Consumption of antimicrobial drugs, such as antibiotics, is linked with antimicrobial resistance. Surveillance of antimicrobial drug consumption is therefore an important element in dealing with antimicrobial resistance. Many countries lack sufficient surveillance systems. Usage of web mined data therefore has the potential to improve current surveillance methods. To this end, we study how well antimicrobial drug consumption can be predicted based on web search queries, compared to historical purchase data of antimicrobial drugs. We present two prediction models (linear Elastic Net, and non-linear Gaussian Processes), which we train and evaluate on almost 6 years of weekly antimicrobial drug consumption data from Denmark and web search data from Google Health Trends. We present a novel method of selecting web search queries by considering diseases and drugs linked to antimicrobials, as well as professional and layman descriptions of antimicrobial drugs, all of which we mine from the open web. We find that predictions based on web search data are marginally more erroneous but overall on a par with predictions based on purchases of antimicrobial drugs. This marginal difference corresponds to ∠1 point mean absolute error in weekly usage. Best predictions are reported when combining both web search and purchase data. This study contributes a novel alternative solution to the real-life problem of predicting (and hence monitoring) antimicrobial drug consumption, which is particularly valuable in countries states lacking centralised and timely surveillance systems.
Background: The web has become a primary information resource about illnesses and treatments for both medical and non-medical users. Standard web search is by far the most common interface for such information. It is therefore of interest to nd out how well web search engines work for diagnostic queries and what factors contribute to successes and failures. Among diseases, rare (or orphan) diseases represent an especially challenging and thus interesting class to diagnose as each is rare, diverse in symptoms and usually has scattered resources associated with it. Methods: We use an evaluation approach for web search engines for rare disease diagnosis which includes 56 real life diagnostic cases, state-of-theart evaluation measures, and curated information resources. In addition, we introduce FindZebra, a specialized (vertical) rare disease search engine. FindZebra is powered by open source search technology and uses curated Background Google Flu Trends (GFT) claimed to generate real-time, valid predictions of population influenza-like illness (ILI) using search queries, heralding acclaim and replication across public health. However, recent studies have questioned the validity of GFT. Purpose To propose an alternative methodology that better realizes the potential of GFT, with collateral value for digital disease detection broadly. Methods Our alternative method automatically selects specific queries to monitor and autonomously updates the model each week as new information about CDC-reported ILI becomes available, as developed in 2013. Root mean squared errors (RMSEs) and Pearson correlations comparing predicted ILI (proportion of patient visits indicative of ILI) with subsequently observed ILI were used to judge model performance. Results During the height of the H1N1 pandemic (August 2 to December 22, 2009) and the 2012–2013 season (September 30, 2012, to April 12, 2013), GFT's predictions had RMSEs of 0.023 and 0.022 (i.e., hypothetically, if GFT predicted 0.061 ILI one week, it is expected to err by 0.023) and correlations of r =0.916 and 0.927. Our alternative method had RMSEs of 0.006 and 0.009, and correlations of r =0.961 and 0.919 for the same periods. Critically, during these important periods, the alternative method yielded more accurate ILI predictions every week, and was typically more accurate during other influenza seasons. Conclusions GFT may be inaccurate, but improved methodologic underpinnings can yield accurate predictions. Applying similar methods elsewhere can improve digital disease detection, with broader transparency, improved accuracy, and real-world public health impacts. Health surveillance systems based on online user-generated content often rely on the identification of textual markers that are related to a target disease. Given the high volume of available data, these systems benefit from an automatic feature selection process. This is accomplished either by applying statistical learning techniques, which do not consider the semantic relationship between the selected features and the inference task, or by developing labour-intensive text classifiers. In this paper, we use neural word embeddings, trained on social media content from Twitter, to determine, in an unsupervised manner, how strongly textual features are semantically linked to an underlying health concept. We then refine conventional feature selection methods by a priori operating on textual variables that are sufficiently close to a target concept. Our experiments focus on the supervised learning problem of estimating influenza-like illness rates from Google search queries. A "flu infection" concept is formulated and used to reduce spurious and potentially confounding features that were selected by previously applied approaches. In this way, we also address forms of scepticism regarding the appropriateness of the feature space, alleviating potential cases of overfitting. Ultimately, the proposed hybrid feature selection method creates a more reliable model that, according to our empirical analysis, improves the inference performance (Mean Absolute Error) of linear and nonlinear regressors by 12 and 28.7 , respectively. Influenza-like illness (ILI) estimation from web search data is an important web analytics task. The basic idea is to use the frequencies of queries in web search logs that are correlated with past ILI activity as features when estimating current ILI activity. It has been noted that since influenza is seasonal, this approach can lead to spurious correlations with features queries that also exhibit seasonality, but have no relationship with ILI. Spurious correlations can, in turn, degrade performance. To address this issue, we propose modeling the seasonal variation in ILI activity and selecting queries that are correlated with the residual of the seasonal model and the observed ILI signal. Experimental results show that re-ranking queries obtained by Google Correlate based on their correlation with the residual strongly favours ILI-related queries.