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      Infodemiology of Alcohol Use in Hong Kong Mentioned on Blogs: Infoveillance Study

      research-article
      , MBBS 1 , , PhD 1 , , , MD 1
      (Reviewer), (Reviewer), (Reviewer), (Reviewer), (Reviewer), (Reviewer)
      Journal of Medical Internet Research
      JMIR Publications Inc.
      alcohol drinking, blogging, blog search, Chinese, Hong Kong, infodemiology, infoveillance, Internet

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          Abstract

          Background

          In 2007 and 2008, the beer and wine tax in Hong Kong was halved and then abolished, resulting in an increase of alcohol consumption. The prevalence of the Internet and a high blogging rate by adolescents and adults present a unique opportunity to study drinking patterns by infodemiology.

          Objective

          To assess and explain the online use of alcohol-related Chinese keywords and to validate blog searching as an infoveillance method for surveying changes in drinking patterns (eg, alcohol type) in Hong Kong people (represented by bloggers on a Hong Kong–based Chinese blogging site) in 2005-2010.

          Methods

          Blog searching was done using a blog search engine, Google Blog Search, in the archives of a Hong Kong–based blog service provider, MySinaBlog from 2005-2010. Three groups of Chinese keywords, each representing a specific alcohol-related concept, were used: (1) “alcohol” (ie, the control concept), (2) “beer or wine”, and (3) “spirit”. The resulting blog posts were analyzed quantitatively using infodemiological metrics and correlation coefficients, and qualitatively by manual effort. The infodemiological metrics were (1) apparent prevalence, (2) actual prevalence, (3) prevalence rate, and (4) prevalence ratio. Pearson and Spearman correlations were calculated for prevalence rates and ratios with respect to per capita alcohol consumption. Manual analysis focused on (1) blog author characteristics (ie, authorship, sex, and age), and (2) blog content (ie, frequency of keywords, description of a discrete episode of alcohol drinking, drinking amount, and genres).

          Results

          The online use of alcohol-related concepts increased noticeably for “alcohol” in 2008 and “spirit” in 2008-2009 but declined for “beer or wine” over the years. Correlation between infodemiological and epidemiological data was only significant for the “alcohol” prevalence rate. Most blogs were managed by single authors. Their sex distribution was even, and the majority were aged 18 and above. Not all Chinese keywords were found. Many of the blog posts did not describe a discrete episode of alcohol drinking and were classified as personal diary, opinion, or emotional outlets. The rest lacked information on drinking amount, which hindered assessment of binge drinking.

          Conclusions

          The prevalence of alcohol-related Chinese keywords online was attributed to many different factors, including spam, and hence not a specific reflection of local drinking patterns. Correlation between infodemiological data (represented by prevalence rates and ratios of alcohol-related concepts) and epidemiological data (represented by per capita alcohol consumption) was poor. Many blog posts were affective rather than informative in nature. Semantic analysis of blog content was recommended given enough expertise and resources.

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          Most cited references51

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            Infodemiology: tracking flu-related searches on the web for syndromic surveillance.

            Syndromic surveillance uses health-related data that precede diagnosis and signal a sufficient probability of a case or an outbreak to warrant further public health response. While most syndromic surveillance systems rely on data from clinical encounters with health professionals, I started to explore in 2004 whether analysis of trends in Internet searches can be useful to predict outbreaks such as influenza epidemics and prospectively gathered data on Internet search trends for this purpose. There is an excellent correlation between the number of clicks on a keyword-triggered link in Google with epidemiological data from the flu season 2004/2005 in Canada (Pearson correlation coefficient of current week clicks with the following week influenza cases r=.91). The "Google ad sentinel method" proved to be more timely, more accurate and - with a total cost of Can$365.64 for the entire flu-season - considerably cheaper than the traditional method of reports on influenza-like illnesses observed in clinics by sentinel physicians. Systematically collecting and analyzing health information demand data from the Internet has considerable potential to be used for syndromic surveillance. Tracking web searches on the Internet has the potential to predict population-based events relevant for public health purposes, such as real outbreaks, but may also be confounded by "epidemics of fear". Data from such "infodemiology studies" should also include longitudinal data on health information supply.
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              Early detection of disease outbreaks using the Internet.

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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications Inc. (Toronto, Canada )
                1439-4456
                1438-8871
                September 2013
                02 September 2013
                : 15
                : 9
                : e192
                Affiliations
                [1] 1School of Public Health, The University of Hong Kong Hong KongChina (Hong Kong)
                Author notes
                Corresponding Author: SY Ho syho@ 123456hku.hk
                Article
                v15i9e192
                10.2196/jmir.2180
                3785983
                23999327
                6949b51e-82d4-490c-a89a-aecefd610cea
                ©KL Chan, SY Ho, TH Lam. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.09.2013.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 23 May 2012
                : 29 July 2012
                : 29 August 2012
                : 25 June 2013
                Categories
                Original Paper

                Medicine
                alcohol drinking,blogging,blog search,chinese,hong kong,infodemiology,infoveillance,internet
                Medicine
                alcohol drinking, blogging, blog search, chinese, hong kong, infodemiology, infoveillance, internet

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