The goal of ProMED-e-mail and GPHIN are similar: to detect an outbreak or unusual events close to the time that astute observers or news media report them. In this section, we explore the potential of analyzing patterns of Internet utilization by sick individuals (or their caregivers) to detect events even earlier.
This area of research is predicated on the assumption that sick people (or their caregivers or doctors) turn to the Internet early during the course of an illness. At present, it is known only that individuals frequently turn to the Internet for health information, but not that they turn to the Internet early in their illnesses. According to a 2004 Harris Interactive Poll, almost 33% of American adults say they "often" or "very often'' search for health information online (Harris Interactive, 2004).A survey by Pew Internet found that on any day as many as 7 million American adults look for health information online. There have been no surveys of the timing of searches relative to illness onset or that distinguished between chronic and acute diseases.
The conventional industry measure of Internet utilization is the number of "hits'' to a website from some region for some period (or the number of searches received by a search engine). To detect increases in Internet utilization by sick individuals against a background of extremely high levels of utilization for other purposes, more specific measures of Internet utilization will likely be necessary—measures such as the number of requests to a health-related website for documents about influenza or the number of queries to Internet search engines that include the word "fever.''
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