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Nemeroff, Seroquel, and ACCME

Nemeroff, Seroquel, and ACCME<br /><br />Roy Poses has <a href="http://hcrenewal.blogspot.com/2009/10/more-on-misleading-promotion-of.html">discussed</a> the atypical antipsychotic drug Seroquel (quetiapine) several times on this site, pointing out manipulation of clinical research results to enhance the appearance of efficacy, and suppression of studies with unfavorable results. I call this augmenting the marketed profile of the drug. Daniel Carlat has commented on published Seroquel data <a href="http://carlatpsychiatry.blogspot.com/2009/06/geodon-ineffective-for-bipolar.html">here</a> and ClinPsych <a href="http://clinpsyc.blogspot.com/search?q=Seroquel">here</a>.<br /><br />AstraZeneca, the marketer of Seroquel, has also been busy with continuing medical education (CME) programs that augment Seroquel’s profile. Last December 8, one such program went on line, aired by the provider CME Outfitters. The program’s title was “Atypical Antipsychotics in Major Depressive Disorder: When Current Treatments Are Not Enough.” The corporate logo for CME Outfitters is Education with Integrity. I will allow readers to decide if the company is meeting its mission statement in this respect.<br /><br />The key opinion leader engaged by CME Outfitters to discuss Seroquel and other atypical antipsychotic drugs was Charles Nemeroff of Emory University. He was joined by 2 KOLs-in-training, whom I will not name. The corporate sponsor that paid CME Outfitters and, indirectly, these presenters was AstraZeneca. I do not need to rehearse here the ethical issues that have surrounded Dr. Nemeroff for the past several years. Suffice it to say that, as a result of those issues, Dr. Nemeroff is no longer chair of the department of psychiatry at Emory University, he is no longer editor-in-chief of the ACNP journal Neuropsychopharmacology, he was removed from involvement with ongoing federally funded research grants at Emory University, and he was put on a short leash by the Emory administration.<br /><br />On December 23, 2008 I filed a formal complaint about Dr. Nemeroff’s program with ACCME. My bill of particulars was lengthy, detailed, and backed up by extensive<br />materials. In due course, ACCME investigated the complaint and found that the program did violate ACCME standards. With respect to content, ACCME determined that Dr. Nemeroff’s program lacked sufficient information about possible adverse effects of treatment with atypical antipsychotic drugs; and failed to emphasize sufficiently the efficacy of alternative treatments. With respect to commercial bias, ACCME determined that bias existed as a result of the absence of contrasting therapy data, and through downplaying the drawbacks related to treatment with atypical antipsychotic drugs in depressed patients.<br /><br />Following these findings by ACCME, the provider was notified of the violations in early September 2009, and the program was removed from the provider’s website. The sanitized statement of violations determined by ACCME does not capture the nuances of deceit, ineptitude, and deficient educational content in Dr. Nemeroff’s program. One remarkable example was Dr. Nemeroff’s citation of data, from one of his own publications, that were previously retracted. Did he think no one would notice?<br /><br />A second example involved biased presentation of the sponsor’s data for Seroquel. Two doses of Seroquel (150 mg and 300 mg) were tested. Only the results for the 300 mg dose were statistically significant. Nevertheless, in the video presentation one of the junior presenters stated very clearly that there was “significant improvement in both response and remission with both doses” of Seroquel. That is a falsification of the scientific record. That falsification does not meet ACCME requirements for fair, balanced, truthful, and honest teaching. As moderator, Dr. Nemeroff was required to correct this false statement made by his junior assistant, but Dr. Nemeroff failed to do so.<br /><br />The negative findings and sanction by ACCME against Dr. Nemeroff’s program are welcome, though I have to say it took ACCME an inordinately long time to complete their work. I also presented ACCME with several follow-on questions, which the Council is now considering. These are:<br /><br />• Did ACCME notify the presenters that their program violated ACCME policies? If not, why not?<br /><br />• Will CME credits be clawed back from physicians and other professionals who obtained credits through the noncompliant program? If not, why not? I believe this would be an effective form of negative feedback to the provider and the presenters.<br /><br />• Does ACCME have a process to require the provider and presenters to ascertain whether any patients were injured as a result of the violations that created biased and deficient information in this program? If not, why not?<br /><br />• Does ACCME require the provider to notify physicians and other professionals who completed the noncompliant program that the provider was sanctioned for violation of ACCME standards? If not, why not?<br /><br />• Does ACCME require the provider to furnish corrective materials to such professionals in order to remedy the bias and incompetence to which they were subjected through violation of ACCME standards, and thereby to remove potential danger to future patients? If not, why not?<br /><br />• Why did ACCME allow the noncompliant program to remain available long after the complaint was filed? I suggest that ACCME needs to place a hold on programs that are subject to active complaint. Had such a policy been in effect in December 2008, the violating program would not have been re-aired by the provider in early 2009, it would not have remained on-line for 9 months, and the damage to the continuing education community would have been contained.<br /><br />• Will ACCME issue a public listing of sanctions it has enforced against providers and presenters? If not, why not? State medical boards do exactly that in relation to physicians and other professionals who violate standards of practice.<br /><br />• Finally, I reminded ACCME that its primary constituents are patients, physicians and other professionals, not commercial or academic CME providers. It seems to me that ACCME was altogether too laissez-faire and dilatory in the way it handled this matter. At the time of my initial complaint last December, I requested expedited review precisely because additional airings of this violating program were scheduled.<br /><br />The good news is that ACCME seems to have got the message that things need to change. As one of their officers wrote to me recently, “We sincerely appreciate the time and effort you have put into participating in our complaints and inquiries process. You have raised important issues that the ACCME will review and address.” I await their next communications on the remaining questions.<br /><br />As for Dr. Nemeroff, he is yesterday’s news. The adverse findings by ACCME about his program serve as a reminder to corporate sponsors and CME companies that Dr. Nemeroff is so compromised by now that he has lost effectiveness as a front man for Pharma. Indeed, he is so toxic that he now glows in the dark.

Nemeroff, Seroquel, and ACCME

Nemeroff, Seroquel, and ACCME Roy Poses has discussed the atypical antipsychotic drug Seroquel (quetiapine) several times on this site, poi...

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This week in search 10/9/09

<span style="font-style:italic;">This is part of a regular series of posts on search experience updates that runs on Fridays. Look for the label "<a href="http://googleblog.blogspot.com/search/label/This%20Week%20in%20Search">This week in search</a>" and subscribe to the series. - Ed.</span><br /><br />This week we made many small improvements to the functionality and usability of our search results. Here's an overview:<br /><br /><span class="Apple-style-span" style="font-weight: bold;">Quick, in-browser viewing of Google Docs</span><br />We've incorporated the <a href="http://googleblog.blogspot.com/2009/10/quickly-view-formatted-pdfs-in-your.html">"Gview" tool from Google Docs on search results</a>. Instead of the old "View as HTML" view, PDFs on search results now have a "Quick View" link that shows you Gview's image-rendered version, which preserves tables and graphics from the document. This means you can view PDF documents quickly and easily right in your browser.<br />Example search: [<a href="http://www.google.com/search?hl=en&rlz=1C1GGLS_enUS291US304&q=1099&aq=f&oq=&aqi=">1099</a>] (note the "Quick view" links on the first two results)<br /><br /><span class="Apple-style-span" style="font-weight: bold;">An improved interface for local information in web search</span><br />We changed our interface for local business information when it occurs in search results. It's now much more readable (larger fonts) and friendlier to use (easier to click on just what you want).<div>Example search: [<a href="http://www.google.com/search?hl=en&rlz=1C1GGLS_enUS291US304&q=pizza+palo+alto&aq=f&oq=&aqi=g2g-m8">pizza palo alto</a>]<br /><br />Here are before and after shots for the search [<a href="http://www.google.com/search?hl=en&rlz=1C1GGLS_enUS291US304&q=bakeries+san+francisco&btnG=Search&aq=f&oq=&aqi=">bakeries san francisco</a>]:<div><br /><table><tbody><tr><td><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgzuvtNARTaltHo0x012mg1R2tP5VRq_vNy55dOR4-gtbnQn6nRC4HubFSd3_CaLpH1ES1DuoXEYkDwhmkW95j3OzTtaBv-wImguxt0DRqudL-6BzAVT9OQCF0E98ujwSY237wk3NVG24No/s1600/bakeries+before.png"><img border="1" height="120" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgzuvtNARTaltHo0x012mg1R2tP5VRq_vNy55dOR4-gtbnQn6nRC4HubFSd3_CaLpH1ES1DuoXEYkDwhmkW95j3OzTtaBv-wImguxt0DRqudL-6BzAVT9OQCF0E98ujwSY237wk3NVG24No/s1600/bakeries+before.png" /></a></td><td><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEghGckUs6wOFefLbpMvCrPJVRGwlaUDPCfQPIA1UQfhErbwNrLCsMXefgGIvPJXTbZRepqw9AR7CZ7xiX1X-P37ofP3MoeGuajbBYZA5V2h_8u2z_MQ5AdSlsOu-VTEKbm_sNUzTTxSSBP4/s1600-h/bakeries+after.png"><img height="120" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEghGckUs6wOFefLbpMvCrPJVRGwlaUDPCfQPIA1UQfhErbwNrLCsMXefgGIvPJXTbZRepqw9AR7CZ7xiX1X-P37ofP3MoeGuajbBYZA5V2h_8u2z_MQ5AdSlsOu-VTEKbm_sNUzTTxSSBP4/s1600/bakeries+after.png" /></a></td></tr></tbody></table> <span class="Apple-style-span" style="font-style: italic;"><span class="Apple-style-span"  style="font-size:small;"> Click on either image for a larger version</span></span></div><div><br /><span class="Apple-style-span" style="font-weight: bold;">Access to multiple providers in weather results</span><br />We also changed the interface for our weather results when they occur in web search. Now you'll see an array of different weather providers to choose from, including The Weather Channel, Weatherunderground and AccuWeather, if you want more detailed weather information. This way, you get the weather information you need, in the layout you prefer, from the service you choose.<br />Example search: [<a href="http://www.google.com/search?hl=en&rlz=1C1GGLS_enUS291US304&q=washington+dc+weather&aq=f&oq=&aqi=g-p1g9">washington dc weather</a>]<br /><br />And here are before and after shots for the search [<a href="http://www.google.com/search?rlz=1C1GGLS_enUS291US304&sourceid=chrome&ie=UTF-8&q=weather">weather</a>] (when done from the <a href="http://maps.google.com/?q=Google%20Inc.@37.423156,-122.084917&hl=en">Googleplex</a>, since the location is auto-detected):<br /><br /><table><tbody><tr><td><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiI56juSk8mUJ0Nu1-dRfxuzmKjgBmRWMD6DgFpupO8nHcsISjiEiUJThyyW8yaoJSdyArrVWSd57YLcd2EMoUsDTlczFNJrzv72BjRo5Jukcj2MU_34Uv2xyPFAmm-s4yvIUoSrLL324uS/s400/weather+before.png"><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiI56juSk8mUJ0Nu1-dRfxuzmKjgBmRWMD6DgFpupO8nHcsISjiEiUJThyyW8yaoJSdyArrVWSd57YLcd2EMoUsDTlczFNJrzv72BjRo5Jukcj2MU_34Uv2xyPFAmm-s4yvIUoSrLL324uS/s1600/weather+before.png" width="250" /></a></td><td><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh4Iw068F6xMT_Rh0tzENVbC2fEpY8yK-gM5VI21HSxo4wxd1CoGRX4A9ZCOZHNow5it3cWiyKkiEu0douf0wBFUFN-1ThVqnr1x8w1iMqsP4DdgPFoti8Dreal6TFyP1f6L3dgEsPXO2nj/s400/weather+after.png"><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh4Iw068F6xMT_Rh0tzENVbC2fEpY8yK-gM5VI21HSxo4wxd1CoGRX4A9ZCOZHNow5it3cWiyKkiEu0douf0wBFUFN-1ThVqnr1x8w1iMqsP4DdgPFoti8Dreal6TFyP1f6L3dgEsPXO2nj/s400/weather+after.png" width="250" /></a></td></tr></tbody></table><span class="Apple-style-span" style="font-style: italic;"><span class="Apple-style-span"  style="font-size:small;">Click on either image for a larger version</span></span><br /><br /><span class="Apple-style-span" style="font-weight: bold;">Public service information for searches related to poison control</span><br />While it's relatively infrequent, people do occasionally turn to Google during medical emergencies. Our goal in these cases is to get our users the help they need as quickly as possible. As of this week, searches related to [poison control] trigger a special result with the phone number for the poison control hotline.</div><div>Example searches: [<a href="http://www.google.com/webhp?hl=en#hl=en&source=hp&q=poison+control&aq=1p&aqi=g-p2g8&oq=pois&fp=7d15299a959dbb33">poison control</a>], [<a href="http://www.google.com/search?hl=en&client=firefox-a&rlz=1R1GGGL_en___US306&hs=ReR&q=first+aid+bleach+poisoning&aq=f&oq=&aqi=">first aid bleach poisoning</a>]<br /><br /><span class="Apple-style-span" style="font-weight: bold;">Search options panel for mobile</span><br />This week on mobile search, we added a Search Options panel so now you can get all of the same slice-and-dice functionality you have from your desktop when you search the web on your phone. Try doing a search from your phone and you will see an "Options" link on the righthand side above the results. Click on it and you see the same panel that you are accustomed to on search from your desktop.<br /><br /><span class="Apple-style-span" style="font-weight: bold;">Crawling AJAX</span><br />We also made an exciting announcement this week about <a href="http://googlewebmastercentral.blogspot.com/2009/10/proposal-for-making-ajax-crawlable.html">making AJAX crawlable</a>. Web applications are becoming increasingly popular, but much of what is contained with a web application is usually inaccessible to our crawlers and thus can't be found in our search. Our team has been busy working on techniques for how to crawl AJAX. This announcement just represents the start, as it's currently in the prototype phase, but it does demonstrate that we are constantly working on how to improve search — our features, ranking, and, in this case, our comprehensiveness. We're always very excited to include new content in our search to make our results even better.<br /><br />Hope you enjoyed this week's features. Stay tuned for what's next!<br /><br /><span class="byline-author">Posted by Marissa Mayer, VP Search Products & User Experience</span></div></div>

This week in search 10/9/09

This is part of a regular series of posts on search experience updates that runs on Fridays. Look for the label " This week in search ...

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More on the Misleading Promotion of Seroquel

Previous posts (<a href="http://hcrenewal.blogspot.com/2009/02/buried-data-smoke-and-mirrors-job-and.html">here</a> and <a href="http://hcrenewal.blogspot.com/2009/05/more-documents-about-selling-of.html">here</a>) noted internal documents from AstraZeneca made public during litigation about its blockbuster atypical antipsychotic drug Seroquel (quetiapine) suggesting that the company's marketers manipulated clinical research results to make them appear more favorable to the product, and suppress studies with unfavorable results that could not be easily manipulated.<br /><br />This week, <a href="http://www.bloomberg.com/apps/news?pid=20601085&sid=aplfa8pUrUsM">Bloomberg News reported </a>testimony from one trial about other aspects of Seroquel's marketing. The marketers' claims were at odds with the company's own research results:<br /><blockquote><br /><em>AstraZeneca Plc advised its sales force to promote the antipsychotic drug Seroquel as 'weight neutral' four years after company research found 'clinically significant' weight gains in users</em>, internal documents show.<br /><br />AstraZeneca’s 'global strategy is to demonstrate to consumers that Seroquel has a weight-neutral profile,' Debbie Holdsworth, a marketing official, wrote in a 'dear colleague' letter dated May 14, 2001. The document was produced during a pretrial examination of former executive John Patterson.<br /><br />'If 45 percent of patients gained significant weight in a year, how could that be weight-neutral?' patient attorney Ed Blizzard asked Patterson, citing a internal 1997 e-mail written by an AstraZeneca doctor, at a hearing in Orlando Oct. 5. </blockquote>Also, evidence was presented that suggested that company marketers consciously promoted the drug for off-label indications over several years:<br /><blockquote><br />Patterson was asked about a 'Seroquel Strategy Summary' issued in December 2000, which <em>described the broadening of Seroquel use 'on and off label' as a sales goal.</em> While doctors are free to prescribe any medicine to treat a given condition, it is illegal for drug companies to promote medicines for uses not approved by the U.S. Food and Drug Administration.<br /><br />'The company has standards and procedures to ensure its sales representatives do not promote off label,' Patterson testified. Still, <em>the goal of off-label promotion remained in strategy summaries for the years 2001 or 2002, he acknowledged</em>.<br /></blockquote><br /><br />Coupled with previous revelations (see posts noted above), it looks like the marketers were employing an integrated strategy combining a variety of deceptions, the sort of broad based <a href="http://hcrenewal.blogspot.com/search/label/stealth%20marketing">stealth marketing </a>approach we have seen employed to promote other health care products.<br /><br />Such strategies undoubtedly have lead to the prescribing of expensive drugs when other treatments, or no treatment would be better, and have helped support the high prices charged for products that are not necessarily so good for the many patients who have ended up getting them. Of course, the money thus generated has let many executives of the companies that employ such marketing strategies become rich. As Bloomberg reported:<br /><blockquote><br />Patterson, who reported directly to AstraZeneca’s chief executive officer, <em>was paid more than $1 million at one point during his tenure at the company</em>. He retired April 1 as executive director of product development, and is the highest- ranking AstraZeneca executive to testify in open court in lawsuits claiming the company withheld information about the risks of Seroquel.<br /></blockquote><br /><br />In my humble opinion, if we really want to reform health care in the US (and around the globe), we need to challenge how health care organizations have used their ability to sponsor medical research to manipulate its design, implementation, analysis and dissemination, and when necessary, to suppress its results to favor their vested interests. We also need to challenge systematically deceptive marketing practices designed to make products and services appear more useful than they really are, thus supporting exaggerated prices and prompting overuse. Unless we challenge these and some other causes of excess prices and excess use, attempts to provide universal health insurance and access will bankrupt us all.<br /><br />(And to preempt anyone in the audience who may recoil from anything that restricts the freedom of action of health care corporations - tell me how manipulation of research, suppression of research, and deceptive marketing is necessary for innovation or for adequate revenues to support good products?  I am not arguing for hamstrung companies.  I am arguing for honest business practices.)<br /><br />Hat tip to <a href="http://pharmagossip.blogspot.com/2009/10/astrazeneca-seroquel-weight-of-evidence.html">PharmaGossip</a>.

More on the Misleading Promotion of Seroquel

Previous posts ( here and here ) noted internal documents from AstraZeneca made public during litigation about its blockbuster atypical ant...

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New in Google Squared: quality improvements, sorting and exporting

Today we're launching a number of improvements to the amount and quality of information you can find with <a href="http://www.google.com/squared">Google Squared</a>, as well as new tools to sort and export the data.<br /><br />As we explained when we <a href="http://googleblog.blogspot.com/2009/06/square-your-search-results-with-google.html">first launched</a> Squared in Labs this summer, the product takes on a difficult technical challenge. It's a first step towards automatically extracting useful facts from all over the web and presenting them in meaningful way. It has the potential to be particularly useful for research questions where the answers may not live on a single website, but instead must be combined from many different pages.<br /><br />Rather than return a list of the most relevant websites, Squared returns a "square" (or table) of facts, sourced from across the Internet. For example, if you search Squared for [<a href="http://www.google.com/squared/search?q=US%20presidents&suggest=1">us presidents</a>], each row on the resulting table represents a particular United States President, and the columns include relevant facts about him, such as date of birth, a picture and a short description.<br /><br />At launch, your first square could include at most 30 facts. With today's update, squares display four times as much data — up to 120 facts. For example, instead of seeing only five presidents and three categories, now you'll see a table with 20 presidents and up to six attributes.<div><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj43p4qLo3xGbb2vX4_X0_og7ZWct4QER25xqO787dysLLWT05cxrj-52QgG9uohQd83nwdwZ4A0bnfZrLvOV2icpv1M7WLXjQBwSxtIDTXK7v4mE5FLUZcaeQwz-YuEP1HxamdPjt-FgyL/s1600-h/dg6t87s8_9hqhzc3d4_b.png" onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5390658315368360290" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj43p4qLo3xGbb2vX4_X0_og7ZWct4QER25xqO787dysLLWT05cxrj-52QgG9uohQd83nwdwZ4A0bnfZrLvOV2icpv1M7WLXjQBwSxtIDTXK7v4mE5FLUZcaeQwz-YuEP1HxamdPjt-FgyL/s400/dg6t87s8_9hqhzc3d4_b.png" style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 354px; height: 400px;" /></a><br />The quality of the information is also better, because we're ranking based on both relevance to your query and whether we can find high quality facts. For example, in the past we would show you a column for "First Lady" even if the column only included a couple accurate names. Now we're actively filtering out items (rows) and attributes (columns) from the initial square if we haven't found enough accurate data. Perhaps more interesting, we built Squared to learn from edits and corrections, so as people have been improving their squares, Google Squared has gotten better for everyone.<br /><br />In addition to improving the information in Squared results, we've also added the ability to sort columns, so you can rank, group and compare items. Squared will even convert units in the background to make sure the data is sorted properly. For example:<br /><ul><li>Sort to find the largest [<a href="http://www.google.com/squared/search?q=european+countries+">european countries</a>] by population or area.</li><li>See which mountains from the [<a href="http://www.google.com/squared/search?q=colorado+14ers">colorado 14ers</a>] are the tallest.</li><li>Make a list of [<a href="http://www.google.com/squared/search?q=new+york+city+thai+restaurants">new york city thai restaurants</a>] to try, grouped by neighborhood. </li><li>Find the newest [<a href="http://www.google.com/squared/search?q=baseball+stadiums+">baseball stadiums</a>]. </li></ul>We've also added the ability to export data from Squared to a <a href="http://docs.google.com/">Google Spreadsheet</a> or a CSV file, which should make it easier to do interesting things with the data. For example, you can build a square for [<a href="http://www.google.com/squared/search?q=african+countries">african countries</a>], add more items and columns, and examine the relationship between the literacy rate and GDP per capita. Once you've built your square to contain all the information you need, you can export the square to Google Spreadsheets and <a href="http://docs.google.com/support/bin/answer.py?hl=en&answer=63728">create a rough scatter plot</a>:</div><div><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhW2fqUFRMU1tCgvznIrSsXLSOGOK82tPsRkdaa5c6b7MA8s5AlaOWEjsn8Y85B2gYmo39DLvYht_VPe_qyCYhmN4uF_vSWsJ76lUdkQak8BBf1Ycto8EZRs57ThdNqiP-83jjsBXfsy1Yl/s1600-h/dg6t87s8_12ckzbm2fk_b.png" onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5390658329472565970" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhW2fqUFRMU1tCgvznIrSsXLSOGOK82tPsRkdaa5c6b7MA8s5AlaOWEjsn8Y85B2gYmo39DLvYht_VPe_qyCYhmN4uF_vSWsJ76lUdkQak8BBf1Ycto8EZRs57ThdNqiP-83jjsBXfsy1Yl/s400/dg6t87s8_12ckzbm2fk_b.png" style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 400px; height: 192px;" /></a><br />There's a lot left to do before Squared is ready to leave Labs — we're still working on improving quality as well as the user interface — but we hope that our recent improvements make it more useful. In its experimental stage, Squared demonstrates an important future direction in search: understanding structured data from across the web to build new tools for organizing and presenting information. Try it out, and <a href="https://survey.googleratings.com/wix/p3187618.aspx">let us know</a> what you think.<br /><br /><span class="byline-author">Posted by Noah Weiss, Associate Product Manager, and Randy Brown, Software Engineer</span></div>

New in Google Squared: quality improvements, sorting and exporting

Today we're launching a number of improvements to the amount and quality of information you can find with Google Squared , as well as ne...

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A tale of 10,000,000 books

<span class="Apple-style-span" style="font-style: italic;"><blockquote>The fundamental reasons why the electric car has not attained the popularity it deserves are (1) The failure of the manufacturers to properly educate the general public regarding the wonderful utility of the electric; (2) The failure of [power companies] to make it easy to own and operate the electric by an adequate distribution of charging and boosting stations. The early electrics of limited speed, range and utility produced popular impressions which still exist.</blockquote></span>This quotation would hardly surprise anyone who follows electric vehicles. But it may be surprising to hear that in the year when it was written thousands of electric cars were produced, and that year was nearly a century ago. This appeared in a <a href="http://books.google.com/books?id=SKkvAAAAYAAJ&pg=RA1-PA1236&dq=electric+vehicle&as_brr=4&ei=aDmvSpelIo3YkQTdsJz1Ag#v=onepage&q=electric%20vehicle&f=false">1916 issue of the journal Electrical World</a>, which I found in <a href="http://books.google.com/">Google Books</a>, our searchable repository of millions of books. It may seem strange to look back a hundred years on a topic that is so contemporary, yet I often find that the past has valuable lessons for the future. In this case, I was lucky — electric vehicles were studied and written about extensively early in the 20th century, and there are many books on the subject from which to choose. Because books published before 1923 are in the public domain, I am able to view them easily.<div><br />But the vast majority of books ever written are not accessible to anyone except the most tenacious researchers at premier academic libraries. Books written after 1923 quickly disappear into a literary black hole. With rare exceptions, one can buy them only for the small number of years they are in print. After that, they are found only in a vanishing number of libraries and used book stores. As the years pass, contracts get lost and forgotten, authors and publishers disappear, the rights holders become impossible to track down.<div><br />Inevitably, the few remaining copies of the books are left to deteriorate slowly or are lost to fires, floods and other disasters. While I was at Stanford in 1998, <a href="http://news.stanford.edu/news/1998/april1/flood41.html">floods damaged or destroyed tens of thousands of books</a>. Unfortunately, such events are not uncommon — a similar flood happened at Stanford just 20 years prior. You could read about it in <a href="http://books.google.com/books?id=D_v-HAAACAAJ">The Stanford-Lockheed Meyer Library Flood Report</a>, published in 1980, but this book itself is no longer available.</div><div><br />Because books are such an important part of the world’s collective knowledge and cultural heritage, Larry Page, the co-founder of Google, first proposed that we digitize all books a decade ago, when we were a fledgling startup. At the time, it was viewed as so ambitious and challenging a project that we were unable to attract anyone to work on it. But five years later, in 2004, Google Books (then called Google Print) was born, allowing users to search hundreds of thousands of books. Today, they number over 10 million and counting.</div><div><br />The next year we were sued by the Authors Guild and the Association of American Publishers over the project. While we have had disagreements, we have a common goal — to unlock the wisdom held in the enormous number of out-of-print books, while fairly compensating the rights holders. As a result, we were able to work together to devise a <a href="http://books.google.com/googlebooks/agreement/">settlement</a> that accomplishes our shared vision. While this settlement is a win-win for authors, publishers and Google, the real winners are the readers who will now have access to a greatly expanded world of books.</div><div><br />There has been some debate about the settlement, and many groups have offered their opinions, both for and against. I would like to take this opportunity to dispel some myths about the agreement and to share why I am proud of this undertaking. This agreement aims to make millions of out-of-print but in-copyright books available either for a fee or for free with ad support, with the majority of the revenue flowing back to the rights holders, be they authors or publishers.</div><div><br />Some have claimed that this agreement is a form of compulsory license because, as in most class action settlements, it applies to all members of the class who do not opt out by a certain date. The reality is that rights holders can <span class="Apple-style-span" style="font-style: italic;">at any time</span> set pricing and access rights for their works or withdraw them from Google Books altogether. For those books whose rights holders have not yet come forward, reasonable default pricing and access policies are assumed. This allows access to the many orphan works whose owners have not yet been found and accumulates revenue for the rights holders, giving them an incentive to step forward.</div><div><br />Others have questioned the impact of the agreement on competition, or asserted that it would limit consumer choice with respect to out-of-print books. In reality, nothing in this agreement precludes any other company or organization from pursuing their own similar effort. The agreement limits consumer choice in out-of-print books about as much as it limits consumer choice in unicorns. Today, if you want to access a typical out-of-print book, you have only one choice — fly to one of a handful of leading libraries in the country and hope to find it in the stacks.</div><div><br />I wish there were a hundred services with which I could easily look at such a book; it would have saved me a lot of time, and it would have spared Google a tremendous amount of effort. But despite a number of important digitization efforts to date (Google has even helped fund others, including some by the Library of Congress), none have been at a comparable scale, simply because no one else has chosen to invest the requisite resources. At least one such service will have to exist if there are ever to be one hundred.</div><div><br />If Google Books is successful, others will follow. And they will have an easier path: this agreement creates a books rights registry that will encourage rights holders to come forward and will provide a convenient way for other projects to obtain permissions. While new projects will not immediately have the same rights to orphan works, the agreement will be a beacon of compromise in case of a similar lawsuit, and it will serve as a precedent for orphan works legislation, which Google has always supported and will continue to support.</div><div><br />Last, there have been objections to specific aspects of the Google Books product and the future service as planned under the settlement, including questions about the quality of bibliographic information, our choice of classification system and the details of our privacy policy. These are all valid questions, and being a company that obsesses over the quality of our products, we are working hard to address them — improving bibliographic information and categorization, and further detailing our privacy policy. And if we don’t get our product right, then others will. But one thing that is sure to halt any such progress is to have no settlement at all.</div><div><br />In the <a href="http://books.google.com/books?id=SJbPAAAAMAAJ&pg=RA1-PA232&dq=alexandria+library+fire&as_brr=4&ei=bxW3Su2hLIHUlATWxsHrDw#v=onepage&q=alexandria%20library%20fire&f=false">Insurance Year Book 1880-1881</a>, which I found on Google Books, Cornelius Walford chronicles the destruction of dozens of libraries and millions of books, in the hope that such a record will “impress the necessity of <span class="Apple-style-span" style="font-style: italic;">something</span> being done” to preserve them. The famous library at Alexandria burned three times, in 48 B.C., A.D. 273 and A.D. 640, as did the Library of Congress, where a fire in 1851 destroyed two-thirds of the collection.</div><div><br />I hope such destruction never happens again, but history would suggest otherwise. More important, even if our cultural heritage stays intact in the world’s foremost libraries, it is effectively lost if no one can access it easily. Many companies, libraries and organizations will play a role in saving and making available the works of the 20th century. Together, authors, publishers and Google are taking just one step toward this goal, but it’s an important step. Let’s not miss this opportunity.<br /><br /><span class="byline-author">Posted by Sergey Brin, Co-Founder & President, Technology</span></div><br />(This first appeared in the New York Times, available <a href="http://www.nytimes.com/2009/10/09/opinion/09brin.html">here</a>.)<br /></div>

A tale of 10,000,000 books

The fundamental reasons why the electric car has not attained the popularity it deserves are (1) The failure of the manufacturers to properl...

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Healthcare Renewal Named a Forbes "Must Read" Health Blog

Healthcare Renewal Named a Forbes "Must Read" Health Blog

Healthcare Renewal has been named a Forbes "must read" health blog, one of three under the category "physician blogs." ...

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Google Flu Trends expands to 16 additional countries

If you're like us, you're probably thinking a lot about how this year's flu season might affect you and your community. To help you out, we at <a href="http://www.google.org/">Google.org</a> are excited to announce the expansion of <a href="http://www.google.org/flutrends/">Google Flu Trends</a> to 16 additional countries, including much of Europe. We've also made the site available in 37 languages. Flu is a global threat, affecting millions worldwide each year, so we're pleased to make this tool available in more regions and languages.<br /><br /><a href="http://googleblog.blogspot.com/2008/11/tracking-flu-trends.html">Last November</a>, we launched Google Flu Trends in the United States after finding a close relationship between how many people search for flu-related topics and how many people actually have flu symptoms. By tracking the popularity of certain Google search queries, we are able to estimate the level of flu, in near real-time. While some traditional flu surveillance systems may take days or weeks to collect and release data, Google search queries can be counted immediately. Google Flu Trends provides an additional surveillance tool that may help public health officials and the public make more informed decisions about preparing for the flu season.<br /><br />In the past year, we've expanded our coverage to include Mexico, New Zealand and Australia and have continued to see a good correspondence between our estimates and official flu activity data. In fact, our analysis of last season shows that Google Flu Trends had a close 0.92 correlation with official U.S. flu data.<br /><br />An important aspect of Google Flu Trends is that we filter out terms that may be popular because people hear about them in the news. What we do not use in the models is a term like [swine flu] since people are more likely to type that into Google because they want to know more information about it, given the news headlines, and not because they actually have H1N1 or swine flu. For more information about how we built this model, take a peek at this video:<br /><br /><object height="340" width="560"><param name="movie" value="http://www.youtube.com/v/6111nS66Dpk&hl=en&fs=1&"><param name="allowFullScreen" value="true"><param name="allowscriptaccess" value="always"><embed src="http://www.youtube.com/v/6111nS66Dpk&hl=en&fs=1&" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="560" height="340"></embed></object><br /><br />If you visit Google Flu Trends for the U.S., you'll notice that the flu season is starting early this year. For tips on how to stay healthy this season, please visit our friends at the <a href="http://www.cdc.gov/flu/protect/preventing.htm">U.S. CDC</a> and <a href="http://www.ecdc.europa.eu/en/healthtopics/Pages/Influenza_A%28H1N1%29_Outbreak.aspx">the ECDC</a>.<br /><br /><span class="byline-author">Posted by Matt Mohebbi and Dan Vanderkam, Software Engineers</span>

Google Flu Trends expands to 16 additional countries

If you're like us, you're probably thinking a lot about how this year's flu season might affect you and your community. To help ...

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