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

BackgroundThe 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.MethodsWe 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.ResultsSearches 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.ConclusionsA 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.

[1]  B. Waterman,et al.  The epidemiology of ankle sprains in the United States. , 2010, The Journal of bone and joint surgery. American volume.

[2]  H. Moldofsky,et al.  Seasonal symptom severity in patients with rheumatic diseases: a study of 1,424 patients. , 2001, The Journal of rheumatology.

[3]  D. Rafferty,et al.  Oxygen cost of walking, physical activity, and sedentary behaviours in rheumatoid arthritis , 2014, Scandinavian journal of rheumatology.

[4]  S. Nuti,et al.  The Use of Google Trends in Health Care Research: A Systematic Review , 2014, PloS one.

[5]  J. Powell,et al.  The Characteristics and Motivations of Online Health Information Seekers: Cross-Sectional Survey and Qualitative Interview Study , 2011, Journal of medical Internet research.

[6]  Rob J Hyndman,et al.  Automatic Time Series Forecasting: The forecast Package for R , 2008 .

[7]  S. Clemes,et al.  Seasonal variation in physical activity, sedentary behaviour and sleep in a sample of UK adults , 2014, Annals of human biology.

[8]  R Core Team,et al.  R: A language and environment for statistical computing. , 2014 .

[9]  H. Menz,et al.  The population prevalence of foot and ankle pain in middle and old age: A systematic review , 2011, PAIN.

[10]  H. Boshuizen,et al.  Disability and health‐related quality of life among patients with rheumatoid arthritis: association with radiographic joint damage, disease activity, pain, and depressive symptoms , 2006, Scandinavian journal of rheumatology.

[11]  R. Purcărea,et al.  Cause and effect: the linkage between the health information seeking behavior and the online environment- a review , 2014, Journal of medicine and life.

[12]  Evaluating the Quality of Internet-Derived Information on Plantar Fasciitis , 2004, Clinical orthopaedics and related research.

[13]  Eleftherios Mylonakis,et al.  Google trends: a web-based tool for real-time surveillance of disease outbreaks. , 2009, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[14]  P. Tucker,et al.  The effect of season and weather on physical activity: a systematic review. , 2007, Public health.

[15]  Hadley Wickham,et al.  ggplot2 - Elegant Graphics for Data Analysis (2nd Edition) , 2017 .

[16]  P. Belmont,et al.  The incidence of plantar fasciitis in the United States military. , 2009, The Journal of bone and joint surgery. American volume.