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Erschienen in: Rheumatology International 4/2021

Open Access 19.10.2020 | Observational Research

Google search data as a novel adjunct to patient and public involvement in rheumatology research

verfasst von: Mrinalini Dey, Sizheng Steven Zhao

Erschienen in: Rheumatology International | Ausgabe 4/2021

Abstract

Patient and public involvement is essential in the design and implementation of research studies to ensure research remains relevant and in line with public priorities. Public views on a given area of research may be sought via platforms such as focus groups or surveys. Here, we present the use of an openly available Google search data query tool, which may be used alongside traditional forms of patient and public involvement in research to highlight public perceptions and priorities. We used an online search query tool (“AnswerThePublic.com”) to explore public Google searches relating to “arthritis,” and an exemplar rheumatic disease, “rheumatoid arthritis.” The most common searches relating to these diseases included quality of life, treatment, prognosis, as well as impacts on life, including work. However, they also reveal concerns that may be more difficult to elicit in face-to-face focus groups, such as questions on alcohol consumption in arthritis, and impacts on mental health. Using public search engine data in research, alongside the important traditional methods of patient and public involvement, is a cost-effective and time-efficient method of gauging public views and concerns on a given topic. It may facilitate broad scoping searches of public priorities and help to guide future research questions.
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Introduction

Patient and public involvement (PPI) is integral to the design and prioritisation of research studies. The National Institute for Health Research (NIHR) defines public involvement in research as “research being carried out ‘with’ or ‘by’ members of the public rather than ‘to’, ‘about’ or ‘for’ them” [1]. PPI are typically conducted by funders and researchers to prioritise research questions, and offering advice as part of a project steering group. The term ‘public’ denotes a wide range of individuals, including patients, potential patients, carers, people using health and social care services, and those who represent them [1]. It is important to distinguish between the views of the public, and those with a professional role in health and social care, especially when considering research design and prioritisation. This facilitates optimal impact and improved enrolment to studies, especially if those with the condition under study are involved from the study’s inception [2]. In the rheumatic diseases, undertaking PPI ensures research remains patient-centred and clinically relevant, across a range of chronic and often debilitating conditions, treated with a wide range of drugs, including immunosuppressants and analgesics.
There is ample evidence demonstrating that PPI is necessary to optimise research design and output [24]. However, at the earliest stages of designing a study, it can be useful to gain a broad overview of public perceptions of a given topic, ensuring increased relevance and potential for wider benefit. Furthermore, it can be difficult to have access to focus groups, especially for junior researchers and clinicians. This has been made all the more difficult by social-distancing measures implemented worldwide due to the COVID-19 pandemic, which are likely to have lasting consequences for months to years. In outpatient specialties such as rheumatology, a quick and easy method of gauging public priorities for research can be through questionnaires and surveys conducted in clinic, but access to this may also be limited in the short-medium term due to increased use of telephone consultations.
There is no replacement for PPI, for example in the form of stakeholder involvement, individual interviews, and focus groups, which will always be necessary to ensure adequate prioritisation and relevance of research. However, large-scale search query tools can overcome some of the issues described above. These openly available online tools are able to collate and display keyword suggestions and predictions based on searches within Google, which is used for 78% of internet searches. With 3.5 billion searches conducted per day through Google, summarising searches this way can provide an excellent overview of public concerns and queries on a given topic [5]. They are already commonplace in marketing, to ensure content is relevant and up-to-date. An example of such a tool includes “AnswerThePublic.com” [6], which is able to fetch data on phrases and questions entered into Google, featuring certain keywords (as entered into the tool by the user), Results are presented in both a tabulated and infographic format, making it efficient to ascertain search patterns and popular phrases.
In healthcare, search query tools may not only serve to confirm prior knowledge from PPI and clinician perceptions, but also reveals searches on more sensitive topics, such as opioid dependence and psychological impact of rheumatic disease, which service-users may not necessarily wish to discuss face-to-face.
We aimed to demonstrate the utility of a search query tool to complement PPI in the rheumatic diseases, using an exemplar rheumatic disease, rheumatoid arthritis.

Methods

We used an openly available search query tool to collate and map Google searches for two separate terms: “arthritis” and “rheumatoid arthritis.” We opted to use “AnswerThePublic.com”, due to ease of use and the resulting visual format of the results. Data on searches performed in Google are presented in real-time, so results are up-to-date at the time of using the search query tool. Since the results at any given time are identical regardless of the individual conducting the search, one author conducted the search for the chosen terms. Search queries are based on Google searches in the region in which it is accessed (e.g. UK); therefore, factors such as the user’s own Google search history are irrelevant.
We first explored public Google searches for “arthritis” to gauge a broad overview of public queries on one of the most commonly-used terms in rheumatology, also used by patients and public. We then assessed search suggestions for “rheumatoid arthritis,” as an exemplar rheumatic disease. Rheumatoid arthritis was selected as it is the most prevalent chronic inflammatory arthritis, and, therefore, likely to be a commonly-searched term in this field [7]. All searches were performed on 19 May 2020.
The output of results for each of the above two queries were delivered in the following categories: questions on the term; prepositions (i.e. searches incorporating additional terms such as “with” and “near”); comparisons (i.e. searches incorporating additional terms such as “and” and “versus”). Results were presented in lists as well as data visualisation images. Search query data for the UK, English language only, were interrogated.

Results

Figure 1 displays the results for search terms relating to questions on “arthritis,” with up to eight of the most common terms shown for each, as an example of output produced by the search query tool. Within each sub-category, the darker stems denote more popular search terms, while paler stems denote less popular search terms.
Subsequent searches are displayed in Tables 1, 2 and 3. Table 1 displays results for search terms relating to prepositions and comparisons to “arthritis”.
Table 1
Top: the eight most common search terms on “arthritis,” using the prepositions: can, without, is with, for, to, near, bottom: the 8 most common search terms on “arthritis,” using the comparators: vs, and, like, or, versus. Searches are ordered in popularity vertically down each column, with the most popular at the top
Searches on “arthritis”: prepositions
With
Near
Without
Can
To
Is
For
Arthritis with rash
Arthritis near me
Arthritis without swelling
Arthritis can opener
Arthritis to the knee
Arthritis is an autoimmune disease
Arthritis for dogs
Arthritis with ulcerative colitis
Arthritis near ear
Arthritis without pain
Arthritis can opener UK
Arthritis to the spine
Arthritis is wrist
Arthritis for cats
Arthritis without swelling
Arthritis near heart
Arthritis without medication
Arthritis can be cured
Arthritis to eat
Arthritis is it hereditary
Arthritis for dummies
Arthritis with psoriasis
Arthritis near thumb
Arthritis without joint pain
Arthritis can you die
Arthritis to fingers
Arthritis is hands
Arthritis for young adults
Arthritis without pain
Arthritis near collar bone
Arthritis without stiffness
Arthritis can I claim pip
Arthritis to hands
Arthritis is curable
Arthritis for dogs medication
Arthritis with skin rash
Arthritis in elbow
Arthritis without fever
Arthritis can you get disability
Arthritis to avoid food
Arthritis is thumb joint
Arthritis for dogs treatment
Arthritis with Crohn's
Arthritis near groin
Arthritis without treatment
Arthritis can I claim disability allowance
Arthritis to lower back
Arthritis is killing me
Arthritis for dogs home remedies
Arthritis with Crohn's disease
Arthritis in spine
Arthritis without swelling or redness
Arthritis can cause fever
Arthritis to avoid
Arthritis is disability
Arthritis for cats natural remedies
Searches on “arthritis”: comparators
 
Arthritis vs gout
Arthritis and tomatoes
Arthritis like conditions
Arthritis or joint pain
Arthritis versus arthritis
 
 
Arthritis vs arthralgia
Arthritis and alcohol
Arthritis like pain that moves around
Arthritis or gout
Arthritis versus rheumatoid arthritis
 
 
Arthritis vs arthrosis
Arthritis and diet
Arthritis like symptoms but not arthritis
Arthritis or RSI
Arthritis versus osteoarthritis
 
 
Arthritis vs MS
Arthritis and COVID
Arthritis like diseases
Arthritis or bone cancer
Arthritis versus fibromyalgia
 
 
Arthritis vs rheumatism
Arthritis and fatigue
Arthritis like pain
Arthritis or osteoarthritis
Arthritis versus gout
 
 
Arthritis vs tendonitis
Arthritis and exercise
Arthritis like pain in hands
Arthritis or fibromyalgia
Arthritis versus bursitis
 
 
Arthritis vs bursitis
Arthritis and rheumatology
Arthritis like pain postpartum
Arthritis or bursitis
Arthritis versus arthrosis
 
 
Arthritis vs osteoarthritis
Arthritis and turmeric
Arthritis like pain in hands during pregnancy
Arthritis or cancer
Arthritis versus tendonitis
 
Table 2
The most common questions asked on “rheumatoid arthritis,” using the interrogative words: who, how, when, are, will, why, what, can, where, which. Searches are ordered in popularity vertically down each column, with the most popular at the top
Searches on “rheumatoid arthritis”: questions
How
When
Are
Will
Why
What
Can
Where
Who
Which
How rheumatoid arthritis affects daily life
When rheumatoid arthritis turns deadly
Are rheumatoid arthritis patients immunosuppressed
Will rheumatoid arthritis show up on x-ray
Why rheumatoid arthritis occurs
What’s rheumatoid arthritis
Can rheumatoid arthritis affect your jaw
Where does rheumatoid arthritis start
Who rheumatoid arthritis
which joints rheumatoid arthritis
How rheumatoid arthritis affects the body
When rheumatoid arthritis is active
Are rheumatoid arthritis and psoriasis related
Will rheumatoid arthritis show up in a blood test
Why rheumatoid arthritis is an autoimmune disease
What rheumatoid arthritis feels like
Can rheumatoid arthritis affect your eyes
Where does rheumatoid arthritis affect
Who gets rheumatoid arthritis
Which is worse rheumatoid arthritis or osteoarthritis
How rheumatoid arthritis starts
When rheumatoid arthritis is fatal
Are rheumatoid arthritis and polymyalgia rheumatica related
Will rheumatoid arthritis go away
Why rheumatoid arthritis causes anaemia
What rheumatoid arthritis symptoms
Can rheumatoid arthritis affect your neck
Where does rheumatoid arthritis affect the body
Who does rheumatoid arthritis affect
 
How rheumatoid arthritis is diagnosed
When does rheumatoid arthritis start
Are rheumatoid arthritis patients immunocompromised
Will rheumatoid arthritis kill me
Why rheumatoid arthritis is called autoimmune disease
What rheumatoid arthritis looks like
Can rheumatoid arthritis be cured
Where is rheumatoid arthritis
Who treat rheumatoid arthritis
 
How rheumatoid arthritis affects movement
When is rheumatoid arthritis diagnosed
Are rheumatoid arthritis patients candidates for dental implants
Will rheumatoid arthritis cripple me
Why rheumatoid arthritis common in females
What rheumatoid arthritis drugs are covered by medicare
Can rheumatoid arthritis kill
Where is rheumatoid arthritis pain
  
How rheumatoid arthritis can be cured
When is rheumatoid arthritis
Are rheumatoid arthritis and ankylosing spondylitis related
Will rheumatoid arthritis spread
Why rheumatoid arthritis causes fatigue
What’s rheumatoid arthritis
Can rheumatoid arthritis cause anaemia
Where is rheumatoid arthritis common
  
How rheumatoid arthritis affects the heart
When is rheumatoid arthritis considered a disability
Are rheumatoid arthritis and lupus related
Will rheumatoid arthritis cause hair loss
Why does rheumatoid arthritis cause fatigue
What rheumatoid arthritis risk factors
Can rheumatoid arthritis cause weight loss
Where do you get rheumatoid arthritis
  
How rheumatoid arthritis is caused
When is rheumatoid arthritis caused
Are rheumatoid arthritis and rheumatic fever related
Will rheumatoid arthritis cause weight loss
Why does rheumatoid arthritis make you tired
What rheumatoid arthritis symptoms
Can rheumatoid arthritis be inherited
Where to live with rheumatoid arthritis
  
Table 3
Top: the most common search terms on “rheumatoid arthritis,” using the prepositions: with, without, can, to, is, for, near, bottom: the eight most common search terms on “rheumatoid arthritis,” using the comparators: vs, and, like, or, versus
Searches on “rheumatoid arthritis”: prepositions
With
Without
Can
To
Is
For
Near
Rheumatoid arthritis with coronavirus
Rheumatoid arthritis without swelling
Rheumatoid arthritis can it kill you
Rheumatoid arthritis to lupus
Rheumatoid arthritis is it hereditary
Rheumatoid arthritis for dummies
Rheumatoid arthritis near me
Rheumatoid arthritis with fibromyalgia
Rheumatoid arthritis without rheumatoid factor
Rheumatoid arthritis can it be cured
Rheumatoid arthritis to hands
Rheumatoid arthritis is an autoimmune disease
Rheumatoid arthritis for child
Rheumatoid arthritis doctors near me
Rheumatoid arthritis with COVID-19
Rheumatoid arthritis without medication
Rheumatoid arthritis can you die
Rheumatoid arthritis to lungs
Rheumatoid arthritis is it dangerous
Rheumatoid arthritis for dogs
Rheumatoid arthritis doctor near me
Rheumatoid arthritis with negative rheumatoid factor
Rheumatoid arthritis without joint pain
Rheumatoid arthritis can it go away
Rheumatoid arthritis to ankle
Rheumatoid arthritis is it inherited
Rheumatoid arthritis for nurses
Rheumatoid arthritis specialist near me
Rheumatoid arthritis with psoriasis
Rheumatoid arthritis without inflammation
Rheumatoid arthritis can it affect the lungs
Rheumatoid arthritis to Chinese
Rheumatoid arthritis is it serious
Rheumatoid arthritis for young adults
Rheumatoid arthritis support group near me
Rheumatoid arthritis with normal rheumatoid factor
Rheumatoid arthritis without pain
Rheumatoid arthritis can I still work
Rheumatoid arthritis to neck
Rheumatoid arthritis is there a cure
Rheumatoid arthritis for medical students
Best doctor for rheumatoid arthritis near me
Rheumatoid arthritis with normal ESR and CRP
Rheumatoid arthritis without fever
Rheumatoid arthritis can it affect eyes
Rheumatoid arthritis to
Rheumatoid arthritis is it genetic
Rheumatoid arthritis for doctors
 
Rheumatoid arthritis with Crohn’s disease
Rheumatoid arthritis without inflammatory markers
Rheumatoid arthritis can you get disability
Rheumatoid arthritis in Hindi
Rheumatoid arthritis is this a disability
Rheumatoid arthritis for exercises
 
Searches on “rheumatoid arthritis”: comparators
Vs
And
Like
Or
Versus
Rheumatoid arthritis vs gout
Rheumatoid arthritis and COVID
Rheumatoid arthritis like diseases
Rheumatoid arthritis or lupus
Rheumatoid arthritis versus arthritis
Rheumatoid arthritis vs lupus
Rheumatoid arthritis and osteoarthritis
Rheumatoid arthritis like syndrome
Rheumatoid arthritis or gout
Rheumatoid arthritis versus osteoarthritis
Rheumatoid arthritis vs osteoarthritis
Rheumatoid arthritis and shielding
Rheumatoid arthritis like symptoms
Rheumatoid arthritis or MS
Rheumatoid arthritis versus fibromyalgia
Rheumatoid arthritis vs osteoarthritis X-ray
Rheumatoid arthritis and eyes
Rheumatoid arthritis like polyarthritis
Rheumatoid arthritis or osteoarthritis
Rheumatoid arthritis versus lupus
Rheumatoid arthritis vs other arthritis
Rheumatoid arthritis and alcohol
Rheumatoid like arthritis
Rheumatoid arthritis or ankylosing spondylitis
Rheumatoid arthritis versus gout
Rheumatoid arthritis vs osteoarthritis hands
Rheumatoid arthritis and exercise
Rheumatoid arthritis feels like
Rheumatoid arthritis or arthritis
Rheumatoid arthritis versus psoriatic arthritis
Rheumatoid arthritis vs reactive arthritis
Rheumatoid arthritis and pip
Rheumatoid arthritis flu like symptoms
Rheumatoid arthritis or psoriatic arthritis
Rheumatoid arthritis versus MS
Rheumatoid arthritis vs psoriatic arthritis
Rheumatoid arthritis and fatigue
Rheumatoid arthritis feels like flu
Rheumatoid arthritis or something else
Rheumatoid arthritis versus osteoarthritis symptoms
Searches are ordered in popularity vertically down each column, with the most popular at the top
Tables 2 and 3 display the results for search terms relating to questions, prepositions, and comparisons to the term “rheumatoid arthritis,” in the same manner as for “arthritis.”
Public searches performed on these topics predominantly relate to impacts on quality of life, relief of debilitating features including pain, and prognosis. On review of questions asked on arthritis, approximately 30% referred to debilitating features or quality of life, while just over 20% were on treatment or prognosis. In the prepositions’ category, approximately 20% of searches were on debilitating features or quality of life, with a further 20% on treatment or prognosis.
For on “rheumatoid arthritis” searches, approximately 20% of search questions were on debilitating features or quality of life, with approximately 30% on treatment or prognosis. Looking at searches on rheumatoid arthritis, by prepositions, approximately 15% were on debilitating features or quality of life, with 30% on treatment or prognosis. The remainder of searches for both arthritis and rheumatoid arthritis covered topics including but not limited to anatomical sites of symptoms, possible associations with other rheumatological diseases (e.g. gout, systemic lupus erythematosus), investigations and diagnosis, and symptoms in animals.

Discussion

We used an openly available online tool to investigate Google searches for the terms “arthritis” and “rheumatoid arthritis,” conducted by the public. Our results reveal striking patterns in search themes, with a focus on treatment, prognosis, quality of life, and debilitating features, including impact on work. While some results were novel, consistencies were seen with previous research in these areas, such as quality of life and patient-reported outcomes. These similarities with traditional methods of PPI suggest a role for a search query tool in this area.
One of the most common themes in searches for both arthritis and rheumatoid arthritis was on treatment. Specifically, some of the most frequently searched questions were “can arthritis be cured?”, “can arthritis be treated?”, “will arthritis go away?”, and “rheumatoid arthritis- can it be cured?”, as well as variations on these questions. This is consistent with previous studies on patient-reported health service needs. A recent scoping review identified that patients with inflammatory arthritis value discussions on treatment outside conventional medicine, such as alternative and complimentary therapies and dietary advice, as well as practical tools to help with daily activities [8]. Indeed, our review of Google searches revealed the following as some of the commonest searches: “arthritis and diet” and “arthritis can opener”, consistent with the findings in this review and elsewhere in the literature [9, 10].
Another common theme in the searches centred on quality of life, and debilitating aspects of arthritis relating to this. Some specific frequently-searched examples include “when arthritis becomes debilitating”, “will rheumatoid arthritis cripple me?”, and “what rheumatoid arthritis feels like”. Quality of life outcomes have been explored increasingly in recent years in the rheumatic diseases. This has sought to increase clinical awareness of the burden of disease on mental health and daily living, with recommendations for factors such as health-related quality of life and fatigue to be routinely assessed in those with conditions including rheumatoid arthritis [1113]. Our review of searches reveal that this remains an important priority in the public domain.
In addition, some specific frequent searches relating to quality of life, revealed public interest in aspects relating to work and arthritis. These included such examples as: “arthritis- can I claim PIP?”, “rheumatoid arthritis- can you work?”, and “is rheumatoid arthritis a disability?”. We know from previous studies and patient-reported outcomes that productivity at work, as well as presenteeism and absenteeism, are affected by all forms of arthritis [1416]. However, these searches demonstrate more sensitive topics, such as eligibility for benefits, that patients may not feel able or comfortable to discuss during appointments. This highlights the need for clinicians to facilitate conversations regarding work and disability during clinic appointments, and the importance of the multi-disciplinary team, including psychologists and occupational therapists, and patient support services.
Patient and public involvement, in rheumatology and elsewhere, has repeatedly highlighted the value placed on their relationship with health professionals, including ease of communication and approachability [8, 17]. Consistent with this, some common Google searches included “rheumatoid arthritis doctors near me” and “rheumatoid arthritis support group near me”. This again demonstrates the importance of access to patient, as well as clinician, support.
The co-existence of fibromyalgia with other rheumatic diseases has become more apparent in recent years, associated with poorer clinical outcomes in inflammatory arthritis [18, 19]. Some of the most common public searches seek to explore this relationship e.g. “arthritis versus fibromyalgia” and “are arthritis and fibromyalgia connected?”. These searches may also represent questions asked by patients during the diagnostic process for inflammatory arthritis or fibromyalgia, as they seek to explore the overlapping symptoms and relationship between the two diseases. This is also consistent with studies demonstrating a sense of ‘invalidation’ experienced by those with fibromyalgia, due to the invisibility and medically-unexplained nature of the syndrome, and the subsequent impact on quality of life outcomes in these patients [20, 21].
Some searches did not follow a theme, or revealed unexpected patterns of search behaviour. One of the commonest phrases was “rheumatoid arthritis and COVID”, consistent with the time at which we conducted this study (i.e. during the UK lockdown and shielding period for those at high-risk of complications of COVID-19, including some patients with rheumatoid arthritis). Other commons searches were on the genetics of rheumatoid arthritis (“is rheumatoid arthritis hereditary?” and “rheumatoid arthritis-is it genetic?”). This perhaps demonstrates a sensitive area which clinicians may not routinely address in clinic, but of importance to the patient. On a similar theme, searches such as “arthritis and alcohol” and “arthritis and sex” reveal similar sensitive topics which may prove potentially embarrassing for the patient to ask, leading them to seek answers on the Internet and online forums.

Future directions

Our use of a search query tool to explore searches conducted on “arthritis” and “rheumatoid arthritis” reveal known concerns from patients and the public, but also demonstrate areas of concern which may not be immediately apparent to researchers and clinicians. There is, therefore, scope to apply this tool as an adjunct to traditional methods of PPI, for example, when planning research in sensitive fields, such as opioid addiction and medication side-effects, for example, corticosteroids. It may also enhance and encourage research in areas including the impact of rheumatic disease on mental health. In the era of COVID-19 and telemedicine, such a tool provides a quick method of ascertaining public concerns and questions on its use, not only in rheumatology, but also other fields. Finally, as our internet and social media habits change, search query tools which are able to capture phrases used on social media may provide additional information on patient perceptions on healthcare-related topics. This has already been done through applications which are able to capture increased social media activity in relation to disease activity, including pain, but there is scope to extend further to incorporate use of specific phrases [22].

Limitations

A key limitation of such a tool is the inability to attribute all searches to a patient body. However, the tool can provide broad indications of public perceptions of a topic, within a given geographical region, e.g. UK. Furthermore, while searches on a topic such as arthritis may not change significantly from one day to another, searches conducted in Google on current and fast-changing situations may do so, which will affect the output from search query tools if conducted at two separate times. A prime example of this is search terms relating to COVID-19. In addition, as described above, search query tools are currently limited in number and can only capture data from the most commonly-used search engine, Google. Search query tools are complimentary, but not identical, to online platforms such as Google Trends which is able to display volumes and patterns of searches on a given topic, but no granularity on the nature of these searches. It is this additional information on extended phrases and questions entered into search engines which may enable their use as an adjunct to traditional PPI. As their utility grows in areas outside marketing, including in healthcare, possibly so too will their scope, including in areas such as social media.

Conclusion

PPI is, and must continue to be, an essential part of research, from inception, to implementation, and dissemination of results. However, we have demonstrated the utility of a search query tool to complement traditional methods of PPI, for example, to conduct scoping searches at a project’s inception, or in addition to PPI, particularly at present, when focus groups may be difficult to convene due to social distancing regulations. Not only are the searches revealed by this tool consistent with known priorities of patients and the public, but they also demonstrate areas which benefit from user anonymity, such as concerns regarding the impact of arthritis on relationships, lifestyle, and work. This has the potential to guide future research questions, increasing the alignment of research priorities with those of the public.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest or funding to declare.
Patient or public involvement was not required for this work.

Ethical approval

Ethical approval was not required for this work.
Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://​creativecommons.​org/​licenses/​by/​4.​0/​.

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Metadaten
Titel
Google search data as a novel adjunct to patient and public involvement in rheumatology research
verfasst von
Mrinalini Dey
Sizheng Steven Zhao
Publikationsdatum
19.10.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
Rheumatology International / Ausgabe 4/2021
Print ISSN: 0172-8172
Elektronische ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-020-04723-0

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