

Last week Paul Levy, one of the early hospital CEO bloggers who is now blogging at Not Running a Hospital, came across what he thought was a significant issue with Google’s new medical search knowledge panels that incorporate information from Mayo Clinic and other sources.

Prostate Cancer SearchThe main issue he raised related to the Prostate Cancer panel, and particularly that robotic surgery was listed first among surgical procedures (instead of alphabetically), with watchful waiting listed among “Other treatments” under the “Also common” heading. Or as he put it:

Observers want to know:  Does this nonalphabetic list represent Mayo Clinic’s view of the most likely, highest priority, or most recommended approach to this disease?

Open the prostate cancer search in a new window and review the panel for yourself. Then come back here for some thoughts. I’ll wait.

Since he published his post, Mr. Levy has tweeted about the topic at least 15 times, starting with this one..

Also, on Saturday Mr. Levy published a related post, this time asking whether Mayo reviewed the “Ad” about Multiple Sclerosis, and questioning its accuracy.

Since he specifically mentioned me in the first post, and because I work at Mayo Clinic, I looked into the process. Far from being anything sinister, I think it’s a really positive educational service that puts reliable health information at the top of Google’s health search results, above any advertising.

Here’s how I understand what’s happening:

  1. Mayo Clinic provided a brief definition for each of about 400 diseases and conditions.
  2. Google drew information from various sources as listed here, (MayoClinic.org was one of them), and created a three-panel display for each topic with an overview, symptoms and treatments.
  3. Mayo Clinic staff reviewed the content of the panels, including treatments ranging from medicines to surgical procedures to diet and lifestyle modification. This did not include a review of list ordering, but only whether the treatments in the list are among the valid options.
  4. Each panel includes a link to the relevant page on MayoClinic.org, such as this one on prostate cancer, for a complete and balanced review of the topic.
  5. These Knowledge Panels aren’t ads.

Back to Mr. Levy’s question…

Observers want to know:  Does this nonalphabetic list represent Mayo Clinic’s view of the most likely, highest priority, or most recommended approach to this disease?

The reality is, these panels do contain direct deep links to Mayo Clinic’s view for all 400+ diseases and conditions, ranging from ADHD and ALS to Heart Attack, PTSD and viral gastroenteritis.

And yes, prostate cancer too.

I’m more mystified at Mr. Levy’s criticism of the MS panel, especially as expressed in this tweet:

The issue he raised is with the number of cases:

MS numbers

Mr. Levy says he did some searching in the National MS Society Web site and found that the estimated number of cases worldwide (his emphasis) is only 2.3 million. But here is the quote in context:

More than 2.3 million people are affected by MS worldwide. Because the Centers for Disease Control and Prevention (CDC) does not require U.S. physicians to report new cases, and because symptoms can be completely invisible, the prevalence of MS in the U.S. can only be estimated. The Society continues to advocate for the establishment of a national registry that will track the number of people living with MS and has made a commitment to re-evaluate the current prevalence estimate and investigate the process by which an updated estimate can be identified. (Emphasis mine this time.)

The Google Knowledge Panel, which Mr. Levy says is “impairing Mayo Clinic’s credibility,” puts the number of U.S. cases of MS in the 200,000 to 3 million range. This WHO report estimates the prevalence at 135 per 100,000 population in the U.S.

The countries reporting the highest estimated prevalence of MS include Hungary (176 per 100 000), Slovenia (150), Germany (149), United States of America (135), Canada (132.5), Czech Republic (130), Norway (125), Denmark (122), Poland (120) and Cyprus (110).

That would put the number of cases in the U.S. at something well over 400,000. And the MS Society seems to indicate (from the passage quoted above) that U.S. cases are likely understated.

The Google Knowledge Panel uses four classes of disease prevalence, based on number of U.S. cases:

  • Very Rare (<20K cases)
  • Rare (20K to 200K)
  • Common (200K to 3 million)
  • Very Common (More than 3 million)

The categories are admittedly broad: Ebola is accurately in the Very Rare group, although the number of U.S. cases is way below 20K. It’s less than 20.

The range is big, but it’s not wrong.

And 400,000 cases of MS in the United States is in the Common range.

Finally, these Knowledge Panels would have happened with or without Mayo’s participation. We had the opportunity to share some of our knowledge via the definitions. We provided content review to help ensure that accurate, reliable health information appears at the top of search results, and and we offered direct links to deeper information on MayoClinic.org. We started with 400 medical topics and plan to work with Google to add up to 600 more.

I hope these answers to Mr. Levy’s questions are helpful.

I’m confident that the panels themselves will be.

Bringing the Social Media Revolution to The Last Frontier

I’m excited to be at the Alyeska Resort in Girdwood Alaska today to speak to the Alaska State Hospital and Nursing Home Association.

The trip here helped me understand just how big Alaska is, and how far it is from the lower 48. One little-known fact (at least I didn’t know it): The flight from Seattle to Anchorage is the same length (about 3 hours and 15 minutes) as the flight from Minneapolis to Seattle.

Once I got to Anchorage, it was a relatively short, but amazingly scenic, trip down AK-1 to the Alyeska Hotel. The highway has lots of places to pull over for photos, and while a photo can’t really show the full beauty, here’s a taste (click to enlarge):

AK-1 Big

One extra positive of coming to present in Alaska is that it’s highly unlikely that many of the participants have heard me speak previously. That lets me do a best-of-the-best presentation. My slides are embedded below:

I look forward to the discussion today, and welcome your comments and questions.

Illustrating the Health Care Social Media Revolution

The Association of Medical Illustrators is holding its annual conference in Rochester, Minnesota this week, and my colleagues in Mayo Clinic Creative Media asked me to be part of the program, discussing our growth and application of social media at Mayo Clinic. Here are the slides I’m using:

I had stopped by the conference briefly yesterday and was impressed by the energy and enthusiasm in the room. It will be a quick ride; my presentation time is 20 minutes…so I want to have the slides here for review. I look forward to the discussion!

Celiac Chancellor

Last Saturday morning I had the pleasure of participating as a patient in the weekly Mayo Clinic Radio program. This edition was all about Celiac Disease, and the guest expert was Dr. Joseph Murray, a Mayo Clinic gastroenterologist who also happens to be my doctor.

Listen to the archived segment here.

I come in at the 14:45 mark, but the whole thing is entertaining and informative.

Mayo Clinic is a leader in research and providing information to patients on Celiac Disease. One of our initiatives is the Celiac Disease Blog, which launched late last year.

Here is our Celiac Disease playlist from the Mayo Clinic YouTube channel:

What’s Next Big Thing in Health Care Social Media?

It’s an understandable question, and one I’m frequently asked. In fact, it came up again this morning in a phone conversation.

Those who ask it typically are looking for tips on the new, cool platform that everyone will be using next year, and that currently is relatively unknown or obscure to the broader population.

The answer that came to me is one that I think will become my new standard:

The next big thing in health care social media will be that social media in health care isn’t a big thing.

I’m not saying that social media won’t be important in health care: I think it will be just the opposite. Social media tools will be incorporated throughout health care, and will be vital elements in all of our communications.

But they won’t feel big because they’ll just be normal. They will have become accepted as a standard way of working. They’ll be as unremarkable as email is today.

That’s when social tools will have realized their enormous potential: when using them becomes standard operating procedure.

Interestingly, just a couple hours after the first conversation, I had a wide-ranging and stimulating discussion with a gentleman from Germany, Peter Carqueville.

Peter PhotoWe enjoyed our video discussion via Skype, and I reminisced about my college days in the early 1980s, when I had to wait in line on Sunday night for the one phone on our dorm floor, to make an expensive collect call. I talked about how amazing it is that today we can talk across seven time zones and an ocean, and that it’s free.

But Peter topped my story: while I looked back on what seemed to be scarcity of telecommunications access,  he had grown up behind the Iron Curtain in what was formerly East Germany, where most families didn’t even have phones.

The next big thing in health care social media will be when we come to take use of social tools for granted as we do unlimited cell phone minutes and text messaging — and free video calls via Skype and Goolge+ — today.