Public Interest in Dry Eye Disease and Its Association With Environmental Parameters in Taiwan: Google Trends Infodemiology Study

TL;DR

Public interest in dry eye disease in Taiwan has risen, linked to environmental pollutants like hydrocarbons, with changes in search focus over time.

Contribution

Identified novel environmental pollutants correlated with public interest in dry eye disease using Google Trends data.

Findings

Public interest in dry eye disease in Taiwan increased significantly from 2018 to 2024.

Hydrocarbons like methane showed strong correlation with search interest in dry eye disease.

Search focus shifted from treatments to natural remedies during the pandemic and to self-diagnosis afterward.

Abstract

A high prevalence of dry eye disease (DED) has intensified public health concerns in Taiwan. With the growing reliance on online resources for health information, platforms such as Google Trends (GT) provide a valuable method for capturing public interest. This approach also allows for the exploration of potential associations between public interest in DED and environmental parameters, which may further elucidate underlying factors contributing to the disease’s rising prevalence.

This study aims to (1) analyze public interest in DED in Taiwan using GT data, (2) investigate correlations between search interest and environmental parameters, and (3) identify shifts in the focus of search over time.

We analyzed GT data from December 2018 to July 2024, focusing on relative search volume (RSV) for DED across Taiwan and its 6 special municipalities. Temporal trends in RSV were assessed using spline regression models, and monthly variations were assessed using the Kruskal-Wallis test. The Spearman correlation analysis was used to evaluate the association between RSV and environmental parameters, while dynamic time warping analysis clarified the temporal alignment of RSV with these parameters. Rising search queries were analyzed to identify shifts in public interest over time. Furthermore, top Google search results for DED-related keywords were assessed for topic coverage, quality, and readability.

A significant rising trend in RSV for DED was observed over the study period in Taiwan (mean instantaneous derivative=0.445; P<.001) and across all 6 special municipalities. Environmental parameters such as methane (CH4), total hydrocarbons, and nonmethane hydrocarbons were identified as novel pollutants strongly correlated with RSV (P<.001), along with known pollutants such as nitric oxide (NO), nitrogen dioxide (NO2), sulfur dioxide (SO2), nitrogen oxides (NOx), and carbon monoxide (CO). Dynamic time warping analysis revealed the strongest temporal alignment was between RSV and hydrocarbons, including CH4 and total hydrocarbons, further emphasizing their potential role in influencing public interest. Assessment of web-based DED information of 80 websites revealed generally low quality (DISCERN score: mean 2.14, SD 0.40), and the average readability corresponded to a college reading level (grade: mean 21.1, SD 4.5). Rising search queries shifted from diagnostic and treatment methods before the COVID-19 pandemic to natural remedies during the COVID-19 lockdown and self-diagnosis and treatment options after the pandemic. Gaps were also identified between public interest and the availability of online information.

Public interest in DED has increased significantly in Taiwan from 2018 to 2024, with hydrocarbons identified as strongly associated environmental parameters. The shifts in related queries reflect changing public interest, accentuating the need for health care information that aligns with public interest and addresses gaps in available resources.

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