title: Internet search query analysis can be used to demonstrate the rapidly increasing public awareness of palliative care in the USA.
abstract: BACKGROUND
  A lack of public awareness of palliative care (PC) has been identified as one of the main barriers to appropriate PC access. Internet search query analysis is a novel methodology, which has been effectively used in surveillance of infectious diseases, and can be used to monitor public awareness of health-related topics.
  
  
  OBJECTIVE
  We aimed to demonstrate the utility of internet search query analysis to evaluate changes in public awareness of PC in the USA between 2005 and 2015.
  
  
  METHODS
  Google Trends provides a referenced score for the popularity of a search term, for defined regions over defined time periods. The popularity of the search term 'palliative care' was measured monthly between 1/1/2005 and 31/12/2015 in the USA and in the UK.
  
  
  RESULTS
  Results were analysed using independent t-tests and joinpoint analysis. The mean monthly popularity of the search term increased between 2008-2009 (p<0.001), 2011-2012 (p<0.001), 2013-2014 (p=0.004) and 2014-2015 (p=0.002) in the USA. Joinpoint analysis was used to evaluate the monthly percentage change (MPC) in the popularity of the search term. In the USA, the MPC increase was 0.6%/month (p<0.05); in the UK the MPC of 0.05% was non-significant.
  
  
  CONCLUSIONS
  Although internet search query surveillance is a novel methodology, it is freely accessible and has significant potential to monitor health-seeking behaviour among the public. PC is rapidly growing in the USA, and the rapidly increasing public awareness of PC as demonstrated in this study, in comparison with the UK, where PC is relatively well established is encouraging in increasingly ensuring appropriate PC access for all.
authors.affiliation: Department of Palliative Medicine, Memorial Sloan Kettering Cancer Center, Zuckermann Research Center, New York, New York, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: McLean
authors.affiliation: The Head and Neck Service of the Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Lennon
authors.affiliation: Department of Palliative Medicine, Memorial Sloan Kettering Cancer Center, Zuckermann Research Center, New York, New York, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Glare
mesh_terms: D001364:Awareness; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D010166:Palliative Care / Q000523:psychology*; D057386:Search Engine; D014481:United States
keywords: Methodological research; info-epidemiology; international comparisons; palliative care