The man helping prevent suicide with Google adverts

Looi, M.-K. (2023).

BMJ.

https://doi.org/10.1136/bmj.p2847 

Here are two excerpts:

Always online

A big challenge in suicide prevention is that people often experience suicidal crises at times when they’re away from clinical facilities, says Nick Allen, professor of psychology at the University of Oregon.

“It’s often in the middle of the night, so one of the great challenges is how can we be there for someone when they really need us, which is not necessarily when they’re engaged with clinical services.”

Telemedicine and other digital interventions came to prominence at the height of the pandemic, but “there’s an app for that” does not always match the patient in need at the right time. Says Onie, “The missing link is using existing infrastructure and habits to meet them where they are.”

Where they are is the internet. “When people are going through suicidal crises they often turn to the internet for information. And Google has the lion’s share of the search business at the moment,” says Allen, who studies digital mental health interventions (and has had grants from Google for his research).

Google’s core business stores information from searches, using it to fuel a highly effective advertising network in which companies pay to have links to their websites and products appear prominently in the “sponsored” sections at the top of all relevant search results.

The company holds 27.5% of the digital advertising market—earning the company around $224bn from search advertising alone in 2022.

If it knows enough about us to serve up relevant adverts, then it knows when a user is displaying red flag behaviour for suicide. Onie set out to harness this.

“It’s about the ‘attention economy,’” he says, “There’s so much information, there’s so much noise. How do we break through and make sure that the first thing that people see when they’re contemplating suicide is something that could be helpful?”

(cut)

At its peak the campaign was responding to over 6000 searches a day for each country. And the researchers saw a high level of response.

Typically, most advertising campaigns see low engagement in terms of clickthrough rates (the number of people that actually click on an advert when they see it). Industry benchmarks consider 3.17% a success. The Black Dog campaign saw 5.15% in Australia and 4.02% in the US. Preliminary data show Indonesia to be even higher—as much as 12%.

Because this is an advertising campaign, another measure is cost effectiveness. Google charges the advertiser per click on its advert, so the more engaged an audience is (and thus what Google considers to be a relevant advert to a relative user) the higher the charge. Black Dog’s campaign saw such a high number of users seeing the ads, and such high numbers of users clicking through, that the cost was below that of the industry average of $2.69 a click—specifically, $2.06 for the US campaign. Australia was higher than the industry average, but early data indicate Indonesia was delivering $0.86 a click.

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I could not find a free pdf.  The link above works, but is paywalled. Sorry. :(

Google bans ads for unproven medical treatments

Megan Graham
www.cnbc.com
Originally posted September 6, 2019

Google on Friday announced a new health care and medicines policy that bans advertising for “unproven or experimental medical techniques,” which it says includes most stem cell, cellular and gene therapies.

A blog post from Google policy advisor Adrienne Biddings said the company will prohibit ads selling treatments “that have no established biomedical or scientific basis.” It will also extend the policy to treatments that are rooted in scientific findings and preliminary clinical experience “but currently have insufficient formal clinical testing to justify widespread clinical use.” The change was first reported by The Washington Post.

The new Google ads policy may put the heat on for the stem cell clinic industry, which has until recently been largely unregulated and has some players who have been accused of taking advantage of seriously ill patients, The Washington Post reported.

“We know that important medical discoveries often start as unproven ideas — and we believe that monitored, regulated clinical trials are the most reliable way to test and prove important medical advances,” Biddings said. “At the same time, we have seen a rise in bad actors attempting to take advantage of individuals by offering untested, deceptive treatments. Often times, these treatments can lead to dangerous health outcomes and we feel they have no place on our platforms.”

The Google post included a quote from the president of the International Society for Stem Cell Research, Deepak Srivastava, who said the new policy is a “much-needed and welcome step to curb the marketing of unscrupulous medical products such as unproven stem cell therapies.”

The info is here.

We Need Data Ethics, Not Just Laws

Chad Wollen
www.adexchanger.com
Originally posted July 18, 2018

With consumer trust in brands at such a low point it is worth reflecting on a home truth: Companies neglected to put the producers of “big data” – consumers – at the heart of their approach to data.

The General Data Protection Regulation (GDPR), the latest step toward building a more transparent relationship between companies and the public, represents a boiling over of concerns about data use.

Far too often, the general attitude appears to be one of companies gaming to see how rules can be observed without the overall spirit being fully embraced. The next, and arguably bigger, step is the ethical one, because it is about companies acting on their own, not because they are ordered to, to do the right thing.

What is clearly needed is a set of ethics that steer what companies can do with data – a set of truths that the industry holds to be self-evident.

In April, the industry was given a good starting point with the World Federation of Advertisers’ call for companies to adhere to a four-point plan to improve data policies. If meeting consumer needs is not enough to drive change then maybe meeting the needs of advertisers will be, and data safety initiatives can follow other moves within the industry to address issues around brand safety and accountability.

The info is here.

CGI ‘Influencers’ Like Lil Miquela Are About to Flood Your Feeds

Miranda Katz
www.wired.com
Originally published May 1, 2018

Here is an excerpt:

There are already a number of startups working on commercial applications for what they call “digital” or “virtual” humans. Some, like the New Zealand-based Soul Machines, are focusing on using these virtual humans for customer service applications; already, the company has partnered with the software company Autodesk, Daimler Financial Services, and National Westminster Bank to create hyper-lifelike digital assistants. Others, like 8i and Quantum Capture, are working on creating digital humans for virtual, augmented, and mixed reality applications.

And those startups’ technologies, though still in their early stages, make Lil Miquela and her cohort look positively low-res. “[Lil Miquela] is just scratching the surface of what these virtual humans can do and can be,” says Quantum Capture CEO and president Morgan Young. “It’s pre-rendered, computer-generated snapshots—images that look great, but that’s about as far as it’s going to go, as far as I can tell, with their tech. We’re concentrating on a high level of visual quality and also on making these characters come to life.”

Quantum Capture is focused on VR and AR, but the Toronto-based company is also aware that those might see relatively slow adoption—and so it’s currently leveraging its 3D-scanning and motion-capture technologies for real-world applications today.

The information is here.

Facebook Uses AI To Predict Your Future Actions for Advertizers

Sam Biddle
The Intercept
Originally posted April 13, 2018

Here is an excerpt:

Asked by Fortune’s Stacey Higginbotham where Facebook hoped its machine learning work would take it in five years, Chief Technology Officer Mike Schroepfer said in 2016 his goal was that AI “makes every moment you spend on the content and the people you want to spend it with.” Using this technology for advertising was left unmentioned. A 2017 TechCrunch article declared, “Machine intelligence is the future of monetization for Facebook,” but quoted Facebook executives in only the mushiest ways: “We want to understand whether you’re interested in a certain thing generally or always. Certain things people do cyclically or weekly or at a specific time, and it’s helpful to know how this ebbs and flows,” said Mark Rabkin, Facebook’s vice president of engineering for ads. The company was also vague about the melding of machine learning to ads in a 2017 Wired article about the company’s AI efforts, which alluded to efforts “to show more relevant ads” using machine learning and anticipate what ads consumers are most likely to click on, a well-established use of artificial intelligence. Most recently, during his congressional testimony, Zuckerberg touted artificial intelligence as a tool for curbing hate speech and terrorism.

The article is here.

Don't Blame PPC, Blame Poor Ethics

Kyle Infante
Forbes.com
Originally posted on February 2, 2018

Here is an excerpt:

To sum up the entire debacle in a nutshell: Marketing entities would create referral ads and websites to bid on highly sought after addiction keywords, drive traffic to their call centers and send people to facilities-based purely on profit. There was no clinical or medical prescreening being conducted, no thought put into placing that individual with the appropriate level of care. Suffering addicts and alcoholics were being misled by strategic digital marketing tactics and pushed to the highest bidder. Often, these high bidders had a slew of ethical issues. This drove the cost per click for each ad through the roof, and soon enough only the Goliaths could compete on PPC (pay per click). Unless you had the money to hire an advertising agency or had an in-house marketer with extensive digital experience, there was no way to survive.

Recently, Google stepped in and placed restrictions on these ads to curb the gross abuse of the market. In September 2017, Google began to limit the kinds of ads facilities could create and just this year placed a temporary ban on all recovery ads to audit the entire industry.

The article is here.

Google Sets Limits on Addiction Treatment Ads, Citing Safety

Michael Corkery
The New York Times
Originally published September 14, 2017

As drug addiction soars in the United States, a booming business of rehab centers has sprung up to treat the problem. And when drug addicts and their families search for help, they often turn to Google.

But prosecutors and health advocates have warned that many online searches are leading addicts to click on ads for rehab centers that are unfit to help them or, in some cases, endangering their lives.

This week, Google acknowledged the problem — and started restricting ads that come up when someone searches for addiction treatment on its site. “We found a number of misleading experiences among rehabilitation treatment centers that led to our decision,” Google spokeswoman Elisa Greene said in a statement on Thursday.

Google has taken similar steps to restrict advertisements only a few times before. Last year it limited ads for payday lenders, and in the past it created a verification system for locksmiths to prevent fraud.

In this case, the restrictions will limit a popular marketing tool in the $35 billion addiction treatment business, affecting thousands of small-time operators.

The article is here.

Groups File Ethics Complaints Over State Department’s Mar-a-Lago Blog Post

Avalon Zoppo and Abigail Williams
NBC.com
Originally posted April 25, 2017

An ethics advocacy group has filed a complaint calling for an investigation into the State Department's glowing description of President Donald Trump's Mar-a-Lago club on its website.

The complaint, filed Tuesday with the Office of Government Ethics by the group Common Cause, is in response to a blog post published on the State Department's ShareAmerica website that referred to Mar-a-Lago as the "winter White House" and noted that it is open to paying members.

Published in early April, prior to a meeting with China's president Xi Jinping at the Palm Beach club, the post detailed the history of Mar-a-Lago and appeared on websites for the U.S. Embassies in the United Kingdom and Albania.

By Monday the post was removed, replaced by a brief note that said it was only meant to inform. "We regret any misperception and have removed the post," the note said. State Department Acting Spokesperson Mark Toner said Tuesday it was not intended to promote any private business.

The article is here.

Who Gets to Be a .Doctor?

By Carl Straumsheim
Inside Higher Ed
Originally posted March 26, 2015

Here is an excerpt:

“'Doctor' itself is a generic term and has a wide variety of uses,” Nevett said, using a “lawn doctor” as an example. “If we limited this top-level domain to just licensed medical practitioners, we would have a quirky situation where a Ph.D. in mathematics would not be permitted to get ‘mathematics.doctor,’ but your local pediatrician would.”

Ph.D. holders will at least have backup options if ICANN doesn’t reverse its decision. Google has been delegated .prof (meant for professionals), and a decision on who gets the rights to .phd is still pending.

The entire article is here.

Ethics of Money in Medicine

By Danielle Ofri
Physician, Writer, Editor


Here is an excerpt:

But this is just one example of unethical allocation of money in medicine. Much ado was rightly made last year when Medicare data showed a few doctors with unsavory and maybe illegal billing practices.  But for all the complaints about doctors’ salaries driving up healthcare costs, hardly anyone made a peep when that same data revealed that it is the salaries of the administrators and executives that are tipping the scales.

Nor did anyone so much as hiccup when it was reported that $455 million dollars was spent on TV ads since the Affordable Care Act was enacted, more than 90% of which was devoted to trying to destroy the ACA. We are so jaded about CEO salaries and the money swamp of politics that we hardly are hardly bothered when we see these statistics.

When I read about the $400 million was spent on TV ads to prevent uninsured Americans from getting health insurance, I was frankly disgusted. If people with deep pockets are really interested in improving our healthcare system there are far better ways to use that money. That handsome sum could have put several thousand nurses in clinics or schools. It could have sponsored medical school for 2000 students from underserved communities.  Heck, it could have purchase 6 million albuterol inhalers and handed them out. But no, the money was squandered on TV advertisements.

The entire article is here.

Ethical Responsibilities of Direct-to-Consumer Neuroscience Companies

By Mary Darby
blog.bioethics.gov
Published on November 5, 2014

As part of the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative, President Obama asked the Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) to “identify proactively a set of core ethical standards – both to guide neuroscience research and to address some of the ethical dilemmas that may be raised by the application of neuroscience research findings.”

This morning, the Bioethics Commission resumed its consideration of ethical issues related to direct-to-consumer (DTC) neuroscience, including products like dietary supplements, neurofeedback devices, and even memory games.

The entire blog post is here.

What Brand Is Your Therapist?

by Lori Gottlieb
The New York Times
Originally published November 23, 2012

Here is an excerpt:


What nobody taught me in grad school was that psychotherapy, a practice that had sustained itself for more than a century, is losing its customers. If this came as a shock to me, the American Psychological Association tried to send out warnings in a 2010 paper titled, “Where Has all the Psychotherapy Gone?” According to the author, 30 percent fewer patients received psychological interventions in 2008 than they did 11 years earlier; since the 1990s, managed care has increasingly limited visits and reimbursements for talk therapy but not for drug treatment; and in 2005 alone, pharmaceutical companies spent $4.2 billion on direct-to-consumer advertising and $7.2 billion on promotion to physicians, nearly twice what they spent on research and development.

According to the A.P.A., therapists had to start paying attention to what the marketplace demanded or we risked our livelihoods. It wasn’t long before I learned that an entirely new specialized industry had cropped up: branding consultants for therapists.

I couldn’t imagine hiring a branding consultant to lure people to the couch. Psychotherapy is perhaps one of the few commercial businesses that doesn’t see itself as one, that views financial gain as unseemly when connected to the delicate work of emotional insight. Moreover, the field is predicated on strict concepts of authenticity, privacy and therapist-patient boundaries. Branding was the antithesis of what we did.

The entire article is here.

Vignette 14: The Psychology of Advertising

Dr. Ron Popeil, a local psychologist, is upgrading his web site.  Along with a variety of upgrades, the web developer/consultant suggests that he add a testimonial page where former patients describe their positive experiences in therapy.  Since the web developer/consultant wants to get that page up and running, he suggests that they use some positive ratings and responses from Angie’s list and several other ratings sites that tell positive stories and experiences with Dr. Popeil.

Dr. Popeil thinks these ideas are good.  However, he researches the APA Ethics Code and believes that he may be acting inappropriately.  To discuss the matter in further detail,  Dr. Popeil calls you for an ethics consult.

What are the ethical issues involved in this situation?

Are there any other concerns about the web developer/consultant’s strategies?

What are some recommendations that you would make to the psychologist?

Drug Marketing Often Targets Med Students: Analysis

Robert Preidt
Medicine.net

Drug company marketing to those attending medical school is common and can cloud students' ethical judgment, researchers warn.

A team led by Kirsten Austad and Aaron S. Kesselheim at Harvard Medical School in Boston analyzed published studies that included a total of 9,850 students at 76 medical schools in the United States. The investigators found that most of the students had some type of interaction with drug companies and that this contact increased during the clinical years, with up to 90% of clinical students receiving some form of marketing materials from drug makers.

Among the students queried, most believed there was no ethical problem in accepting gifts from drug companies. Their justifications included financial hardship or pointing out that most other medical students accepted such gifts.

Nearly two-thirds of the medical students claimed that drug company promotions, gifts or interactions with sales representatives did not affect their impartiality regarding drug makers and their products.

The study authors said their findings suggest that strategies to educate medical students about interactions with drug makers should directly address widely held misconceptions about the effects of marketing.

In addition, medical schools need to introduce reforms, such as rules limiting contact between students and drug company representatives.

"These changes can help move medical education a step closer to two important goals: the cultivation of strong professional values, as well as the promotion of a respect for scientific principles and critical review of evidence that will later inform clinical decision-making and prescribing practices," the researchers concluded.

The study is published in the May 24 online edition of the journal PLoS Medicine.

Pharmaceutical company advertising in The Lancet

The Lancet, Volume 378, Issue 9785, Page 30
Geoffrey Spurling, Peter Mansfield, Geoffrey Spurling, Peter Mansfield, Joel Lexchin

 

The Editor of The Lancet, Richard Horton, is famously quoted as saying: “Journals have devolved into information laundering operations for the pharmaceutical industry.”1 This sentiment is echoed by former New England Journal of Medicine Editor, Marcia Angell, who describes information from the pharmaceutical industry as coming, “mixed with hyperbole, bias and misinformation, and there is often no way to tell which is which.”2 Both of these statements were cited by the Editors of the Journal of Emergency Medicine Australasia in their decision earlier this year to ban drug company advertising from their journal.3

 

We published a systematic review of 40 years of scientific literature dealing with the effect of information from pharmaceutical companies on physicians' prescribing.4 Some studies found that journal advertisements were more strongly associated with prescribing than the scientific articles in the same journals; others found advertising associated with less rational prescribing and greater prescribing costs. However, none found associations between exposure to journal advertisements and improved quality of prescribing, reduced cost, or reduced prescribing overall.4

 

Our review was published in PLoS Medicine—a top-tier medical journal that does not accept pharmaceutical advertising. The Editors' summary of our review concluded that “the findings support the case for reforms to reduce negative influence to prescribing from pharmaceutical promotion.”

 

Is The Lancet prepared to take a stand against drug company advertisements similar to the Journal of Emergency Medicine Australasia?

 

We declare that we have no conflicts of interest.

 

References

1 Horton R. The dawn of McScience. New York Review of Books 2004; 51: 7. PubMed

2 Angell M. The truth about the drug companies: how they deceive us and what to do about it. New York: Random House, 2004.

3 Jelinek GA, Brown AF. A stand against drug company advertising. Emerg Med Australas 2011; 23: 4-6. CrossRef | PubMed

4 Spurling GK, Mansfield PR, Montgomery BD, et al. Information from pharmaceutical companies and the quality, quantity, and cost of physicians' prescribing: a systematic review. PLoS Med 2010; 7: e1000352.