Information-Seeking Strategies in Medicine Queries: A Clinical Eye-Tracking Study with Gaze-Cued Retrospective Think-Aloud Protocol

Background: Medicines are increasingly purchased online, yet little is known regarding the ocular information-seeking behavior with medicine queries in search engines. A share of pharmacies found via search engines operate unlicensed and sell prescription-only medicines without a prescription. This study aimed to investigate how search engine users distinguish between genuine and falsified sources of information in terms of unlicensed and licensed online pharmacies in the case of medicine queries.Methods: Eye-tracking of search tasks (transactional, navigational, informational and two limited results) in a Google search engine environment with retrospective gaze-cued think aloud protocol. Purposive sample of N=50 across three hospitals and one general practitioner. Results: Discovery of a trichotomy of ocular search strategies based on the inclusion or exclusion of URLs in the information-seeking process. Finding of dissonance to existing studies related to fixation duration of search engine result page (SERP) elements. Discovery of an addition to information foraging theory (IFT): proximal cues are, in environments with non-credible information, used in both positive and negative ways.