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Plastic Surgery Research Council

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Evaluation Of Seasonal Patterns In Orthognathic Surgery: A Study Of The Open Source Google Trends Database
Cristin Coquillard, MD, Yida Cai, BS, Samuel Boas, BS, Anand Kumar, MD.
Case Western Reserve University/University Hospitals, Cleveland, OH, USA.

PURPOSE: Google trends is a freely available online tool that allows users to analyze the frequency of search term use over time. This "infodemiology" resource has had broad applications across healthcare research. In plastic surgery, Google trends data may be used to evaluate seasonal and geographical influences that may help inform marketing strategies. The purpose of this study was to evaluate seasonal interest in orthognathic surgery. We hypothesized that peak interest would correlate with school breaks in summer and winter months.
METHODS: Google trends data for orthognathic surgery were gathered from January 2004 to June 2019. Data were reported as relative search volumes (on an adjusted scale from 0-100) by month. Search terms used included "orthognathic surgery", "double jaw surgery", "jaw surgery", "overbite surgery", and "underbite surgery". The data were then analyzed using the previously described R Consinor "seasons" package, in which each search term was tested for seasonal effects by fitting monthly search term data to a parametric cosinor model.
RESULTS: Analysis with Consinor revealed statistically significant seasonality for all search terms, though the relative search volume amplitude of the cosinor model curve was low: orthognathic surgery (p = 0.01, amplitude 2.04), double jaw surgery (p = 0.03, amplitude 4.49), jaw surgery (p = < 0.001, amplitude 3.91), underbite surgery (p = 0.003, amplitude 2.13), overbite surgery (p = <0.001, amplitude 3.31). A clear peak in public interest was seen in July with all search terms but underbite surgery, which had a peak in June. All search terms except double jaw surgery had a smaller second peak in January. The nadir month in search interest varied between terms. There was no clear trend in geographic distribution of search terms.
CONCLUSION: Google trends search volumes over greater than a fourteen-year period do suggest a seasonal difference in interest in orthognathic surgery, with peaks in interest in July and January. Craniofacial surgeons may consider adjusting marketing and patient discussions to reflect increased public interest during these months. However, it is unclear if this statistically significant seasonality represents a clinically significant variation. Future study is needed to correlate these findings with actual surgical volume by month, possibly by comparing with a database such as the National Inpatient Sample.


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