Let’s be honest, we’ve all done it – whether for a lingering headache, dietary titbits or understanding a diagnosis, we’ve all turned to our good friend Google for health advice. And while search engines have made health information more accessible and snackable than ever, there’s a hidden danger many of us may overlook: the reinforcement of our own biases.
Cognitive bias can play a significant role in shaping how patients search online, influencing how users interpret and interact with information. These biases not only affect the decision-making process but also the overall user experience, making it essential for digital platforms to present balanced, accurate information to guide users more effectively.
Let’s get into it, shall we?
What exactly is cognitive bias?
Cognitive bias refers to the systematic errors in our thinking that affect the decisions and judgements we as individuals make. These biases occur because the human brain relies on shortcuts – or, to use its fancier term, heuristics – to process information quickly.
Way back in the day, this evolutionary tool would help early humans navigate their environment, survive and reproduce. In our modern world, it’s particularly helpful when we’re searching online. And sometimes heuristics work in our favour, helping us consume information at pace. But other times, it leads to skewed or irrational conclusions.
This is cognitive bias, and it’s blunting our evolutionary tool. Cognitive biases influence how we perceive, interpret and remember information, impacting everything from our decision-making and social interactions to our perceptions of the world around us. It causes us to make illogical judgements about people, situations, even brands, that aren’t always accurate.
What’s cognitive bias got to do with SEO?
A lot, actually – cognitive biases influence how people perceive and interact with content online. It’s important to consider how these could intercept the way your audience thinks while they’re searching.
By understanding cognitive bias, your SEO strategies can be tailored to create content that helps patients make better, more informed healthcare decisions. And a big part of this is mitigating the potential for reinforcing incorrect content that could be damaging to health – information that confirms a bias in such a way that stops a patient from visiting the doctor, for example, or getting a health screening.
So how do search engines reinforce our cognitive bias?
Google and other search engines aim to personalise the content we see based on our previous searches, clicks and general online behaviour. This means search results can subtly (or perhaps not so subtly) lean into your preconceived notions, effectively confirming them.
In the context of health, this can be really dangerous. It has the propensity to perpetuate misinformation or a misunderstanding of complex medical conditions.
Let’s imagine we’re searching for information about whether there’s a connection between caffeine and hypertension. If you already believe caffeine contributes to high blood pressure, your search terms could already be skewed to confirm this, and you might naturally click on articles that reinforce this view. Over time, this behaviour might lead search engines to prioritise similar content in future searches, creating a bias loop.
I’ve never thought about my Google searches like that before…
It’s worrying, right? And sometimes this bias can become widespread. It can play a significant role in how people make decisions about vaccinating their children, for example, influencing perceptions of vaccine safety, effectiveness and associated risks, leading to decisions that don’t align with scientific evidence or expert recommendations.
A 2023 NHS survey shows vaccination rates in young children are falling. A similar Gov survey published this year on parental attitudes toward vaccines could explain why – it showed most parents were happy with the safety of vaccines for babies, but numbers had fallen to 88% from 92% the year before. 67% of these parents reported seeing vaccine information online, and 10% trusted the internet as its primary source of information on vaccines.
This can have a devastating impact – no better exemplified by the rise in whooping cough at the start of this year. 553 cases of the disease were confirmed in January 2024, compared to 858 cases throughout the whole of 2023. The link between the rise in cases and the steady decline in vaccination uptake for pregnant women and children has been suggested – the Department of Health and Social Care confirmed five infants died of the disease in the first quarter of 2024. As such, there has been a push from the UK Health Security Agency and the DHSC to provide factually correct, up-to-date information to help improve the uptake in vaccinations.
(It’s interesting to note that cognitive bias on vaccinations has been an issue long before the politics of the 2020s. A 2013 dutch study revealed 41% of parents used the internet to look for information about vaccinations – whilst doctors and nurses fell to second and third place – 26% and 24% – respectively.)
Is cognitive bias in search a new concern?
It becomes increasingly prevalent the more sophisticated our search engines become. The problem often lies in how their powerful natural language processing (NLP) capabilities deliver content. Google understands the relationships between words based on their context as well as their placement, and its algorithms are designed to prioritise results that seem most relevant to the user based on this.
Whether we realise it or not, we tend to invite our beliefs to the party when we search, seeking information that confirms the way we view the world around us. And when you’re inserting your own prejudices to your search terms, it often just reinforces what you already believe.
No terrible thing when you’re on the hunt for a good restaurant recommendation – but it can be risky when seeking health information. Just take a look at the above search term for the link between coffee and hypertension – sometimes you can get corroborating results from the same source. It makes trusting content on the internet a precarious task.
So my cognitive bias is present in my search results?
Yes! Unless you’ve been hiding under a rock with no WIFI, you’ve no doubt spotted Google’s snazzy new AI Overview. Don’t worry about getting FOMO if you haven’t – soon, Overviews will be everywhere. In fact, this study found that 86% of keywords already have AI Overview content attached.
The problem is, this feeds into what’s called our ‘anchoring bias’: the tendency to rely too heavily on the first piece of information you see. The first search results can heavily influence a patient’s perception of their condition – and as we’ve learnt from confirmation bias, the first search results are likely to agree with us.
The presence of SGR also moves the first organic results down pretty far – 1,630 pixels, to be exact – and experience tells us the further down the page, the fewer the clicks, meaning searchers are even less likely to continue their research beyond the first information they’re given. Even if subsequent research contradicts the initial information, the damage is effectively done – it can be really difficult to change that first impression.
Blimey. Any other cognitive biases I should be aware of?
There’s loads, actually. A particularly interesting one is the dunning-kruger effect.
We’re not talking about how the blonde actress from Inglorious Basterds gave us a penchant for wide-brimmed hats here, unfortunately. Nope, instead this is when people overestimate their knowledge in a certain area. Some patients believe they fully understand their symptoms and possible conditions after just a few searches, leading them to dismiss professional medical advice. This can lead to self-diagnosis (never wise) and avoidance of healthcare professionals.
Dunning-kruger is intriguing because it turns our own positive health literacy into a negative. Research shows those with a higher health literacy are generally better informed about health issues, and make more informed decisions when it comes to their healthcare compared to those with low health literacy skills.
But, it turns out, the study also suggests those with higher health literacies are more susceptible to a biased view of online health information – particularly when they perceive themselves as highly knowledgeable.
A certain level of understanding is needed from the online material in order to recognise whether messages are in line or against one’s own beliefs, which increases the confirmation bias in those with a higher health literacy.
There are plenty of others, too. Here’s just a few more…
Negativity bias: The tendency to give more weight to negative information. When researching symptoms, people may focus disproportionately on worst-case scenarios. For instance, searches might gravitate toward severe diseases even if common, less serious conditions are more likely.
Framing effect: Decisions can be influenced by how information is presented. The way search results or medical information are framed (‘80% survival rate’ vs. ‘20% mortality rate’) can influence a person’s emotional response and perceived severity of the situation, affecting their further search behavior and decision-making.
Bandwagon effect: The tendency to follow the opinions or behavior of others. When a popular or highly upvoted article or forum post suggests a particular diagnosis, people might be swayed by group consensus rather than relying on medical evidence or professional advice.
How can we mitigate the chances of cognitive bias playing a part in our search results?
Cognitive biases can be hard to combat; the internet is a fickle place, generally designed to hold our attention and make money. But, that doesn’t mean there aren’t things we can do to ensure the content we provide serves as a reliable, unbiased resource.
Here’s five tips to help you beat the bias:
- Understand your audience and their biases: Recognising the inherent biases of your target audience is the first step in combating them. If you know your readers are generally cautious about pharmaceutical treatments, ensure your content acknowledges their concerns but also presents balanced information.
- Consider search intent: Search intent – the reason behind a user’s search query – plays a huge role in the content users engage with. When creating health-related content, think about what people are likely looking for when they type in a particular keyword. Are they seeking reassurance or objective information? Tailor your content to meet this need without succumbing to biased viewpoints.
- Use precise, unbiased keyword phrasing: How you phrase your content can significantly influence how it appears in search results. Using neutral, medically accurate terms will help avoid drawing in users solely looking for content that confirms their biases.
- Rely on authoritative, medically validated sources: Always cite reliable, evidence-based sources like peer-reviewed studies or information from trusted medical institutions. This not only improves your content’s credibility but also helps ensure readers receive accurate, balanced information.
- Regularly audit and update your content: Health information evolves constantly. It’s critical to periodically review and update your content to ensure it reflects the latest medical research. Outdated information can perpetuate misconceptions, which is especially dangerous when dealing with health.
- Use medically qualified writers: We’ve chatted about Google’s E-E-A-T (Experience, Expertise, Authoritativeness, and Trustworthiness) guidelines on this very blog before. They prioritise content from authoritative sources, particularly in the healthcare field. That’s why content should be produced by qualified healthcare writers – and reviewed by qualified experts – so that searchers receive in-depth, accurate information on complex topics. By giving audiences trustworthy content from credible sources, you’re helping them avoid overconfidence from consuming low-quality and superficial content.
The role of healthcare marketers in shaping patient outcomes
As the digital landscape continues to shape how we access health information, the responsibility of marketers in this industry becomes more critical than ever.
While you can’t control how search engines prioritise content, you can influence how your material impacts your patients’ health decisions. By committing to unbiased, evidence-based content, we can ensure we’re providing readers with the accurate, well-rounded information they need to make informed choices when it comes to their health.
Need a hand creating authoritative, medically accurate content? We know a thing or two about that – get in touch with our healthcare marketing experts to see how they can help.
