P4949 - Digital Epidemiology of Peroral Endoscopic Myotomy: Public Interest and Training Disparities in the United States (2014–2024)

Nakul Ganju, MD¹, Shubham Gupta, MD², Shaunak Ganju, BS³, Ahmed Mohamed Ebeid, MD⁴, Lakshmi Chirumamilla, MD⁴, Pinky Bai, MD⁴, Abay Gobezie, MD⁴, Mesay Asfaw, MD⁵, Juan C. Santiago-Gonzalez, MD, MSc⁴, Farshad Aduli, MD⁴
1Department of Medicine, Howard University Hospital, Washington, DC; 2Virtua Health System, Philadelphia, PA; 3Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA; 4Howard University Hospital, Washington, DC; 5Howard University, Washington, DC

Introduction: Peroral endoscopic myotomy (POEM) is an established, minimally invasive first-line therapy for achalasia, endorsed by major gastroenterological societies. National patterns of public awareness and regional access remain incompletely characterized. This study evaluated temporal and geographic trends in public interest in POEM and achalasia across the United States, correlating population search behavior with scholarly output and the distribution of ASGE Advanced Endoscopy Match Programs offering POEM training.

Methods: Google Trends data from 2014–2024 were extracted for POEM-related search terms and combined into a composite Relative Search Volume (RSV, scale 0–100). RSV is a normalized metric reflecting term popularity across time and geography, with 100 as peak interest. Composite RSV trends were analyzed nationally and by state, and compared to annual U.S.-based PubMed publication counts for POEM and achalasia. Fellowship availability was assessed using the geographic distribution of institutions in the ASGE Advanced Endoscopy Fellowship (AEF) Match offering POEM training.

Results: National interest in POEM increased substantially, with composite RSV rising from 13.2 in 2014 to 65.7 in 2024—a nearly fivefold increase. U.S. publication volume rose from 2 in 2014 to a peak of 20 in 2021, with totals ranging from 5–20 in recent years. A moderate positive correlation was observed between composite RSV and publication volume (Pearson r=0.57, p=0.068), suggesting a temporal association between academic dissemination and public awareness. Subregional analysis revealed significant heterogeneity in RSV, with the highest scores in New Hampshire (93.0), Massachusetts (89.0), Ohio (88.0), Tennessee (86.0), and Pennsylvania (85.0). Among the top 25 states by RSV, only New Hampshire and Delaware lacked fellowship programs in the ASGE AEF Match offering POEM training.

Discussion: Public interest in POEM has risen sharply over the past decade, mirroring its clinical adoption and growing presence in major guidelines. However, geographic disparities remain, as shown by high-interest states without affiliated training programs. This disconnect suggests demand for POEM may outpace local procedural capacity. Addressing these gaps may require strategic expansion of training via regional centers, traveling proctorship models, and hybrid educational platforms. These findings support the need for workforce and policy initiatives promoting equitable access to advanced endoscopic care nationwide.


Figure: Figure 1: National Trends in Public Interest and Scholarly Output for POEM (2014–2024)
Left: Composite Relative Search Volume (RSV) from Google Trends for POEM-related terms in the United States, indicating increasing public awareness.
Right: Annual U.S.-based peer-reviewed publications on POEM, demonstrating rising academic engagement over the same period.


Figure: Figure 2. Left: Number of ASGE AEF Match Programs Offering POEM Training by U.S. state in 2024. Right: Composite Relative Search Volume (RSV) for POEM and achalasia by state based on Google Trends data (2014–2024). States with darker blue shading indicate higher public interest (RSV 0–100). Comparison highlights potential geographic disparities between public awareness and training infrastructure.

Disclosures:
Nakul Ganju indicated no relevant financial relationships.
Shubham Gupta indicated no relevant financial relationships.
Shaunak Ganju indicated no relevant financial relationships.
Ahmed Mohamed Ebeid indicated no relevant financial relationships.
Lakshmi Chirumamilla indicated no relevant financial relationships.
Pinky Bai indicated no relevant financial relationships.
Abay Gobezie indicated no relevant financial relationships.
Mesay Asfaw indicated no relevant financial relationships.
Juan Santiago-Gonzalez indicated no relevant financial relationships.
Farshad Aduli indicated no relevant financial relationships.

Nakul Ganju, MD¹, Shubham Gupta, MD², Shaunak Ganju, BS³, Ahmed Mohamed Ebeid, MD⁴, Lakshmi Chirumamilla, MD⁴, Pinky Bai, MD⁴, Abay Gobezie, MD⁴, Mesay Asfaw, MD⁵, Juan C. Santiago-Gonzalez, MD, MSc⁴, Farshad Aduli, MD⁴. P4949 - Digital Epidemiology of Peroral Endoscopic Myotomy: Public Interest and Training Disparities in the United States (2014–2024), ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.