Ophthalmic care may not align with patient need: An analysis on state-wide patient needs and provider density between 2008 and 2022

PURPOSE

This study aims to assess the extent to which the demand for ophthalmologic care among patients at the state level is reflected in Google Trends data, serving as an indicator of patient desire in ophthalmology.

METHODS

For each state, patient interest in ophthalmologic care was estimated using the Google Trends resource measuring web search and YouTube search rates for multiple ophthalmologic terms. We compared the change in search for ophthalmologic terms over time and used ordinary least squares regression to evaluate whether search interest for ophthalmologic terms was able to predict the rate of practicing ophthalmologists in each state. We also compare the changing rates of searches across the web and YouTube to evaluate the resources patients are most likely to utilize.

RESULTS

From 2008 to 2022, web search rates for general ophthalmology related terms increased by 43.98%, while search interest for retinal specific terms increased by 19.51%. YouTube specific results for general ophthalmology terms increased by 55.83% while search for retinal terms fell by 58.48%. Ophthalmologic and retinal specific search interest was not significantly associated with either outcome.

CONCLUSIONS

Our findings suggest that patient information needs, demographic elements, and the educational backgrounds of residents and fellows - those important factors - are surprisingly poorly correlated with ophthalmology provider density. Furthermore, we observed no noteworthy correlation between the search interest in ophthalmology and the overall density of ophthalmologists or retinal specialists. This implies that there is a pressing need to explore and implement strategies aimed at better aligning these influencing factors the choices made by ophthalmologists in selecting their practice locations to bridge the gap between healthcare availability and public interest.

Public and media interest in bed bugs-Europe 2023

In late summer of 2023 bed bug (Cimex lectularius) infestations received much media attention especially from Paris Fashion Week (2023-09-25/2023-10-03). Concern in France has grown in recent years and the public may have been sensitised from the recent release of the report Les punaises de lit: impacts, prévention et lutte from the Agence Nationale de Sécurité Sanitaire. Additionally, families returning from summer travel for the start of the school year (2023-09-04) may have brought Cimex spp. with them. A belief, typically false, that they are associated with poor housekeeping and the commercial sensitivity of infestations makes quantitative data on the occurrence and frequency of the insects difficult to find. Often it was based on the number of consultations with physicians and enquiries about bed bugs. Our study has used Google search frequency (Google Trends) to assess the growth and spread of public interest. It found that concern over the Paris outbreak spread to neighbouring countries and was an inverse function of distance. Health issues are a popular topic in science journalism and articles with bad news, threat, continuity and geographic proximity helped generate considerable media activity such that the public perceptions of the problem were enhanced and suggests that government agencies need to collect well standardised data on bed bug occurrence. Google Trends proved a sensitive tool to follow the public concern over an insect that invokes considerable dread.

Global google trends for construction demonstrate low search volume index for stress, mental and suicide

The comparison of Google internet searches for English words in construction for "construction stress", "construction mental" and "construction suicide" with reference to "construction worker" has not previously been undertaken. It is important to understand internet interest across these 3 terms as all are relevant to mental health and stress in construction. Suicide risk is significantly complex and multifactorial. Our aim is to investigate internet search interest across construction with a focus on mental, stress and suicide, and determine whether there is consistent interest across these search terms.

METHODS

Using Google Trends, data on global search queries we compared "construction mental" or "construction stress" and "construction suicide". Two time periods were compared, the last 5 years and the last 24 months, both till December 8th, 2022. The relationship between web search interest, reflected by search volume index (SVI) for society and community versus the business and industrial category and health category were evaluated.

RESULTS

Open category searches on Google trends for the key words "construction mental" or "construction stress" demonstrated moderate SVI peaks over a 5-year period. Sub-group analyses for the industrial and business category demonstrated consistent low interest in suicide compared to search terms related to stress or mental health.

CONCLUSION

There is limited online interest in construction mental and stress and even less interest in suicide.

Google Trends Analysis of Peripheral Nerve Disease and Surgery

BACKGROUND

Despite advances in the surgical management of peripheral nerve pathologies over the past several decades, it is unknown how public awareness of these procedures has changed. We hypothesize that Google searches for peripheral nerve surgery have increased over time.

METHODS

Google Trends was queried for search volumes of a list of 40 keywords related to the following topics in peripheral nerve surgery: spasticity, nerve injury, prosthetics, and nerve pain. Monthly relative search volume over the first 5 years of the study period (2010-2014) was compared with that of the last 5 years (2018-2022) of the study period.

RESULTS

Search volumes for keywords "nerve injury," "nerve laceration," "peripheral nerve injury," "nerve repair," "nerve transfer", "neuroma," "neuroma pain," "nerve pain," "nerve pain surgery," and "neuroma pain surgery" all increased more than 10% points in relative search volume over the study period (P < 0.0001 for each keyword). In contrast, searches for "rhizotomy," "spasticity surgery," "targeted muscle reinnervation," "bionic arm," and "myoelectric prosthesis" either decreased or remained stable. Technical terms such as "selective neurectomy," "hyperselective neurectomy," "regenerative peripheral nerve interface," and "regenerative peripheral nerve interface surgery" did not have adequate search volume to be reported by Google Trends.

CONCLUSIONS

The increase in Google searches related to nerve injury and pain between 2010 and 2022 may reflect increasing public recognition of these clinical entities and surgical techniques addressing them. Technical terms relating to nerve pain are infrequently searched, surgeons should use plain English terms for online discovery. Interest in spasticity and myoelectric prosthetics remains stable, indicating an opportunity for better public outreach.

Has there been an increase in nitrous oxide use and associated harms in Australia? An analysis of triangulated data sources, 2003-2020

BACKGROUND

There is growing concern, globally, regarding use of nitrous oxide (N2O) for intoxication purposes. This paper aims to examine trends in: (i) past six month N2O use among a sample of people who use regularly use ecstasy and/or other illicit stimulants (2003-2020); (ii) volume of N2O-related Google searches and social media posts (2009-2020); and (iii) N2O-related calls to Poisons Information Centres (PIC) (2004-2020).

METHODS

Data were obtained from annual interviews with sentinel samples of Australians aged ≥16 years who used ecstasy and/or other illicit stimulants ≥monthly and resided in a capital city (∼800 each year); Google search activity; social media posts; and exposure calls to four PIC.

RESULTS

Among samples of people who regularly use ecstasy and/or other illicit stimulants, past six-month N2O use increased 10% each year from 2009 to 2020, with the sharpest increase observed between 2015 and 2018 (25.4% p/year; 95% CI: 14.6-37.1). Frequency and quantity of N2O use remained stable and low. Google search probabilities increased by 1.8% each month from January 2009 and December 2019 (95% CI: 1.5-2.2), with the sharpest increase observed between July 2016 to December 2017 (6.0% p/month; 95% CI: 4.4-7.5). Social media posts increased 2.0% per month from January 2009 and December 2019 (95% CI: 1.1-3.0), with the sharpest increase observed between March and October 2017 (19.2% p/month; 95% CI: 1.7-39.7). The number of N2O-related calls to Australian PIC increased sixfold between 2016 (16) and 2020 (111).

CONCLUSIONS

Triangulation of various data sources indicate significant shifts in N2O use and harms in Australia. This includes increases in use, Google searches and social media posts, although these have plateaued in recent years, coupled with increased rates of harm. These findings correspond with evidence of a global increase in N2O use and harm, highlighting the need for education of both people who use N2O and health professionals.

Effects of the first wave of COVID-19 pandemic on implied stock market volatility: International evidence using a google trend measure

This paper investigates the relationship between investors' attention, as measured by Google search queries, and equity implied volatility during the COVID-19 outbreak. Recent studies show that search investors' behavior data is an extremely abundant repository of predictive data, and investor-limited attention increases when the uncertainty level is high. Our study using data from thirteen countries across the globe during the first wave of the COVID-19 pandemic (January-April 2020) examines whether the search "topic and terms" for the pandemic affect market participants' expectations about future realized volatility. With the panic and uncertainty about COVID-19, our empirical findings show that increased internet searches during the pandemic caused the information to flow into the financial markets at a faster rate and thus resulting in higher implied volatility directly and via the stock return-risk relation. More specifically for the latter, the leverage effect in the VIX becomes stronger as Google search queries intensify. Both the direct and indirect effects on implied volatility, highlight a risk-aversion channel that operates during the pandemic. We also find that these effects are stronger in Europe than in the rest of the world. Moreover, in a panel vector autoregression framework, we show that a positive shock on stock returns may soothe COVID-related Google searches in Europe. Our findings suggest that Google-based attention to COVID-19 leads to elevated risk aversion in stock markets.

Changing Aesthetic Surgery Interest in Men: An 18-Year Analysis

BACKGROUND

Historically, men have been shamed if they cared seemingly too much about their appearance and especially, if they pursued aesthetic surgery. However, due to the changing landscape of the culture, this stigma has seemed to decrease. Men have diverse and quickly changing interests in particular procedures that have not been readily explored in the currently available reports. To examine this, we analyzed interest in specific plastic surgery procedures in men over the last two decades using the Google Trends tool.

METHODS

The most common cosmetic procedures were chosen from the American Society of Plastic Surgeons website and served as the search terms for the Google Trends tool from 2004 to 2021. All 19 procedures were examined for overall trends and for changes in the last decade through comparing the data in bisected time periods.

RESULTS

Interest in all plastic surgery procedures in men increased since 2004 except for breast reduction. Most notably, jawline filler, Botox, microneedling, lip filler, chemical peel, CoolSculpting, and butt lift had the largest trend increases. In the last decade, all procedures showed a significant increase in interest.

CONCLUSIONS

While surgical volume data are valuable, our study shows that Google Trends is a beneficial tool to predict quickly changing and specific trends, especially as the patient population of plastic surgery grows with increased diversity and generational changes. Our study shows that there is an increase in male-centered plastic surgery procedures, especially nonsurgical facial procedures. Male interest in plastic surgery will continue to increase with time.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .

Assessing public perception and awareness of UK mandatory calorie labeling in the out-of-home sector: Using Twitter and Google trends data

Objectives

In 2021 the UK government announced a new obesity policy requiring large out-of-home food outlets to provide mandatory in-store calorie labeling on food and drink items. Public acceptability and engagement with obesity policies could influence the level of impact on wider public health particularly with population-level policies such as calorie labeling. This study aimed to examine public responses and awareness of the policy using social media (Twitter) comments and Google trends data.

Methods

This study examined responses to social media posts on Twitter (tweets) from the UK Department of Health and Social Care detailing the policy, implementation date and post-implementation information about the policy's enforcement. The sentiments of the tweets were coded and the number of likes and replies extracted. This study utilized google trends to examine public awareness of the policy by extracting weekly relative search volume for relevant phrases such as "calorie labeling."

Results

From the 276 replies/quote-tweet extracted, the majority expressed a negative sentiment toward the policy (N = 197/71.4%). There were fewer tweets expressing a positive sentiment (N = 25/8.7%) and a neutral/no sentiment (N = 54/19.6%). There was no difference in the number of "likes" or retweets between tweets expressing positive or negative sentiments. Five themes were identified expressing negative sentiments (most common being negative impacts on eating disorders). Google trends data revealed increased searches for "calorie labels/labeling" during the week of the policy enforcement compared to previous weeks in the last 5 years but no significant differences in searches for specific menu calorie labeling.

Conclusions

This analysis revealed negative sentiment toward and increased searching of calorie labeling information during the announcement and implementation of the 2021 mandatory calorie labeling policy in England. A greater understanding of public responses to calorie labeling policies may help tailor future policies and public communication strategies.

The time trend of information seeking behavior about salt reduction using Google Trends: infodemiological study in Japan

Numerous initiatives have been implemented to reduce salt intake to prevent hypertension and cardiovascular disease. However, salt consumption remains high. No study worldwide has evaluated the public's awareness of salt reduction by analyzing Internet research activity. This research aims to assess trends in the public's attention to salt reduction using Google Trends. We evaluated the relative search volume (RSV) of "salt reduction" in Google Trends from January 1, 2004, to December 31, 2021. Regression coefficients indicated that RSVs increased 0.0091 (95% CI, 0.0085-0.0097, p < 0.001) per year for salt reduction. Among related search terms, search for "salt component," "soy sauce," and "pickled plum" contributed to 9.9 ± 3.2%, 5.8 ± 2.0%, and 3.9 ± 5.5% of total RSVs for salt reduction. Google Trends revealed that the Japanese public's awareness of salt reduction has increased. Related searches might provide insights when people search for salt reduction, which could be helpful for future effective interventions for understanding salt reduction. The trends of Relative search volumes (RSVs) for "salt reduction" and "salt reduction filtered" have significantly increased RSV in 2021 compared to 2004. Google Trends is an effective tool for salt reduction awareness research that provides large amounts of real-time search data.

Public interest in weight loss and diet-related topics in Europe: an infodemiology study of Google trends data from 2004-2022

Obesity is one of the largest health issues in Europe, and media can significantly impact obesity-related habits. This study aimed to determine the trends of public interest in weight loss, physical activity, diet, nutrition, healthy diet, healthy nutrition, optimum nutrition, healthy food, and a combination of weight loss + diet-related topics in Europe, using Google Trends data from 2004 to 2022. Denmark was the most interested in weight loss topics, whereas Ukraine was the least interested. The mean relative search volume (RSV) of "Weight loss + Optimum nutrition" was the most frequent (80.65%), followed by "Weight loss + Physical activity" (78.66%). Searches for "Weight loss" + diet-related topics increased in most European countries according to Jonckheere-Terpstra trend analysis from 2004 to 2022, with searches generally declining in December but increasing in January. Our findings could help scientists and practitioners develop and select strategies, particularly during times of high public interest.

Impact on online research on celebrities' uncommon diseases: the curious case of Justin Bieber and Ramsay Hunt syndrome

Aim

We investigated how to use Internet user searches to gauge the impact of a celebrity illness on global public interest.

Methods

The study design is cross-sectional. Data on Internet searches were obtained from Google Trends (GT) for the period between 2017-2022 using the search words "Ramsay Hunt syndrome" (RHS), "Ramsay Hunt syndrome type 2," "Herpes zoster," and "Justin Bieber." The frequency of specific page views for "Ramsay Hunt syndrome," "Ramsay Hunt syndrome type 1," Ramsay Hunt syndrome type 2," Ramsay Hunt syndrome type 3," "Herpes zoster," and "Justin Bieber" were collected via a Wikipedia analysis tool that shows the number of times a specific page is viewed. Statistical analyses were performed using the Pearson (r) and Spearman's rank correlation coefficient (rho).

Results

GT data, in 2022, show a strong correlation for Justin Bieber and RHS or RHS type 2 (r = 0.75); similarly, Wikipedia data show a strong correlation for Justin Bieber and the others explored terms (r > 0.75). Furthermore, the correlation was strong between GT and Wikipedia for RHS (rho = 0.89) and RHS type 2 (rho = 0.88).

Conclusions

The peak search times for the GT and Wikipedia pages were during the same period. Useful new tools and analyses of Internet traffic data may be effective in assessing the impact of announced celebrity uncommon illnesses on global public interest.

More than just a stye: identifying seasonal patterns using google trends, and a review of infodemiological literature in ophthalmology

PURPOSE

We aim to evaluate the utility of internet search query data in ophthalmology by: (1) Evaluating trends in searches for styes in the United States and worldwide, and (2) Performing a review of literature of infodemiological data in ophthalmology.

METHODS

Google Trends search data for "stye" was analyzed from January 2004 to January 2020 in the United States and worldwide. Spearman's correlation coefficient and sinusoidal modeling were performed to assess the significance and seasonality of trends. Review of literature included searches for "ophthalmology Google trends," "ophthalmology twitter trends," "ophthalmology infodemiology," "eye google trends," and "social media ophthalmology."

RESULTS

Searches for styes were cyclical in the United States and globally with a steady increase from 2004 to 2020 (sum-of-squares F-test for sinusoidal model: p < .0001, r² = 0.96). Peak search volume index (SVI) months were 7.9 months in the United States and 6.8 months worldwide. U.S. temperature and SVI for stye were correlated in the United States at the state, divisional, and country-wide levels (p < .005; p < .005; p < .01 respectively). Seven articles met our literature review inclusion criteria.

CONCLUSIONS

We present a novel finding of seasonality with global and U.S. searches for stye, and association of searches with temperature in the United States. Within ophthalmology, infodemiological literature has been used to track trends and identify seasonal disease patterns, perform disease surveillance, improve resource optimization by identifying regional hotspots, tailor marketing, and monitor institutional reputation. Future research into this domain may help identify further trends, improve prevention efforts, and reduce medical costs.

Relationship of Public Interest in Cardiopulmonary Resuscitation with Cardiac Arrest Epidemiology and National Socioeconomic Indicators: Exploratory Infodemiology Study

STUDY OBJECTIVE

Web-based big data analytics provides a great opportunity to measure public interest in cardiac arrest (CA) and cardiopulmonary resuscitation (CPR). This study aimed to examine associations of online interest in CPR and CA with epidemiological characteristics of out-of-hospital CA (OHCA) and national socioeconomic indicators in a set of European countries.

METHODS

Country-level online search popularity data for CPR and CA topics measured in relative search volume (RSV) with Google Trends (GT), published OHCA epidemiological indicators, and World Bank's socioeconomic statistics of 28 European countries for the year 2017 were analyzed for correlation using Spearman's rank correlation coefficient (r _S ).

RESULTS

Whereas OHCA incidence, bystander CPR rate, and hospital survival did not correlate with RSV for CPR or CA, the rate of return of spontaneous circulation (ROSC) demonstrated a positive correlation with RSV for CPR (r _S = 0.388; P = .042). Further, RSV for CPR positively correlated with countries' gross domestic product and health expenditure (r _S = 0.939 and 0.566; P ≤.002) and negatively correlated with mortality caused by road traffic injury (r _S = -0.412; P = .029).

CONCLUSION

For the sample of European countries, public interest in CPR or CA showed no relationship with real bystander CPR rates and therefore could not be recommended as a proxy of community readiness to attempt resuscitation. The association of RSV for CPR with the rate of ROSC and countries' socioeconomic characteristics suggests it could be used for identifying geographies with poor performance of prehospital systems in terms of managing CA, in particular where effective epidemiological surveillance for CA may be unavailable.

Tracking Population-Level Anxiety Using Search Engine Data: Ecological Study

BACKGROUND

Anxiety disorders are the most prevalent mental disorders globally, with a substantial impact on quality of life. The prevalence of anxiety disorders has increased substantially following the COVID-19 pandemic, and it is likely to be further affected by a global economic recession. Understanding anxiety themes and how they change over time and across countries is crucial for preventive and treatment strategies.

OBJECTIVE

The aim of this study was to track the trends in anxiety themes between 2004 and 2020 in the 50 most populous countries with high volumes of internet search data. This study extends previous research by using a novel search-based methodology and including a longer time span and more countries at different income levels.

METHODS

We used a crowdsourced questionnaire, alongside Bing search query data and Google Trends search volume data, to identify themes associated with anxiety disorders across 50 countries from 2004 to 2020. We analyzed themes and their mutual interactions and investigated the associations between countries' socioeconomic attributes and anxiety themes using time-series linear models. This study was approved by the Microsoft Research Institutional Review Board.

RESULTS

Query volume for anxiety themes was highly stable in countries from 2004 to 2019 (Spearman r=0.89) and moderately correlated with geography (r=0.49 in 2019). Anxiety themes were predominantly long-term and personal, with "having kids," "pregnancy," and "job" the most voluminous themes in most countries and years. In 2020, "COVID-19" became a dominant theme in 27 countries. Countries with a constant volume of anxiety themes over time had lower fragile state indexes (P=.007) and higher individualism (P=.003). An increase in the volume of the most searched anxiety themes was associated with a reduction in the volume of the remaining themes in 13 countries and an increase in 17 countries, and these 30 countries had a lower prevalence of mental disorders (P<.001) than the countries where no correlations were found.

CONCLUSIONS

Internet search data could be a potential source for predicting the country-level prevalence of anxiety disorders, especially in understudied populations or when an in-person survey is not viable.

Unpacking Inequities in ADHD Diagnosis: Examining Individual-Level Race/Ethnicity and State-Level Online Information-Seeking Patterns

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent, persistent, and costly mental health condition. The internet is an increasingly popular source for information related to ADHD. With a nationally representative sample (2018 NSCH), we aimed to separate individual- and state-level effects to examine inequities in ADHD diagnoses. We extracted state-level relative search volumes using "ADHD," "ADHD treatment," "ADHD medication," and "ADHD therapy" from Google Trends, and sociodemographic and clinical variables from the 2018 National Survey of Children's Health (N = 26,835). We examined state variation in ADHD-related information-seeking and applied multilevel modeling to examine associations among individual-level race/ethnicity, state-level information-seeking patterns, and ADHD diagnoses. Online information seeking related to ADHD varies by state and search term. Individual-level racial/ethnic background and state-level information-seeking patterns were associated with ADHD diagnoses; however, their cross-level interaction was not significant. This study adds to the strong body of evidence documenting geographical variation and diagnostic disparity in mental health and the growing literature on the impact of the digital divide on population health, indicating an urgent need for addressing inequities in mental health care. Increasing public interest in and access to empirically supported online information may increase access to care, especially among people of color.

Macroeconomic effects of uncertainty: a Google trends-based analysis for India

This study proposes a new high-frequency indicator to measure economic policy uncertainty in the context of India, a large emerging market economy. Based on internet search intensity data, the proposed index tends to peak around domestic and global events associated with uncertainty that may prompt economic agents to alter their decisions to spend, save, invest and hire. Using an external instrument with structural vector autoregression (SVAR-IV) framework, we provide fresh evidence on the causal impact of uncertainty on the Indian macroeconomy. We show that surprise increases in uncertainty lead to a fall in output growth and an increase in inflation. This effect is found to be mainly driven by a fall in private investments vis-à-vis consumption indicating a dominant supply-side impact of uncertainty. Lastly, taking the case of output growth, we show that adding our uncertainty index to standard forecasting models leads to better forecasting accuracy compared to other alternate indicators of macroeconomic uncertainty.

Validating the GCP data hypothesis using internet search data

The Global Consciousness Project (GCP) operates under the hypothesis that events that elicit widespread emotion or draw the simultaneous attention of a large number of people could affect the output of hardware-generated random numbers. The hypothesis thus suggests that the mind, in some sense, can interact with matter at a distance, a controversial suggestion because such a mechanism could challenge some current understandings. Testing the validity of the hypothesis thus carries substantial merit as negative results would reinforce already established scientific perceptions, whereas positive results would point in the direction of a needed update. In this paper, it is hypothesized that events inflicting a strong emotional response should also trigger the need for information. As such, global internet search trends should correlate with the GCP data, allowing for the hypothesis to be objectively tested. In practice, Google Trends search data is used to construct several search indexes that are correlated with GCP data aggregates using time series statistics. It is found that the GCP data significantly correlates with the indexes and can be used to improve the statistical model's in-sample fit. Furthermore, it is found that out-of-sample forecasts can be made more accurate if the GCP data is used. The results thus point toward the validity of the GCP data hypothesis and that the data produced by the GCP can be put to practical use by, for example, forecasters.

Research and Public Interest in Mindfulness in the COVID-19 and Post-COVID-19 Era: A Bibliometric and Google Trends Analysis

Public and research interest in mindfulness has been growing, and the Coronavirus disease 2019 (COVID-19) pandemic seems to have accelerated this growth. This study was conducted to investigate the public and research interest in mindfulness in the context of COVID-19. The term 'Mindfulness' was searched in Google Trends, and data were collected from December 2004 to November 2022. The relationship between the relative search volume (RSV) of 'Mindfulness' and that of related topics was analyzed, and 'Top related topics and queries' for the search term 'Mindfulness' were investigated. For bibliometric analysis, a search was conducted in the Web of Science database. Keyword co-occurrence analysis was conducted, and a two-dimensional keyword map was constructed using VOSviewer software. Overall, the RSV of 'Mindfulness' increased slightly. The RSVs of 'Mindfulness' and 'Antidepressants' showed an overall significant positive correlation (r = 0.485) but a statistically significant negative correlation during the COVID-19 era (-0.470). Articles on mindfulness in the context of COVID-19 were closely related to depression, anxiety, stress, and mental health. Four clusters of articles were identified, including 'mindfulness', 'COVID-19', 'anxiety and depression', and 'mental health'. These findings may provide insights into potential areas of interest and identify ongoing trends in this field.

Public interest in food sustainability: an infodemiology study of Google trends data in Europe from 2010-2021

Understanding food sustainability and healthy diets public awareness is of utmost importance since consumers are the main drivers of global consumption patterns. Using Google Trends data, from 2010 to 2021, we aim to explore the temporal dynamics of food sustainability public interest across Europe and its association with interest in sustainability, healthy diet, Mediterranean diet (MedDiet), and flexitarianism. Public interest in food sustainability has increased and is positively associated with the interest in the topic of sustainability. With few exceptions, no general association between food sustainability and healthy diet or MedDiet interest were found. Consistent associations between food sustainability and flexitarianism were found across most of the European regions and countries. Despite the growing interest, only flexitarianism seems to be associated with food sustainability. Understanding consumers' interest in food sustainability is crucial for the transition towards healthy and sustainable diets and to define educational and behavioural interventions.

Proxies to the monthly active user number of Geo AR Mobile games - online search volume as a proposal

Mobile game metrics have received attention since the emergence of big data technology and data-based decision-making. Among different metrics, the monthly active user number is usually significant because it shows the level of players' engagement and the profit of this game as a business. Therefore, the monthly active user number is valuable for researchers, analysts, and decision-makers interested in the mobile game industry. However, the actual monthly active user number data typically have the accuracy, accessibility, granularity, and cost problems. Therefore, a proxy to the monthly active user number would be helpful to facilitate the decision-making process. This paper proposes to capture user activity through the searches on the Internet from an information-seeking perspective. And the online search volume, wiki page view, social media posts and views are proposed as potential proxies. This paper proposes that the online search volume is an acceptable proxy for the monthly active user number in the context of Geo Augmented Reality (AR) mobile games through data analysis.

Social media and internet search data to inform drug utilization: A systematic scoping review

Introduction

Drug utilization is currently assessed through traditional data sources such as big electronic medical records (EMRs) databases, surveys, and medication sales. Social media and internet data have been reported to provide more accessible and more timely access to medications' utilization.

Objective

This review aims at providing evidence comparing web data on drug utilization to other sources before the COVID-19 pandemic.

Methods

We searched Medline, EMBASE, Web of Science, and Scopus until November 25th, 2019, using a predefined search strategy. Two independent reviewers conducted screening and data extraction.

Results

Of 6,563 (64%) deduplicated publications retrieved, 14 (0.2%) were included. All studies showed positive associations between drug utilization information from web and comparison data using very different methods. A total of nine (64%) studies found positive linear correlations in drug utilization between web and comparison data. Five studies reported association using other methods: One study reported similar drug popularity rankings using both data sources. Two studies developed prediction models for future drug consumption, including both web and comparison data, and two studies conducted ecological analyses but did not quantitatively compare data sources. According to the STROBE, RECORD, and RECORD-PE checklists, overall reporting quality was mediocre. Many items were left blank as they were out of scope for the type of study investigated.

Conclusion

Our results demonstrate the potential of web data for assessing drug utilization, although the field is still in a nascent period of investigation. Ultimately, social media and internet search data could be used to get a quick preliminary quantification of drug use in real time. Additional studies on the topic should use more standardized methodologies on different sets of drugs in order to confirm these findings. In addition, currently available checklists for study quality of reporting would need to be adapted to these new sources of scientific information.

Forecasting HFMD Cases Using Weather Variables and Google Search Queries in Sabah, Malaysia

HFMD is a viral-mediated infectious illness of increasing public health importance. This study aimed to develop a forecasting tool utilizing climatic predictors and internet search queries for informing preventive strategies in Sabah, Malaysia. HFMD case data from the Sabah State Health Department, climatic predictors from the Malaysia Meteorological Department, and Google search trends from the Google trends platform between the years 2010-2018 were utilized. Cross-correlations were estimated in building a seasonal auto-regressive moving average (SARIMA) model with external regressors, directed by measuring the model fit. The selected variables were then validated using test data utilizing validation metrics such as the mean average percentage error (MAPE). Google search trends evinced moderate positive correlations to the HFMD cases (r_0-6weeks: 0.47-0.56), with temperature revealing weaker positive correlations (r_0-3weeks: 0.17-0.22), with the association being most intense at 0-1 weeks. The SARIMA model, with regressors of mean temperature at lag 0 and Google search trends at lag 1, was the best-performing model. It provided the most stable predictions across the four-week period and produced the most accurate predictions two weeks in advance (RMSE = 18.77, MAPE = 0.242). Trajectorial forecasting oscillations of the model are stable up to four weeks in advance, with accuracy being the highest two weeks prior, suggesting its possible usefulness in outbreak preparedness.

Does searching online for vaccination information affect vaccination coverage? Evidence from Sub-Saharan African countries

The Internet is reshaping the way people access health information. Over the past decades, an increasing number of people have been using the Internet to access vaccine-related information. Many studies suggest that the Internet can help improve people's understanding of health issues but at the same time facilitate the rapid spread of misinformation. This study explores the impact that searching the Internet for immunization information has on vaccination coverage. Using Google trends data, we found that access to online vaccination information has impacted vaccine uptake from 2004 to 2017, in Sub-Saharan African countries. The results indicate an overall positive impact on vaccine uptake. We also found that the effects are heterogeneous among vaccines. The effect is statistically significant for the vaccine related to high-risk disease, but not significant for the controversial vaccine and the vaccine related to low-risk disease.

Trends in public interest in child abuse in the United States: An infodemiology study of Google Trends from 2004 to 2022

INTRODUCTION

More than 1 in 7 children in the United States experience abuse annually with rates remaining consistent over the past 2 decades. During this timeframe, several high-profile cases of child abuse and neglect were publicized in national media in addition to multiple investigations uncovering Indigenous children dying from abuse at Indian Boarding Schools. Increased media attention among other public health and medical topics has been linked to increased public interest, thus, our objective was to investigate trends in public interest from 2004 to 2022.

METHODS

To assess trends in public interest, we extracted monthly relative search interest in child abuse from Google Trends. We constructed linear regression to determine the long-term trajectory of interest, and also compared the slope of the trend to other topics, such as domestic violence. Further, we compared mean relative search interest (RSI) from Child Abuse Awareness Month (April) to other months via t-test. Lastly, we assess by-state correlations of RSI and number of children abused.

RESULTS

Since 2004, search interest in child abuse has significantly declined in the United States-more than other related search terms. Child Abuse Awareness Month showed spikes in RSI which were greater than other months. By-state correlations of RSI and abuse were moderate to weak.

CONCLUSION

Despite heavy media attention covering stories of child abuse during the past 2 decades, search interest in child abuse has significantly declined. This trend may be related to aversion to secondary traumatic stress as news broadcasts often include stories of violence-of which child abuse stories may be most provoking. Following journalism guidance from the Centers for Disease Control and Prevention, reporting with focus on resiliency and prevention, rather than the individuals who perpetrated the crime, may provide more community support and increased public interest.

European national health plans and the monitoring of online searches for information on diabetes mellitus in different European healthcare systems

Diabetes mellitus (DM) is a serious non-communicable disease (NCD) and relies on the patient being aware of their condition, proactive, and having adequate medical care. European countries healthcare models are aware of the impact of these variables. This study evaluates the impact of online health information seeking behavior (OHISB) during World Diabetes Mellitus Day (WDMD) in European countries from 2014 to 2019 by grouping countries according to the changes in citizens' search behavior, diabetes mellitus prevalence, the existence of National Health Plans (NHP), and their respective healthcare systems. We extracted data from Global Burden of Disease, Google Trends (GT), Public Health European Commission, European Coalition for Diabetes, and the Spanish Ministry of Health. First, we used the broken-line models to analyze significant changes in search trends (GT) in European Union member countries in the 30-day intervals before and after the WDMD (November 14) from 2014 to 2019. Then the results obtained were used in the second phase to group these countries by factor analysis of mixed data (FAMD) using the prevalence of DM, the existence of NHP, and health models in each country. The calculations were processed using R software (gtrendsR, segmented, Factoextra, and FactoMineR). We established changes in search trends before and after WDMD, highlighting unevenness among European countries. However, significant changes were mostly observed among countries with NHP. These changes in search trends, in addition to being significant, were reiterated over time and occurred especially in countries belonging to the Beveridge Model (Portugal, Spain, and Sweden) and with NHPs in place. Greater awareness of diabetes mellitus among the population and continuous improvements in NHP can improve the patients' quality of life, thus impacting in disease management and healthcare expenditure.

COVID-19 Changes Public Awareness about Food Sustainability and Dietary Patterns: A Google Trends Analysis

The COVID-19 pandemic has not only affected healthcare systems and global economies but also directly impacted food security and purchasing behaviors. The aim of this study is to investigate if COVID-19 has induced changes in public interest regarding Food Sustainability and healthy-sustainable dietary patterns across Europe and in European regions. A Google Trends search was performed using the search terms "Food Sustainability + Sustainable Diet + Sustainable Food" (grouped as "Food Sustainability") and the topics "Sustainability", "Healthy Diet", "Mediterranean Diet", and "Flexitarianism" for the years 2010 to 2022. Data were obtained for 12 countries in Europe. The trends in interest after the COVID-19 outbreak were forecast based on previous data. After the COVID-19 outbreak, an increase in Food Sustainability interest was observed and was higher than forecast based on the previous data. A significant interest increase in Sustainability was observed; nevertheless, this increase was smaller than the forecast increase. Mixed results were obtained for dietary patterns across European regions, yet, considering the mean interest for Europe, it seems that the COVID-19 pandemic outbreak dampened the interest in dietary patterns such as the Healthy Diet and Flexitarianism and promoted an interest in the Mediterranean Diet. Understanding consumers' beliefs and behaviors toward food choices is crucial for the transition towards sustainable diets, and definitions of educational and behavioral interventions are essential to this transition.

Impact of the COVID-19 pandemic on travel behavior: A case study of domestic inbound travelers in Jeju, Korea

This study analyzes a large-scale navigation dataset that captures travel activities of domestic inbound visitors in Jeju, Korea in the first nine months of 2020. A collection of regression models are introduced to quantify the dynamic effects of local and national COVID-19 indicators on their travel behavior. Results suggest that behavior of inbound travelers was jointly affected by pandemic severity locally and remotely. The daily number of new cases in Jeju has a greater impact on reducing travel activities than the national-level daily new cases of COVID-19. The impacts of the pandemic did not diminish over time but produced heterogeneous effects on travels with different trip purposes. Our findings reveal the persistence of COVID-19's effects on travel behavior and the variability in travelers' responses across tourism activities with different levels of perceived health risks. The implications for crisis management and recovery strategies are also discussed.

Quality assessment of consumer-facing websites on sodium reduction

The purpose of this paper is to evaluate the quality of information and guidance on dietary sodium reduction available on consumer‐facing websites. Google Trends was used to identify the five most‐used search terms related to dietary sodium reduction. For each term, websites on the first two pages were collected (n = 18–20). Of 93 websites collected, 24 were excluded due to defective links, duplicate websites, or not being consumer‐focused. The remaining 69 websites were evaluated using a novel instrument, JHU‐SALT, that includes 14 questions on topics related to salt reduction. The questions are grouped into three domains (“information,” “guidance,” and “accuracy”). For each question, websites were scored using a 3‐step ordinal scale (“topic not addressed,” “topic somewhat addressed,” or “topic addressed adequately”). Only three of 14 JHU‐SALT questions were addressed adequately by a majority of websites. Many websites provided information on the adverse health effects of a high sodium diet (74%, n = 51) or mentioned intake recommendations (64%, n = 44). Information on fundamental concepts was largely missing. The majority of websites (80%, n = 55) provided information on lifestyle strategies to reduce blood pressure, but most did not provide guidance to help implement those strategies. While missing information was common, misinformation was uncommon. The DISCERN questionnaire was utilized as well. Consumers seeking information and guidance on dietary sodium reduction will find that most available websites provide accurate but limited information, and insufficient guidance on how to lower sodium intake. Websites that provide both relevant information and guidance are needed to help consumers effectively reduce dietary sodium.

Public awareness for "classic" childhood diseases and inflammatory syndromes in children during the COVID-19 pandemic

OBJECTIVES

The objective was to analyze in silico public search interest during the COVID-19 pandemic for some classic infectious childhood diseases, e.g., measles, mumps, chickenpox, scarlet fever, and inflammatory diseases like Kawasaki disease and the pediatric inflammatory multisystem syndrome (PIMS).

STUDY DESIGN

In this study, a comparison of five childhood diseases in public search trends with the pediatric inflammatory multisystem syndrome was performed.

METHODS

Google Trends data for the period of five years for six childhood diseases were used. We used topics coverings all languages worldwide and all connected search queries.

RESULTS

Public search interest decreased during the COVID-19 pandemic for some classic infectious childhood diseases. Search interest for the pediatric inflammatory multisystem syndrome, despite strong indication of a connection with COVID-19, remained relatively low compared to Kawasaki disease.

PRACTICE IMPLICATIONS

Better understanding of Google Trends can map public awareness of childhood diseases in terms of time course and search intensity.

CONCLUSIONS

Public interest during the pandemic was generated for diseases with suspected connection to COVID-19, presumably due to media triggers.

Forecasting National and Regional Youth Unemployment in Spain Using Google Trends

In Spain, the youth unemployment rate is one of the highest in the European Union. With the pandemic caused by Covid-19, young people face high unemployment rates and are more vulnerable to a decrease in labour demand. This paper analyses and predicts youth unemployment using Google Trends indices in Spain for the period between the first quarter of 2004 and the second quarter of 2021, being the first work to carry out this study for Spain and the first to use the regional approach for the country. Vector autoregressive Bayesian models and vector error correction models have been used for national data, and Bayesian panel data models and fixed effects model for regional data. The results confirm that forecasts based on Google Trends data are more accurate in predicting the youth unemployment rate.

Online searches for SGLT-2 inhibitors and GLP-1 receptor agonists correlate with prescription rates in the United States: An infodemiological study

Several clinical trials have demonstrated that many SGLT-2 inhibitors (SGLT2i) and GLP-1 receptor agonists (GLP-1 RA) can reduce the risk of cardiovascular events in patients with Type 2 diabetes and atherosclerotic cardiovascular disease. Recent reports indicate an underutilization of new cardiometabolic drugs, including SGLT2i and GLP-1 RA. We aimed to evaluate the use of online search volumes to reflect United States prescription rates. A repeated cross-sectional analysis of Google search volumes and corresponding data from the IQVIA National Prescription Audit (NPA) of pharmacy dispensing of newly prescribed drugs was performed. Monthly data for online searches and prescription between January 1, 2016 and December 31, 2021 were collected for selected SGLT2i and GLP-1 RA. Prescription data for drugs classes (SGLT2i and GLP-1 RA) and individual drugs were calculated as the total of queried data for branded drug names. Trends were analyzed for visual and quantitative correlation as well as predictive patterns. Overall, online searches increased by 157.6% (95% CI: 142.2-173.1%) and 295.2% (95% CI: 257.7-332.6%) for SGLT2i and GLP-1RA between 2016 and 2021. Prescription rates raised by 114.6% (95% CI: 110.8-118.4%) and 221.0% (95% CI: 212.1-229.9%) for SGLT2i and GLP-1RA for this period. Correlation coefficients (range 0.86-0.99) were strongest for drugs with growing number of prescriptions, for example dapagliflozin, empagliflozin, ertugliflozin, dulaglutide, and semaglutide. Online searches might represent an additional tool to monitor the utilization trends of cardiometabolic drugs. Associations were strongest for drugs with reported cardioprotective effect. Thus, trends in online searches complement conventionally acquired data to reflect and forecast prescription trends of cardiometabolic drugs.

Utilizing Google trends to monitor coronavirus vaccine interest and hesitancies

Introduction

Vaccine hesitancy remains a serious challenge for ending the coronavirus disease 2019 (COVID-19) pandemic. Digital media has played an immense role in the spread of information during the pandemic. One method to gauge public interest in COVID-19 related information is to examine patterns of online search queries.

Methods

Google Trends (GT) was used to analyze results for search terms relating to COVID-19 vaccine misinformation, information, and accessibility from October 1st, 2020 to May 27th, 2021. GT allows you to compare multiple queries at one time. The resultant relative search volumes (RSVs) range from 0 to 100. The search term and point in time on the graph that has the greatest search volume is given a score of 100 and all other terms and times are given values relative to that maximum. Search interest peaks were analyzed by subgroups (misinformation, information seeking, and access seeking) and across key time points throughout the pandemic.

Results

GT analysis revealed that search interest related to vaccine misinformation, general information, and access seeking changed in relation to events taking place throughout the pandemic. The most commonly searched terms in each subgroup were: “Covid vaccine infertility”, “Covid vaccine side effects”, and “Covid vaccine appointment”. Searches related to misinformation peaked in December 2020. Search terms in the general information category peaked in April 2021. RSVs for access seeking terms peaked in March 2021 and have decreased since April 2021.

Conclusion

Misinformation RSVs were highest after FDA authorization and have multiple repeated spikes after subsequent vaccine announcements. General information seeking terms peaked concurrently with increased vaccination uptake in the United States. Search interest has decreased with wider vaccine availability, despite many individuals in the United States remaining unvaccinated. GT can be used to monitor trends in public attitudes and misinformation regarding COVID-19 vaccines and further target education.

Associations of lockdown stringency and duration with Google searches for mental health terms during the COVID-19 pandemic: A nine-country study

OBJECTIVES

We examined the associations of lockdown stringency and duration with Google searches for four mental health concepts (i.e., "Anxiety," "Depression," "Suicide," "Mental Health") in nine countries (i.e., Hungary, India, Iran, Italy, Paraguay, Serbia, South Africa, Spain, Turkey) during the COVID-19 pandemic.

METHODS

We retrieved national-level data for each country from Google Trends and the Global Panel Database of Pandemic Policies. In our primary analysis, we used data from all countries to estimate a set of multilevel regression models examining associations of overall lockdown stringency and lockdown duration with relative search volumes for each mental health term. We repeated the models after replacing overall lockdown stringency with each of the lockdown stringency components.

RESULTS

A negative association was found between overall lockdown stringency and "Depression." Lockdown duration and the most stringent stay-at-home requirements were negatively associated with "Anxiety." Policies that recommended or required the cancelation of public events evidenced negative associations with "Depression," whereas associations between policies that required some or all levels of schooling to close and "Depression" were positive. Policies that recommended or required workplaces to close and those that enforced quarantines on non-citizens arriving from high-risk regions or closed borders entirely were negatively associated with "Suicide."

CONCLUSIONS

Lockdown duration and some lockdown policies during the COVID-19 pandemic were generally associated with significantly lower, rather than higher, Google searches for selected mental health terms. These findings could be used alongside other evidence to develop future lockdown strategies that are sensitive to mental health issues during public health crises.

Evaluating breast cancer websites targeting Arabic speakers: empirical investigation of popularity, availability, accessibility, readability, and quality

Background

Nowadays, patients have access to all types of health information on the internet, influencing their decision-making process. The Middle East and North Africa (MENA) region consists of 22 countries with an estimated population of around 600 million. Breast cancer is the highest diagnosed cancer in this region. Websites are commonly the go-to cancer information sources. A large population of the MENA region is only fluent in the Arabic language, thus access to Arabic websites is in more demand. However, little is known about breast cancer websites that cater to an Arabic-speaking audience. This study aims at evaluating Arabic breast cancer websites and offering recommendations to improve engagement and access to health information.

Methods

This study employed a cross-sectional analysis approach. Google trends was used to reveal the top searched topics across the MENA region, which in turn were used as search terms to identify the websites. To be included, a website had to be active, available in Arabic, and contain breast cancer information. The evaluation was based on a combination of automated and expert-based evaluation methods through five dimensions: Availability, Accessibility, Readability, Quality, and Popularity.

Results

Overall most of the websites performed poorly in the five dimensions and require careful reassessment concerning design, content, and readability levels; Only one website performed well in all dimensions, except for readability. Generally, the readability scores indicated that the websites were above the recommended level of reading. None of the websites passed the automated accessibility tests. The expert evaluation using the “Health on the Net” checklist showed good results for most websites.

Conclusions

Breast cancer rates are rising in the MENA region, therefore having comprehensive, accurate, trustworthy, and easy-to-understand health information in their native language is a must. The results from this study show a need for improving the accessibility to breast cancer information websites available to Arabic speakers. The search was limited to three search engines yielding 10 websites and only one tool was used per dimension. Future work is needed to overcome these limitations. Collaboration between multiple stakeholders is necessary to develop websites that contain easy-to-read and understand high-quality information.

Low online search interest in teleneurology before and during COVID-19 pandemic: an infodemiological study

Background

The conduct of patient consults greatly changed during the time of the COVID-19 pandemic. There was a decrease in face-to-face patient consults and enhanced utilization of virtual consults. Infodemiological studies, using Google Trends, focus on internet search trends that may reflect public interest and awareness in diseases and as a proxy of public health risk perception.

Objectives

We aimed to investigate the online behavior of internet users on teleneurology, telehealth, and telemedicine during the time of the pandemic, as reflected in search volume indices (SVI) projected in Google Trends.

Methods

We used the data from Google Trends to quantify the interest of internet users in teleneurology, telehealth, and telemedicine. These keywords were entered in Google Trends as search terms. Data included were searches conducted from 2016 to 2020 to depict the transition into the pandemic.

Results

The SVI of teleneurology was unchanged during the 5-year period search relative to the SVIs of telehealth and telemedicine. Contrary to the noted worldwide increase in the SVI of telehealth and telemedicine during the year of pandemic, teleneurology’s SVI remained stable despite the increase of its utilization. Focusing on teleneurology, the highest SVI was observed in 2018.

Conclusion

There was an increase in the SVI of telehealth and telemedicine, possibly implying an increase in the general awareness of these virtual methods of health care, as catalyzed by the pandemic. However, the stable SVI of teleneurology may signify that the public awareness regarding it remained unchanged despite the increase in application in clinics and hospitals.

Restrictive and stimulative impacts of COVID-19 policies on activity trends: A case study of Kyoto

This paper employs regression with ARIMA errors (RegARIMA) to quantify the impacts of multiple non-pharmaceutical interventions, daily new cases, seasonal and calendar effects, and other factors on activity trends across the timeline of the ongoing COVID-19 pandemic in Japan. The discussion focuses on two controversial policy sets imposed by the Japanese government that aim to contain the pandemic and to stimulate the recovery of the economy. The containing effect was achieved by stay-at-home requests and declaring a "State of Emergency" in the combat against the first waves of infectious cases. After observing reduced cases, Go-to-travel and Go-to-eat campaigns were launched in July 2020 to encourage recreational travel and to revive the economy. To better understand the impact of the policies we utilize "Google trends" which measure how much these policies are looked up online. We suggest this reflects how much they are part of the public discussion. A case study is conducted in Kyoto, a city famous for tourism. The proposed RegARIMA model is compared with linear regression and time series models. The outperformances in measuring the magnitude of intervention impacts and forecasting the future trends are confirmed by using a total of twelve activity and mobility indices as the dependent variable. Nine indices are released by Google and Apple and three are obtained from local Wi-Fi packet sensors. The effect of the State of Emergency declaration is found to erode at the second implementation, and the second stage of the Go-to-travel campaign successfully stimulated travel demand in the autumn sighting season of 2020.

COVID-19 And the african financial markets : Less infection, less economic impact ?

Has the relatively low number of COVID-19 cases and deaths saved Africa from the disease's economic and financial consequences ? This article assesses the impact of the pandemic on the volatility of major African stock markets using a panel data model. Like other financial markets worldwide, Africa's have been characterised by increased volatility during the pandemic. The markets appear to respond to the external shocks caused by the health crisis, and Google search volume activity related to the COVID-19 virus, which is treated here as a proxy for panic and fear, is associated with an increase in market volatility of around 7%. For health data, only increases in confirmed cases appear to impact the stability of African markets, and the relatively low fatality rate has had no influence on market dynamics. However, Political responses are associated with a drop in volatility, while the fear of global financial markets exacerbates it. These results have several implications in terms of risk management.

Impact of the world hand hygiene and global handwashing days on public awareness between 2016 and 2020: Google trends analysis

BACKGROUND

Scientific evidence suggest that hand hygiene as one of the most effective measures to control infection. To promote good hand hygiene practices, the World Health Organization introduced May 5 as World Hand Hygiene Day (WHHD), and international stakeholders established Global Handwashing Day (GHD) on October 15. However, its contributions to raising public awareness of hand hygiene is unclear.

METHODS

This study evaluates the impact of the WHHD and GHD on the public awareness of hand hygiene in Japan, the United Kingdom, the United States, and worldwide from 2016 to 2020, using the relative search volume of "Hand hygiene" in Google Trends as a surrogate. To identify a statistically significant timepoint of a trend change, we performed Joinpoint regression analysis.

RESULTS

Upticks of the relative search volumes as well as joinpoints were noted worldwide around the WHHD and GHD from 2016 to 2019, but no joinpoints were identified around the WHHD and GHD in 2020. No such changes were observed in Japan, the United Kingdom, and the United States during these periods.

CONCLUSIONS

While the WHHD was originally established to raise awareness of hand hygiene in healthcare facilities, our result suggests that the WHHD and GHD may not have effectively disseminated the importance of hand hygiene to the general public at a country level. Additional policy measures to advocate hand hygiene to the public are necessary to communicate its benefits.

COVID-19 and cosmetic tourism: A Google trends analysis of public interests and the experience from a tertiary plastic surgery centre

AIMS

The primary aim of this study was to highlight the burden of cosmetic tourism on the Irish healthcare system during the COVID-19 pandemic. Our secondary aim was to examine the popularity of cosmetic tourism currently through Google Trends data analysis.

METHODS

Data on all patients presenting to our unit with complications of cosmetic tourism were retrospectively reviewed to determine the level of care and resources used for each case. The 'Google Trends' data analysis tool was accessed and the popularity of common plastic surgery topics was analysed over the last two years.

RESULTS

Eight patients were referred for treatment after experiencing complications following elective cosmetic surgery overseas. Complications included seroma¹, infected collection³, wound dehiscence⁵ and implant extrusion.² Length of stay ranged from 1 to 18 days with 63% of patients requiring invasive intervention. Google trends revealed that popularity for plastic surgery topics initially decreased at each lockdown date but increased to pre-pandemic interests after a short period. Related search topics for procedures including the terms, "Turkey" and "Lithuania" increasing in popularity by more than 5000%.

CONCLUSIONS

This case series shows that despite the current pandemic cosmetic tourism is imposing a significant cost on healthcare resources. Analysis of Google Trends has shown that interest in these procedures is increasing despite travel restrictions and risks associated with the pandemic. The public need to be informed of the potentially negative consequences of cosmetic tourism and be discouraged from undertaking surgery overseas during the current crisis.

A babel of web-searches: Googling unemployment during the pandemic

Researchers are increasingly exploiting web-searches to study phenomena for which timely and high-frequency data are not readily available. We propose a data-driven procedure which, exploiting machine learning techniques, solves the issue of identifying the list of queries linked to the phenomenon of interest, even in a cross-country setting. Queries are then aggregated in an indicator which can be used for causal inference. We apply this procedure to construct a search-based unemployment index and study the effect of lock-downs during the first wave of the covid-19 pandemic. In a Difference-in-Differences analysis, we show that the indicator rose significantly and persistently in the aftermath of lock-downs. This is not the case when using unprocessed (raw) web search data, which might return a partial figure of the labour market dynamics following lock-downs.

Infodemiology of flu: Google trends-based analysis of Italians' digital behavior and a focus on SARS-CoV-2, Italy

Introduction

The aim of the current study was to assess if the frequency of internet searches for influenza are aligned with Italian National Institute of Health (ISS) cases and deaths. Also, we evaluate the distribution over time and the correlation between search volume of flu and flu symptoms with reported new cases of SARS-CoV-2.

Materials and methods

The reported cases and deaths of flu and the reported cases of SARS-CoV-2 were selected from the reports of ISS, the data have been aggregated by week. The search volume provided by Google Trends (GT) has a relative nature and is calculated as a percentage of query related to a specific term in connection with a determined place and time-frame.

Results

The strongest correlation between GT search and influenza cases was found at a lag of +1 week particularly for the period 2015-2019. A strong correlation was also found at a lag of +1 week between influenza death and GT search. About the correlation between GT search and SARS-CoV-2 new cases the strongest correlation was found at a lag of +3 weeks for the term flu.

Conclusion

In the last years research in health care has used GT data to explore public interest in various fields of medicine. Caution should be used when interpreting the findings of digital surveillance.

Trends and Seasonality of Information Searches Carried Out through Google on Nutrition and Healthy Diet in Relation to Occupational Health: Infodemiological Study

This study aimed to analyze and relate the population interest through information search trends on Nutrition and Healthy Diet (HD) with the Occupational Health (OH). Ecological and correlational study of the Relative Search Volume (RSV) obtained from Google Trends query, segmented in two searched periods concerning antiquity; date of query: 20 April 2021. The RSV trends for the analyzed three Topics were: Nutrition (R² = 0.02), HD (R² = 0.07) and OH (R² = -0.72). There was a good positive correlation between Nutrition and OH (R = 0.56, p < 0.001) and a moderate one between HD and OH (R = 0.32, p < 0.001). According to seasons, differences were verified between RSV means in the Topics HD (p < 0.01) and OH (p < 0.001). Temporal dependence was demonstrated on Nutrition searches (Augmented Dickey-Fuller = -2.35, p > 0.05). There was only a significant relationship between the RSV Topic HD (p < 0.05) for the Developing and Least Developed countries. The data on the analyzed RSV demonstrated diminishing interest in the search information on HD and OH as well as a clearly positive trend change in recent years for Nutrition. A good positive correlation was observed between the RSV of nutrition and OH whereas the correlation between HD and OH was moderate. There were no milestones found that may report a punctual event leading to the improvement of information searches. Temporal dependence was corroborated in the RSV on Nutrition, but not in the other two Topics. Strangely, only an association was found on HD searches between the Developing and Least Developed Countries. The study of information search trends may provide useful information on the population's interest in the disease data, as well as would gradually allow the analysis of differences in popularity, or interest even between different countries. Thus, this information might be used as a guide for public health approaches regarding nutrition and a healthy diet at work.

Environmental risk factor assessment for major respiratory disorders in metropolitan cities of India using VIIRS Suomi Aerosol data and Google Trends

This study has investigated the association between the amount of atmospheric aerosols and the occurrences of Asthma, Chronic Obstructive Pulmonary Disease (COPD) and Lung Cancer in Delhi, Mumbai, Chennai, Kolkata and Bengaluru. Aerosol Optical Thickness (AOT) data of Visible Infrared Imaging Radiometer Suite (VIIRS) and Google Trends (GT) have been used to acquire information regarding the abundance of atmospheric aerosols and the occurrences of the respiratory diseases respectively. The result of Granger causality test between AOT and GT has shown that Delhi, Mumbai and Chennai were quite vulnerable to the three respiratory diseases whereas Bengaluru did not display so much vulnerability to these ailments. Kolkata was not so much vulnerable to Asthma but did exhibit susceptibility to the other two diseases. GT is validated by correlating with Annual Morbidity data of Delhi. The result of Granger causality test between Particulate Matter (diameter ≤ 10 μm) (PM10) data and GT validates the result of Granger causality between AOT and GT, and shows the trustworthiness of GT and AOT. Thus, this study also proves the usefulness of VIIRS AOT and GT as dependable sources of information on atmospheric aerosols and prevalence of the respiratory diseases respectively, and the effectiveness of Granger causality test as a tool of analysis in health and geographic information systems (GIS).

Global internet search trends related to gastrointestinal symptoms predict regional COVID-19 outbreaks

Background

Real-time surveillance of search behavior on the internet has achieved accessibility in measuring disease activity. In this study, we systematically assessed the associations between internet search trends of gastrointestinal (GI) symptom terms and daily newly confirmed COVID-19 cases at both global and regional levels.

Methods

Relative search volumes (RSVs) of GI symptom terms were derived from internet search engines. Time-series analyses with autoregressive integrated moving average models were conducted to fit and forecast the RSV trends of each GI symptom term before and after the COVID-19 outbreak. Generalized additive models were used to quantify the effects of RSVs of GI symptom terms on the incidence of COVID-19. In addition, dose-response analyses were applied to estimate the shape of the associations.

Results

The RSVs of GI symptom terms could be characterized by seasonal variation and a high correlation with symptoms of “fever” and “cough” at both global and regional levels; in particular, “diarrhea” and “loss of taste” were abnormally increased during the outbreak period of COVID-19, with elevated point changes of 1.31 and 8 times, respectively. In addition, these symptom terms could effectively predict a COVID-19 outbreak in advance, underlying the lag correlation at 12 and 5 days, respectively, and with mutual independence. The dose-response curves showed a consistent increase in daily COVID-19 risk with increasing search volumes of “diarrhea” and “loss of taste”.

Conclusion

This is the first and largest epidemiologic study that comprehensively revealed the advanced prediction of COVID-19 outbreaks at both global and regional levels via GI symptom indicators.

The impact of the Covid-19 pandemic on the business interruption insurance demand in the United States

The article investigates the Covid-19 pandemic related changes in the demand for insurance services in the Unites States due to business interruptions by employing panel vector autoregression models to a dynamic panel data set of 50 states and District of Columbia for three periods of time: 01 January, 2004 to 28 June, 2020; 01 January, 2004 to January 21, 2020 (pre-Covid period); January 22, 2020 to June 28, 2020 (Covid-period). This paper is the first attempt to obtain estimates by applying Google Trends with a search key word "Business Interruption Insurance". The data was collected and reduced to a single scale by US states within the widest possible time span. Google Trends Hits and Initial Claims for Unemployment Insurance Benefits are used as endogenous variables in the built models. In the constructed models, the impact of the exogenous variable New Covid Cases is compared with that of over US billion-dollar natural disasters. The impulse responses show a positive relationship between the Google Trends Hits and Initial Claims with the Covid-factor having a significant impact on the responses. The conducted analyses reveal that the demand for insurance services due to the Covid-19 outbreak in the United States can be expected to increase 2-6 times, with the total amount of the incurred costs for the economy due to the virus ranging from 0.3 to 7 percent of the US-2019 GDP. The results lay the foundation for recommending the insurance market participants to lobby for adoption of public-private protection schemes being able to secure a more efficient response to the pandemic-related losses that may occur in the future.

COVID-19 concerns in cyberspace predict human reduced dispersal in the real world: Meta-regression analysis of time series relationships across American states and 115 countries/territories

On the basis of parasite-stress theory of sociality and behavioral immune system theory, this research examined how concerns regarding the Coronavirus disease 2019 (COVID-19) in cyberspace (i.e., online search volume for coronavirus-related keywords) would predict human reduced dispersal in the real world (i.e., human mobility trends throughout the pandemic) between January 05, 2020 and May 22, 2021. Multiple regression analyses controlling for COVID-19 cases per million, case fatality rate, death-thought accessibility, government stringency index, yearly trends, season, religious holidays, and reduced dispersal in the preceding week were conducted. Meta-regression analysis of the multiple regression results showed that when there were high levels of COVID-19 concerns in cyberspace in a given week, the amount of time people spent at home increased from the previous week across American states (Study 1) and 115 countries/territories (Study 2). Across studies, the associations between COVID-19 concerns and reduced dispersal were stronger in areas of higher historical risks of infectious-disease contagion. Compared with actual coronavirus threat, COVID-19 concerns in cyberspace had significantly larger effects on predicting human reduced dispersal in the real world. Thus, online query data have invaluable implications for predicting large-scale behavioral changes in response to life-threatening events in the real world and are indispensable for COVID-19 surveillance.

COVID-19 and the intentions to migrate from developing countries: Evidence from online search activities in Southeast Asia

COVID-19 has had an enormous effect on labor markets globally. Economic restrictions, notably strict border controls and lockdowns, have led many workers to lose their jobs and forced many migrants to return to their homes or change their migration plans. While adverse effects on labor mobility are expected, variations in the prevalence of COVID-19 and governmental responses to the pandemic across countries are likely to influence workers' intentions to migrate in different ways. To understand the effects of pandemics on the international labor supply, we explore the impact of COVID-19 and the various economic restriction policies on job search behavior by considering cases from Southeast Asian countries using the difference-in-differences (DID) approach with data from Google Trends Index (GTI). We find that the search volume of queries related to the labor market dramatically increased over time following the outbreak of COVID-19. However, we do not observe any positive impact on the search volume related to emigration, regardless of the infection control measures in the host countries. Our results imply that the job insecurity increases after the imposition of lockdown in the respective countries. On the other hand, the expectation to migrate outside of the country, which requires preparation time and incurs high costs, does not seem to have increased in developing countries.