JMIR Publications

ABSTRACT

Background:

Internet search engines are increasingly utilized as the first port-of-call for medical information by the public. The prevalence of allergy in developed countries has also risen steadily over time. There exists significant variability in the quality of health-related information available online. Inaccurately diagnosed and mismanaged allergic disease has major downstream effects on patients, primary care physicians, and regional allergy services.

Objective:

The objectives were to verify that Ireland has a relatively high rate of online allergy-related searches, to establish the proportion of medically accurate webpages the public are likely to encounter, and to compare current search results localized to Dublin with urban centres elsewhere.

Methods:

Google Trends was used to evaluate interest, by region, of allergy-related search terms over a ten year period (2009 – 2019) using terms “allergy”, “allergy test”, “food allergy” and “food intolerance”. These terms were then inputted into Google search, localizing them to cities in Ireland, the UK and the US. Output for each of these searches was reviewed by two independent clinicians and deemed as either rational or non-evidence-based, as outlined by current best practice guidelines. Searches localized to Dublin (Ireland) were initially completed in 2015 and repeated in 2019 to assess for changes in quality of search results over time. Analysis was limited to Google Search pages one and two.

Results:

Ireland has a persistently high demand for online information relating to allergy and ranks 1st worldwide for “allergy test”, 2nd for “food allergy” and “food intolerance”, and 7th for “allergy” over the specified ten-year timeframe. Results for each of the 4 sub-searches in Dublin (2015) showed over 60% of websites promoted non-evidence-based diagnostics. A marginal improvement in scientifically robust information was seen in 2019 but results for “allergy test” and “food intolerance” in particular continued to promote alternative testing 57% of the time. This strongly contrasted with results localized to Southampton and Rochester where academic and hospital-affiliated webpages predominantly featured. Government-funded department of health websites did not feature in the top five results for Dublin searches “allergy testing”, “food allergy” or “food intolerance” in either 2015 or 2019.

Conclusions:

The Irish public demonstrates a keen interest in seeking out allergy-related information online. The proportion of evidence-based websites encountered by the Irish public is considerably lower than that encountered by patients in other urban centres. Factors contributing to this are the lack of a specialist register for allergy in Ireland, inadequate funding for allergy centres currently in operation, and insufficient promotion by the health service of their online health database, which contains useful patient-oriented information on allergy. Increased funding of clinical allergology services will fail to meaningfully impact the health of patients unless there is parallel investment by the health service in ICT consultancy to amplify their online presence.