Health-Web 2.0 is the use of Web tools to personalize health care, collaborate, and promote education, resulting in a need for an infrastructure that facilitates the environment-clinic phenotype relationships. We demonstrate a use case and diffusion of this innovation in allergy.
We report pilot studies as proof-in-concept for a global allergy database. One is external validation of tele-aerobiology. [1] A second is the discovery of online hits correlation with pollen counts. Lastly, electronic rhinitis outcomes questionnaires (eROQ) relationships with pollen counts.
Methods:
National allergy bureau (NAB) protocols and test slide served as reference standards. Microscopic fields were filmed using commercial video microscopes. Certified counters blindly identified the same fields online. Reference data were compared with counter’s readings online.
eROQ were recorded into EHRs from clinic, patient computers or Apple mobile apps.
Online hits from website, Facebook and Google advertisement analytics, and pollen counts were analyzed.
Results:
Pollen identification and counts by 3/4 certified counters using tele-aerobiology showed significant relationships using ANOVA & correlation analysis (p<0.05), when compared with microscopy. Pearson's r and corresponding p values: 0.99 (0.0007), 0.91 (0.00337), 0.0.99 (<0.0001), 0.53 (0.36). Cronbach's alpha = 0.91.
Correlations (Spearman’s ρ) between: Clinic hits: Google impressions (0.4, p<0.0001), Facebook frequency: total pollens, (0.3, p<0.03), Facebook reach: Google impressions ((0.4, p<0.0001), and Facebook reach: clinic hits (0.4, p<0.0002) all revealed significant correlations using non parametric methods.
Patient eROQ symptoms showed statistical relationships with total pollen, specific grass and ragweed counts with correlations and ANOVA (p<0.05).
Conclusions:
We reported [1] internal, and now external validity of Tele-aerobiology.
Relationships between new online signals and old allergy phenotypes are recent phenomenon as a result of Health-Web 2.0. Allergists need to be aware and harness these new advances.
Our findings and current technology will assist in the formation of an international allergy database that will facilitate the study of environment-clinic-pheno-genotype-epitope relationships.[2]
[1] Tele-Aerobiology: A New Cost-effective Web-based Method of Aeroallergen Identification/Counting. JJ Anderson, D Dalan. JACI. Volume 121, Issue 2, Supplement 1. Page S10, February 2008.
[2] Clinical data mining and research in the allergy office. D Dalan. Curr Opin Allergy Clin Immunol. 2010 Jun;10(3):171-7.