Please use this identifier to cite or link to this item:
Appears in Collections:Computing Science and Mathematics Journal Articles
Peer Review Status: Refereed
Title: Integrating Smart Health in the US Health Care System: Infodemiology Study of Asthma Monitoring in the Google Era
Author(s): Mavragani, Amaryllis
Sampri, Alexia
Sypsa, Karla
Tsagarakis, Konstantinos P
Keywords: asthma
big data
Google trends
health care
health informatics
internet behavior
online behavior
smart health
Issue Date: Mar-2018
Citation: Mavragani A, Sampri A, Sypsa K & Tsagarakis KP (2018) Integrating Smart Health in the US Health Care System: Infodemiology Study of Asthma Monitoring in the Google Era. JMIR Public Health and Surveillance, 4 (1), Art. No.: e24.
Abstract: Background: With the internet’s penetration and use constantly expanding, this vast amount of information can be employed in order to better assess issues in the US health care system. Google Trends, a popular tool in big data analytics, has been widely used in the past to examine interest in various medical and health-related topics and has shown great potential in forecastings, predictions, and nowcastings. As empirical relationships between online queries and human behavior have been shown to exist, a new opportunity to explore the behavior toward asthma—a common respiratory disease—is present. Objective: This study aimed at forecasting the online behavior toward asthma and examined the correlations between queries and reported cases in order to explore the possibility of nowcasting asthma prevalence in the United States using online search traffic data. Methods: Applying Holt-Winters exponential smoothing to Google Trends time series from 2004 to 2015 for the term “asthma,” forecasts for online queries at state and national levels are estimated from 2016 to 2020 and validated against available Google query data from January 2016 to June 2017. Correlations among yearly Google queries and between Google queries and reported asthma cases are examined. Results: Our analysis shows that search queries exhibit seasonality within each year and the relationships between each 2 years’ queries are statistically significant (P < .05). Estimated forecasting models for a 5-year period (2016 through 2020) for Google queries are robust and validated against available data from January 2016 to June 2017. Significant correlations were found between (1) online queries and National Health Interview Survey lifetime asthma (r=–.82, P=.001) and current asthma (r=–.77, P=.004) rates from 2004 to 2015 and (2) between online queries and Behavioral Risk Factor Surveillance System lifetime (r=–.78, P=.003) and current asthma (r=–.79, P=.002) rates from 2004 to 2014. The correlations are negative, but lag analysis to identify the period of response cannot be employed until short-interval data on asthma prevalence are made available. Conclusions: Online behavior toward asthma can be accurately predicted, and significant correlations between online queries and reported cases exist. This method of forecasting Google queries can be used by health care officials to nowcast asthma prevalence by city, state, or nationally, subject to future availability of daily, weekly, or monthly data on reported cases. This method could therefore be used for improved monitoring and assessment of the needs surrounding the current population of patients with asthma.
DOI Link: 10.2196/publichealth.8726
Rights: ©Amaryllis Mavragani, Alexia Sampri, Karla Sypsa, Konstantinos P Tsagarakis. Originally published in JMIR Public Health and Surveillance (, 12.03.2018. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Public Health and Surveillance, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.
Licence URL(s):

Files in This Item:
File Description SizeFormat 
Integrating Smart Health in the US Health Care System.pdfFulltext - Published Version2.05 MBAdobe PDFView/Open

This item is protected by original copyright

A file in this item is licensed under a Creative Commons License Creative Commons

Items in the Repository are protected by copyright, with all rights reserved, unless otherwise indicated.

If you believe that any material held in STORRE infringes copyright, please contact providing details and we will remove the Work from public display in STORRE and investigate your claim.