Googling for Health Information

Abstract

Department EditorJennifer P. D'Auria, PhD, RN, CPNPUniversity of North Carolina at Chapel HillSchool of NursingChapel Hill, North Carolina Jennifer P. D'Auria, PhD, RN, CPNP University of North Carolina at Chapel Hill School of Nursing Chapel Hill, North Carolina Internet search engines are tools that help people locate information on the Web quickly and efficiently. Google is used by approximately 65% of people in the United States and is the top general search engine in the world (The Nielsen Company, 2010, April 28The Nielsen CompanyNielsen reports March 2010 U.S. search rankings.http://blog.nielsen.com/nielsenwire/online_mobile/nielsen-reports-december-u-s-search-rankingsDate: 2010, April 28Google Scholar). Google indexes hundreds of millions of Web pages and is estimated to conduct more than 3 billion searches a day (McGee, 2010, February 23McGee M. By the numbers: Twitter vs. Facebook vs. Google Buzz.http://searchengineland.com/by-the-numbers-twitter-vs-facebook-vs-google-buzz-36709Date: 2010, February 23Google Scholar). This article will focus on strategies for conducting effective searches for health information using Google search. When searching for answers to simple health-related questions, “googling” makes sense. The Google search results will display the most relevant and recent pages it can find in the public Web content to answer the user's question. To make the search even easier, links to reliable health information Web sites (e.g., Medline Plus [www.medlineplus.gov], WebMD [www.webmd.com], and Kidshealth [kidshealth.org]) will be found toward the top of the results list. If a searcher requires more specialized health information, a basic Google search will not be the best approach for finding health information. Searchers will need to go beyond a basic Google search and consult expert health information sites and/or librarians to identify the best software and advanced search technologies needed to guide the search process. To be an expert searcher, it pays to learn as much as possible about how a search engine works. Overall, the internal workings of search engines are a bit of a mystery and often are kept secret. The Google search engine is composed of three major components: web crawling, indexing, and processing queries (Google, 2011Google Google basics.http://support.google.com/webmasters/bin/answer.py?hl=en&answer=70897Date: 2011Google Scholar). “Googlebot” is the name of Google's automated search robot that finds and retrieves Web pages. It continuously crawls the Web, following links from page to page while noting new pages, changes to pages, and dead links. Googlebot passes on the text (and HTML code) of each page to the Google Indexer, thus creating a massive database. Google's Query Processor compares the words entered into the search box to the index and recommends the Web pages it considers most relevant to the user's query (Blachman and Peek, 2007Blachman N. Peek J. How Google works.http://www.googleguide.com/google_works.htmlDate: 2007Google Scholar). Search engines, like Google, use many complex algorithms to provide lists of relevant results. These algorithms are revised and tweaked frequently to increase the likelihood that the user will receive the most relevant results. Google is best known for its specialized PageRank algorithm (Google, 2012Google Inside search.http://www.google.com/insidesearch/Date: 2012Google Scholar). The PageRank algorithm assigns a relevancy score to each Web page that determines how it will be displayed in the list of search results. Google will search the Internet based on the text that a user enters into the search box. The most important step to building a successful search is to clearly identify key words that best capture the information needed. The user should consider the audience and the use of special terminology when selecting meaningful key words. For example, if the health information needed is related to diagnosis, treatment (e.g., medications), or outcomes, the user should include one of those terms in the query to obtain more relevant results. If the user is interested in Web pages focused on health professionals or researchers, appropriate medical terms (e.g., “cerebrovascular accident” rather than “stroke”) should be used to avoid retrieving sites focused on consumer health information. Running a couple of test searches in Google is a helpful strategy for identifying important words or phrases to include in a search query. A key word is a reference point that a search engine uses when locating the information a user needs. Key words used in a search should be rank ordered in terms of importance, with the most important terms positioned first in the search box. Google does not search each key word separately but searches for the whole string or phrase that is entered into the search box. It will return Web pages that match all the key words or terms entered into the search box. Pages that have the search terms in the same order or in close proximity to each other will be assigned higher priority by the Google search engine (Blachman and Peek, 2007Blachman N. Peek J. How Google works.http://www.googleguide.com/google_works.htmlDate: 2007Google Scholar). Google improves key word searching by automatically correcting misspellings and finding synonyms or alternate word forms to use in a search query. The most important step to building a successful search is to clearly identify key words that best capture the information needed. The most important step to building a successful search is to clearly identify key words that best capture the information needed. It is important to keep search queries as simple as possible. In general, up to two or three key words can guide uncomplicated searches for health information. Remember, adding more words to the query will narrow the search results. For more complex searches (four to six or more key words), users can use a two-step approach, that is, conduct an initial search with fewer key words and then refine the key words or search query itself after reviewing those initial results. In addition, the Google autocomplete algorithm will suggest other similar search queries to the user as key words are typed into the search box. Google also is expanding its use of semantic search technology. Semantic search strategies use artificial intelligence to understand the intent and the meaning of the key words entered by a user into the search box (Madhu et al., 2011Madhu G. Govardhan A. Rajinikanth T.V. Intelligent semantic Web search engines: A brief survey.International Journal of Web & Semantic Technology. 2011; 2: 34-42https://doi.org/10.5121/ijwest.2011.2103Crossref Google Scholar). The goal of using semantic search strategies combined with traditional key word strategies is to provide more accurate and relevant search results for queries. We will review four search strategies that Google offers to help users build more effective queries. All these strategies can be used in varying combinations to construct more powerful searches. Links to more in-depth information about these and many other strategies can be found on the Google Advanced Search Web page (http://www.google.ca/advanced_search). Boolean logic is a way of combining words and phrases in a search query using three logical connectors: AND, OR, and NOT. These three Boolean operators may be used between search terms to narrow or broaden a search. Most databases, including Google, have an implied AND operator between all words in the search query (Google, 2012Google Inside search.http://www.google.com/insidesearch/Date: 2012Google Scholar). For example, if you enter “child helmet bicycle,” the database will search for “child AND helmet AND bicycle,” only retrieving pages that include all three words. The “OR” operator, when placed between two words, tells the search engine to retrieve pages that contain either word. The “NOT” operator may provide a strategy for eliminating certain groups of items from initial search results (e.g., children NOT teens). The Google Advanced Search screen (http://www.google.ca/advanced_search) provides another approach to incorporating logic into the search query. The “AND” search corresponds to the “all these words” box, the “OR” search is associated with the “any of these words” input box, and the “NOT” search is triggered by entering words into the “none of these words” input box. Phrase searching or surrounding a word or group of words with quotations marks will narrow the search results. The search engine will search for the phrase in the exact order it was entered, such as “attention deficit disorder,” and retrieve pages in which those words appear. It is important to keep in mind that the search engine may miss pages that include “attention deficit hyperactivity disorder.” Phrase or single word searching also can be accomplished via Google Advanced Search (see the aforementioned link) and corresponds to the “this exact word or phrase” input box. Site searching is a helpful strategy for narrowing search results. The “site:” command allows the user to limit results to trustworthy domains or to specific Web sites. If the user adds site:gov to a key word search, only information from Web sites ending in “.gov” will be retrieved. Adding site:aap.org to the search string can retrieve information from the American Academy of Pediatrics (AAP) Web site. The uniform resource locator (URL) of a site also can be cut and pasted into the search box along with selected key words to narrow a search. The best way to become familiar with site searching is to try a few searches (see the Table). Enter the four queries listed in the Table just as they are typed (parentheses and all) one at a time into the Google search box (http://www.google.com) and skim the first page of results for each query. The fourth query includes use of the minus sign (“−”) directly in front of the “s” in “site.” The minus command will eliminate any commercial sites (.com) from the results.TableExamples of searches using the “site:” commandSearch word or phraseSearch results“otitis”Results include pages from a variety of domains“otitis” site:govResults narrowed to only those from “.gov” sites“otitis” site:aap.orgResults are restricted to only documents and pages on the American Academy of Pediatrics Web site“otitis” –site:comRemoves “.com” sites from the results Open table in a new tab The “site:” command allows the user to limit results to trustworthy domains or to specific Web sites.The user also may conduct a site search using the “site or domain” input box on the Google Advanced Search page. The “site:” command allows the user to limit results to trustworthy domains or to specific Web sites. Users may find it helpful to customize their searches by creating a search engine that includes their own collection of Web sites or pages. Google's Custom Search engine (http://www.google.com/cse/docs) provides users with an easy way to create and manage a search engine (http://www.google.com/cse/manage/create). The only requirement for creating a personalized search engine is to have a Google account (which is free). Google has gone beyond simple health information searches; it also has entered the realm of diagnosis. For example, if a parent enters the symptom query “knee pain child” into the Google search box, the search results will include a list of links to information about health conditions that may account for this symptom. Health professionals also use Google to support diagnosis and identification of treatments for patient conditions. What is important to keep in mind for both providers and patients is that the search for credible health information on Google or any other search engine is a partnership. It is the 21st century. Best practices include prescribing the best Web sites for the health information needs of children and families. Prescribe a Web site today! Jennifer P. D'Auria, Associate Professor of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC.