Internet Source Quality May Influence Psoriasis Management

Gabriela A. Cobos, MD

Credit: Tufts Medical Center

A recent study evaluated Google’s trends in the systematic treatment of psoriasis, specifically the most frequently asked questions and the sources of information for each query, to define the role of the Internet in skin care.¹

Commercial and government-based websites achieved high quality scores for psoriasis information, while academic and private websites were of low quality.¹ based on JAMA criteria² Adalimumab revealed the highest search volume, primarily due to its technical details and cost of the drug, rather than its safety profile.¹

“Given that the Internet has a significant impact on the dissemination and understanding of health-related information, dermatologists should consider the appropriateness of their arguments when advising patients on systemic medications for psoriasis,” wrote the research team, led by Gabriela A. Cobos, MD, Department of Dermatology, Tufts Medical Center.

Previous analysis has examined the impact of Google on patients, especially the search engine algorithm of the search engine learning to answer the most frequently asked questions about medical topics.³ However, few studies have examined this tool in terms of asking skin conditions.

In the current analysis, Cobos and his colleagues explored the most frequently asked questions about the systemic treatment of psoriasis vulgaris, in order to evaluate the quality of online health information. Using the Google Trends tool between January 2019 and January 2024, the relative search volume (RSV) of traditional disease-modifying anti-rheumatic drugs (DMARDs), biologics, and small-molecule inhibitors used in the treatment of psoriasis.

Cobos and colleagues also used the People Also Asked (PAA) tool to show the most frequently asked questions about the most researched treatments in each treatment category. The quality of each information source is defined based on the criteria set by them JAMA.

After the analysis, adalimumab treatment showed the highest search volume of all the drugs asked (RSV = 1), followed by apremilast in the small molecule inhibitor and methotrexate in DMARDS (RSV = 1).

Adalimumab showed the most evidence-based questions compared to 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 compared to methotrexate (10.4% vs. 0.5%; P <.001), while methotrexate showed more questions about its risk than adalimumab (40% vs. 23.8%; P = .002).

Cobos and colleagues note that the data for adalimumab show that it is superior to public awareness, due to direct marketing to patients. They pointed out that most of the inquiries were based on the price and details of the objective, rather than the safety, which reflects the trends in similar studies where individuals sought more factual information.

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

Using JAMA’s benchmarking criteria, researchers scored the quality of each source, with business (3.1 out of 4 points) and government sites (3.2 out of 4 points) achieving the highest scores, compared to academic sites (2.3 out of 4 points). and health facilities achieving the lowest score (1.0 out of 4 points).

Since most users are directed to commercial and government-based sites for psoriasis information, Cobos and his colleagues expressed confidence in the quality of the source materials. However, they noted that further development is necessary in the academic and medical fields, from both methods and search engines.

“Improving the visibility and content quality of medical practice websites as determined by JAMA criteria and improving search engine algorithms to prioritize high-quality resources can improve patient access to reliable medical information,” they wrote.

References

1. _{Lim S, Kooper-Johnson S, Chau CA, Chen C. JMIR Dermatol. Published online September 7, 2024. doi:10.2196/62948}
2. _{Silberg WM, Lundberg GD, Musacchio RA. Evaluation, control, and quality assurance of health information on the Internet: Caveant lector et viewer – Reader and viewer beware. JAMA. 1997;277(15):1244-1245.}
3. _{Yamaguchi S, Kimura S, Watanabe S, et al. Analysis of Internet searches for rheumatoid arthritis treatment: What do people ask and read on the Internet?. PLoS One. 2023;18(9):e0285869. Published 2023 Sep 22. doi:10.1371/journal.pone.0285869}