Retrospective Observational Infodemiology Study of Information
and Search Activity on the Internet
Shawndra Hill, Jun Mao, Lyle Ungar, Sean Hennessy, Charles E. Leonard,
John Holmes
J Med Internet Res 2011 (May 10); 13(2):e36
Background: As the incidence of H1N1 increases, the lay public may turn to
the Internet for information about natural supplements for prevention and
treatment. Objective: Our objective was to identify and characterize
websites that provide information about herbal and natural supplements with
information about H1N1 and to examine trends in the public’s behavior in
searching for information about supplement use in preventing or treating
H1N1. Methods: This was a retrospective observational infodemiology study of
indexed websites and Internet search activity over the period January 1,
2009, through November 15, 2009. The setting is the Internet as indexed by
Google with aggregated Internet user data. The main outcome measures were
the frequency of “hits” or webpages containing terms relating to natural
supplements co-occurring with H1N1/swine flu, terms relating to natural
supplements co-occurring with H1N1/swine flu proportional to all terms
relating to natural supplements, webpage rank, webpage entropy, and temporal
trend in search activity. Results: A large number of websites support
information about supplements and H1N1. The supplement with the highest
proportion of H1N1/swine flu information was a homeopathic remedy known as
Oscillococcinum that has no known side effects; supplements with the next
highest proportions have known side effects and interactions. Webpages with
both supplement and H1N1/swine flu information were less likely to be
medically curated or authoritative. Search activity for supplements was
temporally related to H1N1/swine flu-related news reports and events.
Conclusions: The prevalence of nonauthoritative webpages with information
about supplements in the context of H1N1/swine flu and the increasing number
of searches for these pages suggest that the public is interested in
alternatives to traditional prevention and treatment of H1N1. The quality of
this information is often questionable and clinicians should be cognizant
that patients may be at risk of adverse events associated with the use of
supplements for H1N1.
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