Article

What is the prevalence of health-related searches on the World Wide Web? Qualitative and quantitative analysis of search engine queries on the Internet

February 2003
AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium 2003:225-9

Source
PubMed

Authors:

University of Toronto

While health information is often said to be the most sought after information on the web, empirical data on the actual frequency of health-related searches on the web are missing. In the present study we aimed to determine the prevalence of health-related searches on the web by analyzing search terms entered by people into popular search engines. We also made some preliminary attempts in qualitatively describing and classifying these searches. Occasional difficulties in determining what constitutes a "health-related" search led us to propose and validate a simple method to automatically classify a search string as "health-related". This method is based on determining the proportion of pages on the web containing the search string and the word "health", as a proportion of the total number of pages with the search string alone. Using human codings as gold standard we plotted a ROC curve and determined empirically that if this "co-occurance rate" is larger than 35%, the search string can be said to be health-related (sensitivity: 85.2%, specificity 80.4%). The results of our "human" codings of search queries determined that about 4.5% of all searches are "health-related". We estimate that globally a minimum of 6.75 Million health-related searches are being conducted on the web every day, which is roughly the same number of searches that have been conducted on the NLM Medlars system in 1996 in a full year.

Parental internet search in the field of pediatric orthopedics

Article

Full-text available

Jun 2019
Eur J Pediatr

Parents whose children are affected by systemic diseases, anomalies, deformities, or further orthopedic defective positions use the Internet to increase their knowledge. However, there have been few studies that focus, as this one does, on Internet enquiries done before the parents contact the pediatric orthopedic surgeon. This study analyzed data gathered through a standardized questionnaire on general habits of Internet use, parents’ hardware, age, and educational background of the parents. A total of 521 questionnaires were completed for a response rate of 96%. One-quarter of parents (n = 127) attended the consultation because of a gait anomaly or foot deformity, followed by children with DDH (20%, n = 99), clubfoot (9%, n = 47), and scoliosis (6%, n = 29). Parents of children with clubfoot were especially likely to look for health information online (84%, n = 38), followed by parents of children with scoliosis (69%, n = 20), with DDH (67%, n = 66), and with foot deformity/gait anomaly (49%, n = 62). Most people (97%, n = 295) using the Internet for health research purposes made use of a search engine. Concerning use of social media, respondents with clubfoot children were the most numerous (38%, n = 18). There were 35 parents who intended to discuss the results of their Internet research with the pediatric orthopedic surgeon. Most (84%, n = 254) of the respondents who used the Internet for health research planned to do so again.Conclusion: This study documented that the Internet is an important and popular source of information for parents or caregivers in the field of pediatric orthopedics.Level of evidence: Level II; prospective study What is known: •Parents and caregivers often search the Internet for information, particularly before an upcoming operation in the field of orthopedic disorders. What is new: •This study provides recent data on parental Internet research in a large study population.

“In Clarity We Trust!” - An Empirical Study of Factors that Affect the Credibility of Health-Related Information on Websites

Chapter

Jan 2019

“In case of side effects please consult your physician or pharmacist”, used to be the advice for questions regarding the intake of medicine or other health-related issues. Nowadays, the Internet has become the favored place to find this kind of information. However, the quality of online health information is mixed. This becomes an issue when people use online information for important health decisions. According to which criteria do users select the found information? To understand which elements on a website convince people to trust the information or not, we have conducted a study with two objectives: first, to identify factors that trigger credibility; second, to investigate to what extent both the media presentation and the severity of the associated disease influence the assessment of credibility. Possible factors were first collected in three focus groups (N = 17) and then operationalized in a questionnaire. We collected 184 responses, presenting and evaluating three different health websites with different disease complexity and severity (mild vs. life-threatening). The results show that complex information is preferred for more serious diseases. In addition, the disease has a significant influence on the criteria.

Developing a Quality Benchmark for Determining the Credibility of Web Health Information- a Protocol of a Gold Standard Approach

Article

Full-text available

Dec 2021

Background: The current pandemic of COVID-19 has changed the way health information is distributed through online platforms. These platforms have played a significant role in informing patients and the public with knowledge that has changed the virtual world forever. Simultaneously, there are growing concerns that much of the information is not credible, impacting patient health outcomes, causing human lives, and tremendous resource waste. With the increasing use of online platforms, patients/the public require new learning models and sharing medical knowledge. They need to be empowered with strategies to navigate disinformation on online platforms. Methods and Design: To meet the urgent need to combat health “misinformation,” the research team proposes a structured approach to develop a quality benchmark, an evidence-based tool that identifies and addresses the determinants of online health information reliability. The specific methods to develop the intervention are the following: (1) systematic reviews: two comprehensive systematic reviews to understand the current state of the quality of online health information and to identify research gaps, (2) content analysis: develop a conceptual framework based on established and complementary knowledge translation approaches for analyzing the existing quality assessment tools and draft a unique set of quality of domains, (3) focus groups: multiple focus groups with diverse patients/the public and health information providers to test the acceptability and usability of the quality domains, (4) development and evaluation: a unique set of determinants of reliability will be finalized along with a preferred scoring classification. These items will be used to develop and validate a quality benchmark to assess the quality of online health information. Expected Outcomes: This multi-phase project informed by theory will lead to new knowledge that is intended to inform the development of a patient-friendly quality benchmark. This benchmark will inform best practices and policies in disseminating reliable web health information, thus reducing disparities in access to health knowledge and combat misinformation online. In addition, we envision the final product can be used as a gold standard for developing similar interventions for specific groups of patients or populations.

Parental Internet Search in the field of Pediatric Orthopaedics � results from a prospective, controlled study (Preprint)

Preprint

Aug 2018

BACKGROUND The internet has become one of the most important sources to obtain medical and health information. Parents, whose children are affected by systemic diseases, anomalies, deformities or further orthopaedic defective positions, use the internet to increase their knowledge. OBJECTIVE There is a lack of studies with focus of parental enquiries in the internet before contacting the pediatric orthopaedic surgeon. This study shows current trends and also allows a follow up. METHODS Parental internet search was evaluated using a standardized questionnaire. General habits of internet use, local hardware equipment, age and educational background of the parents were analyzed. In particular, parental use of general medical websites, use of search machines like Google or Yahoo or the use of homepages from support groups was asked. RESULTS A total of 521 questionnaires were completed, this corresponds to a response rate of 96%. One quarter of parents attended the consultation because of a gait anomaly or foot deformity, followed by children with DDH (20%), club foot (9%) and scoliosis (6%). 87% of parents use a Smartphone to get internet access, 68% a Laptop, 55% a Tablet and 45% a Laptop. Especially parents with children with clubfoot looked for health information online (80%), followed by scoliosis 69% (n=20), DDH 67% (n=66), foot deformity / gait anomaly 49% (n= 62). 98% of those using the internet for health medical purpose made use of a search engine, 99% (n=291) of internet users searched through Google, with 44% (n=129) of them describing their research helpful. Concerning use of social media responders of clubfoot children were again the most numerous in number (38%, n=18). 10 of them stated to have exchanged with other social media users and 60% of them evaluated social media as helpful. There were 35 parents who intended to discuss the results with their pediatric orthopedic surgeon. 84% of the responders who used the internet for health research would return to the internet. CONCLUSIONS This study documents that the internet is an important source of information for parents or caregivers in the field of pediatric orthopedics and that the meaning goes even further. Treating physicians will increasingly be confronted with the results of internet research. In particular, parents whose children suffer from club feet frequently research the Internet. CLINICALTRIAL The study was conducted in accordance with the principles laid down in the Declaration of Helsinki. Prior to the investigations, an approval was secured by the local board of ethics on 8 of September 2017 (AZ 107/17).

Health Information Retrieval -- State of the art report

Preprint

Full-text available

May 2022

Carla Teixeira Lopes

This report provides an overview of the field of Information Retrieval (IR) in healthcare. It does not aim to introduce general concepts and theories of IR but to present and describe specific aspects of Health Information Retrieval (HIR). After a brief introduction to the more broader field of IR, the significance of HIR at current times is discussed. Specific characteristics of Health Information, its classification and the main existing representations for health concepts are described together with the main products and services in the area (e.g.: databases of health bibliographic content, health specific search engines and others). Recent research work is discussed and the most active researchers, projects and research groups are also presented. Main organizations and journals are also identified.

Differences among frequently used words in clinical practice: Analysis of their frequency in an online search engine and a community question answering service in Japan. (Preprint)

Preprint

Full-text available

Jan 2019

BACKGROUND Despite increasing opportunities for acquiring health information online, discussion of the specific words used in searches has been limited. OBJECTIVE This study clarifies health information sought by Japanese netizens. METHODS This study analyzed the data from one of the most popular domestic search engines (Yahoo! JAPAN Search) and the most popular domestic community question answering (CQA) service (Yahoo! Chiebukuro). We compared the frequency of 100 clinical words appearing in the clinical case reports of medical professionals (“clinical frequency”) with their frequency in Yahoo! JAPAN Search (“search frequency”) search logs and questions posted to Yahoo! Chiebukuro (“question frequency”). Subsequently, the Spearman correlation was used to quantify association patterns between the three search categories. Additionally, user information (sex and age) in search frequency associated with registration were extracted and discussed. RESULTS The correlation coefficient was r = 0.290 (P=.003) between clinical and search frequencies, r = 0.337(P =.001) between clinical and question frequencies, and r = 0.569 (P <.001) between search and question frequencies. Low-frequency words in clinical frequency, (e.g., “hypothyroidism” and “ulcerative colitis”) were high in search frequency. Similarly, the words “pain,” “slight fever,” and “numbness” had high frequency only in the question frequency. The weighted average of the ages was 34.5 ± 2.7 years, and the weighted average of sex (male: -1, female: 1) was 0.1 ± 0.1 in search frequency. Some words were extracted from the search frequency uniquely based on age groups: “dyspnea,” “abdominal pain,” “subjective symptoms,” and “plasma cells” (10-20 years); “plasma cells,” “inflammatory findings,” “hypoxemia,” “cellular wetness,” and “dyspnea on exertion” (20-30 years); “DM (diabetes mellitus),” “jaundice,” and “high blood pressure” (30-40 years); “abnormal shadow,” “plasma cells,” “inflammatory findings,” “hyponatremia,” “cell wetness,” and “hypercalcemia” (40-50 years); “rheumatoid arthritis,” “hypertension,” “abnormal shadow,” and “inflammatory findings” (50-60 years); and “interstitial pneumonia,” “lung cancer,” “gastric cancer,” “hypertension,” “atrial fibrillation,” and “pneumococcus” (60-70 years). CONCLUSIONS The search and question frequencies were similar, but search and clinical frequencies had a discrepancy. Low-clinical frequency words related to diseases such as hypothyroidism and ulcerative colitis had high search frequencies, whereas those related to symptoms such as pain, slight fever, and numbness had high question frequencies. Moreover, high search frequency words include designated intractable diseases such as “ulcerative colitis”; patients with this condition are less than 0.1% of the national population. Therefore, information needs regarding major diseases are not necessarily high, and minor diseases that users seek more frequently should be valued. Some characteristic words for certain age groups were observed (e.g., 20-40 years: “cancer”; 40-60 years: diagnoses and diseases identified in health examinations; 60-70 years: diseases with late adulthood onset and “death”). In conclusion, information providers should be aware of clinical frequency and users’ medical information gaps should be bridged.

Implementation of reproductive life planning (RLP) in primary health care supported by an evidence-based website

Article

Full-text available

Nov 2019

Objectives: The aims of the study were to evaluate how well the reproductive life plan (RLP) tool was implemented in practice and explore the utility of the website www.reproduktivlivsplan.se for patient counselling. Methods: A cross-sectional study was conducted in 2018, in which 73 midwives in primary health care were asked to use the RLP tool and the website in their daily practice. Three months later, participants answered a questionnaire, based on normalisation process theory (NPT), about their implementation experience. Results: The response rate was 73% (n = 53). The mean length of midwifery experience was 15 years. Almost all respondents (89%) reported a positive attitude towards the tool and the website and their ability to use them in practice. The majority agreed to all statements about implementation of the RLP, according to NPT. Use of the RLP also made it easier for midwives to support clients in forming reproductive goals (85%, n = 45), give family planning advice (81%, n = 43), give advice about how to improve health before pregnancy (85%, n = 45) and give advice about how to preserve fertility (89%, n = 47). Nine out of ten respondents said they would recommend the website to other midwives. Conclusion: The RLP was well implemented among the respondents and the majority considered the website to be a useful tool. Long-term studies are needed to further elucidate the effects of the RLP on changes in health behaviour and pregnancy outcomes.

Health information–seeking behaviors and adherence to urgent care discharge instructions

Article

Full-text available

Oct 2019

Background: Although studies suggest that most patients use healthcare professionals as the main source of health information, the ease of Internet access has resulted in a growing number of people who seek health information from other sources. Health information-seeking skills and patterns may influence follow-through with treatment recommendations. Purpose: The purpose of this study was to explore the health information-seeking behaviors (HISBs) of urgent care (UC) patients and the association to adherence to discharge instructions. Methods: A HISB questionnaire was administered to adults presenting for care at a UC clinic. A repeated measure of HISB and the Medical Outcomes Study General Adherence Scale were administered 10-14 days after UC visit. Descriptive and bivariate analyses determined HISB and their association with discharge instruction adherence. Results: Two hundred ten patients completed all surveys. Family and friends were the most common health information source used both before and after an UC visit. Seeking health information through family/friends after the visit was negatively associated with adherence (covariate adjusted p value, .0003). Implications for practice: At times of episodic illness, patients tend to seek health information from family and friends with greater frequency than traditional medical, online, or paper sources. Nurse practitioners working in UC or emergent care settings should include family and friends at the time of discharge teaching because patients may use these sources for additional health information, which may affect instruction adherence.

Sentiment-Aware Recommendation System for Healthcare using Social Media

Preprint

Sep 2019

Over the last decade, health communities (known as forums) have evolved into platforms where more and more users share their medical experiences, thereby seeking guidance and interacting with people of the community. The shared content, though informal and unstructured in nature, contains valuable medical and/or health-related information and can be leveraged to produce structured suggestions to the common people. In this paper, at first we propose a stacked deep learning model for sentiment analysis from the medical forum data. The stacked model comprises of Convolutional Neural Network (CNN) followed by a Long Short Term Memory (LSTM) and then by another CNN. For a blog classified with positive sentiment, we retrieve the top-n similar posts. Thereafter, we develop a probabilistic model for suggesting the suitable treatments or procedures for a particular disease or health condition. We believe that integration of medical sentiment and suggestion would be beneficial to the users for finding the relevant contents regarding medications and medical conditions, without having to manually stroll through a large amount of unstructured contents.

The Association Between Internet Searches and Moisturizer Prescription in Japan: Retrospective Observational Study

Preprint

Oct 2019

Background: Heparinoid is a medication prescribed in Japan for skin diseases, such as atopic dermatitis and dry skin. Heparinoid prescription has increased with instances of internet blogs recommending its use as a cosmetic. Objective: This study aimed to examine the prescription trends in moisturizer use and analyze their association with internet searches. Methods: We used a claims database to identify pharmacy claims of heparinoid-only prescriptions in Japan. Additionally, we used Google Trends to obtain internet search data for the period between October 1, 2007, and September 31, 2017. To analyze the association between heparinoid prescriptions and internet searches, we performed an autoregressive integrated moving average approach for each time series. Results: We identified 155,733 patients who had been prescribed heparinoid. The number of prescriptions increased from 2011 onward, and related internet searches increased from 2012 onward. Internet searches were significantly correlated with total heparinoid prescription (correlation coefficient=.25, P=.005). In addition, internet searches were significantly correlated with heparinoid prescription in those aged 20-59 years at -1-month lag in Google Trends (correlation coefficient=.30, P=.001). Conclusions: Google searches related to heparinoid prescriptions showed a seasonal pattern and increased gradually over the preceding several years. Google searches were positively correlated with prescription trends. In addition, in a particular age group (20-59 years), prescriptions increased with the increase in internet searches. These results suggest that people obtained health-related information on the internet and that this affected their behavior and prescription requests.

Emergence of Cross-innovation Systems: Audiovisual Industries Co-innovating with Education, Health Care and Tourism

Book

Full-text available

Apr 2019

Indrek Ibrus

This book combines economic studies of innovation systems with studies of mediatisation, media convergence, trans- and cross-media and with other approaches within media and culture studies. It elaborates on a new concept, cross-innovation, referring to co-innovation and convergence processes taking place between different sectors of digital service economies. The proposition is that digitisation and mediatisation processes are conditioning new inter-sector dialogues and the emergence of new cross-innovation systems at the borderlines of formerly distinct industries. The case study industries presented are, on the one hand, audiovisual media (film, television, videogames, etc.) and health care, education or tourism, on the other hand. The book builds on 2 years of empirical work across Nordic and Baltic countries, putting a special emphasis on the opportunities and challenges for small countries as they build the cross-innovation systems in the era of media globalisation and platformisation of services. The empirical research of 144 interviews with stakeholders (policy makers, entrepreneurs, managers, professionals) from all four sectors and of secondary data and documentary analysis. The findings tell of complex stories how global platformisation of tourism undermines the emergence of related cross-innovation systems in small countries; how fragmentation of local education and health care markets does not enable the scalability of innovations, but protects local innovation systems for being overtaken by global platform giants. The book has stories of successful facilitation of cross-innovation as well as failures to do so. The ebook edition of this title is Open Access and is freely available to read online.

Evolving role of pharmaceutical physicians in medical evidence and education

Article

Full-text available

Nov 2018

Sajita Setia,1 Nicola J Ryan,2 Prasad S Nair,3 Elma Ching,3 Kannan Subramaniam4 1Medical Affairs, Pfizer Pte Ltd, Singapore; 2Independent Medical Writing Services, Auckland, New Zealand; 3Department of Pharmacy, National University of Singapore, Singapore; 4Global Medical Affairs, Asia-Pacific Region, Pfizer Australia, West Ryde, NSW, Australia Abstract: The role of pharmaceutical physicians who are the experts working in pharmaceutical companies has progressed over the last few decades, from supervising research and development (R&D) studies and/or providing support to marketing teams to serving an independent critical function. In this review, we focus on pharmaceutical physicians serving medical affairs functions in the pharmaceutical industry. Historically, members of the medical affairs team mainly provided a bridge between commercial teams and the R&D sector and between the organization and external stakeholders. Such teams may even have been managed by other departments, with an emphasis on acquiring and generating data for regulatory purposes. In recent years, the role of medical affairs has broadened due to a change in focus and the increasingly stringent regulatory landscape. Strict regulations require the detachment of commercial from medical activities within pharmaceutical organizations. This change provides an opportunity for a different type of partnership, allowing scientifically minded and medically driven initiatives. This article summarizes the key role of pharmaceutical industry-based physicians in medical affairs and discusses the emerging and evolving role of medical affairs for value creation in evidence generation and medical education. Keywords: medical affairs, medical education, pharmaceutical physicians, pharmaceutical industry

Association between Internet searches and moisturizer prescription in Japan (Preprint)

Preprint

Dec 2018

BACKGROUND Heparinoid is a medicine prescribed for skin diseases, such as atopic dermatitis and dry skin, in Japan. Heparinoid prescription has increased with Internet blogs recommending its use as a cosmetic. OBJECTIVE The purpose of this study was to examine the prescription trends in moisturizer use and analyze the association between prescription moisturizer use and Internet searches. METHODS We used an administrative database to demonstrate prescription and Google Trends, and obtained Internet search data for the period between October 1, 2007 and September 31, 2017 in Japan. We identified heparinoid-only prescription from pharmacy data. To analyze the association between heparinoid prescription and Internet searches, we performed an autoregressive integrated moving average approach for each time series. RESULTS We identified 155,733 patients who had been prescribed heparinoid. The number of prescriptions increased from 2011 onward, and related Internet searches increased from 2012 onward. Internet searches were significantly correlated with total heparinoid prescription (0.25, P = .005). In addition, Internet searches were significantly correlated with heparinoid prescription in those aged 20–59 years at 1 month (0.30, P = .001). CONCLUSIONS Prescription heparinoid and Google searches related to heparinoid showed a seasonal pattern and increased gradually over the preceding several years. Google searches were positively correlated with prescription trends. In addition, in a particular age group (20–59 years), prescriptions increased with the increase in Internet searches. These results suggest that people obtained health-related information on the Internet, and this affected their behavior and prescription requests.

Evaluation of the Quality and Reliability of YouTube Videos on Rotator Cuff Tears ,

Article

Full-text available

Feb 2020

Anterior Cervical Discectomy and Fusion YouTube Videos as a Source of Patient Education

Article

Full-text available

Oct 2018

Study design: Cross sectional study. Purpose: To assess the quality of anterior cervical discectomy and fusion (ACDF) videos available on YouTube and identify factors associated with video quality. Overview of literature: Patients commonly use the internet as a source of information regarding their surgeries. However, there is currently limited information regarding the quality of online videos about ACDF. Methods: A search was performed on YouTube using the phrase 'anterior cervical discectomy and fusion.' The Journal of the American Medical Association (JAMA), DISCERN, and Health on the Net (HON) systems were used to rate the first 50 videos obtained. Information about each video was collected, including number of views, duration since the video was posted, percentage positivity (defined as number of likes the video received, divided by the total number of likes or dislikes of that video), number of comments, and the author of the video. Relationships between video quality and these factors were investigated. Results: The average number of views for each video was 96,239. The most common videos were those published by surgeons and those containing patient testimonies. Overall, the video quality was poor, with mean scores of 1.78/5 using the DISCERN criteria, 1.63/4 using the JAMA criteria, and 1.96/8 using the HON criteria. Surgeon authors' videos scored higher than patient testimony videos when reviewed using the HON or JAMA systems. However, no other factors were found to be associated with video quality. Conclusions: The quality of ACDF videos on YouTube is low, with the majority of videos produced by unreliable sources. Therefore, these YouTube videos should not be recommended as patient education tools for ACDF.

“Should I Trust or Should I Go?” or What Makes Health-Related Websites Appear Trustworthy? - An Empirical Approach of Perceived Credibility of Digital Health Information and the Impact of User Diversity

Conference Paper

Jan 2018

Evaluation de la qualité des sites Internet francophones parlant d'alcoolodépendance

Thesis

Jan 2007

Coquard Olivier

Internet, média en plein essor, permet la diffusion d'informations médicales dont la qualité est variable. La dépendance à l'alcool est un problème de santé publique en France, or, à ce jour, la qualité des sites Internet francophones sur ce sujet n'a pas été évaluée. Deux requêtes, utilisant respectivement les mots clés alcoolisme et dépendance alcool sont réalisées dans trois moteurs de recherche populaires (Google, Yahoo et MSN) ; les sites apparaissant dans les 20 premiers résultats sont évalués avec une grille spécifique comportant des critères éthiques (inspirés de Silberg), esthétiques (critères d'Abbott), d'interactivité, de lisibilité, de qualité de contenu ainsi que l'outil DISCERN. La fidélité inter-juge calculée apparaît bonne. Les sites évalués proviennent surtout d'organisations non universitaires et sont de qualité variable. Le contenu est souvent incomplet et parfois erroné. Les aspects d'interactivité sont plutôt mauvais, alors que cela constitue un des atouts d'Internet. Les critères éthiques, esthétiques, de lisibilité et d'interactivité ne semblent pas être corrélés à une bonne qualité de contenu, contrairement au score du DISCERN. Enfin l'information de qualité n'est pas forcément visible dans les premiers résultats des moteurs de recherche.

Readability of Online Health Information: A Meta-Narrative Systematic Review

Article

Jan 2018

Online health information should meet the reading level for the general public (set at sixth-grade level). Readability is a key requirement for information to be helpful and improve quality of care. The authors conducted a systematic review to evaluate the readability of online health information in the United States and Canada. Out of 3743 references, the authors included 157 cross-sectional studies evaluating 7891 websites using 13 readability scales. The mean readability grade level across websites ranged from grade 10 to 15 based on the different scales. Stratification by specialty, health condition, and type of organization producing information revealed the same findings. In conclusion, online health information in the United States and Canada has a readability level that is inappropriate for general public use. Poor readability can lead to misinformation and may have a detrimental effect on health. Efforts are needed to improve readability and the content of online health information.

Evaluating the Dental Caries-Related Information on Brazilian Websites: Qualitative Study

Article

Full-text available

Dec 2017
J MED INTERNET RES

Background: Dental caries is the most common chronic oral disease, affecting 2.4 billion people worldwide who on average have 2.11 decayed, missing, or filled teeth. It impacts the quality of life of patients, socially and economically. However, the comprehension of dental caries may be difficult for most people, as it involves a multifactorial etiology with the interplay between the tooth surface, the dental biofilm, dietary fermentable carbohydrates, and genetic and behavioral factors. Therefore, the production of effective materials addressed to the education and counseling of patients for the prevention of dental caries requires a high level of specialization. In this regard, the dental caries-related contents produced by laypersons and their availability on the Internet may be low-quality information. Objective: The aim of this study was to assess the readability and the quality of dental caries-related information on Brazilian websites. Methods: A total of 75 websites were selected through Google, Bing, Yahoo!, and Baidu. The websites were organized in rankings according to their order of appearance in each one of the 4 search engines. Furthermore, 2 independent examiners evaluated the quality of websites using the DISCERN questionnaire and the Journal of American Medical Association (JAMA) benchmark criteria. The readability of the websites was assessed by the Flesch Reading Ease adapted to Brazilian Portuguese (FRE-BP). In addition, the information presented on the websites was categorized as etiology, prevention, and treatment of dental caries. The statistical analysis was performed using Spearman rank correlation coefficient, Mann-Whitney U test, hierarchical clustering analysis by Ward minimum variance method, Kruskal-Wallis test, and post hoc Dunn test. P<.05 was considered significant. Results: The Web contents were considered to be of poor quality by DISCERN (mean 33.48, standard deviation, SD 9.06) and JAMA (mean 1.12, SD 0.97) scores, presenting easy reading levels (FRE-BP: mean 62.93, SD 10.15). The rankings of the websites presented by Google (ρ=-.22, P=.08), Baidu (ρ=-.19, P=.53), Yahoo! (ρ=.22, P=.39), and Bing (ρ=-.36, P=.23) were not correlated with DISCERN scores. Moreover, the quality of websites with health- and nonhealth-related authors was similar (P=.27 for DISCERN and P=.47 for JAMA); however, the pages with a greater variety of dental caries information showed significantly higher quality scores than those with limited contents (P=.009). Conclusions: On the basis of this sample, dental caries-related contents available on Brazilian websites were considered simple, accessible, and of poor quality, independent of their authorship. These findings indicate the need for the development of specific policies focused on the stimulus for the production and publication of Web health information, encouraging dentists to guide their patients in searching for recommended oral health websites.

Factors affecting seeking health-related information through the internet among patients in Kuwait

Article

Full-text available

Oct 2017

Background The internet is a powerful worldwide communication medium that provides its users with immediate information irrespective of their location, culture, language and time. E-health service will have a great impact in reducing the costs of health care, increasing satisfaction of patients and health professionals, and minimizing the burden on health facilities. Objective This study aims to determine the proportion of patients who obtain health-related information through the internet as well as factors that could affect using the internet for seeking health information. Subjects and methods This study was conducted in six general hospitals in Kuwait. A cross-sectional study was adopted to determine the proportion of patients who obtain health-related information through the internet. It was followed by a case-control study to determine factors that could be associated with on-line search of health information. A questionnaire was used which included data related to socio-demographic characteristics, clinical history and computer experience. The final analysis included 220 participants. Results The majority of participants (93.2%) mentioned that they have used the internet for one or more purposes. Only 129 participants (62.9%) used the internet for obtaining health related information. All studied socio-demographic factors, except age and marital state, and computer skills variables had significant effect on on-line search for health information. After adjustment for confounding, only gender, nationality, level of education, and using computer at work were proved to be significant determinants of the outcome of interest. Conclusion It is important to close the gap in health literacy and increase the use of health information technology to support patient self-management. The creation of an eHealth-literate population should be a priority in Kuwaiti public health policy.

“Being Bipolar”: A Qualitative Analysis of the Experience of Bipolar Disorder as Described in Internet Blogs

Article

Sep 2017

In the light of debates about the nature of bipolar disorder (BD), the current article presents a thematic analysis of Internet “blogs” by self-identified bipolar sufferers. Extreme and frequent fluctuation of mood was considered the principal feature of BD, along with a broad range of other problems. BD was often invoked as an explanation for life difficulties or lack of achievement, and was mostly regarded as a brain disease. Most bloggers emphasized the importance of drug treatment, along with the self-management techniques. The blogs present a “bipolar identity,” which is much broader than traditional definitions, are based on a medicalized model of the disorder, and are connected to the moral function of enabling people to externalize unwanted aspects of the self.

Cureus journal

Article

Feb 2020

Introduction The objective of this study was to investigate quality and scientific accuracy of videos related to rotator cuff tear on YouTube. Methods Term of "rotator cuff tear" was entered to the searching bar of YouTube and the first 50 YouTube videos about rotator cuff tear with the highest view counts were recorded and evaluated by two orthopedists. Title of the videos that met the inclusion criteria were recorded. The videos were evaluated with DISCERN and JAMA scoring system, and Video Power Index. Results The mean DISCERN score was calculated as 35.7±8.9, and the mean JAMA score was found as 2.9±0.4. The mean DISCERN score was statistically significantly higher in the physician group compared to the non-physician group. There was a very strong and statistically significant correlation and an excellent compliance between both observers. Conclusion In general, quality of videos published on YouTube about rotator cuff tear was low.

Exploring Mental Health Issues through the Use of Blogs: A Scoping Review of the Research Evidence

Article

Jan 2020

The aim of this scoping review of the available research evidence was to explore the experiences and perceptions of people with mental health difficulties through the use of blogs. A search of relevant electronic databases was undertaken from January 2009 to February 2019. Selected studies included people who blog about their mental health difficulties online. The PRISMA system was used to present the results of the searches. Following the application of specific inclusion and exclusion criteria, the final number of included studies was eleven. Following data analysis, the subordinate categories in the public category were moderation, confidentiality and boundaries. The subordinate categories in the private sphere included catharsis, enhanced coping strategies and social connectedness. The implications for mental health practice developments and research, are presented and discussed.

Use of internet for accessing healthcare information among patients in an outpatient department of a Tertiary Care Center

Article

Full-text available

Jan 2017

Background: Health information is one of the most accessed topics online. Worldwide, about 4.5% of all Internet searches are for health-related informationand more than 70, 000 websites disseminate health information. However, critics question the quality and credibility of online health information as contents are mostly a result of limited research or are commercialised. There is a need to train people to locate relevant websites where they can efficiently retrieve evidence based information and evaluate the same. The study was conducted with the objectives of determining the prevalence of use of internet for accessing healthcare information amongst literate adult population in an urban area and to assess the association between the demography and the reasons of internet use. Methodology: We used an anonymous, cross sectional survey completed by a sample of out patients of 408 individuals who came to a tertiary care centre at Pune during the year 2015. The survey consisted of 17 questions related to behavioural, attitudinal and demographic items. Results: Out of the total of 408 individuals, 256 (63.2%) individuals used internet for health information though 332 (82.4%) of them were aware of authorised websites for health information and 69 (16.9%) thought information available in the internet can be harmful. Also, 63 out of 256 (24.6%) agreed to the fact that they ask questions to their doctors based on the information that they acquired from internet while surfing about that particular disease/ ailment. More individuals (p

Evaluation of E-health Innovations towards Public Health in Izmir, Turkey

Article

Sep 2021

Seasonal variation and change trends for quit smoking: evidence from Internet search engine query data

Preprint

Full-text available

Dec 2019

Background: The outcomes of smoking have generated considerable clinical interest in recent years. Although people from different countries are more interested to the topic of quit smoking during the winter, few studies have tested this hypothesis. The current study aimed to quantify public interest in quit smoking via Google. Methods: We use Google Trends to obtain the Internet search query volume for terms relating to quit smoking for major northern and southern hemisphere countries in this research. Normally search volumes for the term “quit smoking + stop smoking + smoking cessation” were retrieved within the USA, the UK, Canada, Ireland, New Zealand and Australia from January 2004 to December 2018. Seasonal effects were investigated using cosinor analysis and seasonal decomposition of time series models. Results: Significant seasonal variation patterns in those search terms were revealed by cosinor analysis and demonstrated by the evidence from Google Trends analysis in the representative countries including the USA (pcos = 2.36×10⁻⁷), the UK (pcos < 2.00×10⁻¹⁶), Canada (pcos < 2.00×10⁻¹⁶), Ireland (pcos <2.00×10⁻¹⁶) ,Australia (pcos = 5.13×10⁻⁶) and New Zealand (pcos = 4.87×10⁻⁷). Time series plots emphasized the consistency of seasonal trends with peaks in winter / late autumn by repeating in nearly all years. The overall trend of search volumes, observed by dynamic series analysis, declined from 2004 to 2018. Conclusions: The preliminary evidence from Google Trends search tool showed a significant seasonal variation and decreasing trend for the RSV of quit smoking. Our novel findings in smoking cessation epidemiology need to be verified with further studies, and the mechanisms underlying these findings must be clarified.

Exploratory analysis of the hypertext structure linked to diabetes

Thesis

Jun 2020

Hongyi Shi

Diabetes as a chronic disease requires continuous medical care and constant patient self-management which involve several stakeholders to improve health outcome. This manuscript makes use of World Wide Web network analysis to highlight how stakeholders, providing information about online diabetes communities, link to each other. Thanks to combined state-of-art tools to crawl and visualize topic-sensitive networks, we created DiaMap which includes 430 diabetes-related websites. Then we apply a community detection algorithm of DiaMap. In the end, a color map is associated to the 5 discovered communities class are presented. For better understanding the common interest shared by the same clusters, each website in DiaMap has been annotated using semantic tags. After we employing the machine learning to study which combinations of tags can predict or explain the clusters, we found the community can have a tagging scheme occasionally but it is still hard to use semantical approach to predict accurately the clusters. Last but not least, DiaMap can enrich and complete information retrieval on diabetes based on the current serach engines. We evaluate this though comparing the results provided by querying DiaMap and 4 traditional Search Engines with 5 given questions. DiaMap presents the map-like information visualization of diabetes-related websites to show the picture of diabetes in a digital world. Different from traditional search engines, DiaMap presents the whole picture and uses tags to identify the relevant websites. It somehow changes the way of navigating online diabetes information and could be an alternative or complementary way to retrieve the information online.

Searching for HIV and AIDS Health Information in South Africa, 2004-2019: Analysis of Google and Wikipedia Search Trends

Article

Full-text available

Mar 2022

Background AIDS, caused by HIV, is a leading cause of mortality in Africa. HIV/AIDS is among the greatest public health challenges confronting health authorities, with South Africa having the greatest prevalence of the disease in the world. There is little research into how Africans meet their health information needs on HIV/AIDS online, and this research gap impacts programming and educational responses to the HIV/AIDS pandemic. Objective This paper reports on how, in general, interest in the search terms “HIV” and “AIDS” mirrors the increase in people living with HIV and the decline in AIDS cases in South Africa. Methods Data on search trends for HIV and AIDS for South Africa were found using the search terms “HIV” and “AIDS” (categories: health, web search) on Google Trends. This was compared with data on estimated adults and children living with HIV, and AIDS-related deaths in South Africa, from the Joint United Nations Programme on HIV/AIDS, and also with search interest in the topics “HIV” and “AIDS” on Wikipedia Afrikaans, the most developed local language Wikipedia service in South Africa. Nonparametric statistical tests were conducted to support the trends and associations identified in the data. Results Google Trends shows a statistically significant decline (P<.001) in search interest for AIDS relative to HIV in South Africa. This trend mirrors progress on the ground in South Africa and is significantly associated (P<.001) with a decline in AIDS-related deaths and people living longer with HIV. This trend was also replicated on Wikipedia Afrikaans, where there was a greater interest in HIV than AIDS. Conclusions This statistically significant (P<.001) association between interest in the search terms “HIV” and “AIDS” in South Africa (2004-2019) and the number of people living with HIV and AIDS in the country (2004-2019) might be an indicator that multilateral efforts at combating HIV/AIDS—particularly through awareness raising and behavioral interventions in South Africa—are bearing fruit, and this is not only evident on the ground, but is also reflected in the online information seeking on the HIV/AIDS pandemic. We acknowledge the limitation that in studying the association between Google search interests on HIV/AIDS and cases/deaths, causal relationships should not be drawn due to the limitations of the data.

Comparing Medical Term Usage Patterns of Professionals and Search Engine and Community Question Answering Service Users in Japan: Log Analysis

Article

Full-text available

Apr 2020

Seasonal Variations in Public Inquiries into Laryngitis: An Infodemiology Study

Article

Full-text available

May 2020
J Voice

Objectives Acute laryngitis is a common disease with self-limiting nature. Since the leading cause is attributed to viral infections and thus self-limiting, many affected individuals do not seek professional medical help. However, because the major symptom of hoarseness imposes a substantial burden in everyday life, it might be speculated that web-based search interest on this condition follows incidence rates, with highest peaks during winter months. The aim of this study was to evaluate global public health-information seeking behaviour on laryngitis-related search terms. Methods We utilized Google Trends to assess country-specific, representative laryngitis-related search terms for English and non-English speaking countries of both hemispheres. Extracted time series data from Australia, Brazil, Canada, Germany, the United Kingdom, and the United States of America, covering a timeframe between 2004 and 2019 were first assessed for reliability, followed by seasonality analysis using the cosinor model. Results Direct comparisons revealed different, representative laryngitis-related search terms for English- and non-English speaking countries. Extracted data showed a trend of higher reliability in countries with more inhabitants. Subsequent graphical analysis revealed winter peaks in all countries from both hemispheres. Cosinor analysis confirmed these seasonal variations to be significant (all P < 0.001). Conclusion Public interest in laryngitis-related, online health information displayed seasonal variations in countries from both hemispheres, with highest interest during winter months. These findings emphasize the importance to optimize the distribution of reliable, web-based health education in order to prevent the spread of misinformation and to improve health literacy among general populations.

Medya Araçlarının Kullanımı ile Hekime Güven Arasındaki İlişkinin İncelenmesine Yönelik Bir Saha Araştırması: Isparta İli Örneği A Field Study on the Relationship Between the Use of Media Tools and Trust to Physicians: The Case of Isparta Province

Article

Full-text available

Jan 2022

Objective: This study was conducted to investigate whether there is a relationship between media use and trust in physicians. Material and Methods: The universe of this research, which is benefited from the quantitative research method, consists of 265,000 people in Isparta. The sample consists of 429 people selected from the universe by convenience sampling method. The data of the study were collected by the “Confidence Communication in Patient-Physician Relationship” questionnaire created by Yılmaz and the media usage questionnaire created by the researchers and analyzed using the SPSS program. Results: 54.3% (233 people) of the participants in the study are female and the rest are male. 38.7% (166) of the participants are undergraduate, 22.6% (97 people) are graduate, 11.2% (48 people) are associate degree, 18.6% are high school graduates, and the rest are secondary school graduates. The media type where the most time was spent was found to be the internet (86.7%) and the time spent on the internet was found to be 258 minutes per day. In the subscales of trust in physician, the highest score was in trust in medical care (3.606±0.839) and the lowest score in ethical behavior (2.828±0.951). It was found that as the time the participants spent on television increased, their confidence in the medical decision of the physician and the medical care provided increased. Again, as the number of owned social media increases, trust in the medical decision of the physician decreases. Conclusion: There was no relationship between time spent on the internet and trust in physicians. As the time the participants spent on television increased, confidence in the medical decision of the physician and the medical care provided increased.

Perspectives on Support Material for Referrals to Cochlear Implantation Teams

Article

Jan 2022

Purpose This study used a collaborative approach to explore the needs, barriers, and facilitators to developing cochlear implant referral information material that would be valuable for hard of hearing adults and referring audiologists. Method During the development of a prototype referral aid to be used within the Australian context, a multistage qualitative study was conducted using a consultative process, informal and semistructured interviews, as well as online surveys. A deductive directed content analysis approach was applied to assess respondents' perspectives. A total of 106 participants (37 hard of hearing adults and 69 audiologists) were involved across the multiple phases of this study. Results Referral practices for the evaluation of cochlear implantation candidacy in Australia are highly inconsistent, supporting the need to streamline referral information. The following facilitators were identified to support the development of referral material: appropriate content, perceived patient benefit, and objectivity. Areas for improvement related to the broadness of the content, impact on professional identity, and accessibility. Conclusions Practical insight from patients and referrers can inform the development of patient-facing material related to cochlear implant referrals. Streamlining information used in educational material could alleviate confusion inherent to varied health literacy levels and support patients in making informed decisions related to pursuing, or not, cochlear implantation candidacy evaluation services.

The Association Between Internet Searches and Moisturizer Prescription in Japan: Retrospective Observational Study

Article

Oct 2019

The Quality of Online Information for an Uncommon Malignancy—Neuroendocrine Tumours (NETs)

Article

Full-text available

Feb 2021

Background: Patient information is critical in shared decision-making and patient-centred management for neuroendocrine tumours (NETs). Most adults search the internet for health issues, with over half considering such information to be credible. Therefore, we evaluated the quality of online information on NETs. Methods: Searching for "Neuroendocrine Tumours", the top 20 websites from Google and top 10 from Yahoo and Bing were identified. Open-access websites written in English were included. Websites indicated as advertisements or directed towards healthcare providers were excluded. Each website was evaluated using the JAMA benchmarks, DISCERN instrument, and the Health on the Internet (HONCode) seal by two independent reviewers. Results: We included 16 unique websites after removing duplicates. Four were education pages from healthcare institutions, 10 were Cancer Society pages, and 2 were general information pages. The average score for JAMA benchmarks was 2.3, with 19% of websites receiving the highest score of 4. Specifically, 31% met the benchmark for authorship, 69% for attribution, 94% for disclosure, and 44% for currency. The average score for the DISCERN instrument was 46.5, with no website achieving the maximum of 80 points. The HONCode seal was present in 3 out of 16 websites (18%). Conclusions: We identified major issues with the quality of online information for NETs using validated instruments. The majority of websites identified through common search engines are low-quality. Patients should be informed of the limited quality of online information on NETs. High-quality online information is needed to ensure that patients can avoid misinformation and actively participate in their care.

Seasonal variation and change trends for quit smoking: evidence from Internet search engine query data

Preprint

Full-text available

Jan 2020

Background: The outcomes of smoking have generated considerable clinical interest in recent years. Although people from different countries are more interested in the topic of quit smoking during the winter, few studies have tested this hypothesis. The current study aimed to quantify public interest in quitting smoking via Google. Methods: We use Google Trends to obtain the Internet search query volume for terms relating to quit smoking in major northern and southern hemisphere countries in this research. Normally search volumes for the term “quit smoking + stop smoking + smoking-cessation” were retrieved within the USA, the UK, Canada, Ireland, New Zealand and Australia from January 2004 to December 2018. Seasonal effects were investigated using cosinor analysis and seasonal decomposition of time series models. Results: Significant seasonal variation patterns in those search terms were revealed by cosinor analysis and demonstrated by the evidence from Google Trends analysis in the representative countries including the USA (pcos = 2.36×10⁻⁷), the UK (pcos < 2.00×10⁻¹⁶), Canada (pcos < 2.00×10⁻¹⁶), Ireland (pcos <2.00×10⁻¹⁶) ,Australia (pcos = 5.13×10⁻⁶) and New Zealand (pcos = 4.87×10⁻⁷). Time series plots emphasized the consistency of seasonal trends with peaks in winter / late autumn by repeating in nearly all years. The overall trend of search volumes for quitting smoking, observed by dynamic series analysis, has declined from 2004 to 2018. Conclusions: The preliminary evidence from Google Trends search tool showed a significant seasonal variation and a decreasing trend for the RSV of quit smoking. Our novel findings in smoking-cessation epidemiology need to be verified with further studies, and the mechanisms underlying these findings must be clarified.

Obstetrik Girişimler İçin Kliniğimizde Takip Ettiğimiz Asemptomatik Gebelerin COVID Test Sonuçlarının Değerlendirilmesi

Chapter

Full-text available

Dec 2020

10 Nisan 2020 ile 30 Mayıs 2020 tarihleri arasında, İstanbul Medipol Üniversitesi Medipol Mega Üniversite Hastanesinde obstetrik işlemler yapılacak, COVID-19 enfeksiyon semptomları taşımayan 362 gebeden PCR testi için burun ve boğazdan kombine sürüntü örnekleri alındı, lenfosit sayılarının değerlendirilmesi için hemogram istendi. Üç yüz altmış iki gebeden 2’sinin PCR testi pozitif saptandı, diğerleri negatifti. Hastalar 14 gün sonra telefonla aranarak COVID-19 enfeksiyon semptomları olup olmadığı soruldu. Bu sürede 1 hastada saptanan ateş sonrasında tekrarlanan PCR testi negatif saptandı ve hastada mastit geliştiği belirlendi. Hastaların tamamında lenfopeni saptanmadı.

A new path to address health disparities: How older Aboriginal & Torres Strait Islander women use social media to enhance community health (Protocol)

Article

Full-text available

Mar 2022

Background Digital health offers a fresh avenue to address health disparities experienced by Aboriginal and Torres Strait Islanders. Despite the scant evidence about how Aboriginal and Torres Strait Islanders access and use health technology, the Australian government has prioritised research that uses technology to enable people to manage their health and promote better health outcomes. Older Aboriginal and Torres Strait Islander women are cultural leaders in their communities, enabling them to provide valuable insights about the safety and efficacy of health care messaging. However, no research has engaged older Aboriginal and Torres Strait Islander, women as partners in digital health research. Objective This paper provides a protocol for co-designed translational research that privileges older Aboriginal & Torres Strait Islander women’s cultural expertise to design and test a framework for accessible, culturally safe and feasible digital health technologies. Methods This mixed-methods research project will use the collective impact approach, a user-centred, co-design methodology and yarning circles, a recognised Indigenous research methodology. A series of yarning circles with three different communities will elucidate enablers and barriers to access health information; co-create a framework clarifying what works and does not work for digital health promotion in their communities; and test the framework by co-creating three digital health information programs. Conclusions Privileging the cultural expertise of older Aboriginal and Torres Strait Islander women will provide a novel perspective and vital guidance that end users and developers can trust and rely upon to create and evaluate culturally safe and efficacious digital health promotion programs.

What’s Nissen on the net? the quality of information regarding Nissen fundoplication on the internet

Article

Full-text available

Jul 2022
SURG ENDOSC

Background More patients are turning to the internet for their health information than ever before. This is a growing problem as it is well recognized that medical information on the internet is highly variable. We assessed the quality of information on the internet regarding the anti-reflux procedure, Nissen Fundoplication. Three commonly used measures of website quality are the Health On the Net code, the Journal of the American Medical Association Benchmark criteria, and the DISCERN tool. The HON code is a seal of approval awarded by an independent organization where the JAMA Benchmark and DISCERN Tool are a set of standards that can be utilized by an internet user or webpage creator.Methods We performed a Google search using the term “Nissen Fundoplication”, where we analyzed the top 75 websites. We included English language websites and excluded advertisements, websites for medical professionals, duplicates, and requiring a login. Each website included was evaluated for presence of the HON seal and scored with the JAMA Benchmark and DISCERN criteria to determine quality.ResultsOnly 16.28% of websites were found to be HON code certified. The average JAMA benchmark score was 1.23, with 9.3% websites scoring the maximum 4 points and 39.53% receiving a score of 0. The average DISCERN score was 34.65 out of a total possible score of 75, where the mean score for the overall quality of the website (question 16) was 2.19 out of a maximal score of 5.Conclusion This study, using 3 commonly used validated measures, has found that the quality of online information pertaining to Nissen Fundoplication is sorely lacking. The implications of these results are twofold as an important reference for institutions to update their source material and a guide when providing patients with adequate resources.

Older age and online health information search behaviors: The mediating influence of executive functions

Article

Nov 2021
J CLIN EXP NEUROPSYC

Introduction: Searching the internet for health-related information is a complex and dynamic goal-oriented process that ostensibly places demands on executive functions, which are higher-order cognitive abilities that can deteriorate with older age. This study examined the effects of older age on electronic health (eHealth) search behavior and the potential mediating influence of executive functions. Method: Fifty younger adults (≤ 35 years) and 41 older adults (≥50 years) completed naturalistic eHealth search tasks involving fact-finding (Fact Search) and symptom determination (Symptom Search), a neurocognitive battery, and a series of self-report questionnaires. Results: Multiple regression models controlling for potentially confounding psychiatric symptoms, health conditions, literacy, and demographic variables revealed that older adults were slower and less accurate than younger adults on the eHealth Fact Search task, but not on the eHealth Symptom Search task. Executive functions mediated the relationship between age and Fact and Symptom Search accuracy, independent of basic processing speed and attention. Parallel mediation models showed that episodic memory was not an independent mediator of age and search accuracy for either eHealth task once speed/attention and executive functions were included. Conclusions: Older adults can experience difficulty searching the internet for some health-related information, which is at least partly attributable to executive dysfunction. Future studies are needed to determine the benefits of training in the organizational and strategic aspects of internet search for older adults and whether these findings are applicable to clinical populations with executive dysfunction.

Comparing the medical term usage patterns of professionals with those of search engine/community question answering service users in Japan: Log Analysis (Preprint)

Article

Jan 2019
J MED INTERNET RES

Background: Despite increasing opportunities for acquiring health information online, discussion of the specific words used in searches has been limited. Objective: The aim of this study was to clarify the medical information gap between medical professionals and the general public in Japan through health information-seeking activities on the internet. Methods: Search and posting data were analyzed from one of the most popular domestic search engines in Japan (Yahoo! JAPAN Search) and the most popular Japanese community question answering service (Yahoo! Chiebukuro). We compared the frequency of 100 clinical words appearing in the clinical case reports of medical professionals (clinical frequency) with their frequency in Yahoo! JAPAN Search (search frequency) logs and questions posted to Yahoo! Chiebukuro (question frequency). The Spearman correlation coefficient was used to quantify association patterns among the three information sources. Additionally, user information (gender and age) in the search frequency associated with each registered user was extracted. Results: Significant correlations were observed between clinical and search frequencies (r=0.29, P=.003), clinical and question frequencies (r=0.34, P=.001), and search and question frequencies (r=0.57, P<.001). Low-frequency words in clinical frequency (eg, "hypothyroidism," "ulcerative colitis") highly ranked in search frequency. Similarly, "pain," "slight fever," and "numbness" were highly ranked only in question frequency. The weighted average of ages was 34.5 (SD 2.7) years, and the weighted average of gender (man -1, woman +1) was 0.1 (SD 0.1) in search frequency. Some words were specifically extracted from the search frequency of certain age groups, including "abdominal pain" (10-20 years), "plasma cells" and "inflammatory findings" (20-30 years), "DM" (diabetes mellitus; 30-40 years), "abnormal shadow" and "inflammatory findings" (40-50 years), "hypertension" and "abnormal shadow" (50-60 years), and "lung cancer" and "gastric cancer" (60-70 years). Conclusions: Search and question frequencies showed similar tendencies, whereas search and clinical frequencies showed discrepancy. Low-clinical frequency words related to diseases such as "hypothyroidism" and "ulcerative colitis" had high search frequencies, whereas those related to symptoms such as "pain," "slight fever," and "numbness" had high question frequencies. Moreover, high search frequency words included designated intractable diseases such as "ulcerative colitis," which has an incidence of less than 0.1% in the Japanese population. Therefore, it is generally worthwhile to pay attention not only to major diseases but also to minor diseases that users frequently seek information on, and more words will need to be analyzed in the future. Some characteristic words for certain age groups were observed (eg, 20-40 years: "cancer"; 40-60 years: diagnoses and diseases identified in health examinations; 60-70 years: diseases with late adulthood onset and "death"). Overall, this analysis demonstrates that medical professionals as information providers should be aware of clinical frequency, and medical information gaps between professionals and the general public should be bridged.

Health in the Social Network: An Exploratory Study of the Fan Page “Melhor com Saúde” (“Better with Health”): Challenges and Trends

Chapter

Jan 2019

Denise Cristina Ayres Gomes

This study aims to understand the symbolic dimension of health in the digital environment. We conducted an exploratory study of the fan page “Melhor com Saúde” (“Better with Health”) that has 8.5 million followers on Facebook. We selected the two most commented posts, described the content, and analyzed the first 50 comments for each. We used content analysis by thematic category proposed by Bardin (Análise de conteúdo. Edições, Lisboa, 2004). The fan page focuses on daily issues that tend to affect the body and spiritual balance. Based on an analysis of the most commented posts, we can observe how digital social media reconfigure the meaning of health. The topic expands in the social realm, creating a network of solidarity around new thematic ideas. Today, health becomes associated with well-being and the hedonistic enjoyment of life. Going beyond modern sense of rationality, it encompasses an ethos that is aesthetic, circumstantial, erected, and shared through a communication network.

An Evaluation of the Quality and Content of Web‐based Stoma Information

Article

Nov 2018

Aim Although the internet is commonly the first port of call for medical information it provides unregulated data of variable quality. We aimed to evaluate commonly accessed web‐based information on intestinal stomas using validated and novel scoring systems. Methods The keywords ‘stoma,’ ‘colostomy,’ ‘ileostomy’ and ‘bowel bag’ were entered into the most commonly used internet search engines (Google, Bing and Yahoo). The first ten websites from each search were analysed using the validated Journal of the American Medical Association (JAMA) benchmark criteria and DISCERN scoring systems. A novel stoma‐specific score was devised and applied. Results Forty‐three unique websites were identified. The majority (49%) were from nonprofit or governmental agencies and 9% were from commercial entities. The mean total DISCERN score for all websites was 42.4+/‐ 10.2 (maximum possible score=75). The mean JAMA and stoma‐specific scores were 2.1+/‐1.0 (maximum possible score=4) and 12.9+/‐6.1 (maximum possible score=27). The lowest JAMA scores were in the category of attribution with 70% of websites lacking references for the information provided. A total of 88% displayed disclosure/paid advertiser information. Surgery was described in 67%., an image or diagram was provided in 58% and in 72% a stomal therapist/nurse was mentioned. Iinformation on when to seek medical help was provided in 51%. Conclusion Web‐based information on stomas is of variable content and quality. Authorship and information sources are often unclear.. Only half provided information on when to seek medical help for complications including high output and dehydration. These findings should be highlighted to patients utilising the internet to obtain information on stomas. This article is protected by copyright. All rights reserved.

Seeking Information: A Survey of Rural Spinal Patients' Internet Use and Pain Catastrophizing

Article

Full-text available

Apr 2021

Objective Clinicians are beginning to evaluate the effects that Internet use has on patients. The aim of this study is to provide descriptive information on patients’ use of the Internet in regard to their spinal pain. Additionally, this study aims to examine the patient’s type of Internet usage (information vs. support) and its relationship to pain-related distress. Materials and Methods This quantitative-descriptive, survey-based, correlational, cross-sectional design surveyed 143 spinal surgery patients from the Appalachian region. Participants were administered a demographic questionnaire, the pain catastrophizing scale, and an Internet Use and Spine Patients Questionnaire. Descriptive information on patient Internet use was collected through a retrospective recall of the participants’ Internet use and was analyzed utilizing a frequency distribution. A Pearson (r) correlation was conducted to determine the relationship between Internet use and the severity of pain catastrophizing. Results Spinal surgery patients more frequently use the Internet for information than for support. For the individuals who do utilize the Internet for information, most are finding this tool to be somewhat helpful. For spinal patients who do use the Internet for support, there was a positively correlated relationship with magnification, helplessness, and overall pain catastrophizing. Conclusion Patients who present for spinal surgery are generally using the Internet to gain information on their diagnoses. Pain catastrophizing was elevated in relation to Internet use for support. Limitations and future directions are discussed.

0-1 Yaş Bebeği Olan Annelerin Bebek Bakımına ve Büyüme Gelişmesine İlişkin İnterneti Kullanma Durumunun Değerlendirilmesi

Article

Nov 2020

Normalized Google Distance in the Identification and Characterization of Health Queries

Conference Paper

Jun 2019

Evaluation of Online Counselling Services Based on Turkish Web-based Pharmacy Care Setting: A retrospective Observational Study

Article

Full-text available

Oct 2020
INT J CLIN PRACT

Aims of the study: To determine the types of online pharmacy care services provided by the clinical pharmacists regarding identification of medication-related problems, provision of counselling services for health and disease conditions alongside medications' counselling for patients seeking online consultation about health, medication and lifestyle concerns based on Turkish web-based pharmacy care setting(WPCS). Methods: A retrospective, descriptive cohort study carried out on patients during their online visiting of Turkish WPCS seeking consultation for diverse kinds of concerns from September 2015 to March 2016. Patients' health and medication data were gathered for assessment of health-, medication- and lifestyle-related concerns. Descriptive analysis and Chi square test were used to analyse study data. Study outcomes included personalised online pharmacy care services regarding identification of medication-related problems, counselling services for health and disease conditions and medications' counselling alongside associations with counselling-related concerns by the WPCS. Results: A total of 350 participants enrolled in this study and the majority of them were women (62.6%). Dermatological and gynaecological conditions represented the majority of disease conditions (51.4%, 44.6%), respectively. Within 1 year, 63.7% of the study participants visited the Turkish WPCS more than three times. Medicationand health-related concerns were reported by 90.8% and 68.3% of the study participants, respectively. Medication side effects (44.1%) and an inappropriate medication timing (31.4%) were the major medication-related problems identified. A total of 477 different counselling services regarding health conditions and 990 counselling regarding medications were provided by the clinical pharmacist through the Turkish WPCS. Conclusion: The WPCS could be considered as an additional option for the clinical pharmacist to provide care services regarding identification of medication-related problems, provision of counselling about health and disease conditions alongside different medication counselling to improve health conditions and proper pharmacotherapy management.

Medical Tourism: An Introduction

Chapter

Nov 2019

Anu Rai

Travelling away from your own jurisdictional territory with a desire to get to faster, affordable and reliable medical care facilities is defined as medical tourism. Medical tourism is an ancient social practice of healthcare that dates thousands of years back. Sacred sites of Greece, Egypt, India and Persia have long tied history with healthcare travellers. The changing nature of civilisation and advancement of technology have made a crucial impact on healthcare travel to seek either holistic (i.e., through prayers, relaxation, exercise, visits to mineral springs, sea water or holy river, sacred temple baths) or biomedical (diagnosis, hospitalisation and surgical operations) cures. Globally, migration of patients is increasing every year. While on the one hand, patients migrate to get access to medical facilities inaccessible in their own country or are costlier, on the other hand, there are countries empowered to provide such amenities and cash on this distinct tourist segment. Medical tourism-generating regions are known as MTGRs and countries catering to their medical needs are termed as medical tourism destination regions or MTDRs (Gyu Ko 2011). This chapter highlights medical tourism as the commodity of services. It explores factors working behind the growth of this giant industry, drawing different estimates of market segmentation. It also brings about the gap present in existing knowledge of literature as revealed from an extensive survey of existing literature including patients’ guidebook, case studies, reports and articles.

“Dr. Google” Will See You Now—Assessing the Quality of Information on Oesophageal Cancer on the Internet

Article

Nov 2019

Background Increasingly, patients are consulting the internet for medical information, where the quality is highly variable. We must ensure patients are directed towards high-quality websites. This is particularly true of oesophageal cancer which is often detected at an advanced stage and is frequently fatal. We aim to assess the quality of information on oesophageal cancer available for patients on the Internet. Methods and Materials We searched the top 3 search engines for “Esophageal Cancer”. We analysed the top 20 websites returned by Google and the top 10 websites returned by Yahoo and Bing. All free, English language websites which did not require a password were included. We excluded paid advertisement websites and websites for medical professionals. Duplicate websites were removed. Each website was then evaluated using the JAMA benchmarks, DISCERN tool, presence or absence of the Health On The Internet (HON) seal and the Esophageal Cancer Specific Content Score (ECSCS). Results The average JAMA score was 2 with only three of the eighteen unique websites scoring the maximum of 4 points (17%). The average DISCERN score was 51.5 (64%) with no website achieving the maximum of 80. The HON seal was present in only 5 websites (28%). The average ECSCS was 9.2 with only two websites achieving the maximum of 12 (11%). Conclusions Whilst there are certainly websites providing high-quality information for patients in relation to oesophageal cancer, our study has identified obvious issues. We must ensure that only the highest-quality information is available on the Internet for patients.

Paradigm shift: Beyond the COVID‐19 era, is YouTube the future of education for CABG patients?

Article

Full-text available

Aug 2022
J CARDIAC SURG

Introduction Patients commonly use YouTube for education, and this may have increased due to COVID‐19 related restrictions on access to healthcare professionals. However, YouTube videos lack peer review and regulation. To assess patient education in the COVID‐19 era, we analyzed the quality of YouTube videos on coronary artery bypass graft (CABG) surgery. Methods We searched YouTube using the phrase “coronary artery bypass graft.” Two authors individually used the Journal of the American Medical Association (JAMA), DISCERN, and Health on the Net (HON) systems, to rate the first 50 videos retrieved. Data collected for each video included; number of views, duration since upload, percentage positivity (proportion of likes relative to total likes plus dislikes), number of comments, and video author. Interobserver reliability was assessed using an intraclass correlation coefficient (ICC). Associations between video characteristics and quality were tested using linear regression or t‐tests. Results The average number of views was 575,571. Average quality was poor, with mean scores of 1.93/4 (ICC 0.54) for JAMA criteria, 2.52/5 (ICC 0.78) for DISCERN criteria, and 4.04/8 (ICC 0.66) for HON criteria. Videos uploaded by surgeons scored highest overall (p < .05). No other factors demonstrated significant association with video quality. Conclusion YouTube videos on CABG surgery are of poor quality and may be inadequate for patient education. Given the complexity of the procedure and that beyond the COVID‐19 era, patients are more likely to seek education from digital sources, treating surgeons should advise of YouTube's limitations and direct patients to reliable sources of information.

The Current State of Vascular Surgery Presence and Educational Content in Google and YouTube Internet Search Results

Article

Feb 2021
J VASC SURG

Background Information on the internet regarding vascular disease has not been extensively assessed. Our goal was to compile and appraise the information available via Google and YouTube searches regarding various topics of interest for vascular surgeons and related procedures with a focus on the role of the vascular surgeon (VS). Methods The Google and YouTube platforms were independently queried for 25 keywords/phrases relating to common vascular diagnoses and procedures by two separate researchers from March to July 2019. Paid advertisements or a Society for Vascular Surgery (SVS) webpage or affiliated video in the first 25 results was documented. Results were reviewed for information regarding the responsible medical specialty, the target audience, and disease-related information (screening, risk factors, risk reduction, diagnostic testing, operative treatment, alternative treatment, follow-up, complications, and recovery). Results From the Google search, 357 unique domains of 1241 total webpages were identified with 75% directed towards the public. A SVS page was present in 56% of the first-page results and least likely to be present in searches for claudication, gangrene, carotid stent, rib resection and thrombolysis. VS were mentioned as referral physicians in 56% of the 68% of websites that mentioned a specialty, endovascular specialists/interventional radiology (IR) in 20% and cardiothoracic surgeons (CTS) in 19%. Only 4% of the websites contained information from all categories, with the greatest number for aortic dissection. Advertisements were present in 18% of all searches (most commonly for “varicose vein,” “varicose vein surgery” and “IVC filter”). From YouTube, 1247 search results (613 unique videos) were evaluated with 64% directed towards the public. A SVS affiliated video was present in 36% of searches. In the 47% of videos where a specialty was mentioned, 56% mentioned VS, IR in 10%, and CTS in 7%. Only 0.24% of the videos contained information from all categories. The greatest number of content categories was in videos related to peripheral arterial disease. Across both platforms, dialysis access searches yielded results with the least number of content categories. Conclusions Patient related information regarding vascular surgical topics are readily available on the internet but the content is highly variable and not comprehensive. Only half of the searches mention VS as the referral physician of choice or authority for these medical conditions. Further efforts should focus on developing the online presence of vascular surgery, improving the quality of education of vascular disease on the internet, and directing patients to the vascular specialists to treat these conditions.

The Online Health Care Revolution: How the Web Helps Americans Take Better Care of Themselves

Article

Full-text available

Nov 1999

Consumer Health Informatics

Article

Full-text available

Jul 2000

Gunther Eysenbach

Introduction For the past 100,000 years, people have been able to produce, distribute, and process information in a synchronized manner. About 500 years ago, the situation started to change rapidly. With the advent of the mobile type press, our ability to produce and distribute information started to accelerate, outpacing our capacity to process information. During the past 10 years, we have witnessed how the Internet and the World Wide Web have led to a hyper-production and hyper-distribution of information, which have clearly overwhelmed our capacity to process it. In this chapter we will explore current access to and barriers to further information for consumers. We will discuss how computers and other developments in information technology are ushering in the era of consumer health informatics, and the potential that lies ahead. It is clear that this will be a period in which the public will have unprecedented ability to access information and to participate actively in evidence-

A taxonomy of generic clinical questions: Classification study

Article

Full-text available

Sep 2000

To develop a taxonomy of doctors' questions about patient care that could be used to help answer such questions. Use of 295 questions asked by Oregon primary care doctors to modify previously developed taxonomy of 1101 clinical questions asked by Iowa family doctors. Primary care practices in Iowa and Oregon. Random samples of 103 Iowa family doctors and 49 Oregon primary care doctors. Consensus among seven investigators on a meaningful taxonomy of generic questions; interrater reliability among 11 individuals who used the taxonomy to classify a random sample of 100 questions: 50 from Iowa and 50 from Oregon. The revised taxonomy, which comprised 64 generic question types, was used to classify 1396 clinical questions. The three commonest generic types were "What is the drug of choice for condition x?" (150 questions, 11%); "What is the cause of symptom x?" (115 questions, 8%); and "What test is indicated in situation x?" (112 questions, 8%). The mean interrater reliability among 11 coders was moderate (kappa=0.53, agreement 55%). Clinical questions in primary care can be categorised into a limited number of generic types. A moderate degree of interrater reliability was achieved with the taxonomy developed in this study. The taxonomy may enhance our understanding of doctors' information needs and improve our ability to meet those needs.

How do consumers search for and appraise health information on the world wide web? Qualitative study using focus groups, usability tests, and in-depth interviews

Article

Full-text available

Apr 2002
Br Med J

To describe techniques for retrieval and appraisal used by consumers when they search for health information on the internet. Qualitative study using focus groups, naturalistic observation of consumers searching the world wide web in a usability laboratory, and in-depth interviews. A total of 21 users of the internet participated in three focus group sessions. 17 participants were given a series of health questions and observed in a usability laboratory setting while retrieving health information from the web; this was followed by in-depth interviews. Heidelberg, Germany. Although their search technique was often suboptimal, internet users successfully found health information to answer questions in an average of 5 minutes 42 seconds (median 4 minutes 18 seconds) per question. Participants in focus groups said that when assessing the credibility of a website they primarily looked for the source, a professional design, a scientific or official touch, language, and ease of use. However, in the observational study, no participants checked any "about us" sections of websites, disclaimers, or disclosure statements. In the post-search interviews, it emerged that very few participants had noticed and remembered which websites they had retrieved information from. Further observational studies are needed to design and evaluate educational and technological innovations for guiding consumers to high quality health information on the web.

Expanding the concept of medical information: An observational study of physicians' information needs

Article

May 1992

Obtaining and managing clinically relevant information constitutes a major problem for physicians, for which the development of automated tools is often proposed as a solution. However, designing and implementing appropriate automated solutions presumes knowledge of physicians' information needs. We describe an empirical study of information needs in four clinical settings in internal medicine in a university teaching hospital. In contrast to the retrospective data often used in previous studies, this research used ethnographic techniques to facilitate direct observation of communication about information needs. On the basis of this experience, we address two main issues: how to identify and interpret expressions of information needs in medicine and how to broaden our conception of "information needs" to account for the empirical data.

Patients looking for information on the internet and seeking teleadvice: Motivation, expectations, and misconceptions as expressed in E-mails sent to physicians

Article

Mar 1999
ARCH DERMATOL

To analyze the motivation, expectations, and misconceptions of patients seeking teleadvice or medical information on the Internet. To explore the possible economics and problems of direct physician-to-patient teleadvice via electronic mails (e-mail). Exploratory survey of 209 unsolicited e-mails mostly sent to physicians by individuals seeking teleadvice. University dermatology hospital with a major Web site on the World Wide Web. Two hundred nine patients and information-seeking individuals, mainly with dermatologic problems. Previous contacts with live physicians, disease duration, level of frustration expressed in the e-mails, and type of information sought. Many dermatologic patients who request teleadvice have a chronic disease (81%) and seek a second opinion. Seventeen percent express frustration about previous encounters with live physicians. Forty percent of all e-mails could have been answered by a librarian, 28% of all e-mails were suitable to be answered by a physician via e-mail alone, and in 27% of the cases any kind of consultation would not have been possible without seeing the patient. In at least 5 instances patients attempt self-diagnosis. We found examples for the beneficial effects of the provision of medical information on the World Wide Web but also evidence suggesting that patients are trying to use information on the Internet as a supplement for physicians and that teleadvice might be overused by chronically ill and frustrated patients looking desperately for additional information. Telemedicine via e-mail could substitute a physician visit or telephone call in some cases, but many principal problems must be solved beforehand.

Personal Health Information-Seeking: A Qualitative Review of the Literature

Article

Feb 2001
Stud Health Tech Informat

P Zoë Stavri

This qualitative review establishes Personal Health Information-Seeking (PHIS) as a more accurate description of the patient and health education information-seeking activity commonly known as Consumer Health Information Seeking. This review introduces multiple knowledge or domain facets which need to be considered in order to understand the complexities of this behavior by providing a brief overview of key empirical and theoretical work framed around Metoyer-Duran's ethnolinguistic community information theoretical model originally published in 1991, which should guide PHIS system development.

Consumer health informatics: a consensus description and commentary from American Medical Informatics Association members

Article

Feb 2001

Although interest in Consumer Health Informatics (CHI) has increased, a consensus definition of CHI does not yet exist. To conduct a hypothesis-generating survey of AMIA members regarding definition and research agenda for CHI. We solicited participation among AMIA members in an Internet-based survey focusing on issues related to a definition of CHI. One hundred thirty-five AMIA members responded. Participants indicated a broad spectrum of topics important to CHI including "self-help for disease management" and "patient access to their own medical records." CHI research was felt to rely heavily on public health methods such as epidemiology and outcomes research, a paradigm shift from traditional medical informatics. Responses indicated a perceived lack of funding and need for further research in CHI. A working definition should emphasize the multidisciplinary nature of CHI, include consumer input into CHI design, and focus on public health approaches to evaluation.