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Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder, prevalent among 2-10% of the population.
The objective of this study was to describe where, what, and when people search online for topics related to ADHD.
Data were collected from Microsoft’s Bing search engine and from the community question and answer site, Yahoo Answers. The questions were analyzed based on keywords and using further statistical methods.
Our results revealed that the Internet indeed constitutes a source of information for people searching the topic of ADHD, and that they search for information mostly about ADHD symptoms. Furthermore, individuals personally affected by the disorder made 2.0 more questions about ADHD compared with others. Questions begin when children reach 2 years of age, with an average age of 5.1 years. Most of the websites searched were not specifically related to ADHD and the timing of searches as well as the query content were different among those prediagnosis compared with postdiagnosis.
The study results shed light on the features of ADHD-related searches. Thus, they may help improve the Internet as a source of reliable information, and promote improved awareness and knowledge about ADHD as well as quality of life for populations dealing with the complex phenomena of ADHD.
Attention deficit hyperactivity disorder (ADHD) is a common, chronic, and pervasive pediatric neurodevelopmental psychiatric disorder that is prevalent among 2-10% of the population and has a complex etiology [
Previous literature has indicated the mobility of the real-world daily manifestations of ADHD from early childhood to adulthood as well as gender-related differences [
ADHD symptoms often appear in early childhood, yet the clinical guidelines of the American Academy of Pediatrics recommend diagnosing ADHD only from the age of 4 [
Therefore, from the child’s early years of development up to school years and even during adulthood, parents worldwide may search for resources and solutions related to their child’s behavior.
A previous study of the information needs of parents of children with ADHD revealed that parents’ information resources were related to pediatricians (86%), books (76%), general practitioners (65%), schools (61%), the Internet (59%), and other forms of media (54%) [
Nowadays, the Internet is a popular source of information and medical information is one of the most popular Internet topics thus enabling children’s diagnosis or self-diagnosis as well as support at different coping stages [
In that context, it was found that parents of children with psychiatric diagnoses respond favorably to the Internet as a source of information [
The aim of this study was to explore the dynamic process of Web-based information searches related to ADHD over a 3-month period. The specific goals were to identify
Data were collected from two separate sources: (1) queries made in the United States using the Microsoft Bing search engine (following findings [
Analysis phases and number of questions analyzed by data source. ADHD: attention deficit hyperactivity disorder.
All English language queries submitted to the Bing search engine by users of desktop computers in the United States for the 3-month period between January 2015 and March 2015 were extracted. Queries were filtered to maintain only those that contained the terms “ADHD” or “attention deficit” and “disorder.” A total of 613,069 queries from 222,626 users were identified.
For each query, the text of the query (without use of any automated spelling correction), time, and date were extracted, in addition to a list of pages shown to the user and the pages clicked on by the user. In order to maintain privacy, user identifiers, which were based on browser cookies, were anonymized before access by the investigators. Queries were aggregated preceding analysis preventing individual-level user datum from being examined by the researchers.
We note that the market share of Bing in the United States is around 19%, according to recent estimates [
Questions about ADHD posted on Yahoo Answers, an online community question and answer website, were collected. Bing was used to query questions from Yahoo Answers that contained the term “attention deficit hyperactivity disorder” or the term “ADHD.” This resulted in 1609 unique questions.
The questions extracted from Yahoo were then each labeled by at least three human assessors from the crowdsourcing platform CrowdFlower, who were asked to label the question according to whether the question refers primarily to a person who (1) was diagnosed with ADHD, (2) is suspected of having ADHD, and (3) none of the above.
As presented in
The authors examined a sample of the questions and identified four main categories. Two MSc in occupational therapy research assistants further classified the questions into one of the following four groups:
Personal account
General question about ADHD
Question about ADHD among their pets
Other
A question was defined as “personal” if it was asked in the first person form and included words such as “I” or “my son” or “daughter” or “we” or “my wife,” which reflects the asker’s personal involvement within the question being asked.
A total of 979 personal account type of questions were found and analyzed by the two research assistant raters. Each question was examined to detect any additional information about the person discussed in the question, including the age and gender, whether the person was diagnosed with ADHD or not. Furthermore, the raters analyzed whether the question addressed problems in (1) daily function, related to activities that children do throughout the day, including activities of daily living (such as self-hygiene, dressing, showering, eating, walking), social activities, and play; (2) behavioral manifestations, related to how the child interacts with people in his or her environment at home, school, or at social events; and finally, (3) academic performance, related to issues pertaining to school or spontaneous learning, based on predetermined keywords and examples (see
All other ADHD-related questions that were posted by anyone in the
Bing queries were analyzed while focusing on the
The 10 most popular queries submitted to Bing.
Query category | Query | Total N=613,069, n (%) |
General | ADHDa | 35,010 (5.71) |
Attention deficit disorder | 4616 (0.75) | |
What is ADHD? | 2960 (0.48) | |
Symptoms | ADHD symptoms | 10,945 (1.79) |
Attention deficit disorder symptoms | 2891 (0.47) | |
Test | ADHD test | 2321 (0.37) |
Medications | ADHD medications | 6228 (6.9) |
Children | ADHD in children | 4051 (0.66) |
Adults | Adult ADHD | 3255 (0.53) |
ADHD in adults | 3007 (0.49) |
aADHD: attention deficit hyperactivity disorder.
The 20 most popular websites displayed as a result of the ADHD queries, and their rank in website popularity displayed to the users as a result of their search in the Bing search result engine, are presented in
Most popular websites displayed and clicked on in Bing attention deficit hyperactivity disorder (ADHD) queries.
Website | Rank in display | Rank in click | ADHDa-specific | HoNb approved |
webmd.com | 1 | 1 | No | Yes |
additudemag.com | 2 | 2 | Yes | |
psychcentral.com | 3 | 3 | No | Yes |
wikipedia.org | 4 | 4 | No | |
helpguide.org | 5 | 7 | No | |
cdc.gov | 6 | >20 | No | |
nimh.nih.gov | 7 | 15 | No | |
mayoclinic.org | 8 | 10 | No | |
medicinenet.com | 9 | >20 | No | Yes |
healthline.com | 10 | 8 | No | Yes |
chadd.org | 11 | 18 | Yes | |
add.org | 12 | 13 | Yes | |
add.about.com | 13 | 6 | Yes | Yes |
drugs.com | 14 | 16 | No | Yes |
kidshealth.org | 15 | 20 | No | Yes |
ncbi.nlm.nih.gov | 16 | 9 | No | Yes |
livestrong.com | 17 | 11 | No | |
answers.yahoo.com | 18 | 12 | No | |
healthcentral.com | 19 | 17 | No | Yes |
help4adhd.org | 20 | 19 | Yes |
aADHD: attention deficit hyperactivity disorder.
bHoN: Health on the Net.
The Health on the Net (HoN) foundation is an organization that certifies websites that provide health-related information and certification if they meet specific reliability standards. Interestingly, although 45% of the 20 popular websites that appear in
As presented in
People who made at least one IPQ on Bing also differed in the association of their browsing behavior with Yahoo Answers. The average number of Bing queries made by people in the IPQ population who had a Yahoo Answers result displayed to them was 5.7, compared with 5.4 in the remaining population. However, people in the IPQ population who clicked on a Yahoo Answers result made an average of 14.5 queries on Bing compared with 7.2 made by other users in this sample. Thus, people who have a strong personal interest in ADHD tend to search more on Bing and click more on Yahoo Answers results. Consequently, the following sections will focus on questions from Yahoo Answers.
Analysis of the questions in Yahoo answers focused on
In total, 979 personal questions were found in Yahoo Answers in Phase A, as presented in
Moreover, children who were diagnosed with ADHD were significantly older than those suspected of having ADHD. The average age for the latter was 5.1 years (range 0.5-20, SD 2.5), compared with 7.9 years for diagnosed children (range 3-20, SD 2.7; ranksum,
The relative frequency of each of the three types of issues reported in the questions (daily function, behavioral, academic), stratified by age is presented in
In order to gather more information about the query process, a Cox hazard regression model [
demographics: age and gender
whether the question discussed functional, behavioral, or academic issues related to ADHD
diagnosis status: whether the question discussed a child who was suspected to have ADHD, or already diagnosed with ADHD
whether the person inquiring appeared to be emotional, helpless, or positive
whether the person inquiring asked for information
whether the question mentioned that the child was receiving medication and whether the child had additional diagnoses
For this analysis, only 97.2% (952/979) of questions in which the diagnosis status was known were considered. The statistically significant variables (
Distributions of children’s age for the 952 questions where askers describe whether their child is suspected of attention deficit hyperactivity disorder (ADHD) or diagnosed with it, in Yahoo Answers questions.
Age of children suspected of having attention deficit hyperactivity disorder (ADHD), stratified by gender.
Age of children diagnosed with attention deficit hyperactivity disorder (ADHD), stratified by gender.
Frequency of issues reported in children suspected of attention deficit hyperactivity disorder (ADHD), stratified by age.
Frequency of issues reported in children diagnosed as attention deficit hyperactivity disorder (ADHD), stratified by age.
In Phase B, 13.07% (1609/12,310) of ADHD-related questions by users in our sample were extracted from all 12,310 Yahoo Answers questions. The question was labeled as ADHD-related if the text contained the word ADHD, the name of a drug used to treat ADHD (adderall, amphetamine, buspirone, clonidine, ethylphenidate, melatonin, methamphetamine, methylphenidate, oxycodone, or rember), or common comorbidities of ADHD (developmental deficit malnutrition, autism, learning disability, dyslexia, bipolar, autistic spectrum disorder, mood disorder, Tourette, Asperger’s syndrome, speech impairment, or obsessive compulsive disorder). Of the entire set of questions, 53.79% (6621/12,310) of questions were asked by people in the labeled set of 979 personal account questions. Among the 979 personal questions, there were 13.0% (127/979) of questions labeled as ADHD-related in this set by people who asked a question about a child prediagnosis, and 33.6% (329/979) questions about children postdiagnosis.
Considering all the 6621 questions, the ratio between the probability of asking an ADHD-related question, divided by the probability of asking any type of question, as a function of time is presented in
The questions were stratified by whether they were asked by a user who discussed a child prediagnosis in the labeled set, or a child postdiagnosis. As presented in
The probability ratio of asking an additional attention deficit hyperactivity disorder (ADHD)–related question, divided by suspected of ADHD or already diagnosed.
The aim of this study was to obtain better insights about
This study also found that people, who are interested in ADHD due to a close family member’s diagnosis as reflected in IPQ queries, perform a more extensive search process compared with others. This is in line with search characteristics for other medical conditions [
Currently, the literature about Web-based information seeking among parents of children with ADHD is scarce. To the best of our knowledge, there is no knowledge in the existing literature related to which specific information parents seek for. Results of this study that are presented in
The next highest category (6.9%) of queries was related to medication. Nowadays, medication use is highly common worldwide and is still the mainstay of ADHD treatment in the United States [
Aside from searching for information about ADHD symptoms and medication, 4.5% of the queries asked were related to children and 6.9% related to adults with ADHD. This finding is in accordance with the phenomena of ADHD as a life-span longitudinal disorder, affecting 2-4% of adults [
The study results provided not only a response to the question of
In the personal questions category on Yahoo Answers, where data about gender were available, the gender ratio was 3:1. Respectively, after addressing the questions of
Moreover, it was interesting to obtain information not only about
Another interesting finding is that in both the group that declared and the group that did not declare a diagnosis, 20% or more of the questions around the age of 12 years were related to the academic queries category.
Academic deficits among children with ADHD have long been documented (eg, [
Further to achieving insight about the
When analyzing the phenomena of whether people whose children were diagnosed asked more questions, it was found that these people are less likely to continue to ask questions online. Perhaps this tendency occurs because at this stage, parents refer their questions to their doctor in light of the findings of preference of this source among this population [
In summary, our results indicate that the Internet is indeed a source of information about ADHD and tracking the search process performed by the users on the Web sheds light on people’s needs. Besides the high priority given by parents of adolescents with ADHD to receiving information from the doctor, regardless the time constrains [
Thus, as ADHD is a chronic long-life phenomenon, expert professions may use the Web as a useful source of information for supplying accurate information over time according to this population’s daily needs [
Despite the interesting results, this study has several limitations. As far as known, this is the first study in which a quantitative analysis of the search extent and content was performed. The classification criteria as well as interrater validity need to further be discussed and improved.
Further studies that include more accurate criteria as well as a qualitative analysis of the queries made within international Internet forums are required to achieve better insight about this population’s needs and the existing barriers to seeking help (eg, [
Examples to words that appear in each category.
attention deficit hyperactivity disorder
Health on the Net
Individual Persons Query
None declared.