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Mapundu MT, Kabudula CW, Musenge E, Olago V, Celik T. Text mining of verbal autopsy narratives to extract mortality causes and most prevalent diseases using natural language processing. PLoS One 2024; 19:e0308452. [PMID: 39298425 DOI: 10.1371/journal.pone.0308452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 07/24/2024] [Indexed: 09/21/2024] Open
Abstract
Verbal autopsy (VA) narratives play a crucial role in understanding and documenting the causes of mortality, especially in regions lacking robust medical infrastructure. In this study, we propose a comprehensive approach to extract mortality causes and identify prevalent diseases from VA narratives utilizing advanced text mining techniques, so as to better understand the underlying health issues leading to mortality. Our methodology integrates n-gram-based language processing, Latent Dirichlet Allocation (LDA), and BERTopic, offering a multi-faceted analysis to enhance the accuracy and depth of information extraction. This is a retrospective study that uses secondary data analysis. We used data from the Agincourt Health and Demographic Surveillance Site (HDSS), which had 16338 observations collected between 1993 and 2015. Our text mining steps entailed data acquisition, pre-processing, feature extraction, topic segmentation, and discovered knowledge. The results suggest that the HDSS population may have died from mortality causes such as vomiting, chest/stomach pain, fever, coughing, loss of weight, low energy, headache. Additionally, we discovered that the most prevalent diseases entailed human immunodeficiency virus (HIV), tuberculosis (TB), diarrhoea, cancer, neurological disorders, malaria, diabetes, high blood pressure, chronic ailments (kidney, heart, lung, liver), maternal and accident related deaths. This study is relevant in that it avails valuable insights regarding mortality causes and most prevalent diseases using novel text mining approaches. These results can be integrated in the diagnosis pipeline for ease of human annotation and interpretation. As such, this will help with effective informed intervention programmes that can improve primary health care systems and chronic based delivery, thus increasing life expectancy.
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Affiliation(s)
- Michael Tonderai Mapundu
- Department of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Chodziwadziwa Whiteson Kabudula
- Department of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Johannesburg, South Africa
| | - Eustasius Musenge
- Department of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Victor Olago
- National Health Laboratory Service (NHLS), National Cancer Registry, Johannesburg, South Africa
| | - Turgay Celik
- Wits Institute of Data Science, University of The Witwatersrand, Johannesburg, South Africa
- School of Electrical and Information Engineering, University of The Witwatersrand, Johannesburg, South Africa
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Shi J, Bendig D, Vollmar HC, Rasche P. Mapping the Bibliometrics Landscape of AI in Medicine: Methodological Study. J Med Internet Res 2023; 25:e45815. [PMID: 38064255 PMCID: PMC10746970 DOI: 10.2196/45815] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 08/16/2023] [Accepted: 09/30/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Artificial intelligence (AI), conceived in the 1950s, has permeated numerous industries, intensifying in tandem with advancements in computing power. Despite the widespread adoption of AI, its integration into medicine trails other sectors. However, medical AI research has experienced substantial growth, attracting considerable attention from researchers and practitioners. OBJECTIVE In the absence of an existing framework, this study aims to outline the current landscape of medical AI research and provide insights into its future developments by examining all AI-related studies within PubMed over the past 2 decades. We also propose potential data acquisition and analysis methods, developed using Python (version 3.11) and to be executed in Spyder IDE (version 5.4.3), for future analogous research. METHODS Our dual-pronged approach involved (1) retrieving publication metadata related to AI from PubMed (spanning 2000-2022) via Python, including titles, abstracts, authors, journals, country, and publishing years, followed by keyword frequency analysis and (2) classifying relevant topics using latent Dirichlet allocation, an unsupervised machine learning approach, and defining the research scope of AI in medicine. In the absence of a universal medical AI taxonomy, we used an AI dictionary based on the European Commission Joint Research Centre AI Watch report, which emphasizes 8 domains: reasoning, planning, learning, perception, communication, integration and interaction, service, and AI ethics and philosophy. RESULTS From 2000 to 2022, a comprehensive analysis of 307,701 AI-related publications from PubMed highlighted a 36-fold increase. The United States emerged as a clear frontrunner, producing 68,502 of these articles. Despite its substantial contribution in terms of volume, China lagged in terms of citation impact. Diving into specific AI domains, as the Joint Research Centre AI Watch report categorized, the learning domain emerged dominant. Our classification analysis meticulously traced the nuanced research trajectories across each domain, revealing the multifaceted and evolving nature of AI's application in the realm of medicine. CONCLUSIONS The research topics have evolved as the volume of AI studies increases annually. Machine learning remains central to medical AI research, with deep learning expected to maintain its fundamental role. Empowered by predictive algorithms, pattern recognition, and imaging analysis capabilities, the future of AI research in medicine is anticipated to concentrate on medical diagnosis, robotic intervention, and disease management. Our topic modeling outcomes provide a clear insight into the focus of AI research in medicine over the past decades and lay the groundwork for predicting future directions. The domains that have attracted considerable research attention, primarily the learning domain, will continue to shape the trajectory of AI in medicine. Given the observed growing interest, the domain of AI ethics and philosophy also stands out as a prospective area of increased focus.
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Affiliation(s)
- Jin Shi
- Institute for Entrepreneurship, University of Münster, Münster, Germany
| | - David Bendig
- Institute for Entrepreneurship, University of Münster, Münster, Germany
| | | | - Peter Rasche
- Department of Healthcare, University of Applied Science - Hochschule Niederrhein, Krefeld, Germany
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Yan Y, Fan G, Liao X, Zhao X. Research trends and hotspots on connectomes from 2005 to 2021: A bibliometric and latent Dirichlet allocation application study. Front Neurosci 2022; 16:1046562. [PMID: 36620450 PMCID: PMC9814013 DOI: 10.3389/fnins.2022.1046562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
Background This study aimed to conduct a bibliometric analysis of publications on connectomes and illustrate its trends and hotspots using a machine-learning-based text mining algorithm. Methods Documents were retrieved from the Web of Science Core Collection (WoSCC) and Scopus databases and analyzed in Rstudio 1.3.1. Through quantitative and qualitative methods, the most productive and impactful academic journals in the field of connectomes were compared in terms of the total number of publications and h-index over time. Meanwhile, the countries/regions and institutions involved in connectome research were compared, as well as their scientific collaboration. The study analyzed topics and research trends by R package "bibliometrix." The major topics of connectomes were classified by Latent Dirichlet allocation (LDA). Results A total of 14,140 publications were included in the study. NEUROIMAGE ranked first in terms of publication volume (1,427 articles) and impact factor (h-index:122) among all the relevant journals. The majority of articles were published by developed countries, with the United States having the most. Harvard Medical School and the University of Pennsylvania were the two most productive institutions. Neuroimaging analysis technology and brain functions and diseases were the two major topics of connectome research. The application of machine learning, deep learning, and graph theory analysis in connectome research has become the current trend, while an increasing number of studies were concentrating on dynamic functional connectivity. Meanwhile, researchers have begun investigating alcohol use disorders and migraine in terms of brain connectivity in the past 2 years. Conclusion This study illustrates a comprehensive overview of connectome research and provides researchers with critical information for understanding the recent trends and hotspots of connectomes.
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Affiliation(s)
- Yangye Yan
- Tongji University School of Medicine, Shanghai Eastern Hospital Affiliated to Tongji University, Shanghai, China
| | - Guoxin Fan
- Department of Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China,School of Biomedical Engineering, School of Medicine, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Shenzhen University, Shenzhen, China,Department of Spine Surgery, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiang Liao
- Department of Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China,School of Biomedical Engineering, School of Medicine, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Shenzhen University, Shenzhen, China,*Correspondence: Xiang Liao,
| | - Xudong Zhao
- Clinical Research Center for Mental Disorders, Chinese-German Institute of Mental Health, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China,Xudong Zhao,
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Shi J, Wei S, Gao Y, Mei F, Tian J, Zhao Y, Li Z. Global output on artificial intelligence in the field of nursing: A bibliometric analysis and science mapping. J Nurs Scholarsh 2022. [DOI: 10.1111/jnu.12852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/26/2022] [Accepted: 11/07/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Jiyuan Shi
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
| | - Shuaifang Wei
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
| | - Ya Gao
- Evidence‐Based Medicine Center, School of Basic Medical Sciences Lanzhou University Lanzhou China
| | - Fan Mei
- Chinese Evidence‐Based Medicine Center and Cochrane China Center, West China Hospital Sichuan University Chengdu China
| | - Jinhui Tian
- Evidence‐Based Medicine Center, School of Basic Medical Sciences Lanzhou University Lanzhou China
| | - Yang Zhao
- School of Nursing Southern Medical University Guangzhou China
| | - Zheng Li
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
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Evolutionary stages and multidisciplinary nature of artificial intelligence research. Scientometrics 2022. [DOI: 10.1007/s11192-022-04477-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Park J, Choi W, Jung SU. Exploring Trends in Environmental, Social, and Governance Themes and Their Sentimental Value Over Time. Front Psychol 2022; 13:890435. [PMID: 35837641 PMCID: PMC9275432 DOI: 10.3389/fpsyg.2022.890435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 05/02/2022] [Indexed: 11/13/2022] Open
Abstract
Environmental, social, and governance (ESG) is an indicator that measures a company's non-financial performance. Many firms have recently emphasized the importance of ESG. Ascertaining what topics are being discussed around ESG and how they change over time will contribute significantly to gaining insight into ESG. Using 73,397,870 text data scraped and refined from publicly available Twitter data, this study applied Latent Dirichlet Allocation (LDA) and the dynamic topic model (DTM) to ascertain the hidden structure of the ESG-related document collection and the topics being discussed. The study further conducts a sentiment analysis to examine the sentiment of the general public regarding ESG. Topic modeling shows that various topics regarding ESG are being discussed and evolve over time. Sentiment analysis shows that many people have neutral or positive sentiments toward ESG-related issues. This study contributes to exploring insights into ESG among the public and understanding public reactions toward ESG. We further conclude the study with a discussion of managerial implications and potential future research.
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Affiliation(s)
- Joonbeom Park
- Graduate School of Information, Yonsei University, Seoul, South Korea
| | - Woojoo Choi
- Graduate Business School, Hankuk University of Foreign Studies, Seoul, South Korea
| | - Sang-Uk Jung
- Graduate Business School, Hankuk University of Foreign Studies, Seoul, South Korea
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Choi I, Kim J, Kim WC. Dietary Pattern Extraction Using Natural Language Processing Techniques. Front Nutr 2022; 9:765794. [PMID: 35356732 PMCID: PMC8959352 DOI: 10.3389/fnut.2022.765794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 02/04/2022] [Indexed: 12/03/2022] Open
Abstract
In this study, we observed the changes in dietary patterns among Korean adults in the previous decade. We evaluated dietary intake using 24-h recall data from the fourth (2007–2009) and seventh (2016–2018) Korea National Health and Nutrition Examination Survey. Machine learning-based methodologies were used to extract these dietary patterns. Particularly, we observed three dietary patterns from each survey similar to the traditional and Western dietary patterns in 2007–2009 and 2016–2018, respectively. Our results reveal a considerable increase in the number of Western dietary patterns compared with the previous decade. Thus, our study contributes to the use of novel methods using natural language processing (NLP) techniques for dietary pattern extraction to obtain more useful dietary information, unlike the traditional methodology.
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Affiliation(s)
- Insu Choi
- Department of Industrial and Systems Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Jihye Kim
- Department of Genetics and Biotechnology, College of Life Sciences, Kyung Hee University, Yongin, South Korea
- *Correspondence: Jihye Kim
| | - Woo Chang Kim
- Department of Industrial and Systems Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
- Woo Chang Kim
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Lareyre F, Lê CD, Ballaith A, Adam C, Carrier M, Amrani S, Caradu C, Raffort J. Applications of Artificial Intelligence in Non-cardiac Vascular Diseases: A Bibliographic Analysis. Angiology 2022; 73:606-614. [DOI: 10.1177/00033197211062280] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Research output related to artificial intelligence (AI) in vascular diseases has been poorly investigated. The aim of this study was to evaluate scientific publications on AI in non-cardiac vascular diseases. A systematic literature search was conducted using the PubMed database and a combination of keywords and focused on three main vascular diseases (carotid, aortic and peripheral artery diseases). Original articles written in English and published between January 1995 and December 2020 were included. Data extracted included the date of publication, the journal, the identity, number, affiliated country of authors, the topics of research, and the fields of AI. Among 171 articles included, the three most productive countries were USA, China, and United Kingdom. The fields developed within AI included: machine learning (n = 90; 45.0%), vision (n = 45; 22.5%), robotics (n = 42; 21.0%), expert system (n = 15; 7.5%), and natural language processing (n = 8; 4.0%). The applications were mainly new tools for: the treatment (n = 52; 29.1%), prognosis (n = 45; 25.1%), the diagnosis and classification of vascular diseases (n = 38; 21.2%), and imaging segmentation (n = 38; 21.2%). By identifying the main techniques and applications, this study also pointed to the current limitations and may help to better foresee future applications for clinical practice.
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Affiliation(s)
- Fabien Lareyre
- Department of Vascular Surgery, Hospital of Antibes Juan-les-Pins, Nice, France
- Université Côte d’Azur, Inserm U1065, C3M, Nice, France
- AI Institute 3IA Côte D’Azur, Université Côte D’Azur, Nice, Nice, France
| | - Cong Duy Lê
- Department of Vascular Surgery, Hospital of Antibes Juan-les-Pins, Nice, France
- AI Institute 3IA Côte D’Azur, Université Côte D’Azur, Nice, Nice, France
| | - Ali Ballaith
- Department of Vascular Surgery, University Hospital of Nice, Nice, France
| | - Cédric Adam
- Laboratory of Applied Mathematics and Computer Science (MICS), CentraleSupélec, Paris, France
| | - Marion Carrier
- Laboratory of Applied Mathematics and Computer Science (MICS), CentraleSupélec, Paris, France
| | - Samantha Amrani
- Department of Vascular Surgery, Hospital of Antibes Juan-les-Pins, Nice, France
| | - Caroline Caradu
- Vascular and General Surgery Department, Bordeaux University Hospital, Bordeaux, France
| | - Juliette Raffort
- Université Côte d’Azur, Inserm U1065, C3M, Nice, France
- AI Institute 3IA Côte D’Azur, Université Côte D’Azur, Nice, Nice, France
- Clinical Chemistry Laboratory, University Hospital of Nice, Nice, France
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Gong J, Sihag V, Kong Q, Zhao L. Visualizing Knowledge Evolution Trends and Research Hotspots of Personal Health Data Research: Bibliometric Analysis. JMIR Med Inform 2021; 9:e31142. [PMID: 34723823 PMCID: PMC8593818 DOI: 10.2196/31142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/17/2021] [Accepted: 09/17/2021] [Indexed: 11/13/2022] Open
Abstract
Background The recent surge in clinical and nonclinical health-related data has been accompanied by a concomitant increase in personal health data (PHD) research across multiple disciplines such as medicine, computer science, and management. There is now a need to synthesize the dynamic knowledge of PHD in various disciplines to spot potential research hotspots. Objective The aim of this study was to reveal the knowledge evolutionary trends in PHD and detect potential research hotspots using bibliometric analysis. Methods We collected 8281 articles published between 2009 and 2018 from the Web of Science database. The knowledge evolution analysis (KEA) framework was used to analyze the evolution of PHD research. The KEA framework is a bibliometric approach that is based on 3 knowledge networks: reference co-citation, keyword co-occurrence, and discipline co-occurrence. Results The findings show that the focus of PHD research has evolved from medicine centric to technology centric to human centric since 2009. The most active PHD knowledge cluster is developing knowledge resources and allocating scarce resources. The field of computer science, especially the topic of artificial intelligence (AI), has been the focal point of recent empirical studies on PHD. Topics related to psychology and human factors (eg, attitude, satisfaction, education) are also receiving more attention. Conclusions Our analysis shows that PHD research has the potential to provide value-based health care in the future. All stakeholders should be educated about AI technology to promote value generation through PHD. Moreover, technology developers and health care institutions should consider human factors to facilitate the effective adoption of PHD-related technology. These findings indicate opportunities for interdisciplinary cooperation in several PHD research areas: (1) AI applications for PHD; (2) regulatory issues and governance of PHD; (3) education of all stakeholders about AI technology; and (4) value-based health care including “allocative value,” “technology value,” and “personalized value.”
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Affiliation(s)
- Jianxia Gong
- School of Economics and Management, Southeast University, Nanjing, China
| | - Vikrant Sihag
- Department of Industrial Engineering and Innovation Sciences, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Qingxia Kong
- Department of Technology and Operations Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Lindu Zhao
- School of Economics and Management, Southeast University, Nanjing, China
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He Q, Du F, Simonse LWL. A Patient Journey Map to Improve the Home Isolation Experience of Persons With Mild COVID-19: Design Research for Service Touchpoints of Artificial Intelligence in eHealth. JMIR Med Inform 2021; 9:e23238. [PMID: 33444156 PMCID: PMC8043148 DOI: 10.2196/23238] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 12/18/2020] [Accepted: 01/10/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In the context of the COVID-19 outbreak, 80% of the persons who are infected have mild symptoms and are required to self-recover at home. They have a strong demand for remote health care that, despite the great potential of artificial intelligence (AI), is not met by the current services of eHealth. Understanding the real needs of these persons is lacking. OBJECTIVE The aim of this paper is to contribute a fine-grained understanding of the home isolation experience of persons with mild COVID-19 symptoms to enhance AI in eHealth services. METHODS A design research method with a qualitative approach was used to map the patient journey. Data on the home isolation experiences of persons with mild COVID-19 symptoms was collected from the top-viewed personal video stories on YouTube and their comment threads. For the analysis, this data was transcribed, coded, and mapped into the patient journey map. RESULTS The key findings on the home isolation experience of persons with mild COVID-19 symptoms concerned (1) an awareness period before testing positive, (2) less typical and more personal symptoms, (3) a negative mood experience curve, (5) inadequate home health care service support for patients, and (6) benefits and drawbacks of social media support. CONCLUSIONS The design of the patient journey map and underlying insights on the home isolation experience of persons with mild COVID-19 symptoms serves health and information technology professionals in more effectively applying AI technology into eHealth services, for which three main service concepts are proposed: (1) trustworthy public health information to relieve stress, (2) personal COVID-19 health monitoring, and (3) community support.
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Affiliation(s)
- Qian He
- Department of Design Organisation & Strategy, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Fei Du
- Department of Design Organisation & Strategy, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Lianne W L Simonse
- Department of Design Organisation & Strategy, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
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Zhang Y, Cao B, Wang Y, Peng TQ, Wang X. When Public Health Research Meets Social Media: Knowledge Mapping From 2000 to 2018. J Med Internet Res 2020; 22:e17582. [PMID: 32788156 PMCID: PMC7453331 DOI: 10.2196/17582] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 05/12/2020] [Accepted: 07/25/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Social media has substantially changed how people confront health issues. However, a comprehensive understanding of how social media has altered the foci and methods in public health research remains lacking. OBJECTIVE This study aims to examine research themes, the role of social media, and research methods in social media-based public health research published from 2000 to 2018. METHODS A dataset of 3419 valid studies was developed by searching a list of relevant keywords in the Web of Science and PubMed databases. In addition, this study employs an unsupervised text-mining technique and topic modeling to extract research themes of the published studies. Moreover, the role of social media and research methods adopted in those studies were analyzed. RESULTS This study identifies 25 research themes, covering different diseases, various population groups, physical and mental health, and other significant issues. Social media assumes two major roles in public health research: produce substantial research interest for public health research and furnish a research context for public health research. Social media provides substantial research interest for public health research when used for health intervention, human-computer interaction, as a platform of social influence, and for disease surveillance, risk assessment, or prevention. Social media acts as a research context for public health research when it is mere reference, used as a platform to recruit participants, and as a platform for data collection. While both qualitative and quantitative methods are frequently used in this emerging area, cutting edge computational methods play a marginal role. CONCLUSIONS Social media enables scholars to study new phenomena and propose new research questions in public health research. Meanwhile, the methodological potential of social media in public health research needs to be further explored.
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Affiliation(s)
- Yan Zhang
- School of Media and Communication, Shenzhen University, Shenzhen, China
| | - Bolin Cao
- School of Media and Communication, Shenzhen University, Shenzhen, China
| | - Yifan Wang
- School of Media and Communication, Shenzhen University, Shenzhen, China
| | - Tai-Quan Peng
- Department of Communication, Michigan State University, East Lansing, MI, United States
| | - Xiaohua Wang
- School of Media and Communication, Shenzhen University, Shenzhen, China
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Braithwaite J, Ludlow K, Testa L, Herkes J, Augustsson H, Lamprell G, McPherson E, Zurynski Y. Built to last? The sustainability of healthcare system improvements, programmes and interventions: a systematic integrative review. BMJ Open 2020; 10:e036453. [PMID: 32487579 PMCID: PMC7265014 DOI: 10.1136/bmjopen-2019-036453] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION The sustainability of healthcare delivery systems is challenged by ageing populations, complex systems, increasing rates of chronic disease, increasing costs associated with new medical technologies and growing expectations by healthcare consumers. Healthcare programmes, innovations and interventions are increasingly implemented at the front lines of care to increase effectiveness and efficiency; however, little is known about how sustainability is conceptualised and measured in programme evaluations. OBJECTIVES We aimed to describe theoretical frameworks, definitions and measures of sustainability, as applied in published evaluations of healthcare improvement programmes and interventions. DESIGN Systematic integrative review. METHODS We searched six academic databases, CINAHL, Embase, Ovid MEDLINE, Emerald Management, Scopus and Web of Science, for peer-reviewed English journal articles (July 2011-March 2018). Articles were included if they assessed programme sustainability or sustained outcomes of a programme at the healthcare system level. Six reviewers conducted the abstract and full-text review. Data were extracted on study characteristics, definitions, terminology, theoretical frameworks, methods and tools. Hawker's Quality Assessment Tool was applied to included studies. RESULTS Of the 92 included studies, 75.0% were classified as high quality. Twenty-seven (29.3%) studies provided 32 different definitions of sustainability. Terms used interchangeably for sustainability included continuation, maintenance, follow-up or long term. Eighty studies (87.0%) clearly reported the timepoints at which sustainability was evaluated: 43.0% at 1-2 years and 11.3% at <12 months. Eighteen studies (19.6%) used a theoretical framework to conceptualise or assess programme sustainability, including frameworks that were not specifically designed to assess sustainability. CONCLUSIONS The body of literature is limited by the use of inconsistent definitions and measures of programme sustainability. Evaluations of service improvement programmes and interventions seldom used theoretical frameworks. Embedding implementation science and healthcare service researchers into the healthcare system is a promising strategy to improve the rigour of programme sustainability evaluations.
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Affiliation(s)
- Jeffrey Braithwaite
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
- NHMRC Partnership Centre in Health System Sustainability, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Kristiana Ludlow
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
- NHMRC Partnership Centre in Health System Sustainability, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Luke Testa
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Jessica Herkes
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Hanna Augustsson
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Gina Lamprell
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Elise McPherson
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Yvonne Zurynski
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
- NHMRC Partnership Centre in Health System Sustainability, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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Using Knowledge Graphs and Cognitive Approaches for Literature Review Analysis: A Framework. INFORM SYST 2020. [DOI: 10.1007/978-3-030-63396-7_41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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