Does Search Engine Optimization come along with high-quality content? A comparison between optimized and non-optimized health-related web pages

Searching for medical information is both a common and important activity since it influences decisions people make about their healthcare. Using search engine optimization (SEO), content producers seek to increase the visibility of their content. SEO is more likely to be practiced by commercially motivated content producers such as pharmaceutical companies than by non-commercial providers such as governmental bodies. In this study, we ask whether content quality correlates with the presence or absence of SEO measures on a web page. We conducted a user study in which N = 61 participants comprising laypeople as well as experts in health information assessment evaluated health-related web pages classified as either optimized or non-optimized. The subjects rated the expertise of non-optimized web pages as higher than the expertise of optimized pages, justifying their appraisal by the more competent and reputable appearance of non-optimized pages. In addition, comments about the website operators of the non-optimized pages were exclusively positive, while optimized pages tended to receive positive as well as negative assessments. We found no differences between the ratings of laypeople and experts. Since non-optimized, but high-quality content may be outranked by optimized content of lower quality, trusted sources should be prioritized in rankings.