Influence of Climate on Google Internet Searches for Pruritus Across 16 German Cities: Retrospective Analysis

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Abstract

Background

The burden of pruritus is high, especially among patients with dermatologic diseases. Identifying trends in pruritus burden and people’s medical needs is challenging, since not all affected people consult a physician.

Objective

The purpose of this study was to investigate pruritus search behavior trends in Germany and identify associations with weather factors.

Methods

Google AdWords Keyword Planner was used to quantify pruritus-related search queries in 16 German cities from August 2014 to July 2018. All identified keywords were qualitatively categorized and pruritus-related terms were descriptively analyzed. The number of search queries per 100,000 inhabitants of each city was compared to environmental factors such as temperature, humidity, particulate matter 10 micrometers or less in diameter (PM10), and sunshine duration to investigate potential correlations.

Results

We included 1150 pruritus-related keywords, which resulted in 2,851,290 queries. “Pruritus” (n=115,680) and “anal pruritus” (n=102,390) were the most-searched-for keywords. Nearly half of all queries were related to the category localization, with Berlin and Munich having a comparatively high proportion of people that searched for pruritus in the genital and anal areas. People searched more frequently for information on chronic compared to acute pruritus. The most populated cities had the lowest number of queries per 100,000 inhabitants (Berlin, n=13,641; Hamburg, n=18,303; and Munich, n=21,363), while smaller cities (Kiel, n=35,027; and Freiburg, n=39,501) had the highest. Temperature had a greater effect on search query number (beta -7.94, 95% CI -10.74 to -5.15) than did PM10 (beta -5.13, 95% CI -7.04 to -3.22), humidity (beta 4.73, 95% CI 2.70 to 6.75), or sunshine duration (beta 0.66, 95% CI 0.36 to 0.97). The highest relative number of search queries occurred during the winter (ie, December to February).

Conclusions

By taking into account the study results, Google data analysis helps to examine people’s search frequency, behavior, and interest across cities and regions. The results indicated a general increase in search queries during the winter as well as differences across cities located in the same region; for example, there was a decline in search volume in Saarbrucken, while there were increases in Cologne, Frankfurt, and Dortmund. In addition, the detected correlation between search volume and weather data seems to be valuable in predicting an increase in pruritus burden, since a significant association with rising humidity and sunshine duration, as well as declining temperature and PM10, was found. Accordingly, this is an unconventional and inexpensive method to identify search behavior trends and respective inhabitants’ needs.

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Most cited references 37

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Clinical classification of itch: a position paper of the International Forum for the Study of Itch.

T Luger, Ulf Darsow, Uwe Gieler … (2006)

Chronic itch is a common and distressing symptom that arises from a variety of skin conditions and systemic diseases. Despite this, there is no clinically based classification of pruritic diseases to assist in the diagnosis and cost-effective medical care of patients with pruritus. The proposed classification focuses on clinical signs and distinguishes between diseases with and without primary or secondary skin lesions. Three groups of conditions are proposed: pruritus on diseased (inflamed) skin (group I), pruritus on non-diseased (non-inflamed) skin (group II), and pruritus presenting with severe chronic secondary scratch lesions, such as prurigo nodularis (group III). The next part classifies the underlying diseases according to different categories: dermatological diseases, systemic diseases including diseases of pregnancy and drug-induced pruritus, neurological and psychiatric diseases. In some patients more than one cause may account for pruritus (category "mixed") while in others no underlying disease can be identified (category "others"). This is the first version of a clinical classification worked out by the members of the International Forum for the Study of Itch. It is intended to serve as a diagnostic route for better evaluation of patients with chronic pruritus and aims to improve patients' care.

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Access to Care and Use of the Internet to Search for Health Information: Results From the US National Health Interview Survey

Daniel J Amante, Timothy Hogan, Sherry L Pagoto … (2015)

Background The insurance mandate of the Affordable Care Act has increased the number of people with health coverage in the United States. There is speculation that this increase in the number of insured could make accessing health care services more difficult. Those who are unable to access care in a timely manner may use the Internet to search for information needed to answer their health questions. Objective The aim was to determine whether difficulty accessing health care services for reasons unrelated to insurance coverage is associated with increased use of the Internet to obtain health information. Methods Survey data from 32,139 adults in the 2011 National Health Interview Study (NHIS) were used in this study. The exposure for this analysis was reporting difficulty accessing health care services or delaying getting care for a reason unrelated to insurance status. To define this exposure, we examined 8 questions that asked whether different access problems occurred during the previous 12 months. The outcome for this analysis, health information technology (HIT) use, was captured by examining 2 questions that asked survey respondents if they used an online health chat room or searched the Internet to obtain health information in the previous 12 months. Several multinomial logistic regressions estimating the odds of using HIT for each reported access difficulty were conducted to accomplish the study objective. Results Of a survey population of 32,139 adults, more than 15.90% (n=5109) reported experiencing at least one access to care barrier, whereas 3.63% (1168/32,139) reported using online health chat rooms and 43.55% (13,997/32,139) reported searching the Internet for health information. Adults who reported difficulty accessing health care services for reasons unrelated to their health insurance coverage had greater odds of using the Internet to obtain health information. Those who reported delaying getting care because they could not get an appointment soon enough (OR 2.2, 95% CI 1.9-2.5), were told the doctor would not accept them as a new patient or accept their insurance (OR 2.1, 95% CI 1.7-2.5 and OR 2.1, 95% CI 1.7-2.5, respectively), or because the doctor’s office was not open when they could go (OR 2.2, 95% CI 1.9-2.7) had more than twice the odds of using the Internet to obtain health information compared to those who did not report such access difficulties. Conclusions People experiencing trouble accessing health care services for reasons unrelated to their insurance status are more likely to report using the Internet to obtain health information. Improving the accuracy and reliability of health information resources that are publicly available online could help those who are searching for information due to trouble accessing health care services.

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The prevalence and clinical characteristics of pruritus among patients with extensive psoriasis.

Karina Chan, Eugene Wee, G. Yosipovitch … (2000)

Many patients with psoriasis are known to suffer from itch. However, the data available regarding itch and its characteristics in psoriasis are sparse. To examine the prevalence of pruritus and various related clinical characteristics in 101 patients with extensive psoriasis. A structured questionnaire was used. Generalized pruritus was a feature of psoriasis in 84% of the patients. In 77% of these it appeared on a daily basis. It involved all areas of the body, had prolonged duration and appeared mainly in the evening and at night. The pruritus significantly affected quality of life. Important daily factors that were found to exacerbate the itch were ambient heat (81%), skin dryness (80%), sweating (65%) and stress (55%). Important factors that were found to ameliorate itch were sleep (57%) and cold showers (55%). The pruritus was found to be unresponsive to most available antipruritics, including phototherapy. Itch intensity as reflected by a visual analogue scale did not correlate with Psoriasis Area and Severity Index scores; however, a highly significant correlation was obtained between the affective descriptors and itch intensity in the worst itch states (r = 0.6, P < 0.001). Pruritus is a common feature of psoriasis and affects quality of life.

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Author and article information

Contributors

Alexander Zink:

Department of Dermatology and AllergySchool of MedicineTechnical University of MunichBiedersteiner Str 29Munich, 80802Germany49 89 4140 303849 89 4140 3552Alexander.zink@tum.de

ORCID: http://orcid.org/0000-0001-9313-6588

Journal

Journal ID (nlm-ta): J Med Internet Res

Journal ID (iso-abbrev): J. Med. Internet Res

Journal ID (publisher-id): JMIR

Title: Journal of Medical Internet Research

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Print): 1439-4456

ISSN (Electronic): 1438-8871

Publication date Collection: July 2019

Publication date (Electronic): 12 July 2019

Volume: 21

Issue: 7

Electronic Location Identifier: e13739

Affiliations

[1 ] Department of Dermatology and Allergy School of Medicine Technical University of Munich Munich Germany

[2 ] The Institute for Medical Information Processing, Biometry, and Epidemiology Ludwig Maximilian University Munich Munich Germany

[3 ] Center for Chronic Pruritus Department of Dermatology University Hospital Münster Muenster Germany

Author notes

Corresponding Author: Alexander Zink Alexander.zink@ 123456tum.de

Author information

Linda Tizek http://orcid.org/0000-0002-2749-9791

Maximilian Schielein http://orcid.org/0000-0003-3767-1337

Melvin Rüth http://orcid.org/0000-0002-5333-4659

Sonja Ständer http://orcid.org/0000-0003-3612-7786

Manuel Pedro Pereira http://orcid.org/0000-0001-5649-2698

Bernadette Eberlein http://orcid.org/0000-0003-4509-6491

Tilo Biedermann http://orcid.org/0000-0002-5352-5105

Alexander Zink http://orcid.org/0000-0001-9313-6588

Article

Publisher ID: v21i7e13739

DOI: 10.2196/13739

PMC ID: 6659391

PubMed ID: 31301128

SO-VID: 82d9a19c-15ea-4bb9-be8b-e7685a222d42

Copyright © ©Linda Tizek, Maximilian Schielein, Melvin Rüth, Sonja Ständer, Manuel Pedro Pereira, Bernadette Eberlein, Tilo Biedermann, Alexander Zink. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 12.07.2019.

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/.as well as this copyright and license information must be included.

History

Date received : 18 February 2019

Date revision requested : 8 May 2019

Date revision received : 24 May 2019

Date accepted : 4 June 2019

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