Script to "Going Beyond Research As We Know It"
Jon Chandler
Peter Winters
17 Jul, 2006
Review: Going Beyond Research As We Know It
EphMRA Annual Conference. Athens, Greece
22 Jun, 2006
The slides from the Conference papers are available on the EphMRA site including those from this paper.
Slide 1
The theme of this conference is ‘myths’.
When we were boys at school myths and mythology were a part of the ancient world, a part of classical civilisation. Classical mythology to a 12 year old boy was a set of quirky and colourful stories.
Later on looking at mythology through the eyes of anthropology, sociology and psychology, mythology becomes more than this, these quirky stories become mechanisms through which the ancients understood the world around them and understood how to act in it.
Within the world of research we are all myth makers. Individually and collectively we create ‘stories’ about research. These stories speak about research, they direct our attention to particular directions, they direct our attention away from others.
Slide 2
In this paper we want to talk about some of the myths that have grown up surrounding internet research. We want to challenge some of these myths and to argue for a more imaginative use of internet as a research vehicle.
Slide 3
We would like to look at internet research in the healthcare arena, how it is currently being used and where it might be taken.
In order to do this we want to look at the whole idea of myth as ‘guide to life’; myth as simultaneously informative and constraining. We also want to investigate some of the key ‘myths’ that have grown up around internet research. Exploring what is currently believed about the internet as a research vehicle.
Finally we want to look at how we can push that mythology in new directions; identifying opportunities to travel to new places if we can only break out of the constraints of our current assumptions.
Slide 4
So let us look at this first idea; myth as a guide to life.
Slide 5
Most of us here today probably already know what we are trying to say. We know that our everyday lives are governed by myths. In principle we all know about these ‘myths’, but it is always hard to articulate exactly what they are. When we look to the academic world for help we find that they have the same problem. Myth and mythology are slippery customers, talked about in different ways at different points in time and talked about as different things at different points in time.
Slide 6
Most obviously there are differences between how we talk about ancient and modern mythology.
On the one hand we have classical mythology. The world of the ancients, in which some ‘big stories’ spoke about life in a big way. Many academic traditions have seen ancient mythology as part storytelling and part cosmology. Ancient mythology not only tells stories, it also reflects and reinforces a world view.
We also talk about myth and mythology within our own everyday worlds. We routinely hear of modern myths or urban myths. These may be more mundane and more urbane, but they still provide a cosmology of sorts.
And within the world of healthcare and research we have our own cosmology in miniature composed of a myriad of ideas and assumptions; groups are good for this and bad for that, sample size is important, you can’t do it in France in August.
Slide 7
Many academic traditions looking at ancient mythology have seen it as more than the mere stories that we saw as eleven or twelve year olds.
As an eleven year old boy this story helped me develop some caution about picking things up.
Slide 8
Or this one … if you see a woman with writhing snakes for hair … look the other way.
Slide 9
Our own world has its own mythology. Whether these myths are about everyday life, or market research or medicine, our lives are governed by our own little mythologies.
Slide 10
Across different countries and different historical moments we frequently encounter the idea that corruption is deeply embedded in politics. If someone at a dinner party were to say all politicians are corrupt, others might nod in agreement.
Slide 11
But if we think hard we can find what we would think of as exceptions. The contemporary mythology of corruption and politics is part true and part false.
Slide 12
Or another urban myth of our day, exemplified here by Mr Bean and his friend that white men can’t dance or white men have no rhythm. Perhaps here some of us here would think of ourselves and also start to nod.
Slide 13
However, again there are exceptions and we see that this particular urban myth is again part true part false.
Slide 14
There are myths about research as well. These are just the assumptions that we make. The act of asking respondents’ questions reflects a belief that the consumer can in some way help us. Underlying much of what is done in the name of market research is an assumption that the consumer has the answer.
But there are many examples where consumers have not known the answer. Brands and products that have been rejected in research have gone on to become very successful. This is not because consumers are stupid, it is because it is not always reasonable to expect them to be able to predict the future.
What is true in consumer research is also true in healthcare research. We ask all kinds of medical professionals all sorts of questions because ultimately we are interested in predicting the future, the problem here is that they do not know the future, because it has not happened yet. It remains for us to make it.
Slide 15
In a similar way we in the healthcare industry all conspire in perpetuating the myth that differences between drugs matter. A vast marketing effort is expended on perpetuating this myth.
But when we delve deep, and sometimes not so deep, into physician attitudes and drivers we find that in some therapy areas they see many of the therapies as more or less inter-changeable, objective features and characteristics offer limited differentiation.
Slide 16
So what of our myth making and the internet?
Slide 17
The emergence of the internet has been subject to a great deal of mythology. The dotcom revolution has seen share prices go madly up and down and has made fortunes for some with the foresight to develop some simple ideas.
In the research world it has been interesting to see how conservative some of this internet mythology has been. Very often in wondering where internet based research will take us, vision has not been very visionary, it has been constrained by the world as we see it now.
Slide 18
We have heard a lot about the internet and market research.
We have heard a lot about the idea of conducting group discussions over the internet. Here the internet potentially overcomes some of the logistical difficulties of organising group discussions. If we can conduct group discussions over the internet, then suddenly distance between respondents does not matter. In some ways this is an appealing myth, it is the holy grail for qualitative researchers, now everyone can stay home and still participate.
Alternatively we have heard and seen much about quantitative research and the internet. Here the internet offers the potential to put a questionnaire in front of a respondent without the aid of an interviewer.
Slide 19
In practice, much of the development of internet based research has involved the transfer to this new medium of quantitative research previously conducted using other data collection methodologies, particularly phone research.
The reason this is a great idea is that it is very simple. It simply involves coupling a type of research that is already very familiar with a new vehicle that is rapidly becoming very familiar.
The use of Internet research for this type of quantitative research is well established for most physician groups in most major markets.
Slide 20
Underpinning all this development is a new and emerging mythology. There are those apocryphal stories about speed of turnaround. Everyone knows someone who can talk about studies where fieldwork involving large national and international samples were turned around in hours and days rather than weeks.
The internet is not only about speed it is also about an ease of access that contributes to speed. One of the most vital tools for any health care practitioner in the modern world is a computer with an internet connection. With this single tool physicians can access nearly everything they have forgotten from their training and a lot more that they never learned. If they have this single tool they become a potential candidate for internet based research regardless of where they are.
The revolutions in accessibility and speed are also linked with fundamental changes in the cost base of research. When we take the interviewer out of the equation some of the cost base is reduced. Indeed, Internet research offers potential cost-efficiencies in many areas of the data collection and data presentation process. Propositions about speed, access and cost, are a part of the emerging mythology of internet research. Again we can ask whether these are part true and part false.
Here research can tell us something …
Slide 21
In early 2004, Medefield conducted an online study amongst 138 pharmaceutical company market researchers who were active in commissioning quantitative studies.
The purpose of the study was to understand usage and attitudes towards different methodologies – particularly compared to Internet research. Some of you may remember completing the Internet survey.
For one of the questions, respondents were asked about what they considered to be the advantages and disadvantages of Internet Research compared to other methodologies. “Speed of Research” was the single most mentioned reason, followed, some way behind by it being “Cost effective”.
Slide 22
A further question was asked amongst those who had actually conducted an Internet Research project. Specifically about that study, they were asked about the reasons that contributed to why they chose the Internet as the methodology for that study.
Again, “speed of research” and “cost” were the most important reasons. The implication for this data is that because we think that internet research is particularly good for “speed” and “cost” reasons, these are the key reasons for choosing this methodology.
Slide 23
Let’s consider “the myth of speed”. There is a lot of truth in this notion, but Internet research is not always faster than other methodologies. Indeed, talk to people who work for e-fieldwork agencies and they will say that part of their job is to temper their client’s expectations regarding timelines for certain types of job!
Slide 24
Here are some examples of situations where Internet research can take longer than traditional methodologies.
First, questionnaires can sometimes take weeks to develop if they are particularly complex and require numerous amendments. Given the way that web-survey software is designed, it can take a long time to cut and paste questions around a questionnaire once programmed; much easier to do it in Word!
Secondly, if phone recruitment is required to generate a sample, there is a good chance it would have been quicker to do the study by phone only. Indeed, some methodologies require an initial phone contact with doctors, such as most Detail Follow-Up studies, and, almost by definition, these will be quicker if conducted by phone only, rather than having an Internet component.
Finally, complex questionnaires in multiple languages can take longer to develop with Internet Research than with a questionnaire developed in Word. Having said that, it does seem as though things are getting faster as web-survey builders get more efficient, and the technology improves such that multiple languages can be incorporated quicker into a survey design. On the other hand, as more features and options become available with Internet research, perhaps this will make some surveys take longer to prepare!
Slide 25
For many types of study specification, the Internet is certainly cheaper than traditional methodologies. For example, I would expect a straightforward specification of GPs across major markets to be around 25% cheaper than phone interviews these days.
Slide 26
Yet Internet research is not always cheaper. A number of things can drive up the cost;
economies of scale require scale in the first place, smaller studies just can’t compete; all those question changes I just talked about also have to be paid for; as does any custom recruitment.
Slide 27
Much of what we have seen in the exploitation of the internet as a vehicle for market research in the healthcare arena has in some ways been very predictable. What researchers and organisations have done is recognise a clear opportunity. They have taken existing forms of research adjusted them a little and exploited a new way of accessing respondents.
Slide 28
As we have suggested this exploitation of the new vehicle has taken place ‘within the box’ rather than ‘outside the box’. In its first phase of development most of the exploitation of the internet as a research vehicle has been constrained by what research is doing now. But perhaps the time that internet research really gets interesting will be the next phase; when it starts getting to grips with the idea that the internet is a new medium that can offer us new possibilities. To fully exploit the internet we should stop trying to do what we did before and ask the question “what can we do now”.
Slide 29
In trying to address the “what can we do now” question, there are some basic parameters within which we have to think.
Firstly we are in the business of research and so it seems reasonable to say that we are viewing the internet as a vehicle for getting feedback, for gaining understanding and for generating data. In this we need to recognise that one of the ‘big features’ of this new vehicle is its distinctive format. Everything has to happen via a screen. Our communication with ‘respondents’ takes place via a two dimensional screen that is television like. It is also via a screen that we can largely control.
The other ‘big feature’ of the internet vehicle is its remote nature. As we have already seen time and space don’t work in the same way with internet research. Hundreds of physicians could be completing your questionnaire at the same time, right around the world. What is interesting here is that so far much of the development of internet research has been built around an exploitation of remote interaction rather than the screen.
Slide 30
We can go beyond ideas of access, speed and cost and ask what else this new vehicle can give us. Here we would suggest four elements in a new mythology of internet research.
Firstly this new vehicle allows us to be absolutely consistent in the way that we communicate with respondents. We can control much more precisely what is presented to them and how it is presented.
In turn this means an end of interviewer effects on data. We abolish interviewer contamination, we abolish interviewer error in the presentation of questions and material, we abolish interviewer error in the capture of response.
If we ask what the screen format can do for us we realise that the screen itself opens up a raft of new opportunities. Put simply a computer screen is similar to a television. With internet research we can get people to respond to whatever can be presented to them on the screen in front of them. We have the possibility of presentation that is far richer, and also more controlled, than was previously possible.
Likewise the screen format also opens up possibilities in the way that we allow or encourage people to respond. We are no longer constrained by a paper based or verbal format. We are constrained only by whatever can be done via that screen.
Slide 31
So …. what could be if we are interested in richer presentation and response…. Well it could be this..
Slide 32
It could be telling respondents that we will be showing them visuals and then showing them
Slide 33
Silence
[Allow visual to show for 2 seconds only]
Slide 34
Using this Tachitoscopic research technique respondents were asked to specify “which drug is being promoted by the advertising which uses the visual you have just seen?”.
Slide 35
And again
[Allow visual to show for 2 seconds only]
Slide 36
And again
[Allow visual to show for 2 seconds only]
Slide 37
And again
[Allow visual to show for 2 seconds only]
Slide 38
And again
[Allow visual to show for 2 seconds only]
Slide 39
This is not another ad visual. It is a picture of an iceberg. It represents the conscious and obvious in contrast to the invisible below.
At present most quantitative work taps into conscious reflection, the text book and post rationalised accounts that physicians have of their own behaviour. It is for those questions where we ask them about “how often?”, “how much?”, “how good/bad is it?” and so on.
Yet, pushing at the boundaries of what is done via the internet there are a whole variety of opportunities to use the screen more creatively to understand their more sub-conscious reactions to material we present to them.
Slide 40
We can ask doctors to define the essence or fundamentals of a brand. Lexicometric analysis, from their verbatim responses, can then start to tell us where their thoughts are focussed.
Slide 41
Or in this exercise, we can ask respondents to play the balloon game. Three brands are up in a balloon but it is plummeting to earth. Participants must argue why each brand should be saved or thrown out of the balloon. Analysis will show us how far brands are vulnerable and where they are exposed.
Slide 42
Or we can use one of a growing number of rating and ranking mechanisms designed to make the process more interesting and intuitive. Ranking and rating questions can be quite tiresome for respondents to complete with traditional questions.
Slide 43
Or we could use adjective batteries to understand associations that physicians have with a brand.
Slide 44
Or what archetypes are associated with such a brand. The question here is what would any of these exercises offer us?
Slide 45
To explore “what could be”, we conducted a study for this paper in May 2006. For this we are very grateful for the support of Medefield, for sponsoring the fieldwork costs, and DTW Research for providing the ad visuals.
We conducted a survey amongst around 50 GPs using a 20-minute online questionnaire employing a range of these kinds of techniques.
We explored the ARB market where more conventional forms of qualitative research have largely failed to find differentiation between products.
Slide 46
In this ad visual test, 42% gave a “Don’t know” response.
Overall, only 13% correctly identified it as from the Diovan advert, 45% thought it was for a competitor or failed to specifically identify the drug. Interestingly, 8% thought it was for Micardis, a competitor which uses a similar visual style.
Of the rest, the large majority did not correctly identify this visual.
Slide 47
Cozaar employs a more distinctive ad visual than Diovan.
Whilst many also gave a “Don’t know” response here, 30%, almost one in three, correctly identified this visual as being the one used to promote Cozaar. There is also good evidence that it had a fairly unique execution as no other alternative was mentioned more than once.
Slide 48
We can assess brands in terms of both the type and strength of associations.
Amias, which is known as Atacand outside of the UK, is set apart by having widespread associations with a caring and healing role. The adjective association supported this; Amias/Atacand was particularly thought as “friendly”, “caring” and almost the only drug to have “empathetic” associations.
Slide 49
With Cozaar we see quite a different portrait.
Whilst it has some of the softer elements associated with Amias/Atacand, more than anything it appears straightforward and business like. Again, adjective associations support this as it was particularly seen as “established”, “reliable”, “practical” and “effective”.
Slide 50
With Micardis, there is less breadth of association and a different focus. Rather than the softness and approachability of Amias/Atacand, we see elements of a technical, perhaps R&D focus.
Slide 51
When we get to Teveten, we see less focus on emotionally powerful dimensions. It is interesting here that our measures of brand attachment show very limited bonding to Teveten.
Slide 52
We can also use the information to start to understand strengths and vulnerabilities with each brand. Here is the data from the “balloon” question with regard to Cozaar. The defence of the brand focuses upon its brand presence. Where there are concerns, these suggest that for some, there is a sense that it is passed its prime and in need of refreshment.
Slide 53
What are the “take home” messages from this paper?
We know that the industry is currently using Internet research for its “speed” and “cost” benefits. These are the myths that drive how and why this research tool is being used.
We are suggesting that there are new places we can go with Internet research. Internet research allows us to develop new measurements given the TV-screen like interface we have with respondents.
There are probably a great many new applications that can be developed. This paper has focused on how Internet research can be made more useful for brand research. We can measure ‘softer dimensions’ that were previously the province of qualitative research. We can develop measurements that are useful in tracking pharmaceutical brands in ways that are brand sensitive and help us measure the more emotional dimensions of communication.
Thank you.
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