Worrall Amy P, Kelly Claire, O'Neill Aine, O'Doherty Murray, Kelleher Eoin, Cushen Anne Marie, McNally Cora, McConkey Samuel, Glavey Siobhan, Lavin Michelle, de Barra Eoghan
Department of Infectious Diseases, Beaumont Hospital, Dublin, Ireland.
Department of Haematology, Beaumont Hospital, Dublin, Ireland.
JMIR Form Res. 2021 Aug 31;5(8):e21817. doi: 10.2196/21817.
Early evidence of COVID-19-associated coagulopathy disseminated rapidly online during the first months of 2020, followed by clinical debate about how best to manage thrombotic risks in these patients. The rapid online spread of case reports was followed by online interim guidelines, discussions, and worldwide online searches for further information. The impact of global online search trends and online discussion on local approaches to coagulopathy in patients with COVID-19 has not been studied.
The goal of this study was to investigate the relationship between online search trends using Google Trends and the rate of appropriate venous thromboembolism (VTE) prophylaxis and anticoagulation therapy in a cohort of patients with COVID-19 admitted to a tertiary hospital in Ireland.
A retrospective audit of anticoagulation therapy and VTE prophylaxis among patients with COVID-19 who were admitted to a tertiary hospital was conducted between February 29 and May 31, 2020. Worldwide Google search trends of the term "COVID-19" and anticoagulation synonyms during this time period were determined and correlated against one another using a Spearman correlation. A P value of <.05 was considered significant, and analysis was completed using Prism, version 8 (GraphPad).
A statistically significant Spearman correlation (P<.001, r=0.71) was found between the two data sets, showing an increase in VTE prophylaxis in patients with COVID-19 with increasing online searches worldwide. This represents a proxy for online searches and discussion, dissemination of information, and Google search trends relating to COVID-19 and clotting risk, in particular, which correlated with an increasing trend of providing thromboprophylaxis and anticoagulation therapy to patients with COVID-19 in our tertiary center.
We described a correlation of local change in clinical practice with worldwide online dialogue and digital search trends that influenced individual clinicians, prior to the publication of formal guidelines or a local quality-improvement intervention.
2020年最初几个月,与新型冠状病毒肺炎(COVID-19)相关凝血功能障碍的早期证据在网上迅速传播,随后引发了关于如何最佳管理这些患者血栓形成风险的临床讨论。病例报告在网上迅速传播之后,又出现了在线临时指南、讨论以及全球范围内的在线信息搜索。全球在线搜索趋势和在线讨论对COVID-19患者凝血功能障碍的本地处理方法的影响尚未得到研究。
本研究的目的是调查使用谷歌趋势的在线搜索趋势与爱尔兰一家三级医院收治的COVID-19患者队列中适当的静脉血栓栓塞(VTE)预防和抗凝治疗率之间的关系。
对2020年2月29日至5月31日期间收治于一家三级医院的COVID-19患者的抗凝治疗和VTE预防进行回顾性审计。确定该时间段内“COVID-19”一词及抗凝同义词在全球范围内的谷歌搜索趋势,并使用Spearman相关性分析将两者相互关联。P值<0.05被认为具有统计学意义,分析使用Prism 8版本(GraphPad)完成。
在两个数据集之间发现了具有统计学意义的Spearman相关性(P<0.001,r = 0.71),表明随着全球范围内在线搜索的增加,COVID-19患者的VTE预防有所增加。这代表了在线搜索和讨论、信息传播以及与COVID-19和凝血风险相关的谷歌搜索趋势,特别是与我们三级中心为COVID-19患者提供血栓预防和抗凝治疗的增加趋势相关。
在正式指南发布或本地质量改进干预之前,我们描述了临床实践中的本地变化与影响个体临床医生的全球在线对话和数字搜索趋势之间的相关性。