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Attacking "Crusaders" Against Conflicts of Interest with Logical Fallacies

An <a href="http://www.nature.com/nm/journal/v15/n5/full/nm0509-463.html">editorial </a>appeared in the latest edition of Nature Medicine that suggested "crusaders" are making much too much fuss over insignificant "competing financial interests." [Anonymous. A really serious conflict. Nature Medicine 2009; 15: 463-4] The Editorial's Arguments Instead of regarding all conflicts of interest as part of a "monolithic scourge," it suggested we should only attack them in two specific situations. Bad Conflicts of Interest The first is when it leads to falsification of research data: <blockquote>If there is one reason we need to worry about CFIs [competing financial interests], it is because they could lead to misconduct whenever a researcher has a financial incentive to fabricate data. So, if a clinical trial goes ahead on the basis of fraudulent preclinical work or if a drug is approved on the basis of false clinical data, the problem is more profound than can be addressed by the declaration of a CFI. Researchers or clinicians who produce sham data to continue receiving funds from a company must be subject to severe disciplinary actions from their institutions and funding bodies. </blockquote> The second is when it leads to withholding of data in certain circumstances: <blockquote>Companies that conceal negative data from regulators to receive approval for their drug should face not only fines but also penalties as serious as criminal charges. In any case, the focus should move away from CFI declarations and toward exposing and punishing scientific misconduct. </blockquote> Some Conflicts of Interest are Unavoidable On the other hand, the editorial asserted that conflicts of interest are unavoidable in certain situations. <blockquote> But even though a lot has been written about this subject, it is seldom acknowledged that not all CFIs are equally insidious and that some are even necessary for the success of translational research. Scientists who share their expertise with a company and clinicians who agree to conduct a clinical trial have to be compensated for their work in the same way that every other professional ought to be rewarded for his or her labor. To suggest that they should make their contributions freely is disingenuous, and to argue that they should not get involved at all can only slow the development of new medicines. Academic institutions and their employees must be free to benefit financially from the fruits of the advances made in their laboratories, either by independently developing them into products or by selling them to the highest bidder. In the US, the Bayh-Dole Act has protected this right for nearly three decades, and CFIs that result from a university's right to enact this policy should not raise eyebrows. </blockquote> Bad Outcomes of the "Crusade" Against Conflicts of Interest In addition, the editorial argued that because of excess attention paid to minor or unavoidable conflicts of interest, bad things may happen. Clinical trials would be discouraged. <blockquote>However, the fact remains that clinical trials are very expensive, and only the pharmaceutical sector has both the incentive and the deep pockets to pay for them. </blockquote> And innovation would be slowed. <blockquote>A third issue that is rarely acknowledged is that the stridency with which the CFI crusaders fight financial interests has created a milieu in which pharmaceutical firms have increasingly less breathing space to conduct their business, leading to a further slowing of drug development. </blockquote> Finally, the editorial exhorted: <blockquote>Let us instead accept that most financial interests do not represent a conflict as a matter of course and that the influence of money is negative only if it leads to scientific fraud—the one infidel we need to burn at the crusader's stake. </blockquote>Logical Fallacies and Inflammatory Rhetoric It is discouraging to see such sloppy thinking and inflammatory rhetoric appear under the masthead of a prominent journal. How was the thinking sloppy? Let me count the ways, and explain the logical fallacies used by the editorial to support its contention. Arguing that Conflicts are Unavoidable Using False Dilemmas and Appeals to Common Practice The editorial suggests some conflicts of interest may be unavoidable, even necessary for the advancement of science. To do this, it provided a series of <a href="http://www.nizkor.org/features/fallacies/false-dilemma.html">false dilemmas </a>and <a href="http://www.nizkor.org/features/fallacies/appeal-to-common-practice.html">appeals to common practice</a>. A false dilemma is an argument that x and y are mutually exclusive, when they are not. An appeal to common practice is an argument that because something is common practice, it is necessary, moral, correct, or the only course possible. The editorial argued that researchers would not work for free, implying that if drug and device companies could not pay researchers to perform clinical trials, no clinical trials would be done. This is a false dilemma, because it is based on the unstated assumption that there is no other possible source of payment for clinical trial researchers other than the companies whose products the trials evaluate. It may be true that it would be hard to get anyone to conduct clinical trials for free, but there is no law of nature that dictates that all clinical trials must be financed directly by companies whose products are the subjects of these trials, or that prevents clinical trials from being funded by government agencies and/or non-governmental organizations disinterested in whether the results favor one treatment or another. Such disinterested sponsors paying researchers would not create conflicts of interest. The editorial argued that if academic institutions and their employees cannot benefit financially from "the fruits of the advances made in their laboratories," there would be no drug and device development. This is a false dilemma, because it is based on the unstated assumption that the only setting for drug and device development is academic institutions. There is no natural law, however, that restricts drug and device development to academic institutions, or prevents drug development to be done by drug and device companies, or by independent laboratories. The editorial also appended an appeal to common practice. Bayh-Dole may be the current law in the US, but it is hardly natural law. The editorial argued that without the "deep pockets" of the "pharmaceutical sector" and device companies, no one would pay for clinical research. This was a repetition of the false dilemma noted above. There is no natural law that prevents government and non-governmental organizations from sponsoring clinical trials. The editorial again appended an appeal to common practice. Current laws and social conventions have made drug and device companies extremely profitable, but continuation of their profitability is hardly inevitable. Red Herrings to Distract from Other Bad Effects of Conflicts While the editorial identified two particularly bad kinds of conflicts of interest, it ignored other instances that could be equally bad. This was something of a <a href="http://www.nizkor.org/features/fallacies/red-herring.html">red herring</a>. Although the two examples of bad effects of conflicts of interest were undeniably important, they distracted from other bad effects which the editorial chose to ignore. The editorial correctly identified falsification of data as bad, but ignored the entire catalog of ways in which clinical research studies can be manipulated to make them more likely to favor a sponsor's product. See our posts (<a href="http://hcrenewal.blogspot.com/2008/04/another-example-of-manipulation-of.html">here</a> and <a href="http://hcrenewal.blogspot.com/2005/05/medical-journal-are-extension-of.html">here</a>) and the links contained therein for multiple examples of such manipulation. The editorial noted that concealing data from regulators in order to win drug approval is bad, but ignored all the instances in which data has been suppressed outside of the regulatory process to make drugs or devices seem more efficacious or less dangerous than they really are. See <a href="http://hcrenewal.blogspot.com/search/label/suppression%20of%20medical%20research">this link </a>for some of our posts containing relevant examples. If it is bad to fool people who must make regulatory decisions, why is it not so bad to fool physicians and patients who must decide whether to use drugs or devices? The editorial further ignored that conflicts that affect how research is conducted or reported may be linked to conflicts that affect how research is disseminated or used in decision making. The clinical researcher who is paid by a drug or device company to conduct a clinical trial may also be an academic physician paid by the same company as a consultant or through a speakers' bureau to give talks and presentations, and write review articles favorable to the company's product. If it would be bad for the researcher to falsify data to make the product look better, why would it be acceptable for the researcher to act as a huckster for the product while pretending to be a disinterested academic? See <a href="http://hcrenewal.blogspot.com/search/label/stealth%20marketing">this link </a>for posts discussing stealth marketing, and <a href="http://hcrenewal.blogspot.com/search/label/key%20opinion%20leaders">this one </a>for posts discussing the use of key opinion leaders. Ambiguity and Ad Hominem Attacks Inflating the Bad Effects of Fighting Conflicts While the editorial minimized the bad outcomes of conflicts of interest, it resorted to ambiguity and inflammatory language to exaggerate what might happen were conflicts to be reduced. Its most dire prediction of the results of reducing conflicts was that doing so would create a "milieu" in which "pharmaceutical firms have increasingly less breathing space." Literally, this statement was nonsense. Metaphorically, it did not make a clear argument that these highly profitable companies (and even more profitable device companies) could not survive in a "milieu" in which their products were tested by researchers which the companies could not influence. This was not clearly a logical fallacy, but just word-play presented a reasoned argument. Given how prevalent political correctness is, repeatedly characterizing people concerned about conflicts of interest as "crusaders" is inflammatory indeed. Being called "<a href="http://hcrenewal.blogspot.com/2009/04/who-is-now-scolding-pharmascolds.html">pharmascolds</a>" is one thing, but "crusader" in some circles is regarded as equivalent to racist, a nasty term to label those who promote the separation of clinical research and medical education from commercial interests. Thus, the editorial winds up with a rather nasty version of an <a href="http://www.nizkor.org/features/fallacies/ad-hominem.html">ad hominem </a>attack. We have seen numerous <a href="http://hcrenewal.blogspot.com/search/label/logical%20fallacies">examples </a>of the use of logical fallacies in defense of conflicts of interest, often by authors who were themselves conflicted. It is especially sad to see the editors of a scholarly medical journal employ such logical fallacies in the defense of conflicts of interest. ADDENDUM (11 May, 2009) - See also the<a href="http://www.beforeyoutakethatpill.com/index.php/2009/05/11/chowder-headed-nature-editorial-lashes-out-at-conflict-of-interest-crusaders/"> comments </a>by Dr Doug Bremner in the Before You Take That Pill Blog. ADDENDUM (20 May, 2009) - For an example of how the term "crusader" has become politically incorrect in the US context, see <a href="http://www.boston.com/news/local/massachusetts/articles/2009/05/14/college_converts_its_crusader_teams/">this article</a> in the Boston Globe.

Attacking "Crusaders" Against Conflicts of Interest with Logical Fallacies

An editorial appeared in the latest edition of Nature Medicine that suggested "crusaders" are making much too much fuss over insig...

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The power of video

We recently announced the winners of the <a href="http://www.climatesaverscomputing.org/">Climate Savers Computing Initiative</a> (CSCI) Power Down for the Planet video contest. In March, we challenged you to create videos to educate, entertain, and inform others about the importance of energy efficient computing and you did not disappoint. The submissions made us laugh (a lot) and almost cry (okay, just a little). Not only are these videos really creative, but also they help promote a smarter, greener computing future. The global grand prize, $5000 cash and laptops, went to a team from Southern California for their entry "<a href="http://www.youtube.com/watch?v=1GtkBwwF89w">Power Down: One Computer at a Time</a>." Students from the <a href="http://www.powerdownfortheplanet.org/about-the-challenge/participating-universities/">19 participating colleges and universities</a> were also eligible to win the student grand prize. This award goes to a team from Jackson State University for their "<a href="http://www.youtube.com/watch?v=c4U1JloVCDI">Power Down the Planet</a>" entry. They will take home $5,000, <a href="http://www.specialized.com/us/en/bc/SBCBkModel.jsp?spid=40433&eid=178">2009 Specialized Globe Vienna Deluxe 1 bikes powered by Specialized</a>, and software. To all the winners, congratulations! Check out a playlist of some of our favorite video entries: <object height="385" width="480"><param name="movie" value="http://www.youtube.com/p/1B7149EAC1413A24&hl=en&fs=1"><param name="allowFullScreen" value="true"><param name="allowscriptaccess" value="always"><embed src="http://www.youtube.com/p/1B7149EAC1413A24&hl=en&fs=1" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="480" height="385"></embed></object> Posted by Alice Ryan, Green Rocket Scientist

The power of video

We recently announced the winners of the Climate Savers Computing Initiative (CSCI) Power Down for the Planet video contest. In March, we c...

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Strengthening a worldwide community with Google Friend Connect

Site owners often tell us that to build strong communities on the web, they have to be a jack-of-all-trades. With <a href="http://www.google.com/friendconnect/" id="vvfc" title="Google Friend Connect">Google Friend Connect</a>, we want to empower any website to awaken their community, even if the site owner doesn't have the technical background or the time to build social features from scratch. Today we're launching an enhanced comments gadget. With this gadget, visitors from all over the world can leave messages in their native tongue, and other viewers will be able to instantly translate these comments into the language of their choice. For websites like <a href="http://www.earthhour.org/home/" id="vd:7" title="Earth Hour">Earth Hour</a>, where people from many countries are working together to conserve energy, this comments gadget offers users a new way to engage in more meaningful discussions, regardless of what language they speak. Watch the video below to learn more: <object height="344" width="425"><param name="movie" value="http://www.youtube.com/v/4HQ81jgnvBQ&hl=es&fs=1"><param name="allowFullScreen" value="true"><param name="allowscriptaccess" value="always"><embed src="http://www.youtube.com/v/4HQ81jgnvBQ&hl=es&fs=1" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" height="344" width="425"></embed></object> The comments gadget is just one way Friend Connect can help webmasters foster deeper interactions between site members. You may have seen that over the past few weeks we have added several new gadgets to the <a href="http://www.google.com/friendconnect/home/gadgets" id="x62d" title="the Friend Connect gallery">Friend Connect gallery</a>, all with the goal of helping people interact with one another on the sites they enjoy. These gadgets include the <a href="http://googlesocialweb.blogspot.com/2009/04/promote-your-event-with-new-gadget.html" id="lt68" title="the event gadget">event gadget</a> for promoting an upcoming event and letting members indicate if they're attending, as well as two gadgets built by OpenSocial developers: the <a href="http://googlesocialweb.blogspot.com/2009/04/making-polls-social.html" id="i518" title="the Polls gadget">Polls gadget</a>, which gives opinion polls a social twist, and the <a href="http://googlesocialweb.blogspot.com/2009/04/engage-your-community-with-get-answers.html" id="l19x" title="the Get Answers gadget">Get Answers gadget</a>, which lets members ask questions to the community and answer questions posted by others. To learn more about these gadgets, or to keep your eye out for future gadgets we will be rolling out for Friend Connect, please visit the <a href="http://googlesocialweb.blogspot.com/" id="kj6b" title="the Social Web blog">Social Web Blog</a>. Posted by Mussie Shore, Product Manager, Google Friend Connect

Strengthening a worldwide community with Google Friend Connect

Site owners often tell us that to build strong communities on the web, they have to be a jack-of-all-trades. With Google Friend Connect , we...

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The 2008 Founders' Letter

Posted by Sergey Brin, Co-founder & President, Technology Every year our founders take turns writing a letter that is included in our annual report. We originally published the <a href="http://investor.google.com/2008_founders_letter.html">2008 Founders' Letter</a> on our Investor Relations site. Since today is the annual Stockholders' Meeting at our Mountain View headquarters, we wanted to make it more widely available. We welcome you to have a read, and you can also check out the <a href="http://investor.google.com/webcast">webcast</a> of the Stockholders' Meeting, beginning at 2 p.m. PT today. – Ed. Introduction Since 2004, when Google began to have annual reports, Larry and I have taken turns writing an annual letter. I never imagined I would be writing one in the midst of an economic crisis unlike any we have seen in decades. As I write this, search queries are reflecting economic hardship, the major market indexes are one half of what they were less than 18 months ago, and unemployment is at record levels. Nonetheless, I am optimistic about the future, because I believe scarcity breeds clarity: it focuses minds, forcing people to think creatively and rise to the challenge. While much smaller in scale than today's global collapse, the dot-com bust of 2000-2002 pushed Google and others in the industry to take some tough decisions — and we all emerged stronger as a result. This new crisis punctuates the end of our first decade as a company, a decade that has brought great change to Google, the web and the Internet as a whole. As I reflect on this short time period, our accomplishments and our shortcomings, I am very excited about what the next ten years may bring. But let me start a little farther back — in 1990, the very first web page was created at <a href="http://info.cern.ch/">http://info.cern.ch/</a>. By late 1992, there were only 26 websites in the world so there was not much need for a search engine. When NCSA Mosaic (the first widely used web browser) came out in 1993, every new website that was created would get posted to its "What's New" page at a rate of about one a day: <a href="http://www.dejavu.org/prep_whatsnew.htm">http://www.dejavu.org/prep_whatsnew.htm</a>. Just five years later, in 1998, web pages numbered in the tens of millions, and search became crucial. At this point, Google was a small research project at Stanford; later that year it became a tiny startup. The search index sat on a small number of disk drives enclosed within Lego-like blocks. Perhaps a few thousand people, mostly academics, used the service. Fast-forward to today, the changes in scale are striking. The web itself has grown by about a factor of 10,000, as has our search index. The number of people who use Google's services every day is now in the hundreds of millions. More importantly, billions of people now have access to the Internet via computers and mobile phones. Like many other web companies, the vast majority of our services are available worldwide and free to users because they are supported by ads. So a child in an Internet cafe in a developing nation can use the same online tools as the wealthiest person in the world. I am proud of the small role Google has played in the democratization of information, but there is much more left to do. Search Search remains at the very core of what we do at Google, just as it has been from our earliest days. As the scale has changed dramatically over the years, the presentation and quality of our search results have also undergone many changes since 1998. In the past year alone we have made 359 changes to our web search — nearly one per day. Some are not easy to spot, such as changes in ranking based on personalization (launched broadly in 2005) but they are important in getting the most relevant search results. Others are very easy to see and improve search efficiency in a very clear way, such as spelling correction, annotations, and suggestions. While I am proud of what has been accomplished in search over the past decade, there are important areas in which I wish we had made more progress. Perfect search requires human-level artificial intelligence, which many of us believe is still quite distant. However, I think it will soon be possible to have a search engine that "understands" more of the queries and documents than we do today. Others claim to have accomplished this, and Google's systems have more smarts behind the curtains than may be apparent from the outside, but the field as a whole is still shy of where I would have expected it to be. Part of the reason is the dramatic growth of the web — for any particular query, it is likely there are many documents on the topic using the exact same vocabulary. And as the web grows, so does the breadth and depth of the curiosity of those searching. I expect our search engine to become much "smarter" in the coming decade. So too will the interfaces by which users look for and receive information. While many things have changed, the basic structure of Google search results today is fairly similar to how it was ten years ago. This is partly because of the benefits of simplicity; in fact, the Google homepage has become increasingly simple over the years: <a href="http://blogoscoped.com/archive/2006-04-21-n63.html">http://blogoscoped.com/archive/2006-04-21-n63.html</a>. But we are starting to see more significant changes in search interfaces. Today you can search from your cell phone by just speaking into it and Google Reader can suggest interesting blogs without any query at all. It is my expectation that in the next decade our searches and results will look very different than they do today. One of the most striking changes that has happened in the past few years is that search results are no longer just web pages. They include images, videos, books, maps, and more. From the outset, we realized that to have comprehensive search we would have to venture beyond web pages. In 2001, we launched Google Image Search and via Google Groups we made available and searchable the most comprehensive archive of Usenet postings ever assembled (800 million messages dating back to 1981). Just this past fall we expanded Image Search to include the LIFE Magazine photo archive. This is a collection of 10 million photos, more than 95 percent of which have never been seen before, and includes historical pictures such as the Skylab space station orbiting above Earth and Neil Armstrong landing on the moon. Integrating images into search remains a challenge, primarily because we are so reliant on the surrounding text to gauge a picture's relevance. In the future, using enhanced computer vision technology, we hope to be able to understand what's depicted in the image itself. YouTube Video is often thought of as an entertainment medium, but it is also a very important source of high-quality information. Some queries seem like natural choices to show video results, such as for sports and travel destinations. Yet videos are also great resources for topics such as computer hardware and software (I bought my last RAID based on a video review), scientific experiments, and education such as courses on quantum mechanics. Google Video was first launched in 2005 as a search service for television content because TV close-captioning made search possible and user-generated video had yet to take off. But it subsequently evolved to a site where individuals and corporations alike could post their own videos. Today Google Video searches many different video hosting sites, the largest of which is YouTube, which we acquired in 2006. Every minute, 15 hours worth of video are uploaded to YouTube — the equivalent of 86,000 new full length movies every week. YouTube channels now include world leaders (the President of the United States and prime ministers of Japan, the UK and Australia), royalty (the Queen of England and Queen Rania of Jordan), religious leaders (the Pope), and those seeking free expression (when Venezuelan broadcaster El Observador was shut down by the government, it started broadcasting on YouTube). When it began, online video was associated with small fuzzy images. Today, many of our uploads are in HD quality (720 rows and greater) and can be streamed to computers, televisions, and mobile phones with increasing fidelity (thanks to improvements in video compression). In the future, vast libraries of movie-theater-quality video (4000+ columns) will be available instantly on any device. Books Books are one of the greatest sources of information in the world and from the earliest days of Google we hoped to eventually incorporate them into our search corpus. Within a couple of years, Larry was experimenting with digitizing books using a jury-rigged contraption in our office. By 2003, we launched Google Print, now called Google Book Search. Today, we are able to search the full text of almost 10 million books. Moreover, in October we reached a landmark agreement with a broad class of authors and publishers, including the Authors' Guild and the Association of American Publishers. If approved by the Court, this deal will make millions of in-copyright, out-of-print books available for U.S. readers to search, preview, and buy online — something that has been simply unavailable to date. Many of these books are difficult, if not impossible, to find because they are not sold through bookstores or held on most library shelves; yet they make up the vast majority of books in existence. The agreement also provides other important public benefits, including increased access to users with disabilities, the creation of a non-profit registry to help others license these books, the creation of a corpus to promote basic research, and free access to full texts at a kiosk in every public library in the United States. Geo While digitizing all the world's books is an ambitious project, digitizing the world is even more challenging. Beginning with our acquisition of Keyhole (the basis of Google Earth) in October 2004, it has been our goal to provide high-quality information for geographic needs. By offering both Google Earth and Google Maps, we aim to provide a comprehensive world model encompassing all geographic information including imagery, topography, road, buildings, and annotations. Today we stitch together images from satellites, airplanes, cars, and user uploads, as well as collect important data, such as roads, from numerous different sources including governments, companies, and directly from users. After the launch of Google Map Maker in Pakistan, users mapped 25,000 kilometers of uncharted road in just two months. Ads We always believed that we could have an advertising system that would add value not only to our bottom line but also to the quality of our search result pages. Rather than relying on distracting flashy ads, we developed relevant, clearly marked text-based ads above and to the right of our search results. After a number of early experiments, the first self-service system known as AdWords launched in 2000 starting with 350 advertisers. While these ads yielded small amounts of money compared to banner ads at the time, as the dot-com bubble burst, this system became our life preserver. As we syndicated it to EarthLink and then AOL, it became an important source of revenue for other companies as well. Today, AdWords has grown beyond just being a feature of Google. It is a vast ecosystem that provides valuable traffic and leads to hundreds of thousands of businesses: indeed in many ways it has helped democratize access to advertising, by creating an open marketplace where small business and start-ups can compete with well-established, well-funded companies. AdWords is also an important source of revenue for websites that create the content that we all search. Last year, AdSense (our publisher-facing program) generated more than $5 billion dollars of revenue for our many publishing partners. Also in the last year we ventured further into other advertising formats with the acquisition of DoubleClick. This may seem at odds with the value we place on relevant text-based ads. However, we have found that richer ad formats have their place such as video ads within YouTube and dynamic ads on game websites. In fact, we also now serve video ads on television with our AdSense for TV product. Our goal is to match advertisers and publishers using the formats and mediums most appropriate to their goals and audience. Despite the progress in our advertising systems and the growth of our base of advertisers, I believe there are significant improvements still to be made. While our ad system has powerful features, it is also complex, and can confuse many small and local advertisers whose products and services could be very useful to our users. Furthermore, the presentation formats of our advertisements are not the optimal way to peruse through large numbers of products. In the next decade, I hope we can more effectively incorporate commercial offerings from the tens of millions of businesses worldwide and present them to consumers when and where they are most useful. Apps Within a couple of years of our founding, a number of colleagues and I were starting to hit the limitations of our traditional email clients. Our mailboxes were too big for them to handle speedily and reliably. It was challenging or impossible to have email available and synchronized when switching between different computers and platforms. Furthermore, email access required VPN (virtual private networks) so everyone was always VPN'ing, thereby creating extra security risks. Searching mail was slow, awkward, and cumbersome. By the end of 2001 we had a prototype of Gmail that was used internally. Like several existing services at the time, it was web-based. But unlike those services it was designed for power users with high volumes of email. While our initial focus was on internal usage, it soon became clear we had something of value for the whole world. When Gmail was launched externally, in 2004, other top webmail sites offered 2MB and 4MB mailboxes, less than the size of a single attachment I might find in a message today. Gmail offered 1 Gigabyte at launch, included full-text search, and a host of other features not previously found in webmail. Since then Gmail has continued to push the envelope of email systems, including functionality such as instant messaging, video-conferencing, and offline access (launched in Gmail Labs this past January). Today some Googlers have more than 25 gigabytes of email going back nearly 10 years that they can search through in seconds. By the time you read this, you should be able to receive emails written in French and read them in English. The benefits of web-based services, also known as cloud computing, are clear. There is no installation. All data is stored safely in a data center (no worries if your hard drive crashes). It can be accessed anytime, anywhere there is a working web browser and Internet connection (and sometimes even if there is not one — see below). Perhaps even more importantly, new forms of communication and collaboration become possible. I am writing this letter using Google Docs. There are several other people helping me edit it simultaneously. Moments ago I stepped away and worked on it on a laptop. Without having to hit save or manage any synchronization all the changes appeared in seconds on the desktop that I am back to using now. In fact, today I have worked on this document using three different operating systems and two different web browsers, all without any special software or complex logistics. In addition to Gmail and Google Docs, the Google Apps suite of products now includes Spreadsheets, Calendar, Sites, and more. It is also now available to companies, universities, and other organizations. In fact, more than 1 million organizations use Google Apps today, including Genentech, the Washington D.C. city government, the University of Arizona, and Gothenburg University in Sweden. Because tens of millions of consumers already use our products, it is easy for organizations — from businesses to non-profits — to adopt them. Very little training is required and the passionate Google users already in these organizations are usually excited to help those who need a hand. In many ways, Google Apps are even more powerful in a business or group than they are for individuals because Apps can change the way businesses operate and the speed at which they move. For example, with Google Apps Web Forms we innovated by addressing the key problem of distributed data collection, making it incredibly simple to collect survey data from within the enterprise — a critical feature for collecting internal feedback we use extensively when "dogfooding" all of our products. There are a number of things we could improve about these web services. For example, since they have arisen from different groups and acquisitions, there is less uniformity across them than there should be. For example, they can have different sharing models and chat capabilities. We are working to shift all of our applications to a common infrastructure. I believe we will achieve this soon, creating greater uniformity and capability across all of them. Chrome We have found the web-based service model to have significant advantages. But it also comes with its own set of challenges, primarily related to web browsers, which can be slow, unreliable, and unable to function offline. Rather than accept these shortcomings, we have sought to remedy them in a number of ways. We have contributed code and generated revenue for several existing web browsers like Mozilla Firefox, enabling them to invest more in their software. We have also developed extensions such as Google Gears, which allows a browser to function offline. In the past couple of years, however, we decided that we wanted to make some substantial architectural changes to how web browsers work. For example, we felt that different tabs should be segregated into separate sandboxes so that one poorly functioning website does not take down the whole browser. We also felt that for us to continue to build great web services we needed much faster Javascript performance than current browsers offered. To address these issues we have created a new browser, called Google Chrome. It has a multiprocess model and a very fast JavaScript engine we call V8. There are many other notable features, so I invite you to try it out for yourself. Chrome is not yet available on Mac and Linux so many of us, myself included, are not able to use it on a regular basis. If all goes well, this should be addressed later this year. Of course, this is just the start, and Chrome will continue to evolve. Furthermore, other web browsers have been spurred on by Chrome in areas such as JavaScript performance, making everyone better off. Android We first created mobile search for Google back in 2000 and then we started to create progressively more tailored and complex mobile offerings. Today, the phone I carry in my pocket is more powerful than the desktop computer I used in 1998. It is possible that this year, more Internet-capable smartphones will ship than desktop PCs. In fact, your most "personal" computer, the one that you carry with you in your pocket, is the smartphone. Today, almost a third of all Google searches in Japan are coming from mobile devices — a leading indicator of where the rest of the world will soon be. However, mobile software development has been challenging. There are different mobile platforms, customized differently to each device and carrier combination. Furthermore, deploying mobile applications can require separate business arrangements with individual carriers and manufacturers. While the rise of app stores from Apple, Nokia, RIM, Microsoft, and others as well as the adoption of HTML 5 on mobile platforms have helped, it is still very difficult to provide a service to the largest group of network-connected people in the world. We acquired the startup Android in 2005 and set about the ambitious goal of creating a new mobile operating system that would allow open interoperation across carriers and manufacturers. Last year, after a lot of hard work, we released Android to the world. As it is open source, anyone is free to use it and modify it. We look forward to seeing how this open platform will spur greater innovation. Furthermore, Android allows for easy creation of applications which can be deployed on any Android device. To date, more than 1000 apps have been uploaded to the Android Market including Shop Savvy (which reads bar codes and then compares prices), our own Latitude, and Guitar Hero World Tour. AI The past decade has seen tremendous changes in computing power amplified by the continued growth of Google's data centers. It has enabled the growth and processing of increasingly large data sets such as the web, the world's books, and video. This in turn has allowed problems once considered to be in the fantasy realm of artificial intelligence to come closer to reality. Google Translate supports automatic machine translation between 1640 language pairs. This is made possible by large computer clusters and vast repositories of monolingual and multilingual texts: <a href="http://www.google.com/intl/en/help/faq_translation.html">http://www.google.com/intl/en/help/faq_translation.html</a>. This technology also allows us to support translated search where the query gets translated to another language and the results get translated back. While the earliest Google Voice Search ran as a crude demo in 2001, today our own speech recognition technology powers GOOG411, the voice search feature of the Google Mobile App, and Google Voice. It, too, takes advantage of large training sets and significant computing capability. Last year, PicasaWeb, our photo hosting site, released face recognition, bringing a technology that is on the cutting edge of computer science to a consumer web service. Just a few months ago we released Google Flu Trends, a service that uses our logs data (without revealing personally identifiable information) to predict flu incidence weeks ahead of estimates by the Centers for Disease Control (CDC). It is amazing how an existing data set typically used for improving search quality can be brought to bear on a seemingly unrelated issue and can help to save lives. I believe this sort of approach can do even more — going beyond monitoring to inferring potential causes and cures of disease. This is just one example of how large data sets such as search logs coupled with powerful data mining can improve the world while safe guarding privacy. Conclusion Given the tremendous pace of technology, it is impossible to predict far into the future. However, I think the past decade tells us some things to expect in the next. Computers will be 100 times faster still and storage will be 100 times cheaper. Many of the problems that we call artificial intelligence today will become accepted as standard computational capabilities, including image processing, speech recognition, and natural language processing. New and amazing computational capabilities will be born that we cannot even imagine today. While about half the people in the world are online today via computers and mobile phones, the Internet will reach billions more in the coming decade. I expect that by using simple yet powerful models of computing such as web services, everyone will be more productive. These tools enable individuals, small groups, and small businesses to accomplish tasks that only large corporations could achieve before, whether it is making and releasing a movie, marketing a product, or reporting on a war. When I was a child, researching anything involved a long trip to the local library and good deal of luck that one of the books there would be about the subject of interest. I could not have imagined that today anyone would be able to research any topic in seconds. The dark clouds currently looming over the world economy are a hardship for us all, but by the time today's children grow up, this recession will be a footnote in history. Yet the technologies that we create between now and then will define their way of life.

The 2008 Founders' Letter

Posted by Sergey Brin, Co-founder & President, Technology Every year our founders take turns writing a letter that is included in our an...

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Medical Cyber Piracy: Are National Electronic Health Records Plans Premature?

In 1961, President John F. Kennedy stood before a joint session of Congress and declared: <blockquote style="font-family: arial;">"It is time for a great new American enterprise -- time for this nation to take a clearly leading role in space achievement, which in many ways may hold the key to our future on earth ... First, I believe that this nation should commit itself to achieving the goal, before this decade is out, of landing a man on the moon and returning him safely to the earth. No single space project in this period will be more impressive to mankind, or more important for the long-range exploration of space; and none will be so difficult or expensive to accomplish."</blockquote> In setting such an ambitious goal, the President was primarily putting at risk a handful of volunteer astronauts, several of whom actually did perish in the effort. In 2009, President Obama committed the U.S. to full interconnected electronic health records (EHR's) by 2014. In doing so, the President may be putting at risk millions of <a href="http://hcrenewal.blogspot.com/2009/03/draft-patient-rights-statement-and.html">non-volunteer</a>, ordinary people if the following is an example of what we can look forward to: <blockquote> <a href="http://www.washingtonpost.com/wp-dyn/content/article/2009/05/07/AR2009050702515.html">Authorities Hunt Hackers in Breach of Va. Health Data</a> By Brian Krebs and Anita Kumar Washington Post Staff Writers Thursday, May 7, 2009 2:06 PM RICHMOND, May 7 -- The FBI and Virginia State Police are searching for hackers who have demanded the state pay them a $10 million ransom by Thursday for the return of millions of personal pharmaceutical records they stole from the state's prescription drug database. The hackers claim to have accessed 8 million patient records and 35 million prescriptions collected by the Prescription Monitoring Program. ... State officials learned on April 30 that hackers had replaced the site's homepage with a ransom note demanding the $10 million payment [hence my title of medical cyber piracy - although perhaps I should call it cyber terrorism? -ed.] in order to receive a password needed to retrieve the records, according to a posting on Wikileaks.org, an online clearinghouse for leaked documents. The program's computer system has been shut down since last week's breach, but all data were backed up and those files have been secured, Whitley Ryals said. Virginians are still able to get prescriptions filled. "We do have some of systems restored, but we're being very careful in working with experts and authorities to take essential steps as we proceed forward," she said. "Only when the experts tell us that these systems are safe and secure for being live and interactive will that restoration be complete." State law requires the agency notify individuals whose personal information may have been accessed. Officials are working with state attorneys to figure out how and when they will do that. The state-run database allows doctors and pharmacies to track powerful narcotics and painkillers to reduce the abuse, theft and illegal sale of the controlled substances sold under labels such as OxyContin and Vicodin. It was set up as a pilot program in southwestern Virginia in 2003 and expanded statewide in 2006. Emily Wingfield, chief deputy director of the Department of Health Professions, said the database contained 31.3 million prescription records as of Jan. 1. About 1 million records are added every month, she said. [And now the customary disclaimer - ed.] State officials say they have no evidence that any personal information is at risk, but they recommend that anyone concerned about possible identity theft keep track of personal financial statements and periodically review credit reports. </blockquote> Only the world's dreamiest and most naive optimist could believe that these occurrences of medical cyber piracy - or worse - would not become commonplace, with rapid expansion of a diverse array of commercial electronic health records systems among our nation's thousands of hospitals and hundreds of thousands of practitioners. This is especially true at our current levels of information technology, but also at "our" (meaning, the existing pool of IT professional's) current levels of competence and intellectual capability to manage this technology. This story in today's Wall Street Journal is another case in point along those lines: <blockquote style="font-family: arial;"><a href="http://online.wsj.com/article/SB124165272826193727.html">FAA's Air-Traffic Networks Breached by Hackers</a> By SIOBHAN GORMAN <a href="http://online.wsj.com/search/search_center.html?KEYWORDS=SIOBHAN+GORMAN&ARTICLESEARCHQUERY_PARSER=bylineAND"></a><h3 class="byline"> </h3>WASHINGTON -- Civilian air-traffic computer networks have been penetrated multiple times in recent years, including an attack that partially shut down air-traffic data systems in Alaska, according to a government report. The report, which was released by the Transportation Department's inspector general Wednesday, warned that the Federal Aviation Administration's modernization efforts are introducing new vulnerabilities that could increase the risk of cyberattacks on air-traffic control systems. The FAA is slated to spend approximately $20 billion to upgrade its air-traffic control system over the next 15 years. The increasing reliance of modernized systems on the Internet "is especially worrisome at a time when the nation is facing increased threats from sophisticated nation-state sponsored cyber attacks," wrote Assistant Inspector General Rebecca Leng.... Security tests identified 763 "high risk" vulnerabilities that could allow hackers access to administrative systems, which could then provide a path to more-sensitive operational systems, the report said.... Last year, hackers of unspecified origin "took over FAA computers in Alaska" to effectively become agency insiders, and traveled the agency networks to Oklahoma, where they stole the network administrator's password and used it to install malicious codes, the report said. These hackers also gained the ability to obtain 40,000 FAA passwords and other information used to control the administrative network, it said. In February, another cyber break-in yielded the personal information of 48,000 current and former agency employees. "The threat of hackers interfering with our air-traffic control systems is not just theoretical; it has already happened," said Republican Rep. Tom Petri of Wisconsin, one of the lawmakers who requested the report. "We must regard the strengthening of our air-traffic control security as an urgent matter."</blockquote> In Nov. 2008 I wrote in a post "<a href="http://hcrenewal.blogspot.com/2008/11/should-us-call-moratorium-on-ambitious.html">Should The U.S. Call A Moratorium On Ambitious National Electronic Health Records Plans</a>?" that 2009 might not be the optimal time for a major national health IT initiative, and that a moratorium on such efforts should be considered. I amplified the point in <a href="http://hcrenewal.blogspot.com/2009/01/i-ask-again-should-us-call-moratorium.html">this followup post</a> and at <a href="http://hcrenewal.blogspot.com/search?q=moratorium">these posts</a> as well. The Virginia prescription records debacle adds to my concerns. There are some national initiatives, such as a lunar landing, that are supported by a likely, relatively small extension of existing technologies, plus a low risk factor or risk factor to a small number of people. There are other national initiatives whose time may not yet have come due to technological limitations, but even more importantly, due to the advanced technology developed by the (brilliant) few outpacing the capabilities of the (average) many to manage it properly. One needs to ask - without conflict of interest - if the risks of any mass social and technological engineering initiative such as national EHR's are truly outweighed by the benefits at this point in time. This is not an easy decision. The common refrain that to not proceed with national EHR now would "hold back innovation", however, is one of objectification of the people. It is a "HIT live or let die" philosophy (let people die, or be injured physically or socially, so that IT may live) in my opinion. I report, you decide. -- SS May 8, 2009 addendum: The "live and let ... die" attitude can be seen in the concluding paragraph in a response by AMIA to Penn researcher Ross Koppel's JAMA article "<a href="http://jama.ama-assn.org/cgi/content/extract/301/12/1276">Health Care Information Technology Vendors' "Hold Harmless" Clause - Implications for Patients and Clinicians</a>." The AMIA response <a href="http://www.amia.org/files/AMIA%20Response%20to%20Commentary%20in%20JAMA4.27.09.pdf">here</a> (PDF) concludes with this paragraph: <div style="margin-left: 40px;">While we support increased transparency around error disclosure, the belief that the best approach to increase the safety and effectiveness of EHR systems is by legal regulation of system vendors is misplaced. Such an approach would stifle innovation and not achieve the desired goals. </div> I am sympathetic to these concerns, but only to the extent that I can tolerate the commentary's apparent irrationally exuberant and naive character. I ask: how, exactly, are the beliefs "misplaced"? Who actually holds "misplaced" views? Those people who argue for patient and medical professional rights, a cautious approach to HIT, and regulation (as has occurred for decades in other biomedical industries such as pharma and medical devices), or those people who believe vendors can be counted on to disclose defects 100% by themselves on an "honor" system, without regulation? Ironically, I believe their is much to be learned from another Penn researcher, in an article published in today's Philadelphia Inquirer: <blockquote>Posted on Fri, May. 8, 2009 <a href="http://www.philly.com/inquirer/home_top_stories/20090508_Looking_back__years_after_Penn_gene-therapy_death.html">Looking back, years after Penn gene-therapy death</a> By Marie McCullough Inquirer Staff Writer </blockquote>This is one of the strongest cautionary tales regarding the unbridled drive for "innovation" that I've seen in some time. -- SS

Medical Cyber Piracy: Are National Electronic Health Records Plans Premature?

In 1961, President John F. Kennedy stood before a joint session of Congress and declared: "It is time for a great new American ente...

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What's your Google story?

Working on the search team over the last few years, I have heard interesting stories of how Google has made a difference to individuals across the world. For instance, Yanick Cusson from Canada wrote to tell us about how he found his father: <div><div style="direction: ltr;"><blockquote>"I will always remember the very first day I got Internet at home. I had not seen my father in 17 years and had no clue where he was. The very first web page I went to was Google, and I simply wrote his name in the search box, and guess what? A public announcement from the government dated four years back mentioned him as promoted! I called the person who wrote the announcement, and by luck, she worked one floor up from my father's office. She transferred me directly to him, and we started talking. We have been in touch since then, and it's great!"</blockquote> </div> </div> It's stories like this that show us how Google Search can make a real difference for people — and that's what keeps us excited to come to work every day. If you have a story to share about how Google Search has made an impact on your life, we would love to hear it. <a href="http://services.google.com/feedback/share_success">Tell us here</a> by writing your story or <a href="https://www.google.com/accounts/ServiceLogin?service=youtube&hl=es_ES&passive=true&ltmpl=sso&uilel=3&continue=http%3A//www.youtube.com/signup%3Fhl%3Des_ES%26warned%3D%26nomobiletemp%3D1%26next%3D/my_videos_upload">posting a video</a>. We look forward to hearing from you. Posted by Jack Menzel, Group Product Manager

What's your Google story?

Working on the search team over the last few years, I have heard interesting stories of how Google has made a difference to individuals acro...

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Tuning in to TV data

This post is the latest in an ongoing series on <a href="http://googleblog.blogspot.com/search/label/measurement">The Power of Measurement</a>. Previous topics have covered ways to make your website as successful as possible through tools such as <a href="http://googleblog.blogspot.com/2009/02/stop-bouncing-tips-for-website-success.html">Analytics</a> and <a href="http://googleblog.blogspot.com/2009/03/make-sense-of-your-site-tips-for.html">Website Optimizer</a>. -Ed. What if the ads we saw when watching TV were always just what we wanted to see? Well, we believe it is possible to make TV ads more relevant to viewers and to deliver more value to advertisers. Television is becoming more like the web. Just as users click with their mouse to choose what's most relevant to them on the web, viewers send signals about what they want to see on television with clicks of the remote control. Each week, Google analyzes data from millions of anonymized set-top boxes (STBs) to see which channels they were tuned to second by second. This data is provided by our partner, EchoStar. We're then able to use <a href="http://www.google.com/adwords/tvads/metrics/index.html">tuning metrics</a> to provide our advertisers with <a href="http://www.google.com/adwords/tvads/guide/reports.html">next-day reports</a> of how many televisions showed their ads nationwide and how the audience responded with their remotes. We look at the various tuning metrics as signals from the audience about what they want to see and when. One of the metrics we've been exploring is the <a href="http://www.google.com/adwords/tvads/metrics/page5.html">% Initial Audience Retained</a> (%IAR). This is the percentage of the audience that was present at the beginning of the ad and then stayed tuned-in through the entire ad. If most viewers see an ad they like and decide to stay tuned-in, that ad would have a high %IAR. Many factors affect audience behavior, including the nature of the programming, the time of day, the day of week, and, of course, the personality of each viewer. But ads themselves also have an impact. By identifying which factors affect tune-away, we can focus in on how the audience reacted to the ad itself. Check out this video to learn what we found: <object height="340" width="560"><param name="movie" value="http://www.youtube.com/v/Ri4uORl60qI&hl=en&fs=1"><param name="allowFullScreen" value="true"><param name="allowscriptaccess" value="always"><embed src="http://www.youtube.com/v/Ri4uORl60qI&hl=en&fs=1" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" height="340" width="560"></embed></object> The chart below shows all TV commercials that aired on the Google TV Ads platform August through November 2008. Each dot represents an ad, and they are lined up from left to right in order of their %IAR as compared to what we'd expect given other factors (e.g., time of day, network, etc). The red dots on the left represent ads where more audience tuned away than expected. The green dots on the right represent ads where more of the audience stayed tuned than expected. The black dots in the middle are "normal," meaning there was no significant difference between the audience retention for those ads versus what you would expect based on historical data. <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEimR3MQ6HS_OgIYzayMtVOukyprApznGAmFSFoHpLBwL8y4H9ynPIIzN1L0PfpTrd_qcIhYUlWCXUf4c76c-vgbIRvKH95-MSjxDng-qj0nQRYHJJgYIzvnVZ5PvuoKsrcCHNgSoK7adBnf/s1600-h/quality.png" onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5332840189251809538" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEimR3MQ6HS_OgIYzayMtVOukyprApznGAmFSFoHpLBwL8y4H9ynPIIzN1L0PfpTrd_qcIhYUlWCXUf4c76c-vgbIRvKH95-MSjxDng-qj0nQRYHJJgYIzvnVZ5PvuoKsrcCHNgSoK7adBnf/s400/quality.png" style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 324px; height: 322px;" /></a><div style="text-align: center;">(Click on the image for a full-size version) </div>The next question we wanted to answer was how well this historical data could predict the future audience reaction. If we can use the past to predict the future, then we can get closer to putting relevant ads in front of TV viewers. So we selected one ad with relatively high audience tune-away (red dot) and one ad with relatively low tune-away (green dot) to run side-by-side on national television to test our findings. In the graph below, the diagonal line shows where audiences reacted the same to both ads. The points above that line represent airings when more of the audience stayed tuned to the ad that had previously retained audiences better. We learned audiences reacted predictably to the two ads. <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiLfwnsCsiCdC4MJOOvCkr0mGvJrgCZhhc_Kzx4O9XowEM48K831dVUh7KBEu5TujB5hmp3Y1K2Lu3DbyUJ_fE-PWJefeZ1N9XJNywbuDR8L7VXgazl2EOda83XOrJRKpcI41ClmscAoweJ/s1600-h/airings.png" onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5332840439042105842" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiLfwnsCsiCdC4MJOOvCkr0mGvJrgCZhhc_Kzx4O9XowEM48K831dVUh7KBEu5TujB5hmp3Y1K2Lu3DbyUJ_fE-PWJefeZ1N9XJNywbuDR8L7VXgazl2EOda83XOrJRKpcI41ClmscAoweJ/s400/airings.png" style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 399px; height: 400px;" /></a> <div style="text-align: center;">(Click on the image for a full-size version) </div> Through our analysis of tuning data from millions of set-top boxes, we're getting closer to matching the right ads to the right television audience. It takes a lot of processing power to make sense of the enormous amount of data, but the insights to be gleaned are very powerful. Not only are we able to offer advertisers better measurement and more accountability for their TV campaigns, our goal is to also create a better viewing experience for TV audiences by showing viewers what they want to see. Posted by By Dan Zigmond, Technical Lead for Google TV Ads

Tuning in to TV data

This post is the latest in an ongoing series on The Power of Measurement . Previous topics have covered ways to make your website as success...

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