Saposnik Florencia E, Huber Joelene F
Faculty of Social Sciences, McMaster University, Hamilton, ON, Canada.
Paediatric Medicine, The Hospital for Sick Children, Toronto, ON, Canada.
JMIR Pediatr Parent. 2020 Dec 7;3(2):e20913. doi: 10.2196/20913.
Ninety percent of adults in the United States use the internet, and the majority of internet users report looking on the web for health information using search engines. The rising prevalence of autism spectrum disorder (ASD), uncertainty surrounding its etiology, and variety of intervention approaches contribute to questions about its causes and treatments. It is not known which terms people search most frequently about ASD and whether web search queries have changed over time. Infodemiology is an area of health informatics research using big data analytics to understand web search behavior.
The objectives were to (1) use infodemiological data to analyze trends in web-based searches about the causes and treatments of ASD over time and (2) inform clinicians and ASD organizations about web queries regarding ASD.
Google Trends was used to analyze web searches about the causes and treatments of ASD in the United States from 2004 to 2019. The search terms analyzed for queries about causes of ASD included vaccines, genetics, environmental factors, and microbiome and those for therapies included applied behavior analysis (ABA), gluten-free diet, chelation therapy, marijuana, probiotics, and stem cell therapy.
Google Trends results are normalized on a scale ranging from 0 to 100 to represent the frequency and relative interest of search topics. For searches about ASD causes, vaccines had the greatest frequency compared to other terms, with an initial search peak observed in 2008 (scaled score of 81), reaching the highest frequency in 2015 (scaled score of 100), and a current upward trend. In comparison, searches about genetics, environmental factors, and microbiome occurred less frequently. For web searches about ASD therapies, ABA consistently had a high frequency of search interest since 2004, reaching a maximum scaled score of 100 in 2019. The analyses of chelation therapy and gluten-free diet showed trending interest in 2005 (scaled score of 68) and 2007 (scaled score of 100), respectively, followed by a steady decline since (scaled scores of only 10 and 16, respectively, in 2019). Searches related to ASD and marijuana showed a rise in 2009 (scaled score of 35), and they continue to trend upward. Searches about probiotics and stem cell therapy have been relatively low (scaled scores of 22 and 18, respectively), but are gradually gaining interest. Web search volumes for stem cell therapy in 2019 surpassed both gluten-free diet and chelation therapy as web-searched interventions for ASD.
Google Trends is an effective infodemiology tool to analyze large-scale web search trends about ASD. The results showed informative variation in search trends over 15 years. These data are useful to inform clinicians and organizations about web queries on topics related to ASD, identify knowledge gaps, and target web-based education and knowledge translation strategies.
在美国，90%的成年人使用互联网，且大多数互联网用户表示会使用搜索引擎在网上查找健康信息。自闭症谱系障碍（ASD）的患病率不断上升，其病因存在不确定性，干预方法多种多样，这些都引发了关于其病因和治疗的诸多问题。目前尚不清楚人们搜索ASD最频繁的词汇是什么，以及网络搜索查询是否随时间发生了变化。信息流行病学是健康信息学研究的一个领域，利用大数据分析来理解网络搜索行为。
目标是（1）利用信息流行病学数据分析基于网络搜索ASD病因和治疗方法随时间的趋势，以及（2）为临床医生和ASD组织提供有关ASD网络查询的信息。
使用谷歌趋势分析2004年至2019年美国关于ASD病因和治疗方法的网络搜索。分析ASD病因查询的搜索词包括疫苗、遗传学、环境因素和微生物群，分析治疗方法的搜索词包括应用行为分析（ABA）、无麸质饮食、螯合疗法、大麻、益生菌和干细胞疗法。
谷歌趋势结果在0到100的范围内进行了标准化处理，以代表搜索主题的频率和相对关注度。对于ASD病因的搜索，与其他词汇相比，疫苗的搜索频率最高，2008年出现首个搜索高峰（缩放分数为81），2015年达到最高频率（缩放分数为100），目前呈上升趋势。相比之下，关于遗传学、环境因素和微生物群的搜索频率较低。对于ASD治疗方法的网络搜索，自2004年以来，ABA的搜索兴趣频率一直很高，2019年达到最大缩放分数100。螯合疗法和无麸质饮食的分析分别显示在2005年（缩放分数为68）和2007年（缩放分数为100）出现搜索兴趣趋势，随后自那时起稳步下降（2019年分别仅为10和16的缩放分数）。与ASD和大麻相关的搜索在2009年有所上升（缩放分数为35），并且继续呈上升趋势。关于益生菌和干细胞疗法的搜索一直相对较低（分别为22和18的缩放分数），但兴趣逐渐增加。2019年干细胞疗法的网络搜索量超过了无麸质饮食和螯合疗法，成为ASD的网络搜索干预手段。
谷歌趋势是分析关于ASD大规模网络搜索趋势的有效信息流行病学工具。结果显示了15年搜索趋势中的丰富变化。这些数据有助于为临床医生和组织提供有关ASD相关主题网络查询的信息，识别知识差距，并针对基于网络的教育和知识转化策略。
