Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May 22:27:e65101.
doi: 10.2196/65101.

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

Jinsoo Kim  1 , Ansun Jeong  2 , Juseong Jin  3 , Sangjun Lee  4   5   6 , Do Kyoon Yoon  7 , Soyeoun Kim  8
Affiliations

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

Jinsoo Kim et al. J Med Internet Res. .

Abstract

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.

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

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Trends in the total weekly emergency department visits for diarrhea-related symptoms from NEDIS and the mean weekly relative search volumes, including diarrhea and its synonyms from NAVER, from January 2017 to December 2021. ED: emergency department; NEDIS: National Emergency Department Information System; RSV: relative search volume.
Figure 2
Figure 2
Actual values (black line), fitted values (red line), and predicted values (blue line with 95% CIs) from Autoregressive Integrated Moving Average with Exogenous models showing the associations between weekly relative search volumes for diarrhea synonyms—upset stomach, watery diarrhea, and acute enteritis—and weekly emergency department visits for diarrhea and watery diarrhea across lag times of 0 to 2 weeks. (A) Weekly relative search volumes for “upset stomach” associated with weekly emergency department visits with diarrhea. (B) Weekly relative search volumes for “watery diarrhea” associated with weekly emergency department visits with watery diarrhea. (C) Weekly relative search volumes for “acute enteritis” associated with weekly emergency department visits with watery diarrhea. ARIMAX: Autoregressive Integrated Moving Average with Exogenous variables; ED: emergency department; RSVs: relative search volumes.
Figure 3
Figure 3
Age group–based distribution of relative search volumes for diarrhea and its synonyms from NAVER and emergency department visits for diarrhea-related symptoms from the National Emergency Department Information System, from January 2017 to December 2021. (A) National Emergency Department Information System (B) NAVER. ED: emergency department; NEDIS: National Emergency Department Information System; RSV: relative search volume.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Park J, Yeo Y, Ji Y, Kim B, Han K, Cha W, Son M, Jeon H, Park J, Shin D. Factors associated with emergency department visits and consequent hospitalization and death in Korea using a population-based national health database. Healthcare (Basel) 2022;10(7):1324. doi: 10.3390/healthcare10071324. https://www.mdpi.com/resolver?pii=healthcare10071324 healthcare10071324 - DOI - PMC - PubMed
    1. Weiss A, Jiang H. Most frequent reasons for emergency department visits, 2018. HCUP Statistical Brief. 2021. [202-07-30]. https://hcup-us.ahrq.gov/reports/statbriefs/sb277-Top-Reasons-Hospital-S... .
    1. Bellido-Blasco J, Arnedo-Pena A. Epidemiology of infectious diarrhea. Environ Health. 2011:659. doi: 10.1016/b978-0-444-63951-6.00689-6. - DOI
    1. Perin J, Mulick A, Yeung D, Villavicencio F, Lopez G, Strong KL, Prieto-Merino D, Cousens S, Black RE, Liu L. Global, regional, and national causes of under-5 mortality in 2000-19: an updated systematic analysis with implications for the sustainable development goals. Lancet Child Adolesc Health. 2022;6(2):106–115. doi: 10.1016/S2352-4642(21)00311-4. https://linkinghub.elsevier.com/retrieve/pii/S2352-4642(21)00311-4 S2352-4642(21)00311-4 - DOI - PMC - PubMed
    1. Aoun L, Lakkis N, Antoun J. Prevalence and outcomes of web-based health information seeking for acute symptoms: cross-sectional study. J Med Internet Res. 2020;22(1):e15148. doi: 10.2196/15148. https://www.jmir.org/2020/1/e15148/ v22i1e15148 - DOI - PMC - PubMed

LinkOut - more resources