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Pereira TV, Saadat P, Bobos P, Iskander SM, Bodmer NS, Rudnicki M, Dan Kiyomoto H, Montezuma T, Almeida MO, Bansal R, Cheng PS, Busse JW, Sutton AJ, Tugwell P, Hawker GA, Jüni P, da Costa BR. Effectiveness and safety of intra-articular interventions for knee and hip osteoarthritis based on large randomized trials: A systematic review and network meta-analysis. Osteoarthritis Cartilage 2024:S1063-4584(24)01389-X. [PMID: 39265924 DOI: 10.1016/j.joca.2024.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 08/08/2024] [Accepted: 08/25/2024] [Indexed: 09/14/2024]
Abstract
OBJECTIVE To quantify the effectiveness and safety of intra-articular interventions for knee and hip osteoarthritis (OA) through a systematic review and Bayesian random-effects network meta-analysis. DESIGN We searched CENTRAL and regulatory agency websites (inception-2023) for large, English-language, randomized controlled trials (RCTs) (≥100 patients/group) examining any intra-articular intervention. PRIMARY OUTCOME pain intensity. SECONDARY OUTCOMES physical function and safety outcomes. Pain and function outcomes were analyzed at 2, 6, 12, 24, and 52 weeks post-randomization, and presented as standardized mean differences (SMDs) (95% credible intervals, 95% CrI). The prespecified minimal clinically important between-group difference (MID) was -0.37 SMD. Safety outcomes were presented as odds ratios (OR) (95% CrI). FINDINGS Among 57 RCTs (22,795 participants) examining 18 intra-articular interventions, usual care or placebo, treatment effects were larger in 35 high-risk-of-bias trials than in 22 low/unclear-risk-of-bias trials. In the main analysis (excluding high-risk-of-bias trials), triamcinolone had the highest probabilities of reaching the MID at weeks 2 and 6 (75.3% and 90%, respectively) with corresponding SMDs of -0.48 (95% CrI,-0.85 to -0.10) and -0.53 (95% CrI,-0.79 to -0.27) compared to placebo (1 trial). The complex homeopathic products Tr14/Ze14 showed therapeutic potential at week 6 compared to placebo (SMD:-0.42, 95% CrI,-0.71 to -0.11, 63.5% probability of reaching the MID, 1 trial). Hyaluronic acid had no effect on pain (SMD:-0.04, 95% CrI,-0.19 to 0.11, 11 trials) but a higher risk of dropouts due to adverse events (OR: 2.01, 95% CrI,1.08 to 3.77) and serious adverse events (OR: 1.86, 95% CrI, 1.16 to 3.03) than placebo. CONCLUSION Triamcinolone had the highest probabilities to have a treatment effect beyond the MID at weeks 2-6. Large RCTs with lower risk of bias indicate that the effects of 16 intra-articular interventions in knee or hip OA were smaller than the MID, and that most were consistent with placebo effects. Lack of evidence of long-term effectiveness underscores the need for further research beyond 24 weeks.
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Affiliation(s)
- Tiago V Pereira
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Pakeezah Saadat
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Pavlos Bobos
- School of Physical Therapy, Western University, London, ON, Canada; Western's Bone and Joint Institute, Western University, London, ON, Canada
| | - Samir M Iskander
- Schulich School of Medicine, University of Western Ontario, London N6A 3K7, Canada
| | - Nicolas S Bodmer
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; University of Zurich, Medical Faculty, CH-8091 Zurich, Switzerland
| | - Martina Rudnicki
- Institute of Ophthalmology, University College London, London, UK
| | - Henry Dan Kiyomoto
- Department of Physiotherapy, Faculty of the Americas (FAM), São Paulo, Brazil
| | - Thais Montezuma
- Health Technology Assessment Unit, Oswaldo Cruz German Hospital, São Paulo, Brazil
| | - Matheus O Almeida
- Health Technology Assessment Unit, Oswaldo Cruz German Hospital, São Paulo, Brazil
| | - Rishi Bansal
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Pai-Shan Cheng
- Biostatistics Division, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Jason W Busse
- Department of Anesthesia, McMaster University, Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Alex J Sutton
- Department of Population Health Sciences, University of Leicester, Leicester, UK
| | - Peter Tugwell
- Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Gillian A Hawker
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Peter Jüni
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Bruno R da Costa
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; Institute of Primary Health Care (BIHAM), University of Bern, Switzerland.
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Brinkman JC, Moore ML, Lai C, Tummala SV, Pollock JR, McQuivey KS, Hassebrock JD, Thompson AB, Chhabra A. Patient Interest in Quadriceps Autograft Anterior Cruciate Ligament Reconstruction Is Increasing Over Other Autograft Options: A 12-Year Google Trends Analysis. Arthrosc Sports Med Rehabil 2024; 6:100942. [PMID: 39006776 PMCID: PMC11240022 DOI: 10.1016/j.asmr.2024.100942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 04/02/2024] [Indexed: 07/16/2024] Open
Abstract
Purpose To use Google trends to explore differences in public interest among types of anterior cruciate ligament (ACL) autografts, specifically quadriceps tendon, patellar tendon, and hamstring tendon autografts, between 2008 and 2019. Methods Data were obtained by querying Google Trends for key terms and phrases for online search data ranging from January 2008 to December 2019. Relative search volumes were created based on searches related to ACL reconstruction with comparative analysis generated for search terms related to quadriceps ACL, patellar tendon ACL, and hamstring ACL autografts. Statistical analysis included linear regression analysis, comparison of quarterly search volume trends over time, and comparison of cumulative annual search volumes for 2008 versus 2019. Results Linear models for respective search terms were statistically significant for the quadriceps (P < .001) and patellar (P = .007) tendon autograft groups but not the hamstring group (P = .129). The quadriceps autograft group demonstrated a 12-year search volume trend change of 0.56, which was significantly greater than the hamstring (0.07; P < .001) and patellar tendon (0.168; P < .001) groups. There was no significant difference in the trend change between hamstring and patellar tendon groups (P = .20). Percent change in cumulative relative annual search volumes between 2008 and 2019 was 112% for the quadriceps tendon group, 12.9% for the hamstring group, and 18.6% for the patellar tendon group. Conclusions This study indicates a consistently increasing public interest in quadriceps tendon autograft for ACL reconstruction. The quadriceps autograft group demonstrated a significantly greater 12-year online search volume, greater linear correlation, and larger percent change between 2008 and 2019 compared with patellar tendon or hamstring autograft groups. Clinical Relevance Awareness of patient perceptions has value in informing shared decision-making, aligning patient expectations, and guiding areas of future research. Each of these has an impact on patient care. Being aware of patient interest and expectations is particularly important in areas with controversial or emerging research.
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Affiliation(s)
- Joseph C. Brinkman
- Department of Orthopedic Surgery, Mayo Clinic Arizona, Phoenix, Arizona, U.S.A
| | - M. Lane Moore
- Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, U.S.A
| | - Cara Lai
- Department of Orthopedic Surgery, Mayo Clinic Arizona, Phoenix, Arizona, U.S.A
| | - Sailesh V. Tummala
- Department of Orthopedic Surgery, Mayo Clinic Arizona, Phoenix, Arizona, U.S.A
| | | | - Kade S. McQuivey
- Department of Orthopedic Surgery, Mayo Clinic Arizona, Phoenix, Arizona, U.S.A
| | | | - Adam B. Thompson
- The Robert Larner M.D. College of Medicine at The University of Vermont, Burlington, Vermont, U.S.A
| | - Anikar Chhabra
- Department of Orthopedic Surgery, Mayo Clinic Arizona, Phoenix, Arizona, U.S.A
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Butuca A, Dobrea CM, Arseniu AM, Frum A, Chis AA, Rus LL, Ghibu S, Juncan AM, Muntean AC, Lazăr AE, Gligor FG, Morgovan C, Vonica-Tincu AL. An Assessment of Semaglutide Safety Based on Real World Data: From Popularity to Spontaneous Reporting in EudraVigilance Database. Biomedicines 2024; 12:1124. [PMID: 38791086 PMCID: PMC11117978 DOI: 10.3390/biomedicines12051124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 05/13/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024] Open
Abstract
Some glucagon-like peptide-1 receptor agonists (GLP-1 RAs), first used in the treatment of type 2 diabetes mellitus (T2DM), have been approved for the treatment of obesity in patients with or without T2DM (liraglutide-LIR, semaglutide-SEM, and tirzepatide-TIR). Social media had an important influence on the off-label use of GLP-1 RAs for obesity, especially for SEM. We analyzed the Google queries related to SEM to assess people's interest in this drug. We also investigated the occurrence of adverse drug reactions (ADRs) by searching the EudraVigilance database (EV) for Individual Case Safety Reports (ICSRs) that reported SEM as the suspected drug and performed a descriptive and a disproportionality analysis. The data obtained for SEM were compared to other GLP-1 RAs. SEM had the highest proportions of searches on Google associated with the term "weight loss" and presented the lowest number of severe ADRs, but it also had the highest number of ICSRs reported in EV. Even though no unexpected safety issues have been reported for it until now, SEM has a hi3gh tendency for overdose reports. The most frequent off-label use was reported for SEM and TIR. In order to lower the risks of ADRs, the off-label use should be reduced and carefully monitored.
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Affiliation(s)
- Anca Butuca
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (A.B.); (C.M.D.); (A.M.A.); (A.F.); (A.A.C.); (L.L.R.); (A.M.J.); (A.C.M.); (F.G.G.); (C.M.); (A.L.V.-T.)
| | - Carmen Maximiliana Dobrea
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (A.B.); (C.M.D.); (A.M.A.); (A.F.); (A.A.C.); (L.L.R.); (A.M.J.); (A.C.M.); (F.G.G.); (C.M.); (A.L.V.-T.)
| | - Anca Maria Arseniu
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (A.B.); (C.M.D.); (A.M.A.); (A.F.); (A.A.C.); (L.L.R.); (A.M.J.); (A.C.M.); (F.G.G.); (C.M.); (A.L.V.-T.)
| | - Adina Frum
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (A.B.); (C.M.D.); (A.M.A.); (A.F.); (A.A.C.); (L.L.R.); (A.M.J.); (A.C.M.); (F.G.G.); (C.M.); (A.L.V.-T.)
| | - Adriana Aurelia Chis
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (A.B.); (C.M.D.); (A.M.A.); (A.F.); (A.A.C.); (L.L.R.); (A.M.J.); (A.C.M.); (F.G.G.); (C.M.); (A.L.V.-T.)
| | - Luca Liviu Rus
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (A.B.); (C.M.D.); (A.M.A.); (A.F.); (A.A.C.); (L.L.R.); (A.M.J.); (A.C.M.); (F.G.G.); (C.M.); (A.L.V.-T.)
| | - Steliana Ghibu
- Department of Pharmacology, Physiology and Pathophysiology, Faculty of Pharmacy, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Anca Maria Juncan
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (A.B.); (C.M.D.); (A.M.A.); (A.F.); (A.A.C.); (L.L.R.); (A.M.J.); (A.C.M.); (F.G.G.); (C.M.); (A.L.V.-T.)
| | - Andrei Catalin Muntean
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (A.B.); (C.M.D.); (A.M.A.); (A.F.); (A.A.C.); (L.L.R.); (A.M.J.); (A.C.M.); (F.G.G.); (C.M.); (A.L.V.-T.)
| | - Antonina Evelina Lazăr
- National Institute of Research and Development for Electrochemistry and Condensed Matter, 144 Dr. A. P. Podeanu, 300569 Timisoara, Romania;
| | - Felicia Gabriela Gligor
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (A.B.); (C.M.D.); (A.M.A.); (A.F.); (A.A.C.); (L.L.R.); (A.M.J.); (A.C.M.); (F.G.G.); (C.M.); (A.L.V.-T.)
| | - Claudiu Morgovan
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (A.B.); (C.M.D.); (A.M.A.); (A.F.); (A.A.C.); (L.L.R.); (A.M.J.); (A.C.M.); (F.G.G.); (C.M.); (A.L.V.-T.)
| | - Andreea Loredana Vonica-Tincu
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (A.B.); (C.M.D.); (A.M.A.); (A.F.); (A.A.C.); (L.L.R.); (A.M.J.); (A.C.M.); (F.G.G.); (C.M.); (A.L.V.-T.)
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Tiao J, Wang K, Herrera M, Ren R, Rosenberg AM, Cassie R, Poeran J. There Is Wide Variation in Platelet-rich Plasma Injection Pricing: A United States Nationwide Study of Top Orthopaedic Hospitals. Clin Orthop Relat Res 2024; 482:675-684. [PMID: 37815436 PMCID: PMC10936995 DOI: 10.1097/corr.0000000000002864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/22/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND Demand for platelet-rich plasma (PRP) injections for osteoarthritis has dramatically increased in recent years despite conflicting evidence regarding its efficacy and highly variable pricing in the top orthopaedic centers in the United States, because PRP is typically not covered by insurance. A previous study investigating the mean price of PRP injections obtained information only from centers advertising online the availability of PRP injections. Thus, there is a need for further clarification of the overall availability and variability in cost of PRP injections in the orthopaedic community as well as an analysis of relevant regional demographic and hospital characteristics that could be associated with PRP pricing. QUESTIONS/PURPOSES Our study purposes were to (1) report the availability and price variation of knee PRP injections at top-ranked United States orthopaedic centers, (2) characterize the availability of pricing information for a PRP injection over the telephone, (3) determine whether hospital characteristics (Orthopaedic Score [ U . S. News & World Report measure of hospital orthopaedic department performance], size, teaching status, and rural-urban status) were associated with PRP injection availability and pricing, and (4) characterize the price variation, if it exists, of PRP injections in three metropolitan areas and individual institutions. METHODS In this prospective study, a scripted telephone call to publicly listed clinic telephone numbers was used to determine the availability and price estimate (amount to be paid by the patient) of a PRP injection for knee osteoarthritis from the top 25 hospitals from each United States Census region selected from the U.S. News & World Report ranking of best hospitals for orthopaedics. Univariable analyses examined factors associated with PRP injection availability and willingness to disclose pricing, differences across regions, and the association between hospital characteristics (Orthopaedic Score, size, teaching status, and rural-urban status) and pricing. The Orthopaedic Score is a score assigned to each hospital by U . S. News & World Report as a measure of hospital performance based partly on patient outcomes, with higher scores indicating better outcomes. RESULTS Overall, 87% (87 of 100) of respondents stated they offered PRP injections. Pricing ranged from USD 350 to USD 2815 (median USD 800) per injection, with the highest prices in the Northeast. The largest price range was in the Midwest, where more than two-thirds of PRP injections given at hospitals that disclosed pricing cost USD 500 to USD 1000. Of the hospitals that offered PRP injections, 68% (59 of 87) were willing to disclose price information over the telephone. PRP injection pricing was inversely correlated with hospital Orthopaedic Score (-3% price change [95% CI -5% to -1%]; p = 0.01) and not associated with any of the other hospital characteristics that were studied, such as patient population median income and total hospital expenses. An intracity analysis revealed wide variations in PRP pricing in all metropolitan areas that were analyzed, ranging from a minimum of USD 300 within 10 miles of metropolitan area B to a maximum of USD 1269 within 20 miles of metropolitan area C. CONCLUSION We found that although PRP injections are widely available, pricing continues to be a substantial financial burden on patients, with large price variability among institutions. We also found that if patients are willing to shop around in a metropolitan area, there is potential to save a meaningful amount of money. CLINICAL RELEVANCE As public interest in biologics in orthopaedic surgery increases, knowledge of its pricing should be clarified to consumers. The debated efficacy of PRP injections, combined with our findings that it is an expensive out-of-pocket procedure, suggests that PRP has limited cost-effectiveness, with variable, discrete pricing. As such, the price of PRP injections should be clearly disclosed to patients so they can make informed healthcare decisions.
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Affiliation(s)
- Justin Tiao
- Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kevin Wang
- Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael Herrera
- Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Renee Ren
- Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ashley M. Rosenberg
- Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Richawna Cassie
- Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jashvant Poeran
- Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Institute for Healthcare Delivery Science, Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Kang JM, Bentan M, Coelho DH. Awareness campaigns for cochlear implants: Are we making an impact? Cochlear Implants Int 2024; 25:93-98. [PMID: 38561981 DOI: 10.1080/14670100.2024.2334550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
OBJECTIVE This study aimed to determine if the major public awareness campaign for cochlear implants 'International Cochlear Implant Day' influenced national and international public interest as measured by internet search activity. METHODS Weekly search volume data in the United States, Canada, Australia, Germany, United Kingdom, Brazil, India, Japan, and a 'Worldwide' group for the search topic 'cochlear implant' was collected from Google Trends over a 5-year period (2017-2021). The 'Campaign' window was defined as 1 week before, the week of, and 2 weeks after International Cochlear Implant Day (February 25th). 'Non-Campaign' weeks were considered any data outside the 'Campaign' window. RESULTS Of the studied regions, the United States, United Kingdom, Australia, India, and 'Global' demonstrated a significant increase in internet search activity between 2017 and 2021. Although some individual years showed significant increases during the 'Campaign' period for Canada, Germany, Brazil, and Japan, none showed statistically significant increases over the 5-year period studied. CONCLUSION Public awareness campaigns are recognized crucial elements to delivering effective healthcare, but their success varies worldwide. While data from Google Trends suggests that cochlear implant awareness campaigns can translate into increased internet searches, greater efforts can be made in select countries to improve public interest.
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Affiliation(s)
- Joshua M Kang
- Department of Otolaryngology - Head & Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Mihai Bentan
- Department of Otolaryngology - Head & Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Daniel H Coelho
- Department of Otolaryngology - Head & Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
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Sabatini FM, Cohen-Rosenblum A, Eason TB, Hannon CP, Mounce SD, Krueger CA, Gwathmey FW, Duncan ST, Landy DC. Incidence of Rapidly Progressive Osteoarthritis Following Intra-articular Hip Corticosteroid Injection: A Systematic Review and Meta-Analysis. Arthroplast Today 2023; 24:101242. [PMID: 37941925 PMCID: PMC10630590 DOI: 10.1016/j.artd.2023.101242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/05/2023] [Accepted: 09/14/2023] [Indexed: 11/10/2023] Open
Abstract
Background The American Academy of Orthopedic Surgery recommends intra-articular corticosteroid injections (CSIs) for managing hip osteoarthritis (OA) based on short-term, prospective studies. Recent retrospective studies have raised concerns that CSIs may lead to rapidly progressive OA (RPOA). We sought to systematically review the literature of CSIs for hip OA to estimate the incidence of RPOA. Methods MEDLINE, Embase, and Cochrane Library were searched to identify original research of hip OA patients receiving CSIs. Overall, 27 articles involving 5831 patients published from 1988 to 2022 were included. Study design, patient characteristics, CSI details, follow-up, and cases of RPOA were recorded. Studies were classified by their ability to detect RPOA based on follow-up. Random effects meta-analysis was used to calculate the incidence of RPOA for studies able to detect RPOA. Results The meta-analytic estimate of RPOA incidence was 6% (95% confidence interval, 3%-9%) based on 10 articles classified as able to detect RPOA. RPOA definitions varied from progression of OA within 6 months to the presence of destructive changes. These studies were subject to bias from excluding patients with missing post-CSI radiographs. The remaining 17 articles were classified as unable to detect RPOA, including all of the studies cited in the American Academy of Orthopedic Surgery recommendation. Conclusions The incidence of RPOA after CSIs remains unknown due to variation in definitions and follow-up. While RPOA following CSIs may be 6%, many cases are not severe, and this may reflect selection bias. Further research is needed to understand whether clinically significant RPOA is incident enough to limit CSI use.
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Affiliation(s)
- Franco M. Sabatini
- Department of Orthopaedic Surgery, University of Kentucky, Lexington, KY
| | | | - Travis B. Eason
- Department of Orthopaedic Surgery, University of Kentucky, Lexington, KY
| | - Charles P. Hannon
- Department of Orthopedic Surgery, Washington University, St. Louis, MO
| | - Samuel D. Mounce
- Department of Orthopaedic Surgery, University of Kentucky, Lexington, KY
| | - Chad A. Krueger
- Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Philadelphia, PA
| | - F. Winston Gwathmey
- Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA
| | - Stephen T. Duncan
- Department of Orthopaedic Surgery, University of Kentucky, Lexington, KY
| | - David C. Landy
- Department of Orthopaedic Surgery, University of Kentucky, Lexington, KY
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Mehra M, Brody PA, Kollapaneni SS, Sakhalkar O, Rahimi S. Evaluating the Quality, Readability, and Activity of Online Information on Brain Arteriovenous Malformations. Cureus 2023; 15:e45984. [PMID: 37900528 PMCID: PMC10601510 DOI: 10.7759/cureus.45984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Brain arteriovenous malformations (AVMs) are vascular deformities created by improper connections between arteries and veins, most commonly in the brain and spinal cord. The management is complex and patient-dependent; further understanding of patient education activities is imperative. Internet access has become more ubiquitous, allowing patients to utilize a large database of medical information online. Using Google Trends (GT) (Google LLC, Mountain View, CA, USA), one can see the public interest in a particular topic over time. Further, when presented with numerous search results, patients may not be able to identify the highest-yielding resources, making objective measures of information quality and readability imperative. Methods A GT analysis was conducted for "hereditary hemorrhagic telangiectasia," "cerebral aneurysm," and "arteriovenous malformation". These relative search volumes (RSV) were compared with the 2017 to 2019 annual USA AVM diagnosis quantity for correlation. These RSVs were also compared with the 2017 to 2019 annual USA deaths due to cerebral hemorrhagic conditions. One search was conducted for "brain arteriovenous malformation". Since most users looking for health information online use only the first page of sources, the quality and readability analyses were limited to the first page of results on Google search. Five quality tools and six readability formulas were used. Results Pearson's correlation coefficients showed positive correlations between USA AVM RSVs and annual AVM deaths per capita from 2017 to 2019 (R2=0.932). The AVM annual diagnosis quantity and AVM RSVs showed a strong positive correlation as well (R2=0.998). Hereditary hemorrhagic telangiectasia and cerebral aneurysms had strong positive correlations between their RSVs and their corresponding annual diagnoses in the 2017 to 2019 time period (R2=0.982, R2=0.709). One-way ANOVA, for USA's 2004 to 2021 AVM RSVs and 2004 to 2019 deaths per capita, displayed no month-specific statistically significant repeating pattern (all p>0.483). The DISCERN tool had four websites that qualified as "poor" and five as "good." The average score for the tool was "good." The Journal of the American Medical Association (JAMA) benchmark scores were very low on average, as four websites achieved zero points. There was a wide variance in the currency, relevance, authority, accuracy, and purpose (CRAAP) scores, indicating an inconsistent level of webpage reliability across results. The patient education materials assessment tool (PEMAT) understandability (86.6%) showed much higher scores than the PEMAT actionability (54.6%). No readability score averaged at or below the American Medical Association (AMA)-recommended sixth-grade reading level. Conclusion These GT correlations may be due to patients and families with new diagnoses researching those same conditions online. The seasonality results reflect that no prior research has detected seasonality for AVM diagnosis or presentation. The quality study showed a wide variance in website ethics, treatment information quality, website/author qualifications, and actionable next steps regarding AVMs. Overall, this study showed that patients are routinely attempting to access information regarding these intracranial conditions, but the information available, specifically regarding AVMs, is not routinely reliable and the reading level required to understand them is too high.
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Affiliation(s)
- Mehul Mehra
- Neurological Surgery, Medical College of Georgia, Augusta University, Augusta, USA
| | - Pierce A Brody
- Neurological Surgery, Medical College of Georgia, Augusta University, Augusta, USA
| | | | - Om Sakhalkar
- Neurological Surgery, Medical College of Georgia, Augusta University, Augusta, USA
| | - Scott Rahimi
- Neurological Surgery, Medical College of Georgia, Augusta University, Augusta, USA
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Brinkman JC, McQuivey KS, Hassebrock JD, Moore ML, Pollock JR, Tokish JM. Public Interest in Shoulder Platelet-Rich Plasma Injections Is Increasing: A 10-Year Google Trends Analysis. Arthrosc Sports Med Rehabil 2023; 5:100744. [PMID: 37502225 PMCID: PMC10368834 DOI: 10.1016/j.asmr.2023.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 04/29/2023] [Indexed: 07/29/2023] Open
Abstract
Purpose To quantify and analyze public interest trends in platelet-rich plasma (PRP) therapy for shoulder pathology between 2011 and 2020 using Google Trends data. Methods Google Trends data were queried for online search data ranging from January 2011 to December 2020. Various combinations of terms related to PRP and shoulder pathology were queried. Terms related to corticosteroid therapy in association with shoulder pathology were also generated for comparative analysis. Analyses were performed regarding trends in online search volumes. Results Linear models were generated to evaluated trends in the volume of online searches for PRP and corticosteroid therapy for shoulder pathology. For both the PRP and steroid groups, linear models showed a statistically significant increase in search volume for the period studied (P < .001). The PRP group showed a significantly greater growth rate than the steroid group (P < .001). There were no statistically significant differences in online search volume when compared between different geographic and socioeconomic locations. Conclusions This study indicates consistently increasing public interest in PRP injections in the shoulder. The rate of online search volume growth of PRP is significantly greater than that of corticosteroid injections for the period studied. Clinical Relevance Awareness of patient perceptions has value in informing shared decision making, aligning patient expectations, and guiding areas of future research. Each of these has an impact on patient care. Being aware of patient interest and expectations is particularly important in areas with controversial or emerging research.
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Affiliation(s)
| | - Kade S. McQuivey
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, U.S.A
| | | | - M. Lane Moore
- Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, U.S.A
| | | | - John M. Tokish
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, U.S.A
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9
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Jang CW, Bang M, Park JH, Cho HE. Impact of changes in clinical practice guidelines for intra-articular injection treatments for knee osteoarthritis on public interest and social media. Osteoarthritis Cartilage 2023; 31:793-801. [PMID: 36813156 DOI: 10.1016/j.joca.2022.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 12/20/2022] [Accepted: 12/20/2022] [Indexed: 02/24/2023]
Abstract
OBJECTIVE To summarize changes in recommendations for injection treatments for knee osteoarthritis (OA) in current clinical practice guidelines (CPGs) and to assess whether these changes have affected public interest according to Google data and content in YouTube videos. DESIGN A literature search to identify CPGs revised since 2019 that provide recommendations regarding the five intra-articular injection treatments for knee OA (corticosteroid [CS], hyaluronic acid [HA], stem cell [SC], platelet-rich plasma [PRP], and botulinum toxin [BT]) was conducted to assess perspective changes for each treatment. Data from Google Trends were examined to identify changes in search volume from 2004 to 2021 using a join-point regression model. Relevant YouTube videos were divided into those uploaded before and after changes in CPGs and compared according to degrees of recommendation for each treatment to identify the effect of changes in CPGs on video production. RESULTS All eight identified CPGs released after 2019 recommended HA and CS use. Most CPGs were the first to state a neutral or opposing stance concerning the use of SC, PRP, or BT. Interestingly, relative searches on Google for SC, PRP, and BT has increased greater than those for CS and HA. YouTube videos produced after CPGs changed continue to recommend SC, PRP, and BT as much as those produced before CPGs were revised. CONCLUSIONS Although knee OA CPGs have changed, public interest and healthcare information providers on YouTube have not reacted to this shift. Improved methods to propagate updates to CPGs warrant consideration.
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Affiliation(s)
- C W Jang
- Department of Rehabilitation Medicine, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - M Bang
- Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.
| | - J H Park
- Department of Rehabilitation Medicine, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Medical Device Engineering and Management, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Integrative Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - H E Cho
- Department of Rehabilitation Medicine, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Republic of Korea.
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10
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Laubach L, Chiang B, Sharma V, Jacobs J, Krumme JW, Kuester V. Alternative and Adjunct Treatments for Scoliosis: A Google Trends Analysis of Public Popularity Compared With Scientific Literature. Cureus 2023; 15:e38682. [PMID: 37288184 PMCID: PMC10243736 DOI: 10.7759/cureus.38682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2023] [Indexed: 06/09/2023] Open
Abstract
Purpose As Google searches have often been found to provide inaccurate information regarding various treatments for orthopedic conditions, it becomes important to analyze search trends to understand what treatments are most popularly considered and the quality of information available. We sought to compare the public interest in popular adjunct/alternative scoliosis treatments to the published literature on these topics and assess any temporal trends in the public interest in these treatments. Methods The study authors compiled the most common adjunct/alternative treatments for scoliosis on PubMed. Chiropractic manipulation, Schroth exercises, physical therapy, pilates, and yoga, along with "scoliosis," were each entered into Google Trends, collected from 2004 to 2021. A linear regression analysis of covariance (ANCOVA) was done to determine whether there was a linear relationship between Google Trends' popularity and PubMed publication data. The seasonal popularity of the terms was assessed using locally estimated scatterplot smoothing (LOESS) regression. Results Google Trends and publication frequency linear regression curves were different for chiropractic manipulation (p < 0.001), Schroth exercises (p < 0.001), physical therapy (p < 0.001), and pilates (p = 0.003). Chiropractic manipulation (p < 0.001), Schroth exercises (p = 0.003), and physical therapy (p < 0.001) had positive trends, and yoga (p < 0.001) had a negative trend. Chiropractic manipulation and yoga were more popular in the summer and winter months. Conclusion Google Trends can provide orthopedic surgeons and other healthcare professionals with valuable information on which treatments are gaining popularity with the public, so physicians may specifically inform themselves prior to patient encounters, leading to more productive shared decision-making.
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Affiliation(s)
- Logan Laubach
- Orthopaedic Surgery, Virginia Commonwealth University School of Medicine, Richmond, USA
| | - Benjamin Chiang
- General Surgery, Riverside University Health System Medical Center, Riverside, USA
| | - Viraj Sharma
- Orthopaedic Surgery, Virginia Commonwealth University School of Medicine, Richmond, USA
| | - Jonathon Jacobs
- Biostatistics, Virginia Commonwealth University School of Medicine, Richmond, USA
| | - John W Krumme
- Orthopaedic Surgery, University of Missouri Kansas City School of Medicine, Leawood, USA
| | - Victoria Kuester
- Orthopaedic Surgery, Virginia Commonwealth University School of Medicine, Richmond, USA
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11
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Cohen SA, Kossler AL. The use of Google Trends and Twitter data as a tool for evaluating public interest in hyaluronic acid eyelid filler. J Clin Transl Res 2023; 9:76-83. [PMID: 37034000 PMCID: PMC10075089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/04/2023] [Accepted: 01/12/2023] [Indexed: 04/11/2023] Open
Abstract
Background Google Trends and the Twitter Academic Research Product Tract (TARPT) are free, online tools that can be used to evaluate public interest in plastic surgery procedures. Aim The aim of the study was to evaluate the correlation between online public interest in hyaluronic acid eyelid filler on two popular web platforms (Google and Twitter) and hyaluronic acid filler procedure volumes in the United States. Methods The Google Trends database and the TARPT tool were used to calculate the number of annual Google searches and Twitter tweets, respectively, related to 10 search terms associated with hyaluronic acid eyelid filler injections from January 2010 to December 2020. Annual procedure volumes for hyaluronic acid filler injections were obtained from the American Society of Plastic Surgery (ASPS). Univariate linear regression was used to correlate Google searches to ASPS procedure volumes and Twitter tweet volumes to ASPS procedure volumes. Results Significant positive correlations were found between Google Trends data and ASPS procedure volumes for 8/10 search terms and between Twitter tweet volumes and ASPS procedure volumes for 6/10 search terms, respectively. Online public interest in eyelid filler related search terms increased significantly over time according to an exponential model (P < 0.0001). Conclusions We observed statistically significant positive associations between public interest related to eyelid filler on two online platforms, Google and Twitter, and hyaluronic acid soft-tissue filler procedure volumes. The Google Trends and TARPT databases represent free information sources for surgeons that may be used to inform marketing and advertising decisions and to anticipate patient inquiries during the patient encounter. Relevance for Patients Information provided by the Google Trends and TARPT tools can be used by surgeons to (1) inform marketing and advertising strategies and (2) gain insight into which procedures patients are researching during a given time period, preparing them to best address the evolving needs of patients.
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Affiliation(s)
- Samuel A. Cohen
- Byers Eye Institute at Stanford, Department of Ophthalmology, Stanford University School of Medicine. Stanford, CA, United States of America
| | - Andrea L. Kossler
- Byers Eye Institute at Stanford, Department of Ophthalmology, Stanford University School of Medicine. Stanford, CA, United States of America
- Corresponding author: Andrea L. Kossler Director of Ophthalmic Plastic, Reconstructive Surgery, and Orbital Oncology, Byers Eye Institute at Stanford, Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, United States of America. E-mail:
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Abella MK, Abella TT, Yoshida KT. The Relationship Between Public Interest and Surgical Demand During the COVID-19 Pandemic. Cureus 2023; 15:e37122. [PMID: 37153257 PMCID: PMC10159371 DOI: 10.7759/cureus.37122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2023] [Indexed: 04/07/2023] Open
Abstract
INTRODUCTION Surgical databases are useful for examining outcomes and case volume to improve care, while public interest data has the potential to track the supply and demand of medical services in specific communities. However, the relationship between public interest data and case volume from surgical databases, specifically during disruptive instances like the coronavirus pandemic, is unknown. Therefore, the purpose of this study is to determine how public interest data is related to the case volume of coronavirus and other surgical procedures performed during the coronavirus pandemic. METHODS This retrospective study included a review of appendectomy, total hip arthroplasty (THA), and total knee arthroplasty (TKA) cases from the National Surgery Quality Improvement Project and relative search volume (RSV) of hip replacement, knee replacement, appendicitis, and coronavirus from Google Trends from 2019 to 2020. T-tests were used to compare surgical caseload and RSV data before and after the COVID-19 surge in March 2020, while linear models were used to determine relationships between confirmed procedures and relative search volumes. RESULTS The RSV for knee replacement (p < 0.001, Cohen's D [d] = -5.01, 95% confidence interval [CI]: -7.64 to -2.34) and hip replacement (p < 0.001, d = -7.22, 95% CI: -10.85 to -3.57) had a large dip during the coronavirus pandemic, while the RSV for appendicitis had a smaller dip (p = 0.003, d = -2.37, 95% CI: -3.93 to -0.74). Linear models showed very strong linear relationships between surgical RSV and surgical volume for TKA (R2 = 0.931) and THA (R2 = 0.940). CONCLUSIONS There was a significant reduction in the number of elective surgeries, which correlated to drops in public interest during COVID-19. The strong correlations between RSV, surgical volume, and coronavirus cases indicate that public interest can be used to track and predict surgical case volume. Our findings allow for greater insight into the use of public interest data to gauge surgical demand.
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Kang JM, Coelho DH. Public Health Awareness Campaigns in Otolaryngology: Are We Making an Impact? EAR, NOSE & THROAT JOURNAL 2023:1455613221149637. [PMID: 36646068 DOI: 10.1177/01455613221149637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE To determine if public awareness campaigns in Otolaryngology-Head and Neck Surgery are influencing public interest, as measured by internet searches. STUDY DESIGN Database Query. SETTING Internet. METHODS Six awareness campaigns were analyzed over 5 years (2016-2020). Each campaign was assigned one or more relevant Google search terms/topics. Weekly data on United States internet search queries for these topics/terms were collected from Google Trends. "Campaign" dates were defined as 1 week before and 2 weeks after any awareness "day" or "week," and 2 weeks prior and 2 weeks after any awareness "month." "Non-campaign" weeks were considered any data outside the "campaign" window. A Welch's unpaired t-test was used to determine statistically significant differences between "campaign" dates and "non-campaign" dates. RESULTS Of the awareness campaigns studied, only "Kids ENT Health Month" (search topic "adenoidectomy," P = < .001) and "Cochlear Implant Day" (search topic "cochlear implant," P = .004615) demonstrated a significant increase in internet search activity during the time frame of interest between 2016 and 2020. Although there were some individual years with significant increases for select search terms/topics corresponding to their campaign of interest, none of the campaigns showed increases over the 5-year period studied. CONCLUSION Public health advocacy and outreach has long been recognized as an important component of optimizing otolaryngologic care. However, such efforts to increase public awareness may have varying or even minimal impact. Though an imperfect tool, data from Google Trends suggests that with few exceptions, awareness campaigns in otolaryngology do not necessarily translate to increased internet searches.
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Affiliation(s)
- Joshua M Kang
- Department of Otolaryngology - Head & Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Daniel H Coelho
- Department of Otolaryngology - Head & Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
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14
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Cohen SA, Tijerina JD, Kossler A. The Readability and Accountability of Online Patient Education Materials Related to Common Oculoplastics Diagnoses and Treatments. Semin Ophthalmol 2022; 38:387-393. [PMID: 36524760 DOI: 10.1080/08820538.2022.2158039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE To assess the readability and accountability of online patient education materials related to oculoplastic diagnoses and treatments, and to determine the source of information encountered by patients searches. METHODS We conducted a Google search for 20 search terms related to common oculoplastic diagnoses and treatments and analyzed the first 10 patient education websites populated for each term. Readability was assessed using four validated measures: Gunning Fog Index, Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook, and New Dale-Chall Readability. Accountability was assessed using 4 JAMA benchmarks on a scale of 0-4, with one point awarded for each of the following accountability criteria provided on the website: (1) including all authors and their relevant credentials (2) listing references (3) providing disclosures and (4) providing date of last update. RESULTS The average grade level of 200 websites analyzed was 10.89, with 29% written at less than the 6th grade reading level recommended by the American Medical Association. The source of online information was most frequently educational institutions (36%) and private practices (34%), with fewer online patient education materials from national organizations (18%) and crowdsourced websites (12%). There were no significant differences in readability when comparing searches related to oculoplastics diagnoses versus treatments. Websites averaged 0.91 out of a maximum of 4 recommended accountability criteria, reflecting low overall accountability. CONCLUSIONS Online education resources encountered by patients are often written at inappropriate reading levels and demonstrate low accountability. Online patient education materials are most frequently maintained by educational institutions and private practices, with fewer articles from national organizations. Revision of online materials may be necessary to improve health literacy among oculoplastic patients.
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Affiliation(s)
- Samuel A. Cohen
- Department of Ophthalmology, Byers Eye Institute at Stanford, Watson Court Palo Alto, Stanford, CA, USA
- Department of Ophthalmology Stanford University School of Medicine, Campus Drive, Stanford, CA, USA
| | | | - Andrea Kossler
- Department of Ophthalmology, Byers Eye Institute at Stanford, Watson Court Palo Alto, Stanford, CA, USA
- Department of Ophthalmology Stanford University School of Medicine, Campus Drive, Stanford, CA, USA
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15
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Cohen SA, Tijerina JD, Shah SA, Amarikwa L, Kossler AL. #CosmeticsTwitter: Predicting Public Interest in Nonsurgical Cosmetic Procedures Using Twitter Data. Aesthet Surg J 2022; 42:NP788-NP797. [PMID: 35675468 DOI: 10.1093/asj/sjac147] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The utilization of social media in plastic surgery is expanding. The Twitter Academic Research Product Tract (TARPT) database provides plastic surgeons the opportunity to monitor public interest in plastic surgery procedures. Previously, TARPT was shown to be effective in tracking public interest in surgical cosmetic facial and body procedures. OBJECTIVES The authors sought to determine the ability of the TARPT tool to track and predict public interest in nonsurgical cosmetic procedures and to examine temporal public interest trends in nonsurgical cosmetic procedures. METHODS The authors employed the TARPT tool to calculate the total number of tweets containing keywords related to 15 nonsurgical cosmetic procedures from 2010 to 2020. Annual case volumes were obtained for each of the 15 procedures from annual reports provided by the American Society of Plastic Surgeons. Univariate linear regression was employed to compare tweet volumes and procedure volumes, with P < 0.05 as a threshold for significance. RESULTS Univariate linear regression revealed significant positive correlations between tweet volumes and American Society of Plastic Surgeons procedure volumes for 10 search terms representing 6 nonsurgical cosmetic procedures: "xeomin," "microdermabrasion," "facial filler," "fat filler," "fat injections," "fat transfer," "hyaluronic acid filler," "hyaluronic acid injection," "HA filler," and "PRP filler." Thirty-two search terms did not demonstrate a significant relationship. CONCLUSIONS The TARPT tool is an informative data source for plastic surgeons with the potential to guide marketing and advertising strategies, and monitor public interest in nonsurgical cosmetic procedures, helping surgeons respond to patients' evolving needs.
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Affiliation(s)
- Samuel A Cohen
- Stanford University School of Medicine, Stanford, CA, USA
| | | | - Shreya A Shah
- Stanford University School of Medicine, Stanford, CA, USA
| | - Linus Amarikwa
- Stanford University School of Medicine, Stanford, CA, USA
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Intraarticular Injections of Mesenchymal Stem Cells in Knee Osteoarthritis: A Review of Their Current Molecular Mechanisms of Action and Their Efficacy. Int J Mol Sci 2022; 23:ijms232314953. [PMID: 36499280 PMCID: PMC9740663 DOI: 10.3390/ijms232314953] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/17/2022] [Accepted: 11/26/2022] [Indexed: 12/03/2022] Open
Abstract
More than 10% of the world's population suffers from osteoarthritis (OA) of the knee, with a lifetime risk of 45%. Current treatments for knee OA pain are as follows: weight control; oral pharmacological treatment (non-steroidal anti-inflammatory drugs, paracetamol, opioids); mechanical aids (crutches, walkers, braces, orthotics); therapeutic physical exercise; and intraarticular injections of corticosteroids, hyaluronic acid, and platelet-rich plasma (PRP). The problem is that such treatments usually relieve joint pain for only a short period of time. With respect to intraarticular injections, corticosteroids relieve pain for several weeks, while hyaluronic acid and PRP relieve pain for several months. When the above treatments fail to control knee pain, total knee arthroplasty (TKA) is usually indicated; however, although a very effective surgical technique, it can be associated with medical and postoperative (surgery-related) complications. Therefore, it seems essential to look for safe and effective alternative treatments to TKA. Recently, there has been much research on intraarticular injections of mesenchymal stem cells (MSCs) for the management of OA of the knee joint. This article reviews the latest information on the molecular mechanisms of action of MSCs and their potential therapeutic benefit in clinical practice in patients with painful knee OA. Although most recent publications claim that intraarticular injections of MSCs relieve joint pain in the short term, their efficacy remains controversial given that the existing scientific information on MSCs is indecisive. Before recommending intraarticular MSCs injections routinely in patients with painful knee OA, more studies comparing MSCs with placebo are needed. Furthermore, a standard protocol for intraarticular injections of MSCs in knee OA is needed.
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Public Interest in Hyaluronic Acid Injections for Knee Osteoarthritis in the United States and Europe: An International Google Trends Analysis. Arthroplast Today 2022; 18:157-162. [PMID: 36353188 PMCID: PMC9638715 DOI: 10.1016/j.artd.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 09/07/2022] [Indexed: 11/11/2022] Open
Abstract
Background Hyaluronic acid injections remain a common nonsurgical alternative for the treatment of knee osteoarthritis despite limited clinical evidence and varying global recommendations regarding its use. We used the Google Trends tool to provide a quantitative analysis of public interest in hyaluronic acid injections for knee osteoarthritis in the United States and Europe. Methods We customized Google Trends parameters to obtain search data from January 2009 to December 2019 in both the United States and Europe. Combinations of "arthritis", "osteoarthritis", "hyaluronic acid", "knee arthritis", "knee osteoarthritis", and "knee injection" were entered into the Google Trends tool, and trend analyses were performed. Results The models generated to describe public interest in hyaluronic acid for knee injections in both the United States and Europe showed increased Google queries as time progressed (P < .001). The United States growth model displayed linear growth (r2 = 0.90) while the European growth model displayed exponential growth (r2 = 0.90). Conclusions Our results indicate a significant increase in Google queries related to hyaluronic acid injections for knee osteoarthritis since 2009 in both the United States and Europe. Our models suggest that despite mixed evidence supporting its use, orthopedic surgeons should expect continued public interest in hyaluronic acid for knee osteoarthritis. The results of our study may help to prepare surgeons for patient inquiries, inform the creation of evidence-based shared decision-making tools, and direct future research.
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Sax OC, Chen Z, Mont MA, Delanois RE. Response to Comment on: The Efficacy of Platelet-Rich Plasma for the Treatment of Knee Osteoarthritis Symptoms and Structural Changes: A Systematic Review and Meta-Analysis. J Arthroplasty 2022; 37:e16-e17. [PMID: 36229160 DOI: 10.1016/j.arth.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 02/02/2023] Open
Affiliation(s)
- Oliver C Sax
- Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
| | - Zhongming Chen
- Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
| | - Michael A Mont
- Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
| | - Ronald E Delanois
- Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
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Moore ML, Brinkman JC, Pollock JR, Deckey DG, Makovicka JL, Bingham JS. Patients are Most Interested in Which Hip Arthroplasty Approach? A 15-year Google Trends Analysis. Arthroplast Today 2022; 17:192-197. [PMID: 36254208 PMCID: PMC9568677 DOI: 10.1016/j.artd.2022.07.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 11/17/2022] Open
Abstract
Background Methods Results Conclusions
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Affiliation(s)
- M. Lane Moore
- Mayo Clinic Alix School of Medicine, Scottsdale, AZ USA
| | - Joseph C. Brinkman
- Mayo Clinic Department of Orthopedic Surgery, Phoenix, AZ, USA
- Corresponding author. Mayo Clinic Department of Orthopedic Surgery, 5777 E Mayo Blvd, Phoenix, AZ 85054, USA. Tel.: +1 480 301 9506.
| | | | - David G. Deckey
- Mayo Clinic Department of Orthopedic Surgery, Phoenix, AZ, USA
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Chiang BJ, Malik Z, Laubach L, Minchu P, Gu A, Chodos MD. Differences of Search Engine Digital Footprints Between Podiatrists and Foot and Ankle Orthopaedic Surgeons: A Need to Join the Digital Era. J Am Acad Orthop Surg 2022; 30:780-788. [PMID: 36067461 PMCID: PMC10158488 DOI: 10.5435/jaaos-d-22-00189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/25/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Search engines generate lists of the most relevant websites using a keyword or phrase query and are integral in guiding consumer preferences. Digital information is important in the field of medicine, influencing what patients learn about their conditions and who they choose as providers. When two types of healthcare providers, such as podiatry and foot and ankle orthopaedic surgeons (FAOSs), share an overlapping consumer market, whichever group has a larger digital footprint receives increased digital engagement. METHODS The Google search engine was used to query nine common foot and ankle-associated terms using a "search term + zip code" format for 150 zip codes divided into urban, suburban, and rural population densities. The first 10 results of each search were classified into one of five categories. Site content was classified as podiatry-oriented, other MD/DO-oriented, or FAOS-oriented. Separately, a ratio between podiatrists and FAOSs was calculated for each population density group. Data were then normalized using this ratio and reanalyzed with the Wilcoxon signed-rank test with significance at P < 0.05. RESULTS Of 13,500 total search results, 4,992 (36.9%) were podiatry-oriented, 2,109 (15.6%) were other MD/DO-oriented, and 436 (3.2%) were FAOS-oriented. All geographic areas featured a higher number of podiatry than FAOS-oriented sites. FAOSs have more results per provider in urban areas (P < 0.001), although podiatrists had more in suburban and rural areas (P < 0.001, P < 0.001). Podiatrists have greater digital engagement in descriptive search terms. "Ankle replacement" has greater FAOS engagement in all three geographic areas. DISCUSSION Foot and ankle-related Internet search terms results are overwhelmingly composed of podiatry-oriented sites. Per provider, regional differences are demonstrated, with FAOS having more sites in urban areas only. FAOS scope-of-practice terms such as "ankle replacement" still retain greater engagement by FAOSs. Search engine optimization and saturation strategies should be considered. LEVEL OF EVIDENCE Level 3 (observational study).
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Affiliation(s)
- Benjamin J Chiang
- From the Virginia Commonwealth University, School of Medicine (Chiang, Malik, Laubach, and Minchu), Riverside University Health System/University of California, Riverside, Department of General Surgery (Chiang), and The George Washington University of Medicine and Health Sciences, Department of Orthopaedic Surgery (Gu, and Chodos)
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Umbilical Cord PRP vs. Autologous PRP for the Treatment of Hip Osteoarthritis. J Clin Med 2022; 11:jcm11154505. [PMID: 35956121 PMCID: PMC9369463 DOI: 10.3390/jcm11154505] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/29/2022] [Accepted: 07/29/2022] [Indexed: 02/07/2023] Open
Abstract
Umbilical cord platelet-rich plasma (C-PRP) has more growth factors and anti-inflammatory molecules compared with autologous PRP (A-PRP) derived from peripheral blood. The aim of this study was to compare intra-articular C-PRP or A-PRP injections in terms of safety and clinical efficacy for the treatment of patients with hip osteoarthritis (OA). This study investigated the results of 100 patients with hip OA treated with three weekly ultrasound-guided injections of either C-PRP or A-PRP. Clinical evaluations were performed before the treatment and after two, six, and twelve months with the HHS, WOMAC, and VAS scores. No major adverse events were recorded. Overall, the improvement was limited with both treatments. Significant improvements in VAS (p = 0.031) and HHS (p = 0.011) were documented at two months for C-PRP. Patients with a low OA grade (Tonnis 1-2) showed a significantly higher HHS improvement with C-PRP than A-PRP at twelve months (p = 0.049). C-PRP injections are safe but offered only a short-term clinical improvement. The comparative analysis did not demonstrate benefits compared with A-PRP in the overall population, but the results are influenced by OA severity, with C-PRP showing more benefits when advanced OA cases were excluded. Further studies are needed to confirm the most suitable indications and potential of this biological injective approach.
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Brinkman JC, Christopher ZK, Moore ML, Pollock JR, Haglin JM, Bingham JS. Patient Interest in Robotic Total Joint Arthroplasty Is Exponential: A 10-Year Google Trends Analysis. Arthroplast Today 2022; 15:13-18. [PMID: 35360676 PMCID: PMC8961076 DOI: 10.1016/j.artd.2022.02.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 12/28/2021] [Accepted: 02/12/2022] [Indexed: 12/11/2022] Open
Abstract
Background The use of robotics in arthroplasty continues to increase. Patient demand, patient expectations, and patient-directed marketing by industry and care providers each likely contributes to its increasing popularity. Trends in patient interest have not been well described. We used the online Google Trends tool to analyze trends in national public interest toward robotic and nonrobotic arthroplasty between 2011 and 2021. Material and methods Google Trends online was queried for search terms related to nonrobotic hip and knee arthroplasty in addition to robotic hip, robotic knee, and general robotic arthroplasty between January 1, 2011, and December 31, 2021. Results Google Trends Data demonstrated a significant linear increase in online searches related to nonrobotic total knee and hip arthroplasty. Online search volume for robotic hip arthroplasty was significant and linear, while that of robotic knee arthroplasty was significant and exponential. When combined, robotic joint arthroplasty demonstrated an exponential trend over the 10-year period. This increase was noted to be statistically significant when compared with nonrobotic arthroplasty search volume. Conclusion Our study demonstrates that public interest in robotic total joint arthroplasty has increased significantly from 2011 through 2020. When compared with online search volume for conventional arthroplasty, this increasing growth is statistically significant. Public interest in robotic arthroplasty is anticipated to continue to increase, and care providers should be aware of this trend that impacts patient perceptions and expectations. Despite significant growth in interest for robotic arthroplasty, there is incomplete evidence supporting its use over nonrobotic arthroplasty. Additional high-quality studies are needed to inform provider decision-making and appropriately guide public interest in robot-assisted arthroplasty.
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Cohen SA, Tijerina JD, Amarikwa L, Men C, Kossler AL. #PlasticsTwitter: The Use of Twitter Data as a Tool for Evaluating Public Interest in Cosmetic Surgery Procedures. Aesthet Surg J 2022; 42:NP351-NP360. [PMID: 34962572 DOI: 10.1093/asj/sjab429] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Plastic surgeons are increasingly turning to social media to market their services. The newly released Twitter Academic Research Product Track (TARPT) database provides free, customizable analysis of keywords that are included in tweets on the Twitter platform. The TARPT tool may provide valuable insight into public interest in cosmetic surgery procedures. OBJECTIVES The aim of this study was to determine TARPT's utility in tracking and predicting public interest in cosmetic surgery procedures and to examine temporal trends in tweets related to cosmetic facial and body procedures. METHODS The TARPT tool was used to calculate the total number of tweets containing keywords related to 10 facial cosmetic procedures and 7 cosmetic body procedures from 2010 to 2020. Annual volumes for respective procedures were obtained from annual statistics reports of The Aesthetic Society from 2010 to 2020. Tweet volumes and procedure volumes were compared by univariate linear regression, taking P < 0.05 as the cutoff for significance. RESULTS Variations in tweet volume were observed. Univariate linear regression analysis demonstrated statistically significant positive correlations between tweet volumes and procedure volumes for 7 search terms: "eyelid lift," "facelift," "lip injections," "mastopexy," "butt lift," "butt implants," and "liposuction." Many procedure-related keywords were not significant, demonstrating the importance of careful selection of Twitter search terms. CONCLUSIONS The TARPT database represents a promising novel source of information for plastic surgeons, with the potential to inform marketing and advertising decisions for emerging trends in plastic surgery interest before these patterns become apparent in surgical or clinical volumes.
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Affiliation(s)
- Samuel A Cohen
- Stanford University School of Medicine, Stanford, CA, USA
| | | | - Linus Amarikwa
- Stanford University School of Medicine, Stanford, CA, USA
| | - Clara Men
- Stanford University School of Medicine, Stanford, CA, USA
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Intra-Articular Platelet-Rich Plasma Injections in Knee Osteoarthritis: A Review of Their Current Molecular Mechanisms of Action and Their Degree of Efficacy. Int J Mol Sci 2022; 23:ijms23031301. [PMID: 35163225 PMCID: PMC8836227 DOI: 10.3390/ijms23031301] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/17/2022] [Accepted: 01/21/2022] [Indexed: 12/24/2022] Open
Abstract
Knee osteoarthritis (OA) is estimated to affect more than 10% of the population, with a lifetime risk of 45%. Contemporary guidelines advise control of body weight, therapeutic physical exercise, drug treatment (oral non-steroidal anti-inflammatory drugs, paracetamol, opioids), and mechanical aids (walking aids, braces, orthoses). Nevertheless, these treatments typically have only short-term benefits. Intra-articular corticosteroids are typically advised, but only for short-term pain alleviation, given that their benefits last only a few weeks. The efficacy of hyaluronic acid is controversial. When the aforesaid options fail, total knee arthroplasty is generally recommended as an efficacious treatment. However, it is costly and can involve medical and postoperative complications. Therefore, determining alternate safe and effective treatments for knee OA is paramount. Platelet-rich plasma (PRP) has lately been investigated for the treatment of knee OA. This article reviews recent knowledge concerning PRP’s molecular mechanisms of action. The effectiveness of intra-articular PRP injections in the knee joint remains controversial, although most recent publications show pain alleviation in the short term. Orthopedic surgeons treating people with knee OA are becoming increasingly interested in PRP, despite indecisive clinical data and basic science information. Further studies comparing PRP with placebo are required.
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Mao YM, Wang P, Wang XY, Ye DQ. Global Public Interest and Seasonal Variations in Alzheimer's Disease: Evidence From Google Trends. Front Med (Lausanne) 2021; 8:778930. [PMID: 34957153 PMCID: PMC8703029 DOI: 10.3389/fmed.2021.778930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 11/22/2021] [Indexed: 12/01/2022] Open
Abstract
Background: As the world's population ages, Alzheimer's disease (AD), a common neurodegenerative disease, is a major challenge to human health in the future. Understanding the information needs on AD of the global public can contribute to the prevention and control of AD. The purpose of this study was to explore global public interest and seasonal variations in AD using Google Trends (GT). Methods: GT was used to obtain relative search volume (RSV) of the keyword "Alzheimer's disease" in six English-speaking countries (Australia, New Zealand, the USA, the UK, Canada, and Ireland) and the world from January 2004 to December 2020. Cosinor analysis was applied to detect the seasonality of AD-related RSV. Time series plot was used to observe the trend of annual mean AD-related RSV. Globally, hot topics and top rising topics related to AD were also analyzed. In addition, we also explored the geographical distribution characteristics of AD-related RSV. Results: AD-related RSV declined steadily from January 2004 to December 2013 and rose steadily from January 2014 to December 2020. Search popularity of AD is low in the southern hemisphere, compared to the northern hemisphere. Cosinor analysis showed that there were significant seasonal variations in AD-related RSV in six English-speaking countries (all P < 0.05). Interestingly, regardless of the hemisphere, peaks were observed in the winter months and trough in the summer months. Topics related to the characteristics and etiology of AD, early onset AD, AD-related associations, care of AD patients, and diseases that can easily be confused with AD had received special attention. Conclusions: There is increasing global public interest for AD and a significant seasonal variation in AD. A better understanding of the seasonal variations and public interest of AD by governments, health workers and patients can contribute to the prevention, management, and treatment of AD.
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Affiliation(s)
- Yan-Mei Mao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Peng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Xiao-Yu Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
| | - Dong-Qing Ye
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, China
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Cohen SA, Ebrahimian S, Cohen LE, Tijerina JD. Online public interest in common malignancies and cancer screening during the COVID-19 pandemic in the United States. J Clin Transl Res 2021; 7:723-732. [PMID: 34901518 PMCID: PMC8654364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 09/29/2021] [Accepted: 09/29/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND AND AIM The COVID-19 pandemic was declared a national emergency in the United States in March 2020. The Centers for Medicare and Medicaid Services subsequently released recommendations that health-care facilities temporarily delay elective surgeries and non-essential medical procedures. Disruptions to medical care significantly impacted cancer patients, with cancer screenings halted and nonurgent cancer surgeries postponed as health-care facilities shifted resources toward the COVID-19 pandemic. Although it has been reported that cancer screening rates decreased dramatically in the United States in 2020, it is unclear whether this trend was driven by factors related to public interest in cancer and/or cancer screening as opposed to other factors such as clinical backlogs, pandemic-related policies, and/or resource limitations. The purpose of this study was to use the Google Trends tool to evaluate public interest in six common malignancies and four common cancer screening methods during the COVID-19 pandemic. METHODS We used the Google Trends tool to quantify public interest in six different malignancies (Breast Cancer, Colon Cancer, Lung Cancer, Prostate Cancer, Thyroid Cancer, and Cervical Cancer) and four cancer screening methods (Pap Smear, Lung Cancer Screening, Mammogram, and Colonoscopy) in the United States during the COVID-19 pandemic. Welch's t-tests were used to compare monthly search volumes during the COVID-19 pandemic (2020) to the 4 years before the pandemic (2016 - 2019) for all ten search terms included in our study. We used Benjamini-Hochberg to adjust raw p values to account for multiple statistical comparisons. The level of statistical significance was defined by choosing a false discovery rate of 0.05. RESULTS Our results indicate significantly reduced interest in all malignancies studied at the beginning of the COVID-19 pandemic. Public interest in ['Breast Cancer'], ['Colon Cancer'], ['Lung Cancer'], ['Thyroid Cancer'], and ['Cervical Cancer'] significantly decreased in the months of March, April, May, and June 2020 when compared with public interest in 2016-2019. Public interest in cancer screening methods such as ['Pap Smear'], ['Lung Cancer Screening'], ['Mammogram'], and ['Colonoscopy'] significantly deceased in the months of April and May compared to 2016 - 2019 values. However, decreased public interest in cancer screening methods was temporary, with Google search volumes returning to pre-pandemic levels in June 2020 - December 2020. CONCLUSION There was significantly reduced public interest in both common malignancies and cancer screening methods at the beginning of the COVID-19 pandemic in the United States. However, after an initial decline, public interest as indicated by Google search volumes quickly returned to pre-pandemic levels in the second half of the calendar year 2020. In addition, trends in public interest in cancer screening as indicated by Google search volumes aligned with cancer screening uptake rates in the United States during the study period. This finding suggests that Google Trends may serve as an effective tool in gauging the public's interest in cancer and/or cancer screenings in the United States, which makes it a valuable resource that can be used to inform decisions aimed at improving cancer screening rates in the future. RELEVANCE FOR PATIENTS The Google Trends tool can be used to measure public interest in various malignancies and their associated screening methods. Google Trends data may be used to inform measures aimed at improving cancer screening uptake.
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Affiliation(s)
- Samuel A. Cohen
- 1Stanford University School of Medicine, 291 Campus Drive, Stanford, CA, 94305, United States of America,Corresponding author: Samuel A. Cohen Stanford University School of Medicine, 291 Campus Drive, Stanford, CA, 94305, United States of America. Tel: 847-648-3323 E-mail:
| | - Shayan Ebrahimian
- 2UCLA David Geffen School of Medicine, 10833 Le Conte Avenue, Los Angeles, CA, 90095, United States of America
| | - Landon E. Cohen
- 3Keck School of Medicine of USC, 1975 Zonal Avenue, Los Angeles, CA, 90089, United States of America
| | - Jonathan D. Tijerina
- 4Bascom Palmer Eye Institute, 900 NW 17th Street, Miami, FL 33136, United States of America
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Cohen SA, Cohen LE, Tijerina JD, Bouz G, Lefebvre R, Stevanovic M, Heckmann ND. Google trends as a tool for evaluating public interest in total knee arthroplasty and total hip arthroplasty. J Clin Transl Res 2021; 7:456-466. [PMID: 34667892 PMCID: PMC8520707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/16/2021] [Accepted: 06/16/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND AND AIMS There are approximately 1 million total knee arthroplasty (TKA) and total hip arthroplasty (THA) procedures performed annually in the United States. With this number projected to increase, it is vital for orthopedic surgeons and health-care systems to properly anticipate healthcare utilization related to TKA and THA. Google Trends (GT) is a free, open source tool that provides customizable analysis of search terms entered into the Google search engine. We aim to explore the relationship between public interest in TKA and THA as determined by GT data and volume of TKA and THA procedures. METHODS GT data were compiled for ten search terms related to TKA and ten search terms related to THA from January 2009 to December 2017. Annual case volumes for TKA/THA procedures were obtained from the Healthcare Cost and Utilization Project National Inpatient Sample from 2009 to 2017. Trend analysis was performed using univariate linear regression of GT data and TKA/THA case volumes. RESULTS There was a statistically significant positive correlation between GT data and procedure volume for 14 of the 20 search terms studied. Seven TKA-related search terms with a positive correlation to procedure volumes include "total knee replacement," "knee replacement," "knee osteoarthritis," "knee ache," "knee swelling," "knee stiffness," and "chronic knee pain." Seven THA-related search terms with a positive correlation to procedure volumes include "hip arthroplasty," "total hip replacement," "hip replacement," "hip osteoarthritis," "hip ache," "hip swelling," and "chronic hip pain." CONCLUSION GT may provide a high utility as a convenient and informative data set for orthopedic surgeons to analyze public interest in TKA and THA procedures. The data provided by GT have the potential to provide real-time, actionable information that may help surgeons and health systems to characterize public interest in TKA and THA and to best identify and address patient needs. RELEVANCE FOR PATIENTS The GT tool can be used to measure public interest in TKA/THA, which can inform physician expectations for the patient encounter and lead to the creation of decision aids that better inform the public about the risks and benefits of TKA/THA.
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Affiliation(s)
- Samuel A. Cohen
- 1Stanford University School of Medicine 291 Campus Drive, Stanford, CA, 94305, USA,Corresponding author Samuel A. Cohen Stanford University School of Medicine 291 Campus Drive, Stanford, CA, 94305, USA. E-mail:
| | - Landon E. Cohen
- 2Keck School of Medicine, University of Southern California 1975 Zonal Avenue, Los Angeles, CA, 90033, USA
| | | | - Gabriel Bouz
- 4Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, 1975 Zonal Avenue, Los Angeles, CA, 90033, USA
| | - Rachel Lefebvre
- 4Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, 1975 Zonal Avenue, Los Angeles, CA, 90033, USA
| | - Milan Stevanovic
- 4Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, 1975 Zonal Avenue, Los Angeles, CA, 90033, USA
| | - Nathanael D. Heckmann
- 4Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, 1975 Zonal Avenue, Los Angeles, CA, 90033, USA
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