Internet Source Quality Influences Psoriasis Management

Gabriela A. Cobos, MD

Credit: Tufts Medical Center

A recent investigation evaluated Google trends on systemic treatments for psoriasis, particularly the most frequently asked questions and the sources of information for each query, to better define the role of the Internet in dermatological care.¹

Commercial and government-based websites achieved high-quality scores for information on psoriasis, while academic and individual medical practice websites were less trafficked and of lower quality,¹ based on JAMA benchmark criteria.² Adalimumab revealed the highest search volume, primarily for its technical details and medication cost, rather than safety profile.¹

“Given that the internet has a tremendous impact on the dissemination and understanding of health-related information, dermatologists should consider tailoring their discussions when counseling patients on systemic medications for psoriasis,” wrote the investigative team, led by Gabriela A. Cobos, MD, department of dermatology, Tufts Medical Center.

Previous analyses have investigated the influence of Google on patients, particularly the search engine’s machine learning algorithm in answering frequently asked questions on medical topics.³ However, few studies have investigated these tools in the query of dermatological conditions.

For the current analysis, Cobos and colleagues explored the most frequently queried questions for the systemic treatment of psoriasis vulgaris, to assess the quality of online medical information. Using the Google Trends tool between January 2019 and January 2024, the relative search volume (RSV) of traditional disease-modifying antirheumatic drugs (DMARDs), biologics, and small-molecule inhibitors used to treat psoriasis.

Cobos and colleagues also used the People AlsoAsked (PAA) tool to show the most asked questions about the most searched medication in each therapeutic category. The quality of each information source was defined based on the benchmark criteria established by JAMA.

Upon analysis, adalimumab therapy showed the highest search volume among all queried medications (RSV = 1), followed by apremilast in the small molecule inhibitor category and methotrexate among DMARDS (RSV = 1).

Adalimumab demonstrated the most fact-based questions overall when compared with apremilast (46.3% vs. 33.6%; P = .04) and methotrexate (46.3% vs. 32.7%; P = .01), with most questions centered on technical details (24.5%) and cost (12.2%). Apremilast showed more cost-related questions than methotrexate (10.4% vs. 0.5%; P <.001), while methotrexate showed more questions about its risk versus adalimumab (40% vs. 23.8%; P = .002).

Cobos and colleagues noted these data on adalimumab indicate its superiority in public awareness, potentially due to direct-to-patient marketing. They pointed out that most inquiries centered on cost and objective details, rather than safety, reflecting trends in similar studies where individuals sought more factual information.

A total of 782 websites were classified, with most (46.3%) consisting of commercial sites, followed by social media platforms (24.4%), government-based sites (15.2%), academic sites (12.6%), and medical practice sites (1.5%).

Using the JAMA benchmark criteria, investigators scored the quality of each source, with commercial (3.1 of 4 points) and government sites (3.2 of 4 points) achieving the highest scores, compared with academic sites (2.3 of 4 points) and medical practice sites achieving the lowest (1.0 of 4 points) scores.

As most users were directed to commercial and government-based sites for psoriasis information, Cobos and colleagues indicated their reassurance about the quality of the source material. However, they noted further improvement is necessary for academic and medical practice sites, from both the practices and search engines.

“Enhancing the visibility and content quality of medical practice websites as determined by the JAMA benchmark criteria and optimizing search engine algorithms to prioritize higher-quality sources could improve patient access to reliable health information,” they wrote.

References

1. _{Lim S, Kooper-Johnson S, Chau CA, Chen C, Yang FC, Cobos G. Google search trends about systemic psoriasis treatment: what do people want to know about biologics and JAK inhibitors?. JMIR Dermatol. Published online September 7, 2024. doi:10.2196/62948}
2. _{Silberg WM, Lundberg GD, Musacchio RA. Assessing, controlling, and assuring the quality of medical information on the Internet: Caveant lector et viewor--Let the reader and viewer beware. JAMA. 1997;277(15):1244-1245.}
3. _{Yamaguchi S, Kimura S, Watanabe S, et al. Internet search analysis on the treatment of rheumatoid arthritis: What do people ask and read online?. PLoS One. 2023;18(9):e0285869. Published 2023 Sep 22. doi:10.1371/journal.pone.0285869}