Using Social Media to Characterize Public Sentiment Toward Medical Interventions Commonly Used for Cancer Screening: An Observational Study

Patient Experiences and Insights on Chronic Ocular Pain: Social Media Listening Study

BACKGROUND

Ocular pain has multifactorial etiologies that affect activities of daily life, psychological well-being, and health-related quality of life (QoL). Chronic ocular surface pain (COSP) is a persistent eye pain symptom lasting for a period longer than 3 months.

OBJECTIVE

The objective of this social media listening study was to better understand COSP and related symptoms and identify its perceived causes, comorbidities, and impact on QoL from social media posts.

METHODS

A search from February 2020 to February 2021 was performed on social media platforms (Twitter, Facebook, blogs, and forums) for English-language content posted on the web. Social media platforms that did not provide public access to information or posts were excluded. Social media posts from Australia, Canada, the United Kingdom, and the United States were retrieved using the Social Studio platform-a web-based aggregator tool.

RESULTS

Of the 25,590 posts identified initially, 464 posts about COSP were considered relevant; the majority of conversations (98.3%, n=456) were posted by adults (aged >18 years). Work status was mentioned in 52 conversations. Patients' or caregivers' discussions across social media platforms were centered around the symptoms (61.9%, n=287) and causes (58%, n=269) of ocular pain. Patients mentioned having symptoms associated with COSP, including headache or head pressure, dry or gritty eyes, light sensitivity, etc. Patients posted that their COSP impacts day-to-day activities such as reading, driving, sleeping, and their social, mental, and functional well-being.

CONCLUSIONS

Insights from this study reported patients' experiences, concerns, and the adverse impact on overall QoL. COSP imposes a significant burden on patients, which spans multiple aspects of daily life.

Social media use in HPV-, cervical cancer-, and cervical screening-related research: A scoping review

OBJECTIVE

In response to the World Health Organization's global call to eliminate cervical cancer, many countries have targets to implement human papillomavirus (HPV) primary screening. Social media may offer opportunities to promote uptake of HPV screening. We aimed to describe the extent of the scientific literature regarding social media research on HPV, cervical cancer and cervical screening.

METHODS

Seven databases were searched for peer-reviewed English-language studies related to social media research and HPV, cervical cancer and cervical screening published up to November 2023. One reviewer completed the title/abstract screening and two reviewers independently reviewed full-text articles. Data extraction was carried out by one reviewer and verified by a second reviewer. Information such as the research topic, social media platform of interest, participant characteristics, methods, analysis type, outcome measures, and key findings were collected.

RESULTS

In the 58 articles included, researchers used social media in the following ways: evaluate content, recruit participants or disseminate a survey/questionnaire, disseminate health communication content, examine the relationship between social media use and outcomes, and to conduct experiments testing the effects of social media content on outcomes. Twitter and Facebook were the most common platforms mentioned. Four articles explicitly mentioned theory.

CONCLUSIONS

Opportunities for research are identified such as further exploration of how newer social media platforms such as Instagram and TikTok can be used to share HPV content, examination of appropriate images for effective communication, and determining key features of social media content to promote information sharing and improve cervical screening knowledge, attitudes and behaviours.

Evaluation of the Needs and Experiences of Patients with Hypertriglyceridemia: Social Media Listening Infosurveillance Study

BACKGROUND

Hypertriglyceridemia is a risk factor for cardiovascular diseases. Internet usage in China is increasing, giving rise to large-scale data sources, especially to access, disseminate, and discuss medical information. Social media listening (SML) is a new approach to analyze and monitor online discussions related to various health-related topics in diverse diseases, which can generate insights into users' experiences and expectations. However, to date, no studies have evaluated the utility of SML to understand patients' cognizance and expectations pertaining to the management of hypertriglyceridemia.

OBJECTIVE

The aim of this study was to utilize SML to explore the disease cognition level of patients with hypertriglyceridemia, choice of intervention measures, and the status quo of online consultations and question-and-answer (Q&A) search platforms.

METHODS

An infosurveillance study was conducted wherein a disease-specific comprehensive search was performed between 2004 and 2020 in Q&A search and online consultation platforms. Predefined single and combined keywords related to hypertriglyceridemia were used in the search, including disease, symptoms, diagnosis, and treatment indicators; lifestyle interventions; and therapeutic agents. The search output was aggregated using an aggregator tool and evaluated.

RESULTS

Disease-specific consultation data (n=69,845) and corresponding response data (n=111,763) were analyzed from 20 data sources (6 Q&A search platforms and 14 online consultation platforms). Doctors from inland areas had relatively high voice volumes and appear to exert a substantial influence on these platforms. Patients with hypertriglyceridemia engaging on the internet have an average level of cognition about the disease and its intervention measures. However, a strong demand for the concept of the disease and "how to treat it" was observed. More emphasis on the persistence of the disease and the safety of medications was observed. Young patients have a lower willingness for drug interventions, whereas patients with severe hypertriglyceridemia have a clearer intention to use drug intervention and few patients have a strong willingness for the use of traditional Chinese medicine.

CONCLUSIONS

Findings from this disease-specific SML study revealed that patients with hypertriglyceridemia in China actively seek information from both online Q&A search and consultation platforms. However, the integrity of internet doctors' suggestions on lifestyle interventions and the accuracy of drug intervention recommendations still need to be improved. Further, a combined prospective qualitative study with SML is required for added rigor and confirmation of the relevance of the findings.

Determinants of Protective Healthcare Services Awareness among Female Syrian Refugees in Turkey

War-related migration may deprive people of access to a regular healthcare system and cause new diseases to be battled. Since refugee women are more vulnerable to diseases during this period, protective healthcare services awareness is critical for early disease diagnosis. Following the civil war that triggered the migration of millions of Syrians, an extensive survey was undertaken in coordination with the World Health Organization Country Office in Turkey to explore the health status of Syrian refugees in Turkey. Employing the survey data, we aimed to investigate the determinants of the awareness of protective health services (Pap smear test, mammogram, HIV test) among female Syrian refugees. Logit regression analysis was applied in order to investigate the determinants of the awareness of protective health services among the female refugee population. The results revealed a notably low rate of awareness of protective health services among female Syrian refugees. Furthermore, the association of explanatory variables, including socioeconomic factors, healthcare use, and health literacy with the protective health services awareness, was found to be significant.

Midwest rural-urban disparities in use of patient online services for COVID-19

PURPOSE

Rural populations are disproportionately affected by the COVID-19 pandemic. We characterized urban-rural disparities in patient portal messaging utilization for COVID-19, and, of those who used the portal during its early stage in the Midwest.

METHODS

We collected over 1 million portal messages generated by midwestern Mayo Clinic patients from February to August 2020. We analyzed patient-generated messages (PGMs) on COVID-19 by urban-rural locality and incorporated patients' sociodemographic factors into the analysis.

FINDINGS

The urban-rural ratio of portal users, message senders, and COVID-19 message senders was 1.18, 1.31, and 1.79, indicating greater use among urban patients. The urban-rural ratio (1.69) of PGMs on COVID-19 was higher than that (1.43) of general PGMs. The urban-rural ratios of messaging were 1.72-1.85 for COVID-19-related care and 1.43-1.66 for other health care issues on COVID-19. Compared with urban patients, rural patients sent fewer messages for COVID-19 diagnosis and treatment but more messages for other reasons related to COVID-19-related health care (eg, isolation and anxiety). The frequent senders of COVID-19-related messages among rural patients were 40+ years old, women, married, and White.

CONCLUSIONS

In this Midwest health system, rural patients were less likely to use patient online services during a pandemic and their reasons for its use differ from urban patients. Results suggest opportunities for increasing equity in rural patient engagement in patient portals (in particular, minority populations) for COVID-19. Public health intervention strategies could target reasons why rural patients might seek health care in a pandemic, such as social isolation and anxiety.

Social Media Listening to Understand the Lived Experience of Individuals in Europe With Metastatic Breast Cancer: A Systematic Search and Content Analysis Study

Background

Despite a wealth of real-world data on metastatic breast cancer (mBC), insights into the lived experience are lacking. This study aimed to explore how the lived experience of mBC is described on social media.

Methods

A predefined search string identified posts relevant to the lived experience of mBC from Twitter, patient forums, and blogs across 14 European countries. The final data set was analyzed using content analysis.

Results

A total of 76,456 conversations were identified between November 1, 2018, and November 30, 2020. Twitter was the most commonly used social media platform across all 76,456 conversations from the raw data set (n = 61,165; 80%). Automated and manual relevancy checks followed by a final random sampling filter identified 820 conversations for content analysis. The majority of data from the raw data set was generated from the United Kingdom (n = 31,346; 41%). From this final data set, 61% of posts were authored by patients, 15% by friends and/or family members of patients, and 14% by caregivers. A total of 686 conversations described the patient journey (n = 686/820; 84%); 64% of these (n = 439) concerned breast cancer treatment, with approximately 40% of discussions regarding diagnosis and tests (n = 274/686) and less than 20% of discussions surrounding disease management (n = 123/686; 18%). Key themes relating to a lack of effective treatment, prolonged survival and associated quality of life, debilitating consequences of side effects, and the social impacts of living with mBC were identified.

Conclusions

The findings from this study provided an insight into the lived experience of mBC. While retrospective data collection inherently limits the amount of demographic or clinical information that can be obtained from the population sample, social media listening studies offer training to healthcare professionals in communication, the importance of quality of life, organization of healthcare, and even the design of clinical trials. As new targeted therapies are gradually incorporated into clinical practice, innovative technologies, such as social media listening, have the potential to support regulatory procedures and drug toxicity monitoring, as well as provide the patient voice in the regulation of new and existing medicines.

Expression profiles of GPR21, GPR39, GPR135, and GPR153 orphan receptors in different cancers

Orphan receptors have unknown endogenous ligands, are expressed in different tissues, and participate in various diseases such as diabetes, hypertension and cancer. We studied the expression profiles of GPR21, GPR39, GPR135 and GPR153 orphan receptors in several tumour tissues. Cervical, breast, skin, prostate, and astrocytoma tissues were analysed for orphan receptor gene expression using Real time PCR analysis. GPR39 is over-expressed in cervical and prostate cancer tissues, and GPR21 and GPR135 receptors are significantly decreased in cervical, breast, skin, prostate, and astrocytoma tissues, when compared with healthy human fibroblasts. In conclusion, GPR21 and GPR135 receptor gene expression is reduced in cancerous tissues. GPR39 may have a role in the development and evolution of cervical and prostate cancer. These data suggest these receptors may be alternative molecules for new diagnostic approaches, and the design of novel therapeutics against oncological pathologies.

Mediterranean Diet Social Network Impact along 11 Years in the Major US Media Outlets: Thematic and Quantitative Analysis Using Twitter

Background: Media outlets influence social attitudes toward health. Thus, it is important that they share contents which promote healthy habits. The Mediterranean diet (MedDiet) is associated with lower cardiovascular disease risk. Analysis of tweets has become a tool for understanding perceptions on health issues. Methods: We investigated tweets posted between January 2009 and December 2019 by 25 major US media outlets about MedDiet and its components as well as the retweets and likes generated. In addition, we measured the sentiment analysis of these tweets and their dissemination. Results: In total, 1608 tweets, 123,363 likes and 48,946 retweets about MedDiet or its components were analyzed. Dairy (inversely weighted in MedDiet scores) accounted for 45.0% of the tweets (723/1608), followed by nuts 19.7% (317/1608). MedDiet, as an overall dietary pattern, generated only 9.8% (157/1608) of the total tweets, while olive oil generated the least number of tweets. Twitter users’ response was quantitatively related to the number of tweets posted by these US media outlets, except for tweets on olive oil and MedDiet. None of the MedDiet components analyzed was more likely to be liked or retweeted than the MedDiet itself. Conclusions: The US media outlets analyzed showed reduced interest in MedDiet as a whole, while Twitter users showed greater interest in the overall dietary pattern than in its particular components.

Analyzing Psychotherapy on Twitter: An 11-Year Analysis of Tweets From Major U.S. Media Outlets

BACKGROUND

The Internet has become the main source of information on health issues, and information now determines the therapeutic preferences of patients. For this reason, it is relevant to analyze online information discussing psychotherapy.

OBJECTIVE

To investigate tweets posted by 25 major US media outlets between 2009 and 2019 concerning psychotherapy.

METHODS

We investigated tweets posted by 25 major US media outlets about psychotherapy between January 2009 and December 2019 as well as the likes generated. In addition, we measured the sentiment analysis of these tweets.

RESULTS

Most of the tweets analyzed focused on Mindfulness (5,498), while a low number were related to Psychoanalysis (376) and even less to Cognitive-Behavioral Therapy (61). Surprisingly, Computer-supported therapy, Psychodynamic therapy, Systemic therapy, Acceptance and commitment therapy, and Dialectical behavior therapy did not generate any tweet. In terms of content, efficacy was the main focus of the posted tweets, receiving Cognitive-Behavioral Therapy and Mindfulness a positive appraisal.

CONCLUSIONS

US media outlets focused their interest on Mindfulness which may have contributed to the growing popularity in the past years of this therapeutic modality.

Understanding the Lived Experience of Patients with Melanoma: Real-World Evidence Generated through a European Social Media Listening Analysis (Preprint)

Background

Cutaneous melanoma is an aggressive malignancy that is proposed to account for 90% of skin cancer–related mortality. Individuals with melanoma experience both physical and psychological impacts associated with their diagnosis and treatment. Health-related information is being increasingly accessed and shared by stakeholders on social media platforms.

Objective

This study aimed to assess how individuals living with melanoma across 14 European countries use social media to discuss their needs and provide their perceptions of the disease.

Methods

Social media sources including Twitter, forums, and blogs were searched using predefined search strings of keywords relating to melanoma. Manual and automated relevancy approaches filtered the extracted data for content that provided patient-centric insights. This contextualized data was then mined for insightful concepts around the symptoms, diagnosis, treatment, impacts, and lived experiences of melanoma.

Results

A total of 182,400 posts related to melanoma were identified between November 2018 and November 2020. Following exclusion of irrelevant posts and using random sampling methodology, 864 posts were identified as relevant to the study objectives. Of the social media channels included, Twitter was the most commonly used, followed by forums and blogs. Most posts originated from the United Kingdom (n=328, 38%) and Spain (n=138, 16%). Of the relevant posts, 62% (n=536) were categorized as originating from individuals with melanoma. The most frequently discussed melanoma-related topics were treatment (436/792, 55%), diagnosis and tests (261/792, 33%), and remission (190/792, 24%). The majority of treatment discussions were about surgery (292/436, 67%), followed by immunotherapy (52/436, 12%). In total, 255 posts discussed the impacts of melanoma, which included emotional burden (n=179, 70%), physical impacts (n=61, 24%), effects on social life (n=43, 17%), and financial impacts (n=10, 4%).

Conclusions

Findings from this study highlight how melanoma stakeholders discuss key concepts associated with the condition on social media, adding to the conceptual model of the patient journey. This social media listening approach is a powerful tool for exploring melanoma stakeholder perspectives, providing insights that can be used to corroborate existing data and inform future studies.

Fuzzy based feature engineering architecture for sentiment analysis of medical discussion over online social networks

Sentiment analysis is widely used to retrieve the hidden sentiments in medical discussions over Online Social Networking platforms such as Twitter, Facebook, Instagram. People often tend to convey their feelings concerning their medical problems over social media platforms. Practitioners and health care workers have started to observe these discussions to assess the impact of health-related issues among the people. This helps in providing better care to improve the quality of life. Dementia is a serious disease in western countries like the United States of America and the United Kingdom, and the respective governments are providing facilities to the affected people. There is much chatter over social media platforms concerning the patients’ care, healthy measures to be followed to avoid disease, check early indications. These chatters have to be carefully monitored to help the officials take necessary precautions for the betterment of the affected. A novel Feature engineering architecture that involves feature-split for sentiment analysis of medical chatter over online social networks with the pipeline is proposed that can be used on any Machine Learning model. The proposed model used the fuzzy membership function in refining the outputs. The machine learning model has obtained sentiment score is subjected to fuzzification and defuzzification by using the trapezoid membership function and center of sums method, respectively. Three datasets are considered for comparison of the proposed and the regular model. The proposed approach delivered better results than the normal approach and is proved to be an effective approach for sentiment analysis of medical discussions over online social networks.

Social Media Accounts of Food and Beverage Brands Have Disproportionately More Black and Hispanic Followers than White Followers

Introduction: On television, food companies promote their least nutritious products to Black and Hispanic youth more than White youth, but little is known about the extent to which Black and Hispanic adolescents may disproportionately engage with unhealthy food and beverage brands on social media relative to White adolescents. Methods: In 2019, we purchased and analyzed demographic data of social media users who followed 27 of the most marketed food/beverage brands on Instagram and Twitter. We used one-sample t-tests to compare percentages of Black, Hispanic, and White followers of the selected brands' accounts versus all social media accounts, and independent samples t-tests to compare followers of sugary versus low-calorie drink brands. We also used linear regression to examine associations between racially targeted marketing practices and the percentages of Black, Hispanic, and White followers on social media. Results: On Instagram, the percentage of Black followers of the selected brands (12.7%) was higher than the percentage of Black followers of any account (7.8%) (p<0.001). On Twitter, findings were similar for Hispanic users but opposite for White users. A higher racially targeted ratio was positively associated with the percentage of Black followers, and negatively associated with the percentage of White followers. Sugary drink brands had more Hispanic followers than low-calorie drink brands (p<0.001). Conclusions: Unhealthy food/beverage brands that target Black adolescents have a disproportionately higher percentage of Black followers on social media relative to White followers. These findings support the 2019 proposal to restrict racially targeted advertising through the Children's Online Privacy and Protection Act.

Barriers and facilitators towards colonoscopy: a qualitative systematic review

OBJECTIVES

Colonoscopy is integral in the early detection of colorectal cancer (CRC), be it for screening, diagnostic or therapeutic intentions. Despite the presence of multiple screening modalities, colonoscopy remains integral in providing a definitive CRC diagnosis. However, uptake rates remain low worldwide with minimal understanding towards stakeholders' perspectives. This systematic review is the first to outline the barriers and facilitators faced by providers and patients in receiving colonoscopy specifically.

METHODS

Using PRISMA guidelines, our systematic review consolidates findings from Medline, Embase, CINAHL, PsycINFO and Web of Science Core collection. All perceptions of healthcare providers and screening participants aged 45 and above towards colonoscopy were included.

RESULTS

Forty-five articles were included in our review. Five major analytical themes were identified - procedural perceptions, personal experiences, thoughts and concerns, societal influences, doctor-patient relationship and healthcare system. The discrepancies in knowledge between patients and providers have evidently reduced in the present decade, potentially attributable to the rising influence of social media. The sharing of providers' personal experiences, involvement of patients' family in colonoscopy recommendations and propagation of patients' positive recounts were also more apparent in the past compared to the present decade, highlighting the need to reevaluate the balance between medical confidentiality and personal touch. Additionally, Asian patients were reportedly more apathetic towards CRC diagnosis due to their strong belief in destiny, a crucial association consistent with present studies.

CONCLUSION

This study highlights pertinent gaps in our healthcare system, providing crucial groundwork for interventions to be enacted in engendering higher colonoscopy uptake rates.

Findings in Chinese Patients With Parkinson's Disease: A Content Analysis From the SML Study

Social media listening (SML) is a new process for obtaining information from social media platforms to generate insights into users' experiences and has been used to analyze discussions about a multitude of diseases. To understand Parkinson's disease patients' unmet needs and optimize communication between doctors and patients, social media listening was performed to investigate concerns in Chinese patients. A comprehensive search of publicly available social media platforms with Chinese-language content posted between January 2005 and April 2019 in mainland China was performed using defined Parkinson's disease-related terms. After multiple steps of machine screening were performed, a series of posts were derived. The content was summarized and classified manually to analyze and map psychological insights, and descriptive statistics were applied to aggregate findings. A total of 101,899 patient-related posts formed the basis of this study. The topics mainly focused on motor symptoms (n = 54,983), choice of pharmaceutical drugs (n = 45,203) and non-motor symptoms (n = 44,855). The most common symptoms mentioned were tremor (54.5%), pain (22.9%), and rigidity (22.1%). Psychological burden (51%) and work/social burden (48%) were the most concerning burdens for patients and their families. The compound levodopa (43%) and dopamine agonists (23%) were the most common options for the patients, while concerns about new-generation anti-Parkinson's disease medication increased. The portraits of patients suggested varying characteristics across different periods and advocate for personalized service from doctors. In the management of patients, it is imperative to plan individualized therapy and education strategies as well as strategies for social support.

Use of Social Media to Promote Cancer Screening and Early Diagnosis: Scoping Review

BACKGROUND

Social media is commonly used in public health interventions to promote cancer screening and early diagnosis, as it can rapidly deliver targeted public health messages to large numbers of people. However, there is currently little understanding of the breadth of social media interventions and evaluations, whether they are effective, and how they might improve outcomes.

OBJECTIVE

This scoping review aimed to map the evidence for social media interventions to improve cancer screening and early diagnosis, including their impact on behavior change and how they facilitate behavior change.

METHODS

Five databases and the grey literature were searched to identify qualitative and quantitative evaluations of social media interventions targeting cancer screening and early diagnosis. Two reviewers independently reviewed each abstract. Data extraction was carried out by one author and verified by a second author. Data on engagement was extracted using an adapted version of the key performance indicators and metrics related to social media use in health promotion. Insights, exposure, reach, and differing levels of engagement, including behavior change, were measured. The behavior change technique taxonomy was used to identify how interventions facilitated behavior change.

RESULTS

Of the 23 publications and reports included, the majority (16/23, 70%) evaluated national cancer awareness campaigns (eg, breast cancer awareness month). Most interventions delivered information via Twitter (13/23, 57%), targeted breast cancer (12/23, 52%), and measured exposure, reach, and low- to medium-level user engagement, such as number of likes (9/23, 39%). There were fewer articles about colorectal and lung cancer than about breast and prostate cancer campaigns. One study found that interventions had less reach and engagement from ethnic minority groups. A small number of articles (5/23, 22%) suggested that some types of social media interventions might improve high-level engagement, such as intended and actual uptake of screening. Behavior change techniques, such as providing social support and emphasizing the consequences of cancer, were used to engage users. Many national campaigns delivered fundraising messages rather than actionable health messages.

CONCLUSIONS

The limited evidence suggests that social media interventions may improve cancer screening and early diagnosis. Use of evaluation frameworks for social media interventions could help researchers plan more robust evaluations that measure behavior change. We need a greater understanding of who engages with these interventions to know whether social media can be used to reduce some health inequalities in cancer screening and early diagnosis.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.1136/bmjopen-2019-033592.

Understanding the Public's Emotions about Cancer: Analysis of Social Media Data

Cancer survivors suffer from emotional distress, which varies depending on several factors. However, existing emotion management programs are insufficient and do not take into consideration all of the factors. Social media provides a platform for understanding the emotions of the public. The aim of this study was to explore the relationship between the public's emotions about cancer and factors affecting emotions using social media data. We used 321,339 posts on cancer and emotions relating to cancer extracted from 22 social media channels between 1 January 2014, and 30 June 2017. The factors affecting emotions were analyzed using association rule mining and social network analysis. Hope/gratitude was the most frequently mentioned emotion group on social media followed by fear/anxiety/overwhelmed, sadness/depression/loneliness/guilt, and anger/denial. Acute survival stage, treatment method, and breast cancer were associated with hope/gratitude. Early stage, gastrointestinal problems, fatigue/pain/fever, and pancreatic cancer were associated with fear/anxiety/overwhelmed. Surgery, hair loss/skin problems, and fatigue/pain/fever were associated with sadness/depression/loneliness/guilt. Acute survival stage and hair loss/skin problems were associated with anger/denial. We found that emotions concerning cancer differed depending on the cancer type, cancer stage, survival stage, treatment, and symptoms. These findings could guide the development of tailored emotional management programs for cancer survivors that meet the public's needs more effectively.

Examining the Relationship between Youth-Targeted Food Marketing Expenditures and the Demographics of Social Media Followers

Background: To determine how many adolescents follow food/beverage brands on Instagram and Twitter, and examine associations between brands’ youth-targeted marketing practices and percentages of adolescent followers. Methods: We purchased data from Demographics Pro to characterize the demographics of Twitter and Instagram users who followed 27 of the most highly advertised fast food, snack, and drink brands in 2019. We used one-sample t-tests to compare percentages of adolescent followers of the selected brands’ accounts versus all social media accounts, independent samples t-tests to compare followers of sugary versus low-calorie drink brands, and linear regression to examine associations between youth-targeted marketing practices and the percentages of adolescent followers. Results: An estimated 6.2 million adolescents followed the selected brands. A higher percentage of adolescents followed the selected brands’ accounts (9.2%) compared to any account on Twitter (1.2%) (p < 0.001), but not Instagram. A higher percentage of adolescents followed sugary (7.9%) versus low-calorie drink brands (4.3%) on Instagram (p = 0.02), but we observed the opposite pattern for adults on Twitter and Instagram. Television advertising expenditures were positively associated with percentages of adolescent followers of the selected brands on Twitter (p = 0.03), but not Instagram. Conclusions: Food and sugary drink brands maintain millions of adolescent followers on social media.

Decreasing the Impact of Anxiety on Cancer Prevention through Online Intervention

Background: Low levels of public knowledge, incorrect beliefs, and anxiety are the most often mentioned factors that may negatively affect the implementation of preventive campaigns and timely diagnosis of cancer. Cancer is a major unresolved problem for global public health. As a result, many effective preventive measures need to be found and implemented. Methods: For a duration of 18 months, readers of the Polish scientific Internet portal were invited to participate in the Polish On-line Randomized Intervention aimed at Neoplasm Avoidance (PORINA) study. Level of cancer-related anxiety was our main measure (self-declared on a simple five-point Likert scale) in this analysis. Results: A total of 463 participants were qualified for the final analysis. Respondents with a positive family history of cancer (p < 0.001) declared the highest level of cancer-related anxiety, whereas lower levels were declared by those previously treated for cancer (p = 0.006). The conducted educational intervention reduced the declared level of cancer-related anxiety. Conclusions: The results of this study provide evidence that the use of web-based interventions aimed at increasing awareness could reduce cancer-related anxiety and may lead to more frequent consent to undergo some of the medical procedures used to diagnose or treat cancer.

Sentiment Analysis in Health and Well-Being: Systematic Review

Background

Sentiment analysis (SA) is a subfield of natural language processing whose aim is to automatically classify the sentiment expressed in a free text. It has found practical applications across a wide range of societal contexts including marketing, economy, and politics. This review focuses specifically on applications related to health, which is defined as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”

Objective

This study aimed to establish the state of the art in SA related to health and well-being by conducting a systematic review of the recent literature. To capture the perspective of those individuals whose health and well-being are affected, we focused specifically on spontaneously generated content and not necessarily that of health care professionals.

Methods

Our methodology is based on the guidelines for performing systematic reviews. In January 2019, we used PubMed, a multifaceted interface, to perform a literature search against MEDLINE. We identified a total of 86 relevant studies and extracted data about the datasets analyzed, discourse topics, data creators, downstream applications, algorithms used, and their evaluation.

Results

The majority of data were collected from social networking and Web-based retailing platforms. The primary purpose of online conversations is to exchange information and provide social support online. These communities tend to form around health conditions with high severity and chronicity rates. Different treatments and services discussed include medications, vaccination, surgery, orthodontic services, individual physicians, and health care services in general. We identified 5 roles with respect to health and well-being among the authors of the types of spontaneously generated narratives considered in this review: a sufferer, an addict, a patient, a carer, and a suicide victim. Out of 86 studies considered, only 4 reported the demographic characteristics. A wide range of methods were used to perform SA. Most common choices included support vector machines, naïve Bayesian learning, decision trees, logistic regression, and adaptive boosting. In contrast with general trends in SA research, only 1 study used deep learning. The performance lags behind the state of the art achieved in other domains when measured by F-score, which was found to be below 60% on average. In the context of SA, the domain of health and well-being was found to be resource poor: few domain-specific corpora and lexica are shared publicly for research purposes.

Conclusions

SA results in the area of health and well-being lag behind those in other domains. It is yet unclear if this is because of the intrinsic differences between the domains and their respective sublanguages, the size of training datasets, the lack of domain-specific sentiment lexica, or the choice of algorithms.

Evaluating Patient Experiences in Dry Eye Disease Through Social Media Listening Research

INTRODUCTION

Social media listening (SML) is an approach to assess patient experience in different indications. This is the first study to report the results of using SML to understand patients' experiences of living with dry eye disease (DED).

METHODS

Publicly available, English-language social media content between December 2016 and August 2017 was searched employing pre-defined criteria using Social Studio®, an online aggregator-tool for posts from social media channels. Using natural language processing (NLP), posts were indexed using patient lexicon and disease-related keywords to derive a set of patient posts. NLP was used to identify relevance, followed by further manual evaluation and analysis to generate patient insights.

RESULTS

In all, 2279 possible patient records were identified following NLP, which were filtered for relevance to disease area by analysts, resulting in a total of 1192 posts which formed the basis of this study. Of these, 77% (n = 915) were from the USA. Symptoms, causes, diagnosis and treatments were the most commonly discussed themes. Most common symptoms mentioned were eye dryness (138/901), pain (114/901) and blurry vision (110/901). Pharmaceutical drugs (prescription and over-the-counter; 55%; 764/1393), followed by medical devices (20%; 280/1393), were mentioned as major options for managing symptoms. Of the pharmaceutical drugs, eye drops (33%; 158/476) and artificial tears (10%; 49/476) were the most common over-the-counter options reported, and Restasis® (22%; 103/476) and Xiidra® (6%; 27/476) were the most common prescription drugs. Patients voiced a significant impact of DED on their daily activities (4%; 9/224), work (23%; 51/224) and driving (12%; 26/224). Lack of DED specialists, standard diagnostic procedures, effective treatment options and need to increase awareness of DED among patients were identified as the key unmet needs.

CONCLUSIONS

Insights revealed using SML strengthen our understanding about patient experiences and their unmet needs in DED. This study illustrates that an SML approach contributed effectively in generating patient insights, which can be utilised to inform early drug development process, market access strategies and stakeholder discussions.

FUNDING

Novartis Pharma AG, Basel, Switzerland. Plain language summary available for this article.

Preventing distracted driving: A program from initiation through to evaluation

BACKGROUND

Distracted driving(DD) is a public health threat. We initiated a DD program where the objective was to attract parents to a website to download a parent tool box. We report the effectiveness of media strategy.

METHODS

An evidence based interactive DD website was developed which provided a parent tool box. Two different digital media strategies were used. Parent(P)/Teen(T) focus groups were used. Analytics, orders during each media strategy are reported as well the results of the focus group.

RESULTS

There were 73972 visits (>2 min) to the site. The tool box was downloaded/ordered from 10 different countries and 50 states. There were 603 requests via the internet for tools kits, 159 in the first campaign and 444 in the second campaign. Average website time increased from 2.33 min in media campign 1-5.29 min in campaign 2. The focus groups reported the: website was "very useful" in 9/15-P vs 10/15- T.

CONCLUSION

Contextual placement digital advertising and focused social media was more effective in attracting parents to the website, and increased downloads.

LEVEL OF EVIDENCE

III.

TYPE OF STUDY

prospective/retrospective study with economic and valued based evaluations.

Factors Associated with the Quality of Online Information about Scapholunate Interosseous Ligament Insufficiency

Background The Internet is increasingly used by patients to seek health information about their medical conditions. The online information is of variable quality, often difficult to read, and sometimes inaccurate or misleading. This study assessed factors associated with the quality, readability, and dominant tones of online information about scapholunate interosseous ligament (SLIL) insufficiency. Materials and Methods Using the three most used search engines, we entered the terms "wrist sprain," "scapholunate ligament injury," and "SL dissociation" and assessed the quality of the 45 Web sites identified using the DISCERN tool, readability by the Flesch Reading Ease Score, the Flesch-Kincaid Grade Level, the Gunning Fog Index, and the Simple Measure Of Gobbledygook, and dominant tones using the IBM Watson Tone Analyzer and the Linguistic Inquiry and Word Count. Results Online information about SLIL injuries had a mean DISCERN score of 39 ± 8.2. A dominant Web site tone of "sadness" correlated with lower DISCERN scores. A dominant tentative tone in text was associated with easier to comprehend texts. Conclusion The online information regarding SLIL insufficiency is of generally low quality, limited readability, and the underlying tones may be misleading. Professional societies might consider efforts to provide appealing, readable, information about SLIL insufficiency and other less common diagnoses on the Internet.

The Emotional Toll of Inflammatory Bowel Disease: Using Machine Learning to Analyze Online Community Forum Discourse

Background

Patients with inflammatory bowel disease are using online community forums (OCFs) to seek emotional support. The impact of OCFs on well-being and their emotional content are unknown.

Methods

We used an unsupervised machine learning algorithm to identify the thematic content of 51,591 public, online posts from the Crohn’s & Colitis Foundation Community Forum.

Results

We identified 10,702 (20.8%) posts expressing: gratitude (40%), anxiety/fear (20.8%), empathy (18.2%), anger/frustration (13.4%), hope (13.2%), happiness (10.0%), sadness/depression (5.8%), shame/guilt (2.5%), and/or loneliness (2.5%). A common subtheme was the importance of fostering social support.

Conclusions

High-throughput, machine learning-directed analysis of OCFs may help identify psychosocial impacts of inflammatory bowel disease on patients and their caregivers.

Public Perception on Healthcare Services: Evidence from Social Media Platforms in China

Social media has been used as data resource in a growing number of health-related research. The objectives of this study were to identify content volume and sentiment polarity of social media records relevant to healthcare services in China. A list of the key words of healthcare services were used to extract data from WeChat and Qzone, between June 2017 and September 2017. The data were put into a corpus, where content analyses were performed using Tencent natural language processing (NLP). The final corpus contained approximately 29 million records. Records on patient safety were the most frequently mentioned topic (approximately 8.73 million, 30.1% of the corpus), with the contents on humanistic care having received the least social media references (0.43 Million, 1.5%). Sentiment analyses showed 36.1%, 16.4%, and 47.4% of positive, neutral, and negative emotions, respectively. The doctor-patient relationship category had the highest proportion of negative contents (74.9%), followed by service efficiency (59.5%), and nursing service (53.0%). Neutral disposition was found to be the highest (30.4%) in the contents on appointment-booking services. This study added evidence to the magnitude and direction of public perceptions on healthcare services in China’s hospital and pointed to the possibility of monitoring healthcare service improvement, using readily available data in social media.

Public Opinions Toward Diseases: Infodemiological Study on News Media Data

Background

Society always has limited resources to expend on health care, or anything else. What are the unmet medical needs? How do we allocate limited resources to maximize the health and welfare of the people? These challenging questions might be re-examined systematically within an infodemiological frame on a much larger scale, leveraging the latest advancement in information technology and data science.

Objective

We expanded our previous work by investigating news media data to reveal the coverage of different diseases and medical conditions, together with their sentiments and topics in news articles over three decades. We were motivated to do so since news media plays a significant role in politics and affects the public policy making.

Methods

We analyzed over 3.5 million archive news articles from Reuters media during the periods of 1996/1997, 2008 and 2016, using summary statistics, sentiment analysis, and topic modeling. Summary statistics illustrated the coverage of various diseases and medical conditions during the last 3 decades. Sentiment analysis and topic modeling helped us automatically detect the sentiments of news articles (ie, positive versus negative) and topics (ie, a series of keywords) associated with each disease over time.

Results

The percentages of news articles mentioning diseases and medical conditions were 0.44%, 0.57% and 0.81% in the three time periods, suggesting that news media or the public has gradually increased its interests in medicine since 1996. Certain diseases such as other malignant neoplasm (34%), other infectious diseases (20%), and influenza (11%) represented the most covered diseases. Two hundred and twenty-six diseases and medical conditions (97.8%) were found to have neutral or negative sentiments in the news articles. Using topic modeling, we identified meaningful topics on these diseases and medical conditions. For instance, the smoking theme appeared in the news articles on other malignant neoplasm only during 1996/1997. The topic phrases HIV and Zika virus were linked to other infectious diseases during 1996/1997 and 2016, respectively.

Conclusions

The multi-dimensional analysis of news media data allows the discovery of focus, sentiments and topics of news media in terms of diseases and medical conditions. These infodemiological discoveries could shed light on unmet medical needs and research priorities for future and provide guidance for the decision making in public policy.