Examining the Trends in Online Health Information-Seeking Behavior About Chronic Obstructive Pulmonary Disease in Singapore: Analysis of Data From Google Trends and the Global Burden of Disease Study

Effectiveness of an ERAS-based exercise-nutrition management model in enhancing postoperative recovery for thoracoscopic radical resection of lung cancer: A randomized controlled trial

BACKGROUND

To analyze the effect of an exercise-nutrition management model based on the Enhanced Recovery After Surgery (ERAS) concept on patients undergoing thoracoscopic radical surgery for lung cancer.

METHODS

From June 2019 to December 2022, 85 lung cancer patients who underwent thoracoscopic radical lung cancer surgery were randomly divided into 2 groups. The control group, consisting of 42 patients, received routine nursing care during the perioperative period. The study group, comprising 43 patients, implemented an exercise-nutrition management model based on the ERAS concept during the perioperative period. We compared general data, perioperative indicators, compliance, and complications between the 2 groups. Additionally, we assessed the nutritional status using the patient-generated subjective global assessment (PG-SGA), albumin (ALB), prealbumin (PA), and hemoglobin (Hb), as well as lung function, including forced expiratory volume in the first second (FEV1) and maximum voluntary ventilation (MVV), in the patient population following the Piper intervention.

RESULTS

In the study group, the times to first defecation and getting out of bed, the duration of thoracic drainage tube indwelling, and the length of hospital stay were shorter than those in the control group. The VAS scores on the 2nd and 3rd postoperative days were lower in the study group than in the control group (P < .05). Medication compliance was higher in the study group compared to the control group (P < .05). Post-intervention, the PG-SGA scores in the study group were lower, while PA, ALB, and Hb levels were higher than those in the control group (P < .05). The MVV, FEV1, and FVC values were higher in the study group than in the control group after the intervention (P < .05). The PFS and mMRC scores were lower in the study group compared to the control group after the intervention, and the QLQ-C30 scores were higher (P < .05). The incidence of complications was 6.98% in the study group, which was not significantly different from 11.90% in the control group (P > .05).

CONCLUSION

The exercise-nutrition management model, based on the ERAS concept, exhibits significant perioperative effects in patients undergoing thoracoscopic radical resection of lung cancer, improving their nutritional status and reducing complications.

Online health information-seeking behaviours for low back pain in the United Kingdom: analysis of data from Google trends and the Global Burden of Disease Study, 2004-2019

BACKGROUND

Low back pain (LBP) is a leading cause of global disability. Timely health-seeking is crucial for early diagnosis and management of pathologies. Despite increases in internet usage, there is sparse literature regarding online health information-seeking behaviours (OHISBs) for LBP and how they correlate with the LBP disease burden in the UK.

METHODS

To examine OHISB trends, we conducted Prais-Winsten analyses on monthly search volume data from Google Trends in the UK between 1 January 2004 and 1 December 2019. Cross-correlation analyses assessed the relationship between annual LBP search volume and LBP morbidity and mortality data from the Global Burden of Disease study (2004-2019).

RESULTS

From 2004 to 2019, the trend in LBP search volume was curvilinear (β=1.27, t=5.00, p<0.001), with a slope change around the end of 2006. There was a negative linear trend (β=-0.25, t35=-1.52, p<0.14) from 2004 to 2006 and a positive linear trend (β=0.67, t108=9.17, p<0.001) from 2007 to 2019. Cross-correlations revealed positive associations between search volume and disease burden indicators for LBP such as prevalence and incidence at lags 4 and 5.

CONCLUSIONS

A rising trend in OHISBs for LBP was noted between 2004 and 2019. This trend positively correlates with incidence, prevalence and burden measures. These findings emphasise the importance of high-quality online resources to increase awareness around LBP, facilitating early diagnosis and management.

Online public concern about allergic rhinitis and its association with COVID-19 and air quality in China: an informative epidemiological study using Baidu index

BACKGROUND

Allergic rhinitis is a common health concern that affects quality of life. This study aims to examine the online search trends of allergic rhinitis in China before and after the COVID-19 epidemic and to explore the association between the daily air quality and online search volumes of allergic rhinitis in Beijing.

METHODS

We extracted the online search data of allergic rhinitis-related keywords from the Baidu index database from January 23, 2017 to June 23, 2022. We analyzed and compared the temporal distribution of online search behaviors across different themes of allergic rhinitis before and after the COVID-19 pandemic in mainland China, using the Baidu search index (BSI). We also obtained the air quality index (AQI) data in Beijing and assessed its correlation with daily BSIs of allergic rhinitis.

RESULTS

The online search for allergic rhinitis in China showed significant seasonal variations, with two peaks each year in spring from March to May and autumn from August and October. The BSI of total allergic rhinitis-related searches increased gradually from 2017 to 2019, reaching a peak in April 2019, and declined after the COVID-19 pandemic, especially in the first half of 2020. The BSI for all allergic rhinitis themes was significantly lower after the COVID-19 pandemic than before (all p values < 0.05). The results also revealed that, in Beijing, there was a significant negative association between daily BSI and AQI for each allergic rhinitis theme during the original variant strain epidemic period and a significant positive correlation during the Omicron variant period.

CONCLUSION

Both air quality and the interventions used for COVID-19 pandemic, including national and local quarantines and mask wearing behaviors, may have affected the incidence and public concern about allergic rhinitis in China. The online search trends can serve as a valuable tool for tracking real-time public concerns about allergic rhinitis. By complementing traditional disease monitoring systems of health departments, these search trends can also offer insights into the patterns of disease outbreaks. Additionally, they can provide references and suggestions regarding the public's knowledge demands related to allergic rhinitis, which can further be instrumental in developing targeted strategies to enhance population-based disease education on allergic diseases.

Impact of Sickle Cell Awareness Day on online health information seeking in Africa using Google Trends

The United Nations Council Assembly recognized sickle cell disease (SCD) as a global public health problem due to its increasing burden, particularly in sub-Saharan Africa. To raise awareness, a resolution was adopted, designating June 19th as SCD awareness day. However, the impact of this awareness day on online health information seeking behaviour (OHISB) in African countries is not well understood, especially in Nigeria, Ghana and Uganda where SCD prevalence is high. To assess the impact, the study used Google Trends data as a measure of OHISB for SCD. The analysis covered the 60 days before the awareness day, the awareness day itself, and the 60 days afterward. Time series analysis was conducted using joinpoint regression to identify significant changes in OHISB trends. The results indicated that the impact of the Sickle Cell Awareness Day on OHISB varied across African countries and did not consistently inspire significant changes in information seeking behaviour. This suggests the need for more targeted awareness campaigns to improve public knowledge of SCD in Africa. It also highlights the importance of revising the current awareness day or creating alternative health awareness initiatives that adopt a long-term approach and address the specific health needs of the African population. Furthermore, due to limitations in using Google Trends data in some African countries with insufficient data, future research should explore other sources of internet data or conduct surveys to gain a more comprehensive understanding of the impact of the Sickle Cell Awareness Day on OHISB in Africa.

A Google Trends Analysis of Interest in Nonbinary Identities

Emerging research on stigma suggests that society's mistreatment of nonbinary individuals can, in part, be attributed to public uncertainty and a lack of knowledge about nonbinary identities. In response to this, this study drew upon the theoretical framework of uncertainty management to explore research questions related to nonbinary identity and information behaviors by investigating uncertainty management as evidenced by longitudinal Google Trends data related to nonbinary gender identities. If individuals were found to be engaging in information seeking, the result of this behavior may be that they become less likely to hold stigmatizing attitudes toward nonbinary people, and ultimately be less likely to engage in discrimination toward them. Results indicated that indeed there has been an increase in search volume interest related to nonbinary identities in the past decade. The study concludes by presenting the need for further research to clarify the nature of the relationship between stigma and information seeking, as well as presenting a quandary for researchers regarding the desire for more detailed demographic data, as balanced with concerns for privacy.

Did the COVID-19 pandemic impact urticaria information-seeking behavior in China? A retrospective longitudinal study

Purpose

To investigate information-seeking behavior related to urticaria before and during the COVID-19 pandemic in China.

Methods

Search query data for terms related to urticaria were retrieved using Baidu Index database from October 23, 2017 to April 23, 2022, and daily COVID-19 vaccination doses data were obtained from the website of the Chinese Center for Disease Control and Prevention. Among the 23 eligible urticaria search terms, four urticaria themes were generated as classification, symptom, etiology, and treatment of urticarial, respectively. Baidu Search Index (BSI) value for each term were extracted to analyze and compare the spatial and temporal distribution of online search behavior for urticaria before and after the COVID-19 pandemic, and to also explore the correlation between search query and daily COVID-19 vaccination doses.

Results

The classification of urticaria accounted for nearly half of the urticaria queries on the internet. Regular seasonal patterns of BSI were observed in urticaria-related online search, by attaining its highest level in spring and summer and lowest level in winter. The BSIs of all urticaria themes significantly increased after the COVID-19 pandemic than that before the pandemic (all P<0.05). Xizang, Qinghai and Ningxia are the most active geographical areas for increased urticaria-searching activities after the COVID-19 pandemic. There was also a significant positive correlation between daily BSIs and daily COVID-19 vaccination doses in each urticaria theme. Cross-correlation analysis found that the search of symptom, etiology, and treatment attained their strongest correlation with daily COVID-19 vaccination doses at 11-27 days before the injection of vaccine, imply vaccination hesitation related to concerns of urticaria.

Conclusions

This study used the internet as a proxy to provide evidence of public search interest and spatiotemporal characteristics of urticaria, and revealed that the search behavior of urticaria have increased significantly after the COVID-19 pandemic and COVID-19 vaccination. It is anticipated that the findings about such increase in search behavior, as well as the behavior of urticaria-related vaccine-hesitancy, will help guide public health education and policy regulation.

Determinants of public interest in emerging and re-emerging arboviral diseases in Europe: A spatio-temporal analysis of cross-sectional time series data

Introduction

Climate change, the resulting geographical expansion of arthropod disease vectors, and increasing international mobility are contributing to the emergence of arboviral diseases in Europe. Public interest in vector-borne diseases and a subsequent gain of awareness and knowledge are essential to control outbreaks but had not yet been systematically assessed prior to this analysis.

Methods

Trends, patterns, and determinants of public interest in six emerging and re-emerging arboviral diseases were assessed in a spatio-temporal analysis of Google Trends data from 30 European countries between 2008 and 2020 while controlling for potential confounders.

Results

Only public interest in endemic arboviral diseases in Europe displays seasonal patterns and has been increasing since 2008, while no significant patterns or trends could be determined for public interest in non-endemic diseases. The main drivers for public interest in all six analysed arboviral diseases are reported case rates, and public interest drops rapidly as soon as cases decline. For Germany, the correlation of public interest and the geographical distribution of locally-acquired reported cases of endemic arboviral infections could be shown on a sub-country level.

Conclusions

The results of the analysis indicate that public interest in arboviral diseases in Europe is heavily impacted by perceived susceptibility on a temporal as well as on a spatial level. This result may be crucial for the design of future public health interventions to alert the public to the increasing risk of infection with arboviral diseases.

United States Influenza Search Patterns Since the Emergence of COVID-19: Infodemiology Study

Background

The emergence and media coverage of COVID-19 may have affected influenza search patterns, possibly affecting influenza surveillance results using Google Trends.

Objective

We aimed to investigate if the emergence of COVID-19 was associated with modifications in influenza search patterns in the United States.

Methods

We retrieved US Google Trends data (relative number of searches for specified terms) for the topics influenza, Coronavirus disease 2019, and symptoms shared between influenza and COVID-19. We calculated the correlations between influenza and COVID-19 search data for a 1-year period after the first COVID-19 diagnosis in the United States (January 21, 2020 to January 20, 2021). We constructed a seasonal autoregressive integrated moving average model and compared predicted search volumes, using the 4 previous years, with Google Trends relative search volume data. We built a similar model for shared symptoms data. We also assessed correlations for the past 5 years between Google Trends influenza data, US Centers for Diseases Control and Prevention influenza-like illness data, and influenza media coverage data.

Results

We observed a nonsignificant weak correlation (ρ= –0.171; P=0.23) between COVID-19 and influenza Google Trends data. Influenza search volumes for 2020-2021 distinctly deviated from values predicted by seasonal autoregressive integrated moving average models—for 6 weeks within the first 13 weeks after the first COVID-19 infection was confirmed in the United States, the observed volume of searches was higher than the upper bound of 95% confidence intervals for predicted values. Similar results were observed for shared symptoms with influenza and COVID-19 data. The correlation between Google Trends influenza data and CDC influenza-like-illness data decreased after the emergence of COVID-19 (2020-2021: ρ=0.643; 2019-2020: ρ=0.902), while the correlation between Google Trends influenza data and influenza media coverage volume remained stable (2020-2021: ρ=0.746; 2019-2020: ρ=0.707).

Conclusions

Relevant differences were observed between predicted and observed influenza Google Trends data the year after the onset of the COVID-19 pandemic in the United States. Such differences are possibly due to media coverage, suggesting limitations to the use of Google Trends as a flu surveillance tool.