From the Department of Orthopedic Surgery (Davison-Kerwood), University of Illinois, and the University of Illinois College of Medicine (Jiang), Chicago, IL.
J Am Acad Orthop Surg Glob Res Rev. 2022 Nov 15;6(11). doi: 10.5435/JAAOSGlobal-D-22-00131. eCollection 2022 Nov 1.
Before being evaluated by a physician, more than 50% of patients will search their symptoms on the Google search engine. In fact, Google was the engine used for nearly 90% of all online searches between 2016 and 2018. These search data are stored by Google and can be investigated through google extended trends for health (GETH). The goal of this research was to use GETH to correlate Google search probabilities for elective orthopaedic procedures with the orthopaedic surgeon density in each US state to create a surgical demand index (SDI) that could be then compared between states. In addition, this study aims to assess the effects of annual income, percent minority population, and unemployment rate on that SDI.
Google search probabilities were collected using the Google Trends Extraction Tool. Search probabilities were collected in each state for composite search terms. Data were collected in monthly intervals between 2016 and 2018 and averaged. The states were grouped into geographic regions. One-way analysis of variance and pairwise Mann-Whitney U tests were done between these regions. Linear regression analysis was conducted to assess the effect of median annual statewide income, percent minority population, and unemployment rate with SDI.
The analysis of variance and Mann-Whitney U tests demonstrated a difference between regions. Linear regression analysis revealed a notable effect of median income on SDI, but no effect of percent minority population or unemployment rate.
The Midwest and South had higher regional demand than the Northeast and West, with West Virginia being the most in need and the District of Columbia being the least in need. Annual median income had a notable negative effect on SDI, whereas percent minority population and unemployment rate had no effect. This study highlights the inequality that exists in the southern and midwestern United States and identifies one potential predictive factor of this unequal SDI.
在接受医生评估之前，超过 50%的患者会在谷歌搜索引擎上搜索自己的症状。事实上，谷歌是 2016 年至 2018 年间近 90%的在线搜索使用的引擎。这些搜索数据由谷歌存储，可以通过谷歌扩展健康趋势（GETH）进行调查。本研究的目的是使用 GETH 将选择骨科手术的谷歌搜索概率与美国每个州的骨科医生密度相关联，创建一个可以在各州之间进行比较的手术需求指数（SDI）。此外，本研究旨在评估年收入、少数民族人口比例和失业率对该 SDI 的影响。
使用谷歌趋势提取工具收集谷歌搜索概率。在每个州收集复合搜索词的搜索概率。2016 年至 2018 年期间每月收集一次数据并取平均值。将各州分为地理区域。对这些区域进行单向方差分析和两两曼-惠特尼 U 检验。进行线性回归分析，以评估中位数全州年收入、少数民族人口比例和失业率对 SDI 的影响。
方差分析和曼-惠特尼 U 检验表明区域之间存在差异。线性回归分析显示，中位数收入对 SDI 有显著影响，但少数民族人口比例和失业率没有影响。
中西部和南部地区的区域需求高于东北部和西部地区，西弗吉尼亚州的需求最高，哥伦比亚特区的需求最低。年中位数收入对 SDI 有显著的负影响，而少数民族人口比例和失业率没有影响。本研究强调了美国南部和中西部地区存在的不平等现象，并确定了 SDI 不平等的一个潜在预测因素。
