Cancer Internet search activity on a major search engine, United States 2001-2003.

BACKGROUND: To locate online health information, Internet users typically use a search engine, such as Yahoo! or Google. We studied Yahoo! search activity related to the 23 most common cancers in the United States. OBJECTIVE: The objective was to test three potential correlates of Yahoo! cancer search activity--estimated cancer incidence, estimated cancer mortality, and the volume of cancer news coverage--and to study the periodicity of and peaks in Yahoo! cancer search activity. METHODS: Yahoo! cancer search activity was obtained from a proprietary database called the Yahoo! Buzz Index. The American Cancer Society's estimates of cancer incidence and mortality were used. News reports associated with specific cancer types were identified using the LexisNexis "US News" database, which includes more than 400 national and regional newspapers and a variety of newswire services. RESULTS: The Yahoo! search activity associated with specific cancers correlated with their estimated incidence (Spearman rank correlation, rho = 0.50, P = .015), estimated mortality (rho = 0.66, P = .001), and volume of related news coverage (rho = 0.88, P < .001). Yahoo! cancer search activity tended to be higher on weekdays and during national cancer awareness months but lower during summer months; cancer news coverage also tended to follow these trends. Sharp increases in Yahoo! search activity scores from one day to the next appeared to be associated with increases in relevant news coverage. CONCLUSIONS: Media coverage appears to play a powerful role in prompting online searches for cancer information. Internet search activity offers an innovative tool for passive surveillance of health information-seeking behavior.

Cost benefit of influenza vaccination in healthy, working adults: an economic analysis based on the results of a clinical trial of trivalent live attenuated influenza virus vaccine.

INTRODUCTION: Trivalent, intranasal, live attenuated influenza virus vaccine (LAIV) is safe and clinically effective in healthy, working adults. However, the potential economic benefits of vaccinating this population are still uncertain. We therefore conducted a cost benefit analysis of influenza vaccination of healthy working adults utilizing clinical outcome data from a trial of LAIV in healthy working adults. METHODS: This cost benefit analysis was based on the results of a multi-center, randomized, double blind placebo controlled trial that assessed the clinical effectiveness of LAIV in healthy working adults. Outcomes from the trial that were included in the cost benefit analysis were days of work missed, days working but at reduced effectiveness, and days with a health care provider visit due to at least one of the following symptoms: fever, runny nose, sore throat, cough, headache, muscle aches, chills, or tiredness/weakness. Cost data were obtained from nationally representative databases. Probability distributions for the key model variables were defined, and Monte Carlo simulation was used to estimate the mean break even costs for vaccine and its administration. Sensitivity analyses explored how changes in the variables affected these estimates. RESULTS: There were 4561 participants in the clinical trial. LAIV lowered work loss due to illness symptoms by 18% (relative rate [RR] 0.82, 95% confidence interval [CI] 0.74-0.91), days of working at reduced effectiveness by 18% (RR 0.82, 95% CI 0.74-0.91), and days with a health care provider visit by 13% (RR 0.87, 95% CI 0.77-0.98). The mean break even cost for vaccine and its administration was 43.07 US dollars per person vaccinated (5-95% percentiles, 25.72-58.92 US dollars). Major cost drivers were hourly wage and vaccine effectiveness in reducing productivity losses and health care use. CONCLUSION: This cost benefit analysis based on the results of the LAIV trial provides additional evidence that influenza vaccination may provide both health and economic benefits for healthy, working adults.