Online Health Searches Research Articles

Exploring the association between cyberchondria and attention to negative information

Abstract Objectives This study aimed to preliminarily evaluate the relationship between cyberchondria and attention to negative information. Methods The data utilized for this analysis was obtained from a cross-sectional and web-based survey conducted in China between March and April, 2024. All participants were recruited from an online panel belonging to a survey company. Cyberchondria was assessed using the Chinese version of the Cyberchondria Severity Scale - 12 item (CSS-12). Attention to negative information was measured using the negative subscale of the Attention to Positive and Negative Information Scale (APNIS). A multivariable linear regression model was employed to evaluate the relationship between cyberchondria and attention to negative information. Results Out of 344 participants, 315 (91.6% response rate) completed the questionnaire and provided valid responses. Approximately 51.7% (n = 163) were female, 83.8% (n = 264) had completed tertiary or higher education, and 52.7% (n = 166) were urban residents. The average age was 32.6 years (SD = 6.0). The mean score for CSS-12 was 40.6 (SD = 7.8, range: 18-59). The mean scores for the different dimensions of the CSS-12 were: excessiveness, 10.6 (SD = 2.4); distress, 10.3 (SD = 2.7); reassurance, 10.6 (SD = 2.5); and compulsion, 9.1 (SD = 2.7). The mean score for the negative subscale of APNIS was 31.9 (SD = 8.6, range = 12-52). Multivariable linear regression models revealed a statistically significant relationship between cyberchondria and attention to negative information (beta = 0.42, p < 0.001), after adjusting for background characteristics. Conclusions Our findings showed individuals with a higher level of cyberchondria tend to pay more attention to negative information. Therefore, it’s beneficial to develop strategies and interventions that provide accurate, balanced online health information and educate individuals about the risks of excessive online health searches. Key messages • Our findings showed individuals with a higher level of cyberchondria tend to pay more attention to negative information. • It is beneficial to develop strategies and interventions that provide accurate, balanced online health information.

Association between Health Anxiety, Smartphone Addiction, and Cyberchondria

Introduction: Online health information seeking is one of the single most popular platforms in which people gather health-related information. Many sources provide ambiguous and unauthorized health information, which is part of the digital era. Cyberchondria refers to prolonged and repetitive online health searches and negative emotional and physiological responses that occur due to online searches. Health anxiety due to COVID-19 also contributed to online health information seeking. This current study assesses the association between health anxiety and smartphone use with cyberchondria among young adults. Methods: The study sample consisted of 356 individuals aged 18–25 years. We used an online survey for study participants with the Cyberchondria severity scale-12 (CSS-12), Health Anxiety Questionnaire, and the Smartphone Addiction Scale-Short Version. Results: The mean age of participants was 22 years (standard deviation: 2.13). Sixty-two percent of participants used the information obtained by the online platform to diagnose themselves. Excessiveness was more among all other subscales of cyberchondria. The results of linear regression analysis indicated that health anxiety (P < 0.001) and smartphone addiction (P < 0.001) significantly contributed to cyberchondria. Conclusion: This study shows the association between health anxiety and smartphone addiction with cyberchondria. This finding implies the need for a community-level conscientization on cyberchondria. There is a need to carry out promotional and preventive programs regarding the health usage of technology.

Refining the online health information searcher typology: Applying the patient health engagement model.

Despite numerous quantitative findings on online health information seeking, little is known about the process of online health information seeking itself. The study aimed to learn about how adults search for health information online, whether Macias et al.'s Online Health Searcher Typology applies to a broader, non-university sample, and to better identify and understand online health searchers by employing the Patient Health Engagement (PHE) model. This study examined the role of engagement in online health information search processes using think-aloud qualitative interviews with 11 participants in their 30s to 70s. The research applied both thematic analysis and a quantitative coding scheme based on the PHE model to analyse the qualitative data that consists of 500 pages of think-aloud verbatim transcripts. This study found that four (flounderer, skimmer, digester and devourer) out of five types emerged as distinct search styles. Insights into engagement helped distinguish online health searcher types in this sample. The dynamics of the engagement dimension indicate that the online health information search process is multi-dimensional. It is comprised of different levels of cognitive, emotional, and conative responses, further extending the PHE model. Health science librarians and health professionals have a unique opportunity to help individuals better navigate online health search.

Keeping Dr. Google under control: how to prevent and manage cyberchondria.

Keeping Dr. Google under control: how to prevent and manage cyberchondria.

Online Health Search Via Multidimensional Information Quality Assessment Based on Deep Language Models: Algorithm Development and Validation.

Widespread misinformation in web resources can lead to serious implications for individuals seeking health advice. Despite that, information retrieval models are often focused only on the query-document relevance dimension to rank results. We investigate a multidimensional information quality retrieval model based on deep learning to enhance the effectiveness of online health care information search results. In this study, we simulated online health information search scenarios with a topic set of 32 different health-related inquiries and a corpus containing 1 billion web documents from the April 2019 snapshot of Common Crawl. Using state-of-the-art pretrained language models, we assessed the quality of the retrieved documents according to their usefulness, supportiveness, and credibility dimensions for a given search query on 6030 human-annotated, query-document pairs. We evaluated this approach using transfer learning and more specific domain adaptation techniques. In the transfer learning setting, the usefulness model provided the largest distinction between help- and harm-compatible documents, with a difference of +5.6%, leading to a majority of helpful documents in the top 10 retrieved. The supportiveness model achieved the best harm compatibility (+2.4%), while the combination of usefulness, supportiveness, and credibility models achieved the largest distinction between help- and harm-compatibility on helpful topics (+16.9%). In the domain adaptation setting, the linear combination of different models showed robust performance, with help-harm compatibility above +4.4% for all dimensions and going as high as +6.8%. These results suggest that integrating automatic ranking models created for specific information quality dimensions can increase the effectiveness of health-related information retrieval. Thus, our approach could be used to enhance searches made by individuals seeking online health information.

How online searches fuel health anxiety: Investigating the link between health-related searches, health anxiety, and future intention

The Digital revolution has changed the way in which health information is accessed. While some people feel empowered and less anxious after online searches, others are more anxious or puzzled, which may affect their health-related behaviors. By taking into account health anxiety, this paper examines the processes by which people transition from online health searches to the pursuit of healthcare assistance. Based on Stimulus Organism Response (S–O-R) framework, a research model was developed to illustrate the psychological mechanisms of how searching experience shapes users' healthcare behavior. Using partial least squares-structural equation modeling (PLS-SEM) approach, the results support that the online searches trigger different features of health anxiety, which in turn reinforce further healthcare utilization intention. Results also show that response efficacy positively moderates the relationship between perceived illness likelihood and healthcare utilization intentions, while self-efficacy positively moderates the relationship between perceived illness likelihood and further search intention. Three major recommendations are suggested. Information seekers should rely less on internet searches to alleviate anxiety, and become more aware of, self-monitor, and reduce excessive online health searching. Different stakeholders should orient people to high-quality sources. Healthcare practitioners should engage in improving patient-centered information skills and patients’ health information literacy.

A theoretical model of cyberchondria development: Antecedents and intermediate processes

Cyberchondria describes excessive online health searches associated with increased emotional distress. While previous research has examined various antecedents of cyberchondria, how regular online health information seeking (OHIS) turns into cyberchondria has received minimal theoretical attention. This study proposes a theoretical model that illuminates the processes of cyberchondria development among individuals who are anxious about their health. Results from an online survey of 426 Chinese Internet users lend support to the proposed theoretical model, which posits perceived health threat of common symptoms as a trigger of health anxiety that motivates OHIS through the perception of information insufficiency. In this process, positive source beliefs strengthen the effect of information insufficiency on OHIS. This study further identifies negative metacognitive beliefs as a boundary condition for how regular OHIS results in cyberchondria. By conceptualizing the processes of cyberchondria development, this integrative model provides guidance for future theory development and testing in this new research area.

A preliminary investigation of Cyberchondria and its correlates in a clinical sample of patients with obsessive–compulsive disorder, anxiety and depressive disorders attending a tertiary psychiatric clinic

Objectives. This cross-sectional study aimed to investigate the frequency and presentation of cyberchondria (CYB) in patients with obsessive–compulsive disorder (OCD), anxiety disorders (ADs), and major depression disorder (MDD). Methods. Seventy-seven patients (OCD:25, ADs:26, MDD:26) referred to a tertiary psychiatry outpatient clinic and 27 healthy controls (HCs) were included. A ‘working’ definition of CYB was used to measure CYB frequency. CYB severity was measured with the Cyberchondria Severity Scale (CSS). Results. CYB as currently defined was present in just 1.3% of the combined patients’ sample. Using a broader definition (omitting the disability criterion), we found a higher distribution (OCD:12%, ADs:19.2%, MDD:15.4%, HCs:3.7%) and greater CYB symptom severity. Patients with OCD (63.3 ± 18.9) and ADs (63.3 ± 25.9) showed a higher CYB severity, compared with HCs (48.4 ± 9.9, p<.05). In the combined patients’ sample, a positive correlation was found between the CSS scores and measures of health anxiety or hypochondriasis. Higher CYB symptom severity emerged in patients with a positive family history of psychiatric disorders and in those prescribed benzodiazepines or mood-stabilisers. Conclusion. CYB represents a common transdiagnostic syndrome in patients with OCD, ADs, and MDD with a spectrum of severity and indicates a variable burden of illness, supporting the need for specific clinical considerations and interventions. Key points Cyberchondria (CYB) represents a common transdiagnostic syndrome in patients with obsessive–compulsive disorder, anxiety, and depressive disorders. CYB’s frequency as a syndrome of compulsive online health searches associated with an increased anxiety and distress was reported in 10–20% patients. Health anxiety/hypochondriasis showed a strong correlation with CYB. Patients with a positive family history of psychiatric disorders and those prescribed benzodiazepines or mood-stabilisers showed higher CYB symptom severity. Considering the spread of Internet use for health-related information, additional studies investigating CYB in clinical samples are encouraged.

Cyberchondria in the time of the COVID ‐19 pandemic

Cyberchondria is an excessive or repeated online health information seeking that is associated with increasing levels of health anxiety or distress. This article presents a model of cyberchondria during public health crises such as the COVID‐19 pandemic. The factors that contribute to cyberchondria at this time include (a) a heightened perception of threat and fear of a newly identified and poorly understood disease; (b) difficulty in coping with uncertainty associated with the pandemic; (c) lack of authoritative and trustworthy sources of relevant health information; (d) difficulty in coping with abundance of information that is often confusing, conflicting, unverified and constantly updated, along with a decreased ability to filter out unnecessary information; and (e) inability of excessive online health information seeking to provide the necessary information and deliver reassurance. These factors amplify fear and distress, which increases the perception of threat and uncertainty and perpetuates further online health searches. Cyberchondria has significant public health implications because of the associated distress or functional impairment and effects on health behaviors. Cyberchondria should be addressed by targeting a heightened perception of threat, improving management of uncertainty and online health information and promoting an ability to critically appraise the results of online health searches. This should contribute to a better online health information literacy. The model of cyberchondria during the COVID‐19 pandemic explains the hypothesized rise in cyberchondria during public health emergencies and helps to formulate a framework for prevention of cyberchondria and its effective management.

Health Searching Behaviour of Citizens From Countries in the Middle East and North African Region

Most research studies in health information searching behaviour are conducted in developed countries. Little is known with strong governmental support in healthcare initiatives it is interesting to take note of the general information searching practices of citizens in the Middle East and North African region. In this article, a questionnaire was distributed in a university setting in the United Arab Emirates. Sixty participants consisting of citizens from MENA countries participated in this study. The results indicate citizens from the Middle East and North African region do perform online health searches. However, an equal number of citizens use books and mass media to obtain health information. When online methods are utilised, working adults who have more years of experience searching for health information tend to use more medical type search engines. Undergraduate students were generally new to the process of online health information searching. Online health searching in the MENA region is more of a social and educational activity rather than a private activity.

The Cyberchondria Severity Scale (CSS): Validity and Reliability Study of the Turkish Version

Objective: Even though the internet is a valuable resource for medical information, it has the potential to increase anxiety, fear or obsessive-compulsive behaviours, particularly among individuals more prone to health related anxiety. Researchers have found that health anxiety, hypochondria, and online health searches are associated with increased anxious symptomatology. The aim of this study is to investigate the psychometric properties of the Turkish version of the Cyberchondria Severity Scale, a measure of online health anxiety. Method: Three hundred thirty-seven university students with an age range of 16-55 were included in the study. The Cyberchondria Severity Scale (CSS), Internet Addiction Test (IAT), Anxiety Sensitivity Inventory-3 (ASI-3), and Health Anxiety Inventory (HAI) were administered to participants. Results: Confirmatory factor analysis revealed that five-factor solution best fit to the data. The overall and subscales of the CSS had excellent internal consistency (Cronbach α = 0.91, for the overall measure, and Cronbach α values ranged from 0.78 to 0.87), with an exception of ‘mistruct of medical professional’ subscale (Cronbach α = 0.64). The total and subscales of the CSS had generally good convergent validity. Conclusion: The CSS is a newly developed screening tool to assess online health anxiety, and present study demonstrated that the Turkish version of the scale had promising psychometric properties.

Online Health Search Experience: Sentiments from South East Asia

Performing an online health search is a popular activity conducted on the Internet. Research studies from developed countries provide information on source used, type of search performed and devices used to perform the search. However, the same cannot be said about the online health information searching scene in South East Asia. Online health information searching is gaining popularity in South East Asia. Citizens in these countries are turning to the Internet to obtain health information quickly. Current research studies pertaining to online health information searching in South East Asian is limited, particularly relating to search experiences of South East Asian health searchers. Search experience is pertinent as it could deter or encourage the possibility of conducting future health searches. In this research study, a user study was conducted to describe the online search experience of South East Asian health searchers. A face to face interview with 50 participants was conducted. The interview was audio recorded and transcribed verbatim. Results indicate participants have positive and negative search experiences. In some cases, post search outcomes influenced the search experience. Results of this research study contribute to the growing domain of knowledge in relation to online health information searching. Results of this study also provide an understanding pertaining to the search experience of South East Asian online health searchers.

Cyberchondria, cyberbullying, cybersuicide, cybersex: "new" psychopathologies for the 21st century?

Cyberchondria, cyberbullying, cybersuicide, cybersex: "new" psychopathologies for the 21st century?

Content Bias in Online Health Search

Search engines help people answer consequential questions. Biases in retrieved and indexed content (e.g., skew toward erroneous outcomes that represent deviations from reality), coupled with searchers' biases in how they examine and interpret search results, can lead people to incorrect answers. In this article, we seek to better understand biases in search and retrieval, and in particular those affecting the accuracy of content in search results, including the search engine index, features used for ranking, and the formulation of search queries. Focusing on the important domain of online health search, this research broadens previous work on biases in search to examine the role of search systems in contributing to biases. To assess bias, we focus on questions about medical interventions and employ reliable ground truth data from authoritative medical sources. In the course of our study, we utilize large-scale log analysis using data from a popular Web search engine, deep probes of result lists on that search engine, and crowdsourced human judgments of search result captions and landing pages. Our findings reveal bias in results, amplifying searchers' existing biases that appear evident in their search activity. We also highlight significant bias in indexed content and show that specific ranking signals and specific query terms support bias. Both of these can degrade result accuracy and increase skewness in search results. Our analysis has implications for bias mitigation strategies in online search systems, and we offer recommendations for search providers based on our findings.

Use of the internet as a health information resource among French young adults: results from a nationally representative survey.

BackgroundThe Internet is one of the main resources of health information especially for young adults, but website content is not always trustworthy or validated. Little is known about this specific population and the importance of online health searches for use and impact. It is fundamental to assess behaviors and attitudes of young people looking for online health-related information and their level of trust in such information.ObjectiveThe objective is to describe the characteristics of Internet users aged 15-30 years who use the Web as a health information resource and their trust in it, and to define the context and the effect of such use on French young adults’ behavior in relation to their medical consultations.MethodsWe used the French Health Barometer 2010, a nationally representative survey of 27,653 individuals that investigates population health behaviors and concerns. Multivariate logistic regressions were performed using a subsample of 1052 young adults aged 15-30 years to estimate associations between demographics, socioeconomic, and health status and (1) the use of the Internet to search for health information, and (2) its impact on health behaviors and the physician-patient relationship.ResultsIn 2010, 48.5% (474/977) of Web users aged 15-30 years used the Internet for health purposes. Those who did not use the Internet for health purposes reported being informed enough by other sources (75.0%, 377/503), stated they preferred seeing a doctor (74.1%, 373/503) or did not trust the information on the Internet (67.2%, 338/503). However, approximately 80% (371/474) of young online health seekers considered the information found online reliable. Women (P<.001) and people with higher sociocultural positions (OR 0.5, 95% CI 0.3-0.9 and OR 0.4, 95% CI 0.2-0.7 for employees and manual workers, respectively, vs individuals with executive or manager positions) were more likely to use the Internet for health purposes. For a subsample of women only, online health seeking was more likely among those having a child (OR 1.8, 95% CI 1.1-2.7) and experiencing psychological distress (OR 2.0, 95% CI 1.0-4.0). Finally, for online health seekers aged 15-30 years, one-third (33.3%, 157/474) reported they changed their health behaviors (eg, frequency of medical consultations, way of taking care of one’s own health) because of their online searches. Different factors were associated with different outcomes of change, but psychological distress, poor quality of life, and low income were the most common.ConclusionsThe Internet is a useful tool to spread health information and prevention campaigns, especially to target young adults. Young adults trust online information and consider the Internet as a valid source of health advice. Health agencies should ensure the improvement of online health information quality and the creation of health-related websites and programs dedicated to young adults.

Alzheimer’s Disease Dietary Supplements in Websites

Consumer demand for health information and health services has rapidly evolved to capture and even propel the movement to online health information seeking. Seventeen percent (52million) of health information internet users will look for information about memory loss, dementia and Alzheimer's disease (AD) (Fox Pew Internet & American life project: Online health search. Report. Pew Research Center. http://pewinternet.org/Reports/2006/Online-Health-Search-2006.aspx 2006, Pew Research Center. http://pewinternet.org/Reports/2011/HealthTopics.aspx 2011). We examined the content of the 25 most frequently retrieved websites marketing AD dietary supplements. We found that the majority of websites and their products claimed AD-related benefits, including improvement and enhancement of function, treatment for AD, prevention of AD, maintenance of function, delayed progression of AD, and decreased symptoms. Supplements were described as effective, natural, powerful or strong, dependable and pure or of high quality. Peer reviewed references to proper scientific studies were infrequent on websites. Statements highlighting the risks of dietary supplements were as common as statements mitigating or minimizing these risks. Different strategies were used to promote supplements such as popular appeals and testimonials. Further enforcement of relevant policy is needed and preparation of clinicians to deal with requests of patients and caregivers is indicated.

Can Online Consumers Contribute to Drug Knowledge? A Mixed-Methods Comparison of Consumer-Generated and Professionally Controlled Psychotropic Medication Information on the Internet

BackgroundOngoing initiatives to filter online health searches exclude consumer-generated content from search returns, though its inferiority compared with professionally controlled content is not demonstrated. The antidepressant escitalopram and the antipsychotic quetiapine have ranked over the last 5 years as top-selling agents in their respective drug classes. Both drugs have various off-label mental health and non–mental health uses, ranging from the relief of insomnia and migraines to the treatment of severe developmental disorders.ObjectiveOur objective was to describe the most frequently reported effects of escitalopram and quetiapine in online consumer reviews, to compare them with effects described in professionally controlled commercial health websites, and to gauge the usability of online consumer medication reviews.MethodsA stratified simple random sample of 960 consumer reviews was selected from all 6998 consumer reviews of the two drugs in 2 consumer-generated (www.askapatient.com and www.crazymeds.us) and 2 professionally controlled (www.webmd.com and www.revolutionhealth.com) health websites. Professional medication descriptions included all standard information on the medications from the latter 2 websites. All textual data were inductively coded for medication effects, and intercoder agreement was assessed. Chi-square was used to test for associations between consumer-reported effects and website origination.ResultsConsumers taking either escitalopram (n = 480) or quetiapine (n = 480) most frequently reported symptom improvement (30.4% or 146/480, 24.8% or 119/480) or symptom worsening (15.8% or 76/480, 10.2% or 49/480), changes in sleep (36% or 173/480, 60.6% or 291/480) and changes in weight and appetite (22.5% or 108/480, 30.8% or 148/480). More consumers posting reviews on consumer-generated rather than professionally controlled websites reported symptom worsening on quetiapine (17.3% or 38/220 versus 5% or 11/220, P < .001), while more consumers posting on professionally controlled websites reported symptom improvement (32.7% or 72/220 versus 21.4% or 47/220, P = .008). Professional descriptions more frequently listed physical adverse effects and warnings about suicidal ideation while consumer reviews emphasized effects disrupting daily routines and provided richer descriptions of effects in context. The most recent 20 consumer reviews on each drug from each website (n = 80) were comparable to the full sample of reviews in the frequency of commonly reported effects.ConclusionConsumer reviews and professional medication descriptions generally reported similar effects of two psychotropic medications but differed in their descriptions and in frequency of reporting. Professional medication descriptions offer the advantage of a concise yet comprehensive listing of drug effects, while consumer reviews offer greater context and situational examples of how effects may manifest in various combinations and to varying degrees. The dispersion of consumer reviews across websites limits their integration, but a brief browsing strategy on the two target medications nonetheless retrieved representative consumer content. Current strategies for filtering online health searches to return only trusted or approved websites may inappropriately address the challenge to identify quality health sources on the Internet because such strategies unduly limit access to an entire complementary source for health information.

The Outcomes of Anxiety, Confidence, and Self-efficacy With Internet Health Information Retrieval in Older Adults

Technology has a great impact on nursing practice. With the increasing numbers of older Americans using computers and the Internet in recent years, nurses have the capability to deliver effective and efficient health education to their patients and the community. Based on the theoretical framework of Bandura's self-efficacy theory, the pilot project reported findings from a 5-week computer course on Internet health searches in older adults, 65 years or older, at a senior activity learning center. Twelve participants were recruited and randomized to either the intervention or the control group. Measures of computer anxiety, computer confidence, and computer self-efficacy scores were analyzed at baseline, at the end of the program, and 6 weeks after the completion of the program. Analysis was conducted with repeated-measures analysis of variance. Findings showed participants who attended a structured computer course on Internet health information retrieval reported lowered anxiety and increased confidence and self-efficacy at the end of the 5-week program and 6 weeks after the completion of the program as compared with participants who were not in the program. The study demonstrated that a computer course can help reduce anxiety and increase confidence and self-efficacy in online health searches in older adults.

Search Your Way to an Accurate Diagnosis: Predictors of Internet-Based Diagnosis Accuracy

Many people search online for health information and make self-diagnoses. However, little is known about factors affecting whether a person is able to make an accurate Internet-based diagnosis. An online survey (N = 209) was conducted to explore the predictors of Internet-based diagnosis accuracy. A multiple regression analysis showed that approximately 22% of the variance of diagnosis accuracy was accounted for by the linear combination of health-information orientation, eHealth literacy, prior knowledge, and Internet search time. However, only prior knowledge and search time were significant predictors of diagnosis accuracy, with prior knowledge positively and search time negatively related to diagnosis accuracy. A paired t test indicated that participants' diagnosis accuracy increased after the Internet search. This study implies that simply searching all over the Internet for a long time may not produce accurate diagnoses. Online health searches can be beneficial supplements, but they should not replace the expertise of a physician.

Using the Internet and Email for Health Purposes: The Impact of Health Status*

Objective. Increasingly, people use the Internet and email for health purposes; however, we know little about whether this varies by health status. This study examines whether sick or healthy people are more likely to access the Internet, conduct online health searches, and exchange emails regarding health issues.Methods. We conduct multivariate analysis on a random sample of 2,038 adults.Results. Despite greater Internet access, respondents in excellent/good health are less likely to say they conduct online health searches because they have no health concerns or are satisfied with other health sources. In contrast, sick and disabled respondents are more likely to seek medical information online, and do so more frequently. They are also more likely to exchange health emails with friends and physicians.Conclusions. Practitioners especially need to educate their sicker patients about the uneven quality of online health information since they are more likely than healthier patients to conduct online health searches.