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Online filter bubbles and confirmation bias in health care: narrative of a vaccine skeptic

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Oral presentation. 22nd Cochrane Colloquium.
Giordano Pérez Gaxiola. https://www.slideshare.net/giordanopg
Douglas Badenoch. http://www.slideshare.net/DouglasBadenoch

Veröffentlicht in: Gesundheit & Medizin
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Online filter bubbles and confirmation bias in health care: narrative of a vaccine skeptic

  1. 1. Online filter bubbles and confirmation bias in healthcare: Narrative of a vaccine skeptic Giordano Pérez Gaxiola, Douglas Badenoch 22nd Cochrane Colloquium, Hyderabad, India Giordano Pérez Gaxiola, Douglas Badenoch 22nd Cochrane Colloquium, Hyderabad, India
  2. 2. We have no actual or potential conflict of interest in relation to this presentation Image author: Banksy
  3. 3. Outline testingtreatments.org • Filter bubbles • Clinical experience of vaccine scepticism • The experiment • Discussion Image author: Banksy
  4. 4. DuckDuckGo Google
  5. 5. Eli Pariser: Beware online "filter bubbles"
  6. 6. At the office • Mom of a 2 yo boy who doesn’t have MMR • “…I read that it causes autism” testingtreatments.org • Mom of a 9 mo girl • “…do you have mercury free vaccines?”
  7. 7. Anti-vaccine movement testingtreatments.org
  8. 8. Where does it come from? • Nobody likes shots • Generation that did not see diphtheria, measles, testingtreatments.org polio… • Atrocities that have reduced trust in vaccines
  9. 9. Image: Star Trek Atrocity # 1 One that cast doubt in the safety of a vaccine
  10. 10. 1998 testingtreatments.org
  11. 11. testingtreatments.org
  12. 12. http://www.cfr.org/interactives/GH_Vaccine_Map/#/intro testingtreatments.org
  13. 13. Image: Star Trek Atrocity # 2 One that cast doubt in goals of vaccination campaigns
  14. 14. 1988 Global Polio Eradication Initiative 125 countries testingtreatments.org
  15. 15. 2011 Global Polio Eradication Initiative 4 countries testingtreatments.org
  16. 16. testingtreatments.org
  17. 17. testingtreatments.org
  18. 18. May 2014… back to 9 countries who.int testingtreatments.org
  19. 19. Where does it come from? • Nobody likes shots • Generation that did not see diphtheria, measles, testingtreatments.org polio… • Atrocities that have reduced trust in vaccines • Information from the internet
  20. 20. To vaccinate or not to vaccinate? testingtreatments.org
  21. 21. Recommendation by doctors Social norm Factors that influence in vaccination decisions Previous experiences testingtreatments.org Advice from people we trust Advice from trustworthy organisations Betsh C, et al. Opportunities and challenges of Web 2.0 for vaccination decisions. Vaccine 2012;30:3727–3733
  22. 22. Recommendation by doctors Social norm Influenced by the internet? Previous experiences testingtreatments.org Advice from people we trust Advice from trustworthy organisations Betsh C, et al. Opportunities and challenges of Web 2.0 for vaccination decisions. Vaccine 2012;30:3727–3733
  23. 23. Phases in vaccination decisions Betsch C. Innovations in communication: the Internet and the testingtreatments.org psychology of vaccination decisions. Euro Surveill. 2011;16(17):1–6
  24. 24. testingtreatments.org
  25. 25. testingtreatments.org
  26. 26. The role of the internet testingtreatments.org
  27. 27. > 70% trust health information online > 75% do not consider source nor critically appraise Betsh C, et al. Opportunities and challenges of Web 2.0 for vaccination decisions. testingtreatments.Vaccine org 2012;30:3727–3733
  28. 28. Health information online Correct Incorrect MMR/Autism 44 23 Scullard P, et al. Googling children’s health: reliability of medical advice on the internet. Arch testingtreatments.Dis Child org 2010;95(8):580-2 Mastitis/breastf eeding 59 0 Sleep position infants 43 0 Green vomit in infant 16 1
  29. 29. Health information online Information correct Incorrect testingtreatments.org 27 35 17 40 68 10 0 6 14 9 17 2 90 67.5 45 22.5 0 Gov Educational News Companies Interest groups Individual Scullard P, et al. Googling children’s health: reliability of medical advice on the internet. Arch Dis Child 2010;95(8):580-2
  30. 30. English Spanish
  31. 31. Personalisation of the internet testingtreatments.org
  32. 32. What happens if a vaccine skeptic decides to look at what people are saying about vaccines harms? testingtreatments.org
  33. 33. testingtreatments.org
  34. 34. testingtreatments.org
  35. 35. testingtreatments.org
  36. 36. testingtreatments.org
  37. 37. 12,278 + 40,654 + 71,585 124,517 testingtreatments.org
  38. 38. “Type a quote here.” –Johnny Appleseed testingtreatments.org 17,842 13,345 22,705 71,809
  39. 39. More narratives Perception of more risk! Betsch C, et al. The influence of narrative vs. statistical information on perceiving vaccination risks. Medical Decision Making testingtreatments.2011;31(org 5):742–53.
  40. 40. Two positive narratives Two negative narratives Perception of 50% risk! Fagerlin A, Wang C, Ubel PA. Reducing the influence of anecdotal reasoning on people’s health care decisions: is a picture worth a thousand statistics. Medical testingtreatments.Decision org Making 2005;25:398–405.
  41. 41. Anti Pro
  42. 42. Phases in vaccination decisions Euro Sutrevsetinilglt.r e2a0tm1e1nt;s1.o6rg(17):1–6
  43. 43. This is just a case study… testingtreatments.org • Narrative • Obvious limitations of “Likes” …but
  44. 44. Personalisation of the internet might be increasing confirmation bias If I believe in something, it’s because it is true testingtreatments.org
  45. 45. And it does matter! testingtreatments.org
  46. 46. It’s not just health 17/21 comments from climate change deniers testingtreatments.org
  47. 47. People prefer information they agree with testingtreatments.org They are more likely to search for and read information that agrees with their voting behaviour. Borra E, Weber I. Political Insights: Expl oring partisanship in Web search queries. First Monday 2012; 17 (7): 2 July 2012.
  48. 48. About 30% of Facebook health pages are for marketing & advertising Hale et al. Representation of Health Conditions on Facebook: Content Analysis and Evaluation of User Engagement. JMIR 2014; 16(8): e182 testingtreatments.org
  49. 49. But they account for about 47% of “Likes” Hale et al. Representation of Health Conditions on Facebook: Content Analysis and Evaluation of User Engagement. JMIR 2014; 16(8): e182 testingtreatments.org
  50. 50. Can we do anything about it? • It’s possible to influence opinion with alternative viewpoints • Engage with online communities • Tell stories about evidence-based health care testingtreatments.org
  51. 51. Shareable content testingtreatments.org
  52. 52. Evidence of what works • Social marketing for HIV/STI testingtreatments.org testing uptake… • Social media may lead to increased exposure to different viewpoints but tend to be more biased Wei C, Herrick A, Raymond HF, Anglemyer A, Gerbase A, Noar SM. Social marketing interve ntions to increase HIV/STI testing uptake amo ng men who have sex with men and male-to-fe male transgender women. Cochrane Database of Systematic Reviews 2011, Issue 9. Art. No.: CD009337. DOI: 10.1002/14651858.CD00933 7. Yardi S et al. Dynamic debates: An analysis of group polarization over time on twitter. Bull Sci Tech Soc 2010; 30 (5): 316-327
  53. 53. Evidence of what works Current evidence is: testingtreatments.org • Non-randomized • Short duration • Heterogeneity • Poor description of interventions • Poor quality or absent control groups • Substantial attrition Maher et al. Are Health Behavior Change Interventions That Use Online Social Networks Effective? A Systemat ic Review. J Med Internet Res 2014;16(2):e40)
  54. 54. Imitations of success? testingtreatments.org
  55. 55. “A squirrel dying in front of your house may be more relevant to your interests right now than people dying in Africa” - Mark Zuckerberg, Facebook Eli Pariser: Beware online "filter bubbles"
  56. 56. Questions… …comments, advice, warnings, suggestions for future research…. testingtreatments.org

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