Association of Search Query Interest in Gastrointestinal Symptoms With COVID-19 Diagnosis in the United States: Infodemiology Study

Background Coronavirus disease (COVID-19) is a novel viral illness that has rapidly spread worldwide. While the disease primarily presents as a respiratory illness, gastrointestinal symptoms such as diarrhea have been reported in up to one-third of confirmed cases, and patients may have mild symptoms that do not prompt them to seek medical attention. Internet-based infodemiology offers an approach to studying symptoms at a population level, even in individuals who do not seek medical care. Objective This study aimed to determine if a correlation exists between internet searches for gastrointestinal symptoms and the confirmed case count of COVID-19 in the United States. Methods The search terms chosen for analysis in this study included common gastrointestinal symptoms such as diarrhea, nausea, vomiting, and abdominal pain. Furthermore, the search terms fever and cough were used as positive controls, and constipation was used as a negative control. Daily query shares for the selected symptoms were obtained from Google Trends between October 1, 2019 and June 15, 2020 for all US states. These shares were divided into two time periods: pre–COVID-19 (prior to March 1) and post–COVID-19 (March 1-June 15). Confirmed COVID-19 case numbers were obtained from the Johns Hopkins University Center for Systems Science and Engineering data repository. Moving averages of the daily query shares (normalized to baseline pre–COVID-19) were then analyzed against the confirmed disease case count and daily new cases to establish a temporal relationship. Results The relative search query shares of many symptoms, including nausea, vomiting, abdominal pain, and constipation, remained near or below baseline throughout the time period studied; however, there were notable increases in searches for the positive control symptoms of fever and cough as well as for diarrhea. These increases in daily search queries for fever, cough, and diarrhea preceded the rapid rise in number of cases by approximately 10 to 14 days. The search volumes for these terms began declining after mid-March despite the continued rises in cumulative cases and daily new case counts. Conclusions Google searches for symptoms may precede the actual rises in cases and hospitalizations during pandemics. During the current COVID-19 pandemic, this study demonstrates that internet search queries for fever, cough, and diarrhea increased prior to the increased confirmed case count by available testing during the early weeks of the pandemic in the United States. While the search volumes eventually decreased significantly as the number of cases continued to rise, internet query search data may still be a useful tool at a population level to identify areas of active disease transmission at the cusp of new outbreaks.

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Association of Search Query Interest in Gastrointestinal Symptoms With COVID-19 Diagnosis in the United States: Infodemiology Study (Preprint)

10.2196/preprints.19354 ◽

2020 ◽

Author(s):

Anjana Rajan ◽

Ravi Sharaf ◽

Robert S Brown ◽

Reem Z Sharaiha ◽

Benjamin Lebwohl ◽

...

Keyword(s):

United States ◽

Abdominal Pain ◽

Gastrointestinal Symptoms ◽

Population Level ◽

The United States ◽

Medical Attention ◽

Search Query ◽

Search Queries ◽

Search Terms ◽

Case Count

BACKGROUND Coronavirus disease (COVID-19) is a novel viral illness that has rapidly spread worldwide. While the disease primarily presents as a respiratory illness, gastrointestinal symptoms such as diarrhea have been reported in up to one-third of confirmed cases, and patients may have mild symptoms that do not prompt them to seek medical attention. Internet-based infodemiology offers an approach to studying symptoms at a population level, even in individuals who do not seek medical care. OBJECTIVE This study aimed to determine if a correlation exists between internet searches for gastrointestinal symptoms and the confirmed case count of COVID-19 in the United States. METHODS The search terms chosen for analysis in this study included common gastrointestinal symptoms such as diarrhea, nausea, vomiting, and abdominal pain. Furthermore, the search terms fever and cough were used as positive controls, and constipation was used as a negative control. Daily query shares for the selected symptoms were obtained from Google Trends between October 1, 2019 and June 15, 2020 for all US states. These shares were divided into two time periods: pre–COVID-19 (prior to March 1) and post–COVID-19 (March 1-June 15). Confirmed COVID-19 case numbers were obtained from the Johns Hopkins University Center for Systems Science and Engineering data repository. Moving averages of the daily query shares (normalized to baseline pre–COVID-19) were then analyzed against the confirmed disease case count and daily new cases to establish a temporal relationship. RESULTS The relative search query shares of many symptoms, including nausea, vomiting, abdominal pain, and constipation, remained near or below baseline throughout the time period studied; however, there were notable increases in searches for the positive control symptoms of fever and cough as well as for diarrhea. These increases in daily search queries for fever, cough, and diarrhea preceded the rapid rise in number of cases by approximately 10 to 14 days. The search volumes for these terms began declining after mid-March despite the continued rises in cumulative cases and daily new case counts. CONCLUSIONS Google searches for symptoms may precede the actual rises in cases and hospitalizations during pandemics. During the current COVID-19 pandemic, this study demonstrates that internet search queries for fever, cough, and diarrhea increased prior to the increased confirmed case count by available testing during the early weeks of the pandemic in the United States. While the search volumes eventually decreased significantly as the number of cases continued to rise, internet query search data may still be a useful tool at a population level to identify areas of active disease transmission at the cusp of new outbreaks.

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Gastroenteritis in adults

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20184250 ◽

2018 ◽

Vol 5 (11) ◽

pp. 4959

Author(s):

Burair Al Jassas ◽

Marwan Khayat ◽

Hussin Alzahrani ◽

Aghareed Asali ◽

Salem Alsohaimi ◽

...

Keyword(s):

United States ◽

Abdominal Pain ◽

Acute Gastroenteritis ◽

Viral Infections ◽

Diarrheal Disease ◽

The United States ◽

Viral Gastroenteritis ◽

Search Terms ◽

Bacterial Gastroenteritis ◽

Comprehensive Search

Gastroenteritis is the inflammation of intestines and stomach which presents with vomiting, fever, abdominal pain and diarrhea. It could be persistent, acute, or chronic, and can also be classified as infectious or non-infectious. Despite improvement in management, the mortality can reach up to 17,000. In this study, our aim was to understand the various etiologies that cause gastroenteritis in adults, and also discuss methods of management. We conducted this review using a comprehensive search of MEDLINE, PubMed and EMBASE from January 1994 to March 2017. The following search terms were used: acute gastroenteritis, diarrheal disease, viral gastroenteritis, bacterial gastroenteritis, diagnoses of gastroenteritis. Each year, more than 350 million cases of acute gastroenteritis occur in the United States only. The largest portion of gastroenteritis cases is due to viral infections. Therefore, the empiric use of antibiotics is usually not recommended. However, in selected patients, empiric antibiotics therapy is indicated and is associated with significant improvement and decrease in mortality. The primary goal of management of gastroenteritis is treating dehydration.

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Can Users Search Trends Predict People Scares or Disease Breakout? An Examination of Infectious Skin Diseases in the United States

Infectious Diseases Research and Treatment ◽

10.1177/1178633720928356 ◽

2020 ◽

Vol 13 ◽

pp. 117863372092835

Author(s):

Rand Obeidat ◽

Izzat Alsmadi ◽

Qanita Bani Bakr ◽

Laith Obeidat

Keyword(s):

United States ◽

Skin Diseases ◽

The United States ◽

The Internet ◽

Search Term ◽

Care Providers ◽

Search Queries ◽

Additional Tool ◽

Search Terms ◽

The Impact

Background: In health and medicine, people heavily use the Internet to search for information about symptoms, diseases, and treatments. As such, the Internet information can simulate expert medical doctors, pharmacists, and other health care providers. Aim: This article aims to evaluate a dataset of search terms to determine whether search queries and terms can be used to reliably predict skin disease breakouts. Furthermore, the authors propose and evaluate a model to decide when to declare a particular month as Epidemic at the US national level. Methods: A Model was designed to distinguish a breakout in skin diseases based on the number of monthly discovered cases. To apply this model, the authors correlated Google Trends of popular search terms with monthly reported Rubella and Measles cases from Centers for Disease Control and Prevention (CDC). Regressions and decision trees were used to determine the impact of different terms to trigger the occurrence of epidemic classes. Results: Results showed that the volume of search keywords for Rubella and Measles rises when the volume of those reported diseases rises. Results also implied that the overall process was successful and should be repeated with other diseases. Such process can trigger different actions or activities to be taken when a certain month is declared as “Epidemic.” Furthermore, this research has shown great interest for vaccination against Measles and Rubella. Conclusions: The findings suggest that the search queries and keyword trends can be truly reliable to be used for the prediction of disease outbreaks and some other related knowledge extraction applications. Also search-term surveillance can provide an additional tool for infectious disease surveillance. Future research needs to re-apply the model used in this article, and researchers need to question whether characterizing the epidemiology of Coronavirus Disease 2019 (COVID-19) pandemic waves in United States can be done through search queries and keyword trends.

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Correlations in Trends of Sinusitis-Related Online Google Search Queries in the United States

American Journal of Rhinology and Allergy ◽

10.1177/1945892420905761 ◽

2020 ◽

Vol 34 (4) ◽

pp. 482-486

Author(s):

Dhruv Sharma ◽

Morgan M. Sandelski ◽

Jonathan Ting ◽

Thomas S. Higgins

Keyword(s):

United States ◽

Pearson Correlation ◽

Real Life ◽

The United States ◽

Online Search ◽

Search Query ◽

Search Queries ◽

Disease States ◽

Postnasal Drip ◽

Google Search

Background Online search query trends have been shown to correlate with real-life epidemiologic phenomena. Objective The aim of this study was to analyze correlations in trends in Google online search volumes of sinusitis-related terms, including symptomatology and similar disease states. Methods Terms clinically associated with “sinusitis” were determined by consensus. Terms of symptomatology were derived from the validated 22-item sinonasal outcome test (SNOT-22) as well as terminology encountered with the authors’ clinical experience. Terms of disease states that could overlap in symptomatology with sinusitis were then chosen. Google Trends, an online tool for extracting relative frequencies from a public database of search queries, was used to query normalized monthly volumes in the United States from January 2004 to September 2017 of searches related to the topics decided upon by consensus. Bivariate Pearson correlation was used to compare the search queries. Results Online search volumes of “sinusitis” have a distinct seasonal variation, with consistent annual peaks and troughs. In terms of symptomatology, “postnasal drip,” “nasal congestion,” “cough,” “rhinorrhea,” and “sore throat” most highly correlated with “sinusitis” search volumes with statistical significance. “sinusitis” search query volume had a higher positive correlation with “common cold” and “acute sinusitis” than “chronic sinusitis” with regard to disease states. Conclusions Trends in Google online search volumes over time of “sinusitis” symptomatology mimic real-world clinical phenomena and provide insight into the issues affecting the general population.

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Incidence of Benign Meningiomas in the United States: Current and Future Trends

JNCI Cancer Spectrum ◽

10.1093/jncics/pkab035 ◽

2021 ◽

Author(s):

Sonia Bhala ◽

Douglas R Stewart ◽

Victoria Kennerley ◽

Valentina I Petkov ◽

Philip S Rosenberg ◽

...

Keyword(s):

United States ◽

Age Groups ◽

Cancer Registries ◽

Health Impact ◽

The United States ◽

Birth Cohorts ◽

Benign Meningioma ◽

Case Count ◽

Future Burden ◽

Rate Ratios

Abstract Background Benign meningiomas are the most frequently reported central nervous system tumors in the United States (US), with increasing incidence in past decades. However, the future trajectory of this neoplasm remains unclear. Methods We analyzed benign meningioma incidence of cases identified by any means (eg, radiographically with or without microscopic confirmation) in US Surveillance Epidemiology and End Results (SEER) cancer registries among 35–84-year-olds during 2004–2017 by sex and race/ethnicity using age-period-cohort (APC) models. We employed APC forecasting models to glean insights regarding the etiology, distribution, and anticipated future (2018–2027) public health impact of this neoplasm. Results In all groups, meningioma incidence overall increased through 2010, then stabilized. Temporal declines were statistically significant overall and in most groups. JoinPoint analysis of cohort rate-ratios identified substantial acceleration in White men born after 1963 (from 1.1% to 3.2% per birth year); cohort rate-ratios were stable or increasing in all groups and all birth cohorts. We forecast that meningioma incidence through 2027 will remain stable or decrease among 55–84-year-olds but remain similar to current levels among 35–54-year-olds. Total meningioma burden in 2027 is expected to be approximately 30,470 cases, similar to the expected case count of 27,830 in 2018. Conclusions Between 2004–2017, overall incidence of benign meningioma increased and then stabilized or declined. For 2018–2027, our forecast is incidence will remain generally stable in younger age groups but decrease in older age groups. Nonetheless, the total future burden will remain similar to current levels because the population is aging.

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Patterns of dental antibiotic prescribing in 2017: Australia, England, United States, and British Columbia (Canada)

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.87 ◽

2021 ◽

pp. 1-8

Author(s):

Wendy Thompson ◽

Leanne Teoh ◽

Colin C. Hubbard ◽

Fawziah Marra ◽

David M. Patrick ◽

...

Keyword(s):

United States ◽

British Columbia ◽

Broad Spectrum ◽

Antibiotic Prescription ◽

Population Level ◽

The United States ◽

Antibiotic Prescribing ◽

Prescribing Behavior ◽

The Us ◽

Amoxicillin Clavulanic Acid

Abstract Objective: Our objective was to compare patterns of dental antibiotic prescribing in Australia, England, and North America (United States and British Columbia, Canada). Design: Population-level analysis of antibiotic prescription. Setting: Outpatient prescribing by dentists in 2017. Participants: Patients receiving an antibiotic dispensed by an outpatient pharmacy. Methods: Prescription-based rates adjusted by population were compared overall and by antibiotic class. Contingency tables assessed differences in the proportion of antibiotic class by country. Results: In 2017, dentists in the United States had the highest antibiotic prescribing rate per 1,000 population and Australia had the lowest rate. The penicillin class, particularly amoxicillin, was the most frequently prescribed for all countries. The second most common agents prescribed were clindamycin in the United States and British Columbia (Canada) and metronidazole in Australia and England. Broad-spectrum agents, amoxicillin-clavulanic acid, and azithromycin were the highest in Australia and the United States, respectively. Conclusion: Extreme differences exist in antibiotics prescribed by dentists in Australia, England, the United States, and British Columbia. The United States had twice the antibiotic prescription rate of Australia and the most frequently prescribed antibiotic in the US was clindamycin. Significant opportunities exist for the global dental community to update their prescribing behavior relating to second-line agents for penicillin allergic patients and to contribute to international efforts addressing antibiotic resistance. Patient safety improvements will result from optimizing dental antibiotic prescribing, especially for antibiotics associated with resistance (broad-spectrum agents) or C. difficile (clindamycin). Dental antibiotic stewardship programs are urgently needed worldwide.

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LB745 Population-level study of Hidradenitis Suppurativa (HS) in the United States reveals association with obesity and socioeconomic status

Journal of Investigative Dermatology ◽

10.1016/j.jid.2021.07.030 ◽

2021 ◽

Vol 141 (9) ◽

pp. B10

Author(s):

S. Wongvibulsin ◽

G.A. Okoye ◽

L.A. Garza

Keyword(s):

United States ◽

Socioeconomic Status ◽

Hidradenitis Suppurativa ◽

Population Level ◽

The United States

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Bicycle Helmet Use Patterns Among Children

PEDIATRICS ◽

10.1542/peds.97.2.166 ◽

1996 ◽

Vol 97 (2) ◽

pp. 166-173 ◽

Cited By ~ 1

Author(s):

Gregory B. Rodgers

Keyword(s):

United States ◽

Logistic Regression ◽

Geographic Location ◽

Personal Characteristics ◽

The United States ◽

National Sample ◽

Medical Attention ◽

Survey Method ◽

Helmet Use ◽

Use Patterns

Objective. To describe and evaluate the helmet use patterns of children younger than 15 years of age in the United States. Methods. A national telephone survey of bicycle riders was conducted by means of the Mitofsky-Waksberg method of random-digit dialing, a survey method intended to give all telephone numbers in the continental United States an equal probability of selection. Based on information collected in the survey, a logistic regression model was used to determine and quantify the factors associated with helmet use. Results. Information was collected on the bicycle and helmet use patterns of a national sample of 399 children younger than 15 years of age who rode bicycles during the year preceding the survey. This sample projects to the approximately 26.4 million children who are estimated to have ridden bicycles in 1991. About 26% of all child riders owned or had the use of bicycle helmets, and about 15% were reported to have used their helmets all or more than half of the time when riding. Information is provided on the reasons the children did or did not wear helmets. The logistic regression analysis shows that helmet use by children is systematically related to their personal characteristics (eg, age and whether they had previously had bicycle-related accidents requiring medical attention), riding patterns (eg, riding surface), and household demographic characteristics (eg, geographic location and whether household members had attended college). Conclusions. Helmet use rates among children remain low. Less than one fifth of the children who rode bicycles wore helmets all or more than half of the time in 1991. However, based on comparisons with earlier studies, the results of the analysis suggest that helmet use rates have been rising.

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PUBLIC HEALTH

PEDIATRICS ◽

10.1542/peds.25.2.343 ◽

1960 ◽

Vol 25 (2) ◽

pp. 343-347

Author(s):

George M. Wheatley ◽

Stephen A. Richardson

Keyword(s):

Public Health ◽

United States ◽

Cause Of Death ◽

United States Public Health ◽

The United States ◽

Vital Statistics ◽

West Germany ◽

Medical Attention ◽

Age Group ◽

Number Of Children

IN ALL COUNTRIES for which there are vital statistics, accidents are a major cause of death and disability among children. In countries where the food supply is adequate and infectious diseases have been brought under control, accidents have become the leading cause of death in the age group 1 to 19 years. For example, in such countries as Australia, Canada, Sweden, West Germany, and the United States, more than one-third of all deaths in this age group are caused by accidents. The number of children who are injured by accidents fan exceeds the number who are killed. Although no accurate international figures are available, the Morbidity Survey conducted by the United States Public Health Service indicates that in the United States, for every child under 15 killed by accident, 1,100 children are injured severely enough to require medical attention or to be restricted in their activity for at least a day.

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