BACKGROUND: Vaccine hesitancy is a growing global health threat that is increasingly studied through the monitoring and analysis of social media platforms. One understudied area is the impact of echo chambers and influential users on disseminating vaccine information in social networks. Assessing the temporal development of echo chambers and the influence of key users on their growth provides valuable insights into effective communication strategies to prevent increases in vaccine hesitancy. This also aligns with the World Health Organization\'s (WHO) infodemiology research agenda, which aims to propose new methods for social listening.
OBJECTIVE: Using data from a Taiwanese forum, this study aims to examine how engagement patterns of influential users, both within and across different COVID-19 stances, contribute to the formation of echo chambers over time.
METHODS: Data for this study come from a Taiwanese forum called PTT. All vaccine-related posts on the \"Gossiping\" subforum were scraped from January 2021 to December 2022 using the keyword \"vaccine.\" A multilayer network model was constructed to assess the existence of echo chambers. Each layer represents either provaccination, vaccine hesitant, or antivaccination posts based on specific criteria. Layer-level metrics, such as average diversity and Spearman rank correlations, were used to measure chambering. To understand the behavior of influential users-or key nodes-in the network, the activity of high-diversity and hardliner nodes was analyzed.
RESULTS: Overall, the provaccination and antivaccination layers are strongly polarized. This trend is temporal and becomes more apparent after November 2021. Diverse nodes primarily participate in discussions related to provaccination topics, both receiving comments and contributing to them. Interactions with the antivaccination layer are comparatively minimal, likely due to its smaller size, suggesting that the forum is a \"healthy community.\" Overall, diverse nodes exhibit cross-cutting engagement. By contrast, hardliners in the vaccine hesitant and antivaccination layers are more active in commenting within their own communities. This trend is temporal, showing an increase during the Omicron outbreak. Hardliner activity potentially reinforces their stances over time. Thus, there are opposing forces of chambering and cross-cutting.
CONCLUSIONS: Efforts should be made to moderate hardliner and influential nodes in the antivaccination layer and to support provaccination users engaged in cross-cutting exchanges. There are several limitations to this study. One is the bias of the platform used, and another is the lack of a comprehensive definition of \"influence.\" To address these issues, comparative studies across different platforms can be conducted, and various metrics of influence should be explored. Additionally, examining the impact of influential users on network structure and chambering through network simulations and regression analysis provides more robust insights. The study also lacks an explanation for the reasons behind chambering trends. Conducting content analysis can help to understand the nature of engagement and inform interventions to address echo chambers. These approaches align with and further the WHO infodemic research agenda.

The purpose of this observational study was to evaluate the potential epidemiological trend of arboviral diseases most reported in Italy by the dedicated national surveillance system (ISS data) compared to searches on the internet, assessing whether a correlation/association between users\' searches in Google and Wikipedia and real cases exists. The study considers a time interval from June 2012 to December 2023. We used the following Italian search terms: \"Virus Toscana\", \"Virus del Nilo occidentale\" (West Nile Virus in English), \"Encefalite trasmessa da zecche\" (Tick Borne encephalitis in English), and \"Dengue\". We overlapped Google Trends and Wikipedia data to perform a linear regression and correlation analysis. Statistical analyses were performed using Pearson\'s correlation coefficient (r) or Spearman\'s rank correlation coefficient (rho) as appropriate. All the correlations between the ISS data and Wikipedia or GT exhibited statistical significance. The correlations were strong for Dengue GT and ISS (rho = 0.71) and TBE GT and ISS (rho = 0.71), while the remaining correlations had values of r and rho between 0.32 and 0.67, showing a moderate temporal correlation. The observed correlations and regression models provide a foundation for future research, encouraging a more nuanced exploration of the dynamics between digital information-seeking behavior and disease prevalence.

The exponential increase in internet use and the consequent surge in data generation present both opportunities and challenges for public health. Infodemiology, an emerging field at the intersection of information science and public health, seeks to harness the vast amounts of health-related data generated online for public health benefits. This paper provides a comprehensive overview of infodemiology, examining its development, methodologies, and potential to address public health challenges. We discuss the role of infodemiology in identifying and mitigating the spread of misinformation, especially in the context of the COVID-19 pandemic, which underscored the dangers of the \"infodemic\" - an overabundance of information, both accurate and not, that complicates public health responses. Through both demand and supply-based studies, infodemiology offers unique insights into health trends, misinformation dynamics, and the digital behaviors of health information seekers. Tools such as sentiment analysis are highlighted as essential in navigating the vast digital landscape for real-time health data analysis. Despite the potential of infodemiology, challenges such as data overload or misinformation. The paper concludes by emphasizing the importance of interdisciplinary collaboration, the development of advanced analytical tools, and the need for guidelines to maximize the field\'s impact on public health policy and practice.
Wykładniczy wzrost używania internetu oraz wynikający z tego wzrost ilości generowanych danych stwarza zarówno szanse, jak i wyzwania dla zdrowia publicznego. Infodemiologia, niedawno powstała dziedzina, pojawia się na przecięciu nauki związanych z informacją i zdrowia publicznego. Dąży do wykorzystania ogromnych ilości danych zdrowotnych generowanych w internecie na korzyść zdrowia publicznego. Niniejszy artykuł dostarcza kompleksowy przegląd infodemiologii, badając jej rozwój, metodologie oraz potencjał w adresowaniu wyzwań zdrowia publicznego. Omówiona zostaje rola infodemiologii w identyfikowaniu i zapobieganiu rozprzestrzeniania się dezinformacji, szczególnie w kontekście pandemii COVID-19, która podkreśliła niebezpieczeństwa \"infodemii\" - nadmiaru informacji, zarówno prawdziwych, jak i fałszywych, utrudniających działania zdrowia publicznego. Poprzez badania oparte na popycie i podaży, infodemiologia oferuje unikalną perspektywę na trendy w zdrowiu, dynamikę dezinformacji oraz cyfrowe zachowania osób szukających informacji zdrowotnych. Narzędzia takie jak analiza sentymentu są wskazane jako istotne dla analizy danych zdrowotnych w czasie rzeczywistym. Pomimo potencjału infodemiologii, omówione są wyzwania takie jak przeciążenie danymi, czy dezinformacja. Artykuł kończy się podkreśleniem znaczenia interdyscyplinarnej współpracy, rozwoju zaawansowanych narzędzi analitycznych oraz potrzeby wytycznych, aby maksymalizować wpływ tej dziedziny na politykę i praktykę zdrowia publicznego.

UNASSIGNED: In den letzten Jahren ist eine Zunahme von Hauttumoren zu verzeichnen. Ziel dieser Studie war es daher, die Repräsentation von Hautkrebs im öffentlichen Bewusstsein weltweit und in Deutschland zu untersuchen und festzustellen, ob der Skin Cancer Awareness Month in den Suchinteressen der internetnutzenden Bevölkerung in gleicher Weise wie der Breast Cancer Awareness Month weltweit repräsentiert ist.
UNASSIGNED: In dieser Studie wurden die Daten von Google Trends verwendet, um den Grad der öffentlichen Aufmerksamkeit für verschiedene Tumorentitäten und Hautkrebsarten weltweit und in Deutschland zu ermitteln.
UNASSIGNED: Die Ergebnisse dieser Analyse zeigten deutlich ein hohes Niveau für das relative öffentliche Suchinteresse am Thema Brustkrebs weltweit im Sensibilisierungsmonat Oktober. Weltweit und in Deutschland war ein gewisser Anstieg des Suchinteresses beziehungsweise ein gewisser saisonaler Effekt um den Sensibilisierungsmonat Mai für Hautkrebs festzustellen. So zeigte die Analyse beispielsweise ein Suchinteresse im Mai und während der Sommermonate in Deutschland.
UNASSIGNED: Es ist wahrscheinlich, dass die Bevölkerung, zum Beispiel in Deutschland, weiterhin von einer noch stärkeren Betonung des Themas Hautkrebs profitieren könnte.

OBJECTIVE: In recent years, there has been an increase in skin cancer. The aim of this study was therefore to investigate the representation of skin cancer in public awareness worldwide and in Germany, and to determine whether Skin Cancer Awareness Month is represented in the search interests of the Internet-using population in the same way as Breast Cancer Awareness Month worldwide.
METHODS: In this study, Google Trends data were used to track levels of public awareness for different tumor entities and skin cancer types worldwide and for Germany.
RESULTS: The results of this analysis clearly showed a high level of relative public search interest in breast cancer worldwide in the awareness month of October. Worldwide and in Germany, there was a certain increase in search interest and a certain seasonal effect around the May awareness month for skin cancer. For example, the analysis showed a search interest in May and during the summer months in Germany.
CONCLUSIONS: It is likely that the population, for example in Germany, may benefit further from an even greater emphasis on the topic of skin cancer.

BACKGROUND: Although researchers extensively study the rapid generation and spread of misinformation about the novel coronavirus during the pandemic, numerous other health-related topics are contaminating the internet with misinformation that have not received as much attention.
OBJECTIVE: This study aims to gauge the reach of the most popular medical content on the World Wide Web, extending beyond the confines of the pandemic. We conducted evaluations of subject matter and credibility for the years 2021 and 2022, following the principles of evidence-based medicine with assessments performed by experienced clinicians.
METHODS: We used 274 keywords to conduct web page searches through the BuzzSumo Enterprise Application. These keywords were chosen based on medical topics derived from surveys administered to medical practitioners. The search parameters were confined to 2 distinct date ranges: (1) January 1, 2021, to December 31, 2021; (2) January 1, 2022, to December 31, 2022. Our searches were specifically limited to web pages in the Polish language and filtered by the specified date ranges. The analysis encompassed 161 web pages retrieved in 2021 and 105 retrieved in 2022. Each web page underwent scrutiny by a seasoned doctor to assess its credibility, aligning with evidence-based medicine standards. Furthermore, we gathered data on social media engagements associated with the web pages, considering platforms such as Facebook, Pinterest, Reddit, and Twitter.
RESULTS: In 2022, the prevalence of unreliable information related to COVID-19 saw a noteworthy decline compared to 2021. Specifically, the percentage of noncredible web pages discussing COVID-19 and general vaccinations decreased from 57% (43/76) to 24% (6/25) and 42% (10/25) to 30% (3/10), respectively. However, during the same period, there was a considerable uptick in the dissemination of untrustworthy content on social media pertaining to other medical topics. The percentage of noncredible web pages covering cholesterol, statins, and cardiology rose from 11% (3/28) to 26% (9/35) and from 18% (5/28) to 26% (6/23), respectively.
CONCLUSIONS: Efforts undertaken during the COVID-19 pandemic to curb the dissemination of misinformation seem to have yielded positive results. Nevertheless, our analysis suggests that these interventions need to be consistently implemented across both established and emerging medical subjects. It appears that as interest in the pandemic waned, other topics gained prominence, essentially \"filling the vacuum\" and necessitating ongoing measures to address misinformation across a broader spectrum of health-related subjects.

The Internet is an important gateway for accessing health-related information, and data generated through web queries have been increasingly used as a complementary source for monitoring and forecasting of infectious diseases and they may partially address the issue of underreporting. In this study, we assessed whether tick-borne encephalitis (TBE)-related Internet search volume may be useful as a complementary tool for TBE surveillance in Italy. Monthly Google Trends (GT) data for TBE-related information were extracted for the period between January 2017 and September 2022, corresponding to the available time series of TBE notifications in Italy. Time series modeling was performed by applying seasonal autoregressive integrated moving average (SARIMA) models with or without GT data. The search terms relative to tick bites reflected best the observed temporal distribution of TBE cases, showing a correlation coefficient of 0.81 (95 % CI: 0.71-0.88). Particularly, both the reported number of TBE cases and GT searches occurred mainly during the summer. The peak of disease notifications coincided with that of Google searches in 4 of 6 years. Once calibrated, SARIMA models with or without GT data were applied to a validation set. Retrospective forecast made by the model with GT data was associated with a lower prediction error and accurately predicted the peak timing. By contrast, the traditional SARIMA model underestimated the actual number of TBE notifications by 65 %. Timeliness, easy availability, low cost and transparency make monitoring of the TBE-related Internet search queries a promising addition to the traditional methods of TBE surveillance in Italy.

Despite challenges related to the data quality, representativeness, and accuracy of artificial intelligence-driven tools, commercially available social listening platforms have many of the attributes needed to be used for digital public health surveillance of human papillomavirus vaccination misinformation in the online ecosystem.

Contagious exanthematous diseases are becoming a major public health problem. The purpose of this study was to evaluate the potential epidemiological trend of four infectious exanthematous diseases in Italy through the searches on the internet.
We used the following Italian search term: \'Sesta malattia\' (Sixth Disease, in English), \'Eritema Infettivo\' (also knows \'Quinta malattia\' in Italian; Fifth Disease in English), \'Quarta malattia\' (Fourth Disease in English) and \'Scarlattina\' (Scarlet fever in English). We overlapped Google Trends and Wikipedia data to perform a linear regression and correlation analysis. Statistical analyses were performed using the Spearman\'s rank correlation coefficient (rho). The study period is between July 2015 and December 2022.
The diseases considered have a seasonal trend and the search peaks between GT and Wikipedia overlap. A temporal correlation was observed between GT and Wikipedia search trends. Google Trends Internet search data showed strong correlation with Wikipedia with a rho statistically significant for Fifth disease (rho = 0.78), Fourth disease (rho = 0.76) and Scarlet-fever (rho = 0.77), moderate correlation for Sixth disease (rho = 0.32).
Infectious disease searches using Google and Wikipedia can be useful for public health surveillance and help policy makers implement prevention and information programs for the population, in addition to the fact that increases in searches could represent an early warning in the detection of outbreaks.

BACKGROUND: Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease affecting various organs with a wide range of clinical manifestations. Cutaneous lupus erythematosus (CLE) can manifest as a feature of SLE or an independent skin ailment. Health-related quality of life (HRQoL) is frequently compromised in individuals living with lupus. Understanding patients\' perspectives when living with a disease is crucial for effectively meeting their unmet needs. Social listening is a promising new method that can provide insights into the experiences of patients living with their disease (lupus) and leverage these insights to inform drug development strategies for addressing their unmet needs.
OBJECTIVE: The objective of this study is to explore the experience of patients living with SLE and CLE, including their disease and treatment experiences, HRQoL, and unmet needs, as discussed in web-based social media platforms such as blogs and forums.
METHODS: A retrospective exploratory social listening study was conducted across 13 publicly available English-language social media platforms from October 2019 to January 2022. Data were processed using natural language processing and knowledge graph tagging technology to clean, format, anonymize, and annotate them algorithmically before feeding them to Pharos, a Semalytix proprietary data visualization and analysis platform, for further analysis. Pharos was used to generate descriptive data statistics, providing insights into the magnitude of individual patient experience variables, their differences in the magnitude of variables, and the associations between algorithmically tagged variables.
RESULTS: A total of 45,554 posts from 3834 individuals who were algorithmically identified as patients with lupus were included in this study. Among them, 1925 (authoring 5636 posts) and 106 (authoring 243 posts) patients were identified as having SLE and CLE, respectively. Patients frequently mentioned various symptoms in relation to SLE and CLE including pain, fatigue, and rashes; pain and fatigue were identified as the main drivers of HRQoL impairment. The most affected aspects of HRQoL included \"mobility,\" \"cognitive capabilities,\" \"recreation and leisure,\" and \"sleep and rest.\" Existing pharmacological interventions poorly managed the most burdensome symptoms of lupus. Conversely, nonpharmacological treatments, such as exercise and meditation, were frequently associated with HRQoL improvement.
CONCLUSIONS: Patients with lupus reported a complex interplay of symptoms and HRQoL aspects that negatively influenced one another. This study demonstrates that social listening is an effective method to gather insights into patients\' experiences, preferences, and unmet needs, which can be considered during the drug development process to develop effective therapies and improve disease management.