Temporal Association Between ChatGPT-Generated Diarrhea Synonyms in Internet Search Queries and Emergency Department Visits for Diarrhea-Related Symptoms in South Korea: Exploratory Study.

Publisher: JMIR Publications Country of Publication: Canada NLM ID: 100959882 Publication Model: Electronic Cited Medium: Internet ISSN: 1438-8871 (Electronic) Linking ISSN: 14388871 NLM ISO Abbreviation: J Med Internet Res Subsets: MEDLINE

Publication: <2011- > : Toronto : JMIR Publications
Original Publication: [Pittsburgh, PA? : s.n., 1999-

Emergency Service, Hospital*/statistics & numerical data ; Diarrhea*/epidemiology ; Search Engine* ; Internet*; Republic of Korea/epidemiology ; Humans ; Adult ; Middle Aged ; Female ; Male ; Young Adult ; Aged ; Adolescent ; Emergency Room Visits ; Generative Artificial Intelligence

Background: Diarrhea, a common symptom of gastrointestinal infections, can lead to severe complications and is a major cause of emergency department (ED) visits.
Objective: This study explored the temporal association between internet search queries for diarrhea and its synonyms and ED visits for diarrhea-related symptoms.
Methods: We used data from the National Emergency Department Information System (NEDIS) and NAVER (Naver Corporation), South Korea's leading search engine, from January 2017 to December 2021. After identifying diarrhea synonyms using ChatGPT, we compared weekly trends in relative search volumes (RSVs) for diarrhea, including its synonyms and weekly ED visits. Pearson correlation analysis and Granger causality tests were used to evaluate the relationship between RSVs and ED visits. We developed an Autoregressive Integrated Moving Average with Exogenous Variables (ARIMAX) model to further predict these associations. This study also examined the age-based distribution of search behaviors and ED visits.
Results: A significant correlation was observed between the weekly RSV for diarrhea and its synonyms and weekly ED visits for diarrhea-related symptoms (ranging from 0.14 to 0.51, P<.05). Weekly RSVs for diarrhea synonyms, such as "upset stomach," "watery diarrhea," and "acute enteritis," showed stronger correlations with weekly ED visits than weekly RSVs for the general term "diarrhea" (ranging from 0.20 to 0.41, P<.05). This may be because these synonyms better reflect layperson terminology. Notably, weekly RSV for "upset stomach" was significantly correlated with weekly ED visits for diarrhea and acute diarrhea at 1 and 2 weeks before the visit (P<.05). An ARIMAX model was developed to predict weekly ED visits based on weekly RSVs for diarrhea synonyms with lagged effects to capture their temporal influence. The age group of <50 years showed the highest activity in both web-based searches and ED visits for diarrhea-related symptoms.
Conclusions: This study demonstrates that weekly RSVs for diarrhea synonyms are associated with weekly ED visits for diarrhea-related symptoms. By encompassing a nationwide scope, this study broadens the existing methodology for syndromic surveillance using ED data and provides valuable insights for clinicians.
(©Jinsoo Kim, Ansun Jeong, Juseong Jin, Sangjun Lee, Do Kyoon Yoon, Soyeoun Kim. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 22.05.2025.)

Health Commun. 2024 Jul;39(8):1651-1664. (PMID: 38326714)
J Med Internet Res. 2023 Oct 17;25:e45085. (PMID: 37847532)
Gastroenterol Clin North Am. 1993 Sep;22(3):483-97. (PMID: 8406726)
Lancet Child Adolesc Health. 2022 Feb;6(2):106-115. (PMID: 34800370)
J Educ Eval Health Prof. 2023;20:30. (PMID: 37981579)
J Korean Med Sci. 2022 Apr 11;37(14):e108. (PMID: 35411728)
JMIR Public Health Surveill. 2021 May 10;7(5):e18593. (PMID: 33970108)
PLoS One. 2020 Jul 24;15(7):e0236777. (PMID: 32706835)
PLoS One. 2014 Oct 22;9(10):e109583. (PMID: 25337815)
Sci Rep. 2017 Sep 5;7(1):10437. (PMID: 28874880)
JMIR Public Health Surveill. 2020 Apr 13;6(2):e10919. (PMID: 32281540)
Foods. 2025 Jan 14;14(2):. (PMID: 39856905)
Acad Emerg Med. 1998 Jul;5(7):739-44. (PMID: 9678399)
Clin Infect Dis. 2009 Nov 15;49(10):1557-64. (PMID: 19845471)
Proc Natl Acad Sci U S A. 2015 Nov 24;112(47):14473-8. (PMID: 26553980)
Emerg Infect Dis. 2015 Nov;21(11):1906-12. (PMID: 26485066)
BMJ. 2002 Mar 9;324(7337):573-7. (PMID: 11884321)
Am J Gastroenterol. 1997 Nov;92(11):1962-75. (PMID: 9362174)
J Korean Med Sci. 2021 Feb 01;36(5):e44. (PMID: 33527786)
J Infect Dis. 2024 Jul 25;230(1):103-108. (PMID: 39052697)
J Korean Med Sci. 2015 Jan;30(1):95-103. (PMID: 25552889)
Indian J Pediatr. 2017 Dec;84(12):915-921. (PMID: 28687951)
BMC Psychiatry. 2022 Jun 22;22(1):418. (PMID: 35733111)
Healthcare (Basel). 2022 Jul 17;10(7):. (PMID: 35885850)
J Med Internet Res. 2023 May 8;25:e37540. (PMID: 37155231)
Clin Toxicol (Phila). 2012 Feb;50(2):114-9. (PMID: 22320211)
Ann Emerg Med. 2015 Apr;65(4):436-442.e1. (PMID: 25487026)
Int J Environ Res Public Health. 2024 Apr 17;21(4):. (PMID: 38673400)
J Med Internet Res. 2017 Jun 29;19(6):e232. (PMID: 28663162)
Eur Radiol. 2024 May;34(5):2817-2825. (PMID: 37794249)
J Med Syst. 2023 Mar 04;47(1):33. (PMID: 36869927)
Int Endod J. 2024 Mar;57(3):305-314. (PMID: 38117284)
Nature. 2009 Feb 19;457(7232):1012-4. (PMID: 19020500)
Dig Dis Sci. 2017 Mar;62(3):588-592. (PMID: 27878646)
J Med Internet Res. 2023 Jan 16;25:e42401. (PMID: 36603152)
J Med Internet Res. 2020 Jan 10;22(1):e15148. (PMID: 31922490)
J Med Internet Res. 2022 Jan 18;24(1):e23656. (PMID: 35040796)
PLoS One. 2015 Oct 05;10(10):e0139701. (PMID: 26437454)
MMWR Morb Mortal Wkly Rep. 2020 Sep 11;69(36):1250-1257. (PMID: 32915166)
Radiology. 2023 Apr;307(2):e230163. (PMID: 36700838)
J Am Coll Emerg Physicians Open. 2024 Feb 22;5(1):e13105. (PMID: 38405371)
Front Public Health. 2023 Oct 26;11:1196397. (PMID: 37954052)
Gastroenterol Clin North Am. 2003 Dec;32(4):1249-67. (PMID: 14696306)
Urology. 2020 Jun;140:4-6. (PMID: 32298686)
BMC Infect Dis. 2021 Jul 20;21(1):696. (PMID: 34284731)

Keywords: diarrhea; emergency room; relative search volumes; symptoms; synonyms

Date Created: 20250522 Date Completed: 20250522 Latest Revision: 20250609

20260130

PMC12141962

10.2196/65101

40403303