King Catherine, Judge Ciaran, Byrne Aideen, Conlon Niall
Department of Clinical and Laboratory Immunology, St. James's Hospital, Dublin, Ireland.
Paediatric Allergy Department, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland.
J Med Internet Res. 2020 May 13;22(5):e16763. doi: 10.2196/16763.
Internet search engines are increasingly being utilized as the first port of call for medical information by the public. The prevalence of allergies in developed countries has risen steadily over time. There exists significant variability in the quality of health-related information available on the web. Inaccurately diagnosed and mismanaged allergic disease has major downstream effects on patients, general practitioners, and regional allergy services.
This study aimed to verify whether Ireland has a relatively high rate of web-based allergy-related searches, to establish the proportion of medically accurate web pages encountered by the public, and to compare current search results localized to Dublin, Ireland with urban centers elsewhere.
Google Trends was used to evaluate regional interest of allergy-related search terms over a 10-year period using terms "allergy," "allergy test," "food allergy," and "food intolerance." These terms were then inputted into Google search, localizing them to cities in Ireland, the United Kingdom, and the United States. Output for each search was reviewed by two independent clinicians and deemed rational or nonevidence based, as per current best practice guidelines. Searches localized to Dublin were initially completed in 2015 and repeated in 2019 to assess for changes in the quality of search results over time.
Ireland has a persistently high demand for web-based information relating to allergy and ranks first worldwide for "allergy test," second for "food allergy" and "food intolerance," and seventh for "allergy" over the specified 10-year timeframe. Results for each of the four subsearches in Dublin (2015) showed that over 60% of websites promoted nonevidence-based diagnostics. A marginal improvement in scientifically robust information was seen in 2019, but results for "allergy test" and "food intolerance" continued to promote alternative testing 57% (8/14) of the time. This strongly contrasted with results localized to Southampton and Rochester, where academic and hospital-affiliated web pages predominantly featured. Government-funded Department of Health websites did not feature in the top five results for Dublin searches "allergy testing," "food allergy," or "food intolerance" in either 2015 or 2019.
The Irish public demonstrates a keen interest in seeking allergy-related information on the web. The proportion of evidence-based websites encountered by the Irish public is considerably lower than that encountered by patients in other urban centers. Factors contributing to this are the lack of a specialist register for allergy in Ireland, inadequate funding for allergy centers currently in operation, and insufficient promotion by the health service of their web-based health database, which contains useful patient-oriented information on allergy. Increased funding of clinical allergology services will more meaningfully impact the health of patients if there is a parallel investment by the health service in information and communication technology consultancy to amplify their presence on the web.
互联网搜索引擎日益成为公众获取医学信息的首选途径。发达国家过敏症的患病率长期以来一直在稳步上升。网络上与健康相关的信息质量存在显著差异。过敏疾病的误诊和管理不当会对患者、全科医生以及地区过敏服务产生重大的下游影响。
本研究旨在验证爱尔兰基于网络的过敏相关搜索率是否相对较高，确定公众遇到的医学上准确的网页比例，并将当前爱尔兰都柏林的搜索结果与其他城市中心进行比较。
使用谷歌趋势，通过“过敏”“过敏测试”“食物过敏”和“食物不耐受”等术语评估10年间对过敏相关搜索词的地区兴趣。然后将这些术语输入谷歌搜索，将其定位到爱尔兰、英国和美国的城市。每个搜索的结果由两名独立的临床医生进行审查，并根据当前最佳实践指南判定为合理或无证据依据。最初于2015年完成对都柏林的本地化搜索，并于2019年重复进行，以评估搜索结果质量随时间的变化。
爱尔兰对基于网络的过敏相关信息的需求持续很高，在指定的10年时间范围内，“过敏测试”全球排名第一，“食物过敏”和“食物不耐受”排名第二，“过敏”排名第七。2015年都柏林的四项子搜索结果显示，超过60%的网站推广无证据依据的诊断方法。2019年在科学可靠信息方面有小幅改善，但“过敏测试”和“食物不耐受”的结果仍有57%（8/14）的时间在推广替代检测方法。这与南安普顿和罗切斯特的搜索结果形成强烈对比，在那里学术和医院附属网页占主导地位。在2015年和2019年，政府资助的卫生部网站在都柏林搜索“过敏测试”“食物过敏”或“食物不耐受”的前五项结果中均未出现。
爱尔兰公众对在网络上搜索过敏相关信息表现出浓厚兴趣。爱尔兰公众遇到的基于证据的网站比例远低于其他城市中心的患者。造成这种情况的因素包括爱尔兰缺乏过敏专科登记册、目前运营的过敏中心资金不足以及卫生服务部门对其包含有用的面向患者的过敏信息的网络健康数据库宣传不足。如果卫生服务部门同时对信息和通信技术咨询进行投资，以扩大其在网络上的影响力，增加临床过敏服务的资金将更有意义地影响患者的健康。
