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      Using internet search data to explore the global public concerns in ankylosing spondylitis

      , , , ,
      Postgraduate Medical Journal
      BMJ

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          Abstract

          Objective

          This study explored the changes of global public interest in internet search of ankylosing spondylitis (AS) based on Google Trends (GT) data, in order to reflect the characteristics of AS itself.

          Methods

          GT was used to obtain the search popularity scores of the term ’AS’ on a global scale, between January 2004 and December 2018, under the ’health’ classification. Based on the global search data of AS provided by GT, the cosinor analysis was used to test whether there was seasonality in AS.

          Results

          In general, AS related search volume demonstrated a decreasing trend from January 2004 to December 2014 and then remain stable from January 2015 to December 2018. No obvious seasonal variations were detected in AS related search volume (amplitude=1.54; phase: month=3.9; low point: month=9.9; p>0.025), which peaked in April and bottomed out in October. The top 17 rising topics were adalimumab, spondylolisthesis, Morbus, Vladimir Mikhailovich Bekhterev, autoimmune disease, rheumatoid arthritis, ankylosis, HLA- B27 positive, Crohn’s disease, rheumatology, spondylosis, arthritis, uveitis, rheumatism, sacroiliac, psoriatic arthritis and spondylitis.

          Conclusions

          Globally, there is no significant seasonal variation in GT for AS. The top fast-growing topics related to AS may be beneficial for doctors to provide targeted health education of the disease to patients and their families.

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          Most cited references12

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          Is Google Trends a reliable tool for digital epidemiology? Insights from different clinical settings

          Internet-derived information has been recently recognized as a valuable tool for epidemiological investigation. Google Trends, a Google Inc. portal, generates data on geographical and temporal patterns according to specified keywords. The aim of this study was to compare the reliability of Google Trends in different clinical settings, for both common diseases with lower media coverage, and for less common diseases attracting major media coverage. We carried out a search in Google Trends using the keywords “renal colic”, “epistaxis”, and “mushroom poisoning”, selected on the basis of available and reliable epidemiological data. Besides this search, we carried out a second search for three clinical conditions (i.e., “meningitis”, “Legionella Pneumophila pneumonia”, and “Ebola fever”), which recently received major focus by the Italian media. In our analysis, no correlation was found between data captured from Google Trends and epidemiology of renal colics, epistaxis and mushroom poisoning. Only when searching for the term “mushroom” alone the Google Trends search generated a seasonal pattern which almost overlaps with the epidemiological profile, but this was probably mostly due to searches for harvesting and cooking rather than to for poisoning. The Google Trends data also failed to reflect the geographical and temporary patterns of disease for meningitis, Legionella Pneumophila pneumonia and Ebola fever. The results of our study confirm that Google Trends has modest reliability for defining the epidemiology of relatively common diseases with minor media coverage, or relatively rare diseases with higher audience. Overall, Google Trends seems to be more influenced by the media clamor than by true epidemiological burden.
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            Is Open Access

            Are ankylosing spondylitis, psoriatic arthritis and undifferentiated spondyloarthritis associated with an increased risk of cardiovascular events? A prospective nationwide population-based cohort study

            Background To investigate the risk of first-time acute coronary syndrome (ACS), stroke and venous thromboembolism (VTE) in patients with ankylosing spondylitis (AS), psoriatic arthritis (PsA) and undifferentiated spondyloarthritis (uSpA), compared to each other and to the general population (GP). Methods This is a prospective nationwide cohort study. Cohorts with AS (n = 6448), PsA (n = 16,063) and uSpA (n = 5190) patients and a GP (n = 266,435) cohort, were identified 2001–2009 in the Swedish National Patient and Population registers. The follow-up began 1 January 2006, or 6 months after the first registered spondyloarthritis (SpA) diagnosis thereafter, and ended at ACS/stroke/VTE event, death, emigration or 31 December 2012. Crude and age- and sex-standardized incidence rates (SIRs) and hazard ratios (HRs) were calculated for incident ACS, stroke or VTE, respectively. Results Standardized to the GP cohort, SIRs for ACS were 4.3, 5.4 and 4.7 events per 1000 person-years at risk in the AS, PsA and uSpA cohort, respectively, compared to 3.2 in the GP cohort. SIRs for stroke were 5.4, 5.9 and 5.7 events per 1000 person-years at risk in the AS, PsA and uSpA cohort compared to 4.7 in the GP cohort. Corresponding SIRs for VTE were 3.6, 3.2 and 3.5 events per 1000 person-years at risk compared to 2.2 in the GP cohort. Age-and sex-adjusted HRs (95% CI) for ACS events were significantly increased in AS (1.54 (1.31–1.82)), PsA (1.76 (1.59–1.95)) and uSpA (1.36 (1.05–1.76)) compared to GP. Age-adjusted HRs for ACS was significantly decreased in female AS patients (0.59 (0.37–0.97)) compared to female PsA patients. Age-and sex-adjusted HRs for stroke events were significantly increased in AS (1.25 (1.06–1.48)) and PsA (1.34 (1.22–1.48)), and nonsignificantly increased in uSpA (1.16 (0.91–1.47)) compared to GP. For VTE the age-and sex-adjusted HRs for AS, PsA and uSpA were equally and significantly increased with about 50% compared to GP. Conclusions Patients with AS, PsA and uSpA are at increased risk for ACS and stroke events, which emphasizes the importance of identification of and intervention against cardiovascular risk factors in SpA patients. Increased alertness for VTE is warranted in patients with SpA. Electronic supplementary material The online version of this article (doi:10.1186/s13075-017-1315-z) contains supplementary material, which is available to authorized users.
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              Cardiovascular morbidity and mortality in ankylosing spondylitis and psoriatic arthritis

              The cardiovascular burden in inflammatory rheumatic diseases is well recognized. Recently, this burden has been highlighted in ankylosing spondylitis (also known as radiographic axial spondyloarthritis) and psoriatic arthritis. We review the cardiovascular morbidity and mortality in these diseases, as well as the prevalence and incidence of traditional cardiovascular risk factors. We examine the contribution of anti-inflammatory therapy with nonsteroidal anti-inflammatory drugs, disease-modifying anti-rheumatic drugs, and TNF inhibitors on the cardiovascular risk profile. Finally, we examine the available recommendations for the management of cardiovascular comorbidity, as they apply to the spondyloarthritis population.
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                Author and article information

                Contributors
                Journal
                Postgraduate Medical Journal
                Postgrad Med J
                BMJ
                0032-5473
                1469-0756
                January 25 2021
                February 2021
                February 2021
                February 24 2020
                : 97
                : 1144
                : 93-96
                Article
                10.1136/postgradmedj-2019-137407
                32094142
                40098903-cd1d-430e-aed0-cf2064c05486
                © 2020
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