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      Let me Google that for you: a time series analysis of seasonality in internet search trends for terms related to foot and ankle pain

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          Abstract

          Background

          The analysis of internet search traffic may present the opportunity to gain insights into general trends and patterns in information seeking behaviour related to medical conditions at a population level. For prevalent and widespread problems such as foot and ankle pain, this information has the potential to improve our understanding of seasonality and trends within these conditions and their treatments, and may act as a useful proxy for their true incidence/prevalence characteristics. This study aimed to explore seasonal effects, general trends and relative popularity of internet search terms related to foot and ankle pain over the past decade.

          Methods

          We used the Google Trends tool to obtain relative search engine traffic for terms relating to foot and ankle pain and common treatments from Google search and affiliated pages for major northern and southern hemisphere English speaking nations. Analysis of overall trends and seasonality including summer/winter differences was carried out on these terms.

          Results

          Searches relating to general foot pain were on average 3.4 times more common than those relating to ankle pain, and twice as common as searches relating to heel pain. Distinct seasonal effects were seen in the northern hemisphere, with large increases in search volumes in the summer months compared to winter for foot ( p = 0.004, 95 % CI [22.2–32.1]), ankle ( p = 0.0078, 95 % CI [20.9–35.5]), and heel pain ( p = 0.004, 95 % CI [29.1–45.6]). These seasonal effects were reflected by data from Australia, with the exception of ankle pain. Annual seasonal effects for treatment options were limited to terms related to foot surgery and ankle orthoses ( p = 0.031, 95 % CI [3.5–20.9]; p = 0.004, 95 % CI [7.6–25.2] respectively), again increasing in the summer months.

          Conclusions

          A number of general trends and annual seasonal effects were found in time series internet search data for terms relating to foot and ankle pain. This data may provide insights into these conditions at population levels.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s13047-015-0074-9) contains supplementary material, which is available to authorized users.

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          Most cited references10

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          The effect of season and weather on physical activity: a systematic review.

          This study reviewed previous studies to explore the effect of season, and consequently weather, on levels of physical activity. Thirty-seven primary studies (published 1980-2006) representing a total of 291883 participants (140482 male and 152085 female) from eight different countries are described, and the effect of season on moderate levels of physical activity is considered. Upon review of the evidence, it appears that levels of physical activity vary with seasonality, and the ensuing effect of poor or extreme weather has been identified as a barrier to participation in physical activity among various populations. Therefore, previous studies that did not recognize the effect of weather and season on physical activity may, in fact, be poor representations of this behaviour. Future physical activity interventions should consider how weather promotes or hinders such behaviour. Providing indoor opportunities during the cold and wet months may foster regular physical activity behaviours year round.
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            Google trends: a web-based tool for real-time surveillance of disease outbreaks.

            Google Flu Trends can detect regional outbreaks of influenza 7-10 days before conventional Centers for Disease Control and Prevention surveillance systems. We describe the Google Trends tool, explain how the data are processed, present examples, and discuss its strengths and limitations. Google Trends shows great promise as a timely, robust, and sensitive surveillance system. It is best used for surveillance of epidemics and diseases with high prevalences and is currently better suited to track disease activity in developed countries, because to be most effective, it requires large populations of Web search users. Spikes in search volume are currently hard to interpret but have the benefit of increasing vigilance. Google should work with public health care practitioners to develop specialized tools, using Google Flu Trends as a blueprint, to track infectious diseases. Suitable Web search query proxies for diseases need to be established for specialized tools or syndromic surveillance. This unique and innovative technology takes us one step closer to true real-time outbreak surveillance.
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              The epidemiology of ankle sprains in the United States.

              Ankle sprain has been studied in athletic cohorts, but little is known of its epidemiology in the general population. A longitudinal, prospective epidemiological database was used to determine the incidence and demographic risk factors for ankle sprains presenting to emergency departments in the United States. It was our hypothesis that ankle sprain is influenced by sex, race, age, and involvement in athletics. The National Electronic Injury Surveillance System (NEISS) was queried for all ankle sprain injuries presenting to emergency departments between 2002 and 2006. Incidence rate ratios were then calculated with respect to age, sex, and race. During the study period, an estimated 3,140,132 ankle sprains occurred among an at-risk population of 1,461,379,599 person-years for an incidence rate of 2.15 per 1000 person-years in the United States. The peak incidence of ankle sprain occurred between fifteen and nineteen years of age (7.2 per 1000 person-years). Males, compared with females, did not demonstrate an overall increased incidence rate ratio for ankle sprain (incidence rate ratio, 1.04; 95% confidence interval, 1.00 to 1.09). However, males between fifteen and twenty-four years old had a substantially higher incidence of ankle sprain than their female counterparts (incidence rate ratio, 1.53; 95% confidence interval, 1.41 to 1.66), whereas females over thirty years old had a higher incidence compared with their male counterparts (incidence rate ratio, 2.03; 95% confidence interval, 1.65 to 2.65). Compared with the Hispanic race, the black and white races were associated with substantially higher rates of ankle sprain (incidence rate ratio, 3.55 [95% confidence interval, 1.01 to 6.09] and 2.49 [95% confidence interval, 1.01 to 3.97], respectively). Nearly half of all ankle sprains (49.3%) occurred during athletic activity, with basketball (41.1%), football (9.3%), and soccer (7.9%) being associated with the highest percentage of ankle sprains during athletics. An age of ten to nineteen years old is associated with higher rates of ankle sprain. Males between fifteen and twenty-four years old have higher rates of ankle sprain than their female counterparts, whereas females over thirty years old have higher rates than their male counterparts. Half of all ankle sprains occur during athletic activity.
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                Author and article information

                Contributors
                44(0)141 331 8475 , scott.telfer@gcu.ac.uk , scott.telfer@gmail.com
                jim.woodburn@gcu.ac.uk
                Journal
                J Foot Ankle Res
                J Foot Ankle Res
                Journal of Foot and Ankle Research
                BioMed Central (London )
                1757-1146
                3 July 2015
                3 July 2015
                2015
                : 8
                : 27
                Affiliations
                [ ]Research Fellow, Institute of Applied Health Research, Glasgow Caledonian University, Glasgow, G4 0BA UK
                [ ]Professor of Rehabilitation, Institute of Applied Health Research, Glasgow Caledonian University, Glasgow, UK
                Article
                74
                10.1186/s13047-015-0074-9
                4490673
                26146521
                4b5542c2-d4b9-4e74-8fc0-1030c37ec602
                © Telfer and Woodburn. 2015

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 6 February 2015
                : 13 April 2015
                Categories
                Research
                Custom metadata
                © The Author(s) 2015

                Orthopedics
                foot pain,ankle pain,google trends,plantar faciitis,ankle sprain,insoles,foot orthotics
                Orthopedics
                foot pain, ankle pain, google trends, plantar faciitis, ankle sprain, insoles, foot orthotics

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