Cancer information disparities on the internet: An infodemiological study

Exploring the Health-Related Quality of Life of Patients Treated With Immune Checkpoint Inhibitors: Social Media Study

BACKGROUND

Immune checkpoint inhibitors (ICIs) are increasingly used to treat several types of tumors. Impact of this emerging therapy on patients' health-related quality of life (HRQoL) is usually collected in clinical trials through standard questionnaires. However, this might not fully reflect HRQoL of patients under real-world conditions. In parallel, users' narratives from social media represent a potential new source of research concerning HRQoL.

OBJECTIVE

The aim of this study is to assess and compare coverage of ICI-treated patients' HRQoL domains and subdomains in standard questionnaires from clinical trials and in real-world setting from social media posts.

METHODS

A retrospective study was carried out by collecting social media posts in French language written by internet users mentioning their experiences with ICIs between January 2011 and August 2018. Automatic and manual extractions were implemented to create a corpus where domains and subdomains of HRQoL were classified. These annotations were compared with domains covered by 2 standard HRQoL questionnaires, the EORTC QLQ-C30 and the FACT-G.

RESULTS

We identified 150 users who described their own experience with ICI (89/150, 59.3%) or that of their relative (61/150, 40.7%), with 137 users (91.3%) reporting at least one HRQoL domain in their social media posts. A total of 8 domains and 42 subdomains of HRQoL were identified: Global health (1 subdomain; 115 patients), Symptoms (13; 76), Emotional state (10; 49), Role (7; 22), Physical activity (4; 13), Professional situation (3; 9), Cognitive state (2; 2), and Social state (2; 2). The QLQ-C30 showed a wider global coverage of social media HRQoL subdomains than the FACT-G, 45% (19/42) and 29% (12/42), respectively. For both QLQ-C30 and FACT-G questionnaires, coverage rates were particularly suboptimal for Symptoms (68/123, 55.3% and 72/123, 58.5%, respectively), Emotional state (7/49, 14% and 24/49, 49%, respectively), and Role (17/22, 77% and 15/22, 68%, respectively).

CONCLUSIONS

Many patients with cancer are using social media to share their experiences with immunotherapy. Collecting and analyzing their spontaneous narratives are helpful to capture and understand their HRQoL in real-world setting. New measures of HRQoL are needed to provide more in-depth evaluation of Symptoms, Emotional state, and Role among patients with cancer treated with immunotherapy.

Managing Cancer Experiences: An Interpretive Description Study of Internet Information Use

BACKGROUND

People with cancer increasingly use the Internet to find information about their illness. However, little is known regarding people's use of cancer-related Internet information (CRII) to manage their patient experience, defined as patients' cumulative perceptions of interactions with the healthcare system during their illness.

OBJECTIVE

The purpose of this study was to create an understanding of CRII use by people newly diagnosed with cancer and how it shapes their patient experience and informs their interactions with healthcare professionals and healthcare services.

METHODS

An embedded mixed design guided this study. Nineteen people with cancer were interviewed twice and completed a survey about CRII use. Qualitative data were analyzed using thematic analysis. Descriptive statistics summarized the quantitative findings.

RESULTS

Participants of all ages and educational levels reported using CRII as a pivotal resource, across the cancer trajectory. Cancer-related Internet information played a central role in how patients understood their illness and when they sought and used healthcare services. Two themes emerged based on patient interviews: (1) person in context and (2) management of information.

CONCLUSION

Cancer-related Internet information plays a crucial role in how people manage their illness and take control of their patient experience. Participants used CRII to learn about their illness, support their efforts to self-manage, and complement information from professionals.

IMPLICATIONS FOR PRACTICE

Individuals and institutions can promote and encourage tailored CRII use by engaging patients and suggesting websites based on their needs. Doing so may create efficiencies in service use and empower patients to be more involved in their own care.

Online behavior of people visiting a scientific website on epilepsy

We investigated the online behavior of Internet users consulting the website of the Italian Chapter of the International League Against Epilepsy (Lega Italiana Contro l'Epilessia [LICE]). We obtained the visualization statistics of the LICE website using AWStats (https://awstats.sourceforge.io/) and Google Trends (https://trends.google.com/trends/), and compared the statistics of years 2010, 2014, and 2017. The following variables were analyzed: number of unique visitors and visits, visit duration, the day of week and rush hours, most downloaded documents, most viewed pages, keyphrases and keywords used for online searches, origins of searches, and geographic trends of Google searches related to the LICE. The total numbers of unique visitors, visits and page views remained quite stable over time. Most visits (70 to 76.7%) lasted less than 30 s. The most frequent keyphrases and keywords used for online searches were related to clinical guidelines and driving license. Among the most frequently downloaded documents were general guides on epilepsy. The pages with the list of epilepsy centers endorsed by the LICE and those with the list of LICE guidelines were among those most frequently viewed, together with educational videos. Most users directly accessed the website without being referred from external links. No information on geographic origin of Google searches was available. The visualization statistics suggested two distinct populations of visitors. The first one is likely represented by physicians who seek specialist information on diagnosis and management of epilepsy, including guidelines. The second population is represented by lay people who seek accessible and easily comprehensible information to better understand epilepsy and know which centers are best for its management.

Neurology and the Internet: a review

Nowadays, the Internet is the major source to obtain information about diseases and their treatments. The Internet is gaining relevance in the neurological setting, considering the possibility of timely social interaction, contributing to general public awareness on otherwise less-well-known neurological conditions, promoting health equity and improving the health-related coping. Neurological patients can easily find several online opportunities for peer interactions and learning. On the other hand, neurologist can analyze user-generated data to better understand patient needs and to run epidemiological studies. Indeed, analyses of queries from Internet search engines on certain neurological diseases have shown a strict temporal and spatial correlation with the "real world." In this narrative review, we will discuss how the Internet is radically affecting the healthcare of people with neurological disorders and, most importantly, is shifting the paradigm of care from the hands of those who deliver care, into the hands of those who receive it. Besides, we will review possible limitations, such as safety concerns, financial issues, and the need for easy-to-access platforms.