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Internet Memes as Drivers of Health Narratives and Infodemics: Integrative Review. 互联网模因作为健康叙事和信息流行病的驱动因素:综合评价。
IF 2.3 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-12-19 DOI: 10.2196/77029
Alvaro Carmona Pestaña, Iván Herrera-Peco, Beatriz Jiménez-Gómez, Carolina Suárez-Llevat

Background: Digital media memes have emerged as influential tools in health communication, particularly during the COVID-19 pandemic. While they offer opportunities for emotional engagement and community resilience, they also act as vectors for health misinformation, contributing to the global infodemic. Despite growing interest in their communicative power, the role of memes in shaping public perception and misinformation diffusion remains underexplored in infodemiology.

Objective: This integrative review aims to analyze how memes influence emotional, behavioral, and ideological responses to health crises, and to examine their dual role as both contributors to and potential mitigators of infodemics. The paper also explores strategies for integrating memes into public health campaigns and infodemic management.

Methods: A comprehensive literature search was conducted across 3 major databases (MEDLINE, Scopus, and Web of Science), identifying a total of 386 records. Following duplicate removal and eligibility screening, 14 peer-reviewed studies published between 2020 and 2025 were included. An integrative narrative approach was used to synthesize evidence on social media behavior, misinformation dynamics, and digital health campaigns. The analysis was grounded in infodemiological and infoveillance frameworks as established by Eysenbach, incorporating insights from psychology, media studies, and public health.

Results: Memes function as emotionally salient and visually potent carriers of health-related narratives. While they can simplify complex messages and foster adaptive humor during crises, they are also susceptible to distortion, particularly in echo chambers and conspiracy communities. Findings reveal that misinformation-laden memes often leverage humor and disgust to bypass critical thinking, and their viral potential is linked to emotional intensity. However, memes have also been successfully integrated into prebunking strategies, increasing engagement and reducing susceptibility to false claims when culturally tailored. The review identifies key mechanisms that enhance or hinder the infodemiological value of memes, including political orientation, digital literacy, and narrative framing.

Conclusions: Memes are a double-edged sword in the context of infodemics. Their integration into infodemic surveillance and digital health campaigns requires a nuanced understanding of their emotional, cultural, and epistemic effects. Public health institutions should incorporate meme analysis into real-time infoveillance systems, apply evidence-based meme formats in prebunking efforts, and foster digital literacy that enables critical meme consumption. Future infodemiology research should further explore the long-term behavioral impacts of memetic misinformation and the scalability of meme-based interventions.

背景:数字媒体模因已成为卫生传播的重要工具,特别是在2019冠状病毒病大流行期间。虽然它们为情感参与和社区复原力提供了机会,但它们也成为健康错误信息的载体,助长了全球信息流行。尽管人们对模因的传播能力越来越感兴趣,但在信息流行病学中,模因在塑造公众认知和错误信息传播方面的作用仍未得到充分探讨。目的:本综述旨在分析模因如何影响对健康危机的情绪、行为和意识形态反应,并研究它们作为信息流行病的贡献者和潜在缓解者的双重作用。本文还探讨了将模因整合到公共卫生运动和信息管理中的策略。方法:在MEDLINE、Scopus和Web of Science 3个主要数据库中进行文献检索,共检索到386条记录。在重复删除和资格筛选之后,纳入了2020年至2025年间发表的14项同行评议研究。综合叙事方法用于综合有关社交媒体行为、错误信息动态和数字健康运动的证据。该分析以Eysenbach建立的信息流行病学和信息监测框架为基础,结合了心理学、媒体研究和公共卫生的见解。结果:模因是健康相关叙事的情感显著和视觉有效载体。虽然它们可以简化复杂的信息,并在危机期间培养适应性幽默,但它们也容易被扭曲,尤其是在回音室和阴谋团体中。研究结果显示,含有错误信息的表情包经常利用幽默和厌恶来绕过批判性思维,它们的传播潜力与情绪强度有关。然而,模因也成功地融入了预掩体策略,在文化上量身定制的情况下,增加了参与度,降低了对虚假声明的易感性。该审查确定了增强或阻碍模因信息流行病学价值的关键机制,包括政治取向、数字素养和叙事框架。结论:在信息传播的背景下,模因是一把双刃剑。将它们整合到信息流行病监测和数字卫生运动中,需要对它们的情感、文化和认知影响有细致的了解。公共卫生机构应将模因分析纳入实时信息监测系统,在预掩体工作中应用基于证据的模因格式,并培养数字素养,使关键的模因消费成为可能。未来的信息流行病学研究应进一步探讨模因错误信息的长期行为影响和模因干预的可扩展性。
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引用次数: 0
Mapping the Quality of German-Language Health Information on the Treatment of Knee Osteoarthritis: Cross-Sectional Analysis. 绘制关于膝关节骨关节炎治疗的德语健康信息的质量:横断面分析。
IF 2.3 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-12-11 DOI: 10.2196/78007
Sandro Zacher, Jürgen Kasper, Julia Lauberger, Julia Lühnen, Lisa-Marie Redlich, Anke Steckelberg

Background: Patients with knee osteoarthritis have a considerable need for information about their condition, its progression, and available treatments. Decision-making is often complex and requires evidence-based health information material (HIM). When medical consultations do not sufficiently address patients' needs, many seek additional information independently.

Objective: This study aimed to examine the quality of German-language HIM on knee osteoarthritis treatment and its suitability for supporting informed choice. In particular, the study analyzed the content of the HIM and assessed the balance in the presentation of treatment options.

Methods: A descriptive cross-sectional study was conducted. HIM was identified through a combination of search strategies, including a systematic internet search using commonly used German terms related to the treatment of knee osteoarthritis. Identified HIMs were independently assessed by 2 raters using the validated Mapping the Quality of Health Information (MAPPinfo) checklist, which operationalizes the criteria of the Guideline Evidence-Based Health Information. Information quality was calculated on a scale from 0% to 100%, representing compliance with the quality standard. A descriptive content analysis was also carried out to examine the range and balance of treatment options presented, as well as the reporting of benefits and complications associated with total knee arthroplasty (TKA). The presence of certification was recorded.

Results: A total of 94 HIMs were included. On average, the material met 14.6% (SD 9.4%) of the quality criteria. HIM from public and nonprofit providers performed better (mean 40.1%, SD 3.6% and mean 37.2%, SD 23.1%, respectively) than those from other providers. Overall, 14 HIMs presented treatment options in a balanced manner. Among the 78 HIMs that covered TKA, 38.5% (n=30) did not report any benefits, and 35.9% (n=28) omitted potential complications. Certified HIMs showed only moderately higher information quality than uncertified material (mean 26.8%, SD 16% vs mean 12.7%, SD 5.9%).

Conclusions: Our results highlight the urgent need to improve the quality of German-language HIM on knee osteoarthritis. The deficits identified are fundamental and affect all dimensions of information quality. Although HIM from public or nonprofit organizations has better information quality, this does not facilitate informed choice. The frequent omission of complications and benefits of TKA and the unbalanced presentation of treatment options can influence decisions. Until structural improvements are made, patients seeking quality information should favor material from public or nonprofit providers. Additionally, the MAPPinfo checklist could form the basis of a differentiated certification system to make information quality more transparent for patients.

背景:膝关节骨性关节炎患者对其病情、进展和可用治疗方法的信息有相当大的需求。决策往往是复杂的,需要基于证据的卫生信息材料。当医疗咨询不能充分满足患者的需求时,许多人会独立寻求额外的信息。目的:本研究旨在检验德语HIM在膝关节骨关节炎治疗中的质量及其支持知情选择的适用性。该研究特别分析了医疗信息系统的内容,并评估了提供治疗方案的平衡性。方法:采用描述性横断面研究。通过多种搜索策略,包括使用常用的与膝关节骨关节炎治疗相关的德语术语进行系统的互联网搜索,确定了HIM。确定的HIMs由2名评分员使用经过验证的卫生信息质量映射(MAPPinfo)检查表进行独立评估,该检查表实现了指南循证卫生信息的标准。信息质量的计算范围从0%到100%,表示符合质量标准。还进行了描述性内容分析,以检查所提出的治疗方案的范围和平衡,以及报告的益处和与全膝关节置换术(TKA)相关的并发症。证明的存在被记录下来。结果:共纳入94例HIMs。平均而言,材料满足14.6% (SD 9.4%)的质量标准。公立和非营利性医疗机构的HIM表现优于其他医疗机构(平均40.1%,SD 3.6%和平均37.2%,SD 23.1%)。总体而言,14个HIMs以平衡的方式提出了治疗方案。在78例涉及TKA的HIMs中,38.5% (n=30)没有报告任何益处,35.9% (n=28)遗漏了潜在的并发症。经过认证的HIMs显示的信息质量仅略高于未经认证的材料(平均26.8%,标准差16% vs平均12.7%,标准差5.9%)。结论:我们的研究结果强调了提高德语HIM治疗膝关节骨关节炎质量的迫切需要。所确定的缺陷是根本性的,影响到信息质量的所有方面。尽管来自公共或非营利组织的HIM具有更好的信息质量,但这不利于知情选择。经常忽略TKA的并发症和益处以及治疗方案的不平衡会影响决策。在结构得到改善之前,寻求高质量信息的患者应该倾向于从公共或非营利性提供者那里获得材料。此外,MAPPinfo检查表可以构成差异化认证体系的基础,使信息质量对患者更加透明。
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引用次数: 0
Public Interest in Dry Eye Disease and Its Association With Environmental Parameters in Taiwan: Google Trends Infodemiology Study. 台湾干眼病的公众兴趣及其与环境参数的关系:谷歌趋势资讯流行病学研究。
IF 2.3 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-11-14 DOI: 10.2196/74317
Po-Chun Chang, Tsung-Hsien Tsai, Shih-Chieh Shao, Chi-Chin Sun
<p><strong>Background: </strong>A high prevalence of dry eye disease (DED) has intensified public health concerns in Taiwan. With the growing reliance on online resources for health information, platforms such as Google Trends (GT) provide a valuable method for capturing public interest. This approach also allows for the exploration of potential associations between public interest in DED and environmental parameters, which may further elucidate underlying factors contributing to the disease's rising prevalence.</p><p><strong>Objective: </strong>This study aims to (1) analyze public interest in DED in Taiwan using GT data, (2) investigate correlations between search interest and environmental parameters, and (3) identify shifts in the focus of search over time.</p><p><strong>Methods: </strong>We analyzed GT data from December 2018 to July 2024, focusing on relative search volume (RSV) for DED across Taiwan and its 6 special municipalities. Temporal trends in RSV were assessed using spline regression models, and monthly variations were assessed using the Kruskal-Wallis test. The Spearman correlation analysis was used to evaluate the association between RSV and environmental parameters, while dynamic time warping analysis clarified the temporal alignment of RSV with these parameters. Rising search queries were analyzed to identify shifts in public interest over time. Furthermore, top Google search results for DED-related keywords were assessed for topic coverage, quality, and readability.</p><p><strong>Results: </strong>A significant rising trend in RSV for DED was observed over the study period in Taiwan (mean instantaneous derivative=0.445; P<.001) and across all 6 special municipalities. Environmental parameters such as methane (CH4), total hydrocarbons, and nonmethane hydrocarbons were identified as novel pollutants strongly correlated with RSV (P<.001), along with known pollutants such as nitric oxide (NO), nitrogen dioxide (NO2), sulfur dioxide (SO2), nitrogen oxides (NOx), and carbon monoxide (CO). Dynamic time warping analysis revealed the strongest temporal alignment was between RSV and hydrocarbons, including CH4 and total hydrocarbons, further emphasizing their potential role in influencing public interest. Assessment of web-based DED information of 80 websites revealed generally low quality (DISCERN score: mean 2.14, SD 0.40), and the average readability corresponded to a college reading level (grade: mean 21.1, SD 4.5). Rising search queries shifted from diagnostic and treatment methods before the COVID-19 pandemic to natural remedies during the COVID-19 lockdown and self-diagnosis and treatment options after the pandemic. Gaps were also identified between public interest and the availability of online information.</p><p><strong>Conclusions: </strong>Public interest in DED has increased significantly in Taiwan from 2018 to 2024, with hydrocarbons identified as strongly associated environmental parameters. The shifts in related queries
背景:台湾干眼病(DED)的高流行率已引起公众健康关注。随着人们越来越依赖在线资源获取卫生信息,谷歌Trends (GT)等平台为吸引公众兴趣提供了一种有价值的方法。这种方法还允许探索公众对DED的兴趣与环境参数之间的潜在关联,这可能进一步阐明导致该疾病患病率上升的潜在因素。目的:本研究旨在(1)利用GT数据分析台湾DED的公众兴趣,(2)调查搜索兴趣与环境参数之间的相关性,以及(3)确定搜索焦点随时间的变化。方法:我们分析了2018年12月至2024年7月的GT数据,重点分析了台湾及其6个直辖市的DED相对搜索量(RSV)。使用样条回归模型评估RSV的时间趋势,使用Kruskal-Wallis检验评估月度变化。采用Spearman相关分析评价RSV与环境参数的相关性,动态时间规整分析阐明RSV与这些参数的时间一致性。对上升的搜索查询进行了分析,以确定公众兴趣随时间的变化。此外,对与ded相关的关键词的谷歌搜索结果的主题覆盖率、质量和可读性进行了评估。结果:在研究期间,台湾地区DED的RSV呈显著上升趋势(平均瞬时导数=0.445);结论:从2018年到2024年,台湾公众对DED的兴趣显著增加,其中碳氢化合物被认为是与DED密切相关的环境参数。相关查询的变化反映了公众利益的变化,强调了对符合公众利益的卫生保健信息的需求,并解决了可用资源的差距。
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引用次数: 0
Quality and Perception of Attention-Deficit/Hyperactivity Disorder Content on TikTok: Cross-Sectional Study. TikTok上注意力缺陷/多动障碍内容的质量和感知:横断面研究。
IF 2.3 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-11-13 DOI: 10.2196/75973
Katharina Sieferle, Tiziana Guidi, Florence Dorr, Eva Maria Bitzer
<p><strong>Background: </strong>Social media platforms are increasingly used for both sharing and seeking health-related information online. TikTok has become one of the most widely used social networking platforms. One health-related topic trending on TikTok recently is attention-deficit/hyperactivity disorder (ADHD). However, the accuracy of health-related information on TikTok remains a significant concern. Misleading information about ADHD on TikTok can increase stigmatization and lead to false "self-diagnosis," pathologizing of normal behavior, and overuse of care.</p><p><strong>Objective: </strong>This study aims to investigate the quality and usefulness of popular TikTok videos about ADHD and to explore how this content is perceived by the viewers based on an in-depth analysis of the video comments.</p><p><strong>Methods: </strong>We scraped data from the 125 most liked ADHD-related TikTok videos uploaded between July 2021 and November 2023 using a commercial scraping software. We categorized videos based on the usefulness of their content as "misleading," "personal experience," or "useful" and used the Patient Education Materials Assessment Tool for Audiovisual Materials to evaluate the video quality regarding understandability and actionability. By purposive sampling, we selected 6 videos and analyzed the content of 100 randomly selected user comments per video to understand the extent of self-identification with ADHD behavior among the viewers. All qualitative analyses were carried out independently by at least 2 authors; the disagreement was resolved by discussion. Using SPSS (version 27; IBM Corp), we calculated the interrater reliability between the raters and the descriptive statistics for video and creator characteristics. We used one-way ANOVA to compare the usefulness of the videos.</p><p><strong>Results: </strong>We assessed 50.4% (63/125) of the videos as misleading, 30.4% (38/125) as personal experience, and 19.2% (24/125) as useful. The Patient Education Materials Assessment Tool for Audiovisual Materials scores for all videos for understandability and actionability are 79.5% and 5.1%, respectively. With a score of 92.3%, useful videos scored significantly higher for understandability than misleading and personal experience videos (P<.001). For actionability, there was no statistically significant difference depending on the videos' usefulness (P=.415). Viewers resonated with the ADHD-related behaviors depicted in the videos in 220 out of 600 (36.7%) of the comments and with ADHD in 32 out of 600 (5.3%) of the comments. Self-attribution of behavioral patterns varied significantly, depending on the usefulness of the videos, with personal experience videos showing the most comments on self-attribution of behavioral patterns (102/600, 17% of comments; P<.001). For self-attribution of ADHD, we found no significant difference depending on the usefulness of the videos (P=.359).</p><p><strong>Conclusions: </strong>The high number of
背景:社交媒体平台越来越多地用于在线分享和寻求与健康相关的信息。抖音已经成为使用最广泛的社交网络平台之一。最近在TikTok上流行的一个与健康相关的话题是注意力缺陷/多动障碍(ADHD)。然而,TikTok上与健康有关的信息的准确性仍然是一个重大问题。TikTok上关于多动症的误导性信息会增加污名化,导致错误的“自我诊断”,将正常行为病态化,以及过度使用护理。目的:本研究旨在通过对视频评论的深入分析,调查热门TikTok视频的质量和有用性,并探讨观众对这些内容的看法。方法:我们使用商业抓取软件从2021年7月至2023年11月上传的125个最受欢迎的与adhd相关的TikTok视频中抓取数据。我们根据视频内容的有用性将其分类为“误导性”、“个人经验”或“有用”,并使用视听材料患者教育材料评估工具来评估视频质量,包括可理解性和可操作性。通过有目的抽样,我们选取了6个视频,并对每个视频随机抽取的100条用户评论内容进行分析,以了解观众对ADHD行为的自我认同程度。所有定性分析均由至少2位作者独立进行;分歧通过讨论得到解决。使用SPSS (version 27; IBM Corp),我们计算了评分者与视频和创作者特征的描述性统计数据之间的相互信度。我们使用单因素方差分析来比较视频的有用性。结果:50.4%(63/125)的视频具有误导性,30.4%(38/125)的视频具有个人经验,19.2%(24/125)的视频具有实用性。患者教育材料评估工具对所有视频的可理解性和可操作性得分分别为79.5%和5.1%。有用视频的可理解性得分为92.3%,明显高于误导性视频和个人体验视频(p结论:TikTok上大量关于ADHD的误导性视频,以及对这些视频中呈现的症状和行为进行自我认同的用户比例很高,可能会增加误诊。这突出表明需要严格评估社交媒体上的卫生信息,并要求卫生保健专业人员解决这些平台产生的误解。
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引用次数: 0
Current Approaches To and Implementation of Information Environment Assessments in the Context of Public Health: Rapid Review. 公共卫生背景下信息环境评估的当前方法和实施:快速审查。
IF 2.3 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-11-06 DOI: 10.2196/72165
Becky K White, Fernan Talamayan, Tara Rose Aynsley, Richard Bahizire Riziki, Catherine Bertrand-Ferrandis, Kai Von Harbou, Rocio Lopez Inigo, Thomas Moran, Reuben Samuel, David Scales, Sandra Varaidzo Machiri
<p><strong>Background: </strong>With the advances in digital information sharing channels, democratization of content, and access, as well as social shifts in information exchange, we live in increasingly complex information environments. How people process and manage this is layered with multiple determinants that can impact information seeking, health behaviors, and public health. Understanding the dynamics of the information environment in priority populations and its impact on communities and individuals is critical for those working in public health and health emergencies.</p><p><strong>Objective: </strong>This study aimed to provide an overview of the approaches to and implementation of information environment assessments as they relate to public health and health emergencies.</p><p><strong>Methods: </strong>We conducted a rapid scoping review of the approaches to, and implementation of information environment assessments. The search followed guidance from the Joanna Briggs Institute on conducting systematic scoping reviews, and our reporting is in line with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for scoping reviews. We included both academic and gray literature in the English language. As this is an emerging field, an additional step involved input from an informal expert group to identify any further tools or approaches. Studies that assessed, described, or discussed approaches to assessing the information environment were included. We excluded papers where the information environment was not the primary focus, or the focus was on individual components only. Two authors (BKW and SVM) independently screened results for inclusion.</p><p><strong>Results: </strong>A total of 17 publications were identified through the structured literature and internet searches, with an additional 5 sourced from the informal expert group. The review highlighted a significant variety in the breadth and number of domains covered in an assessment, including information needs, seeking, access, production, engagement, information quality, and reach. Some assessments adopted a comprehensive, systems-oriented approach, examining factors influencing information beyond the individual level to encompass broader systemic dynamics, while others were significantly narrower in scope.</p><p><strong>Conclusions: </strong>The COVID-19 pandemic has intensified interest in understanding how the information environment shapes people's access to, engagement with, and ability to act on health information. Assessing the information environment is a critical step in identifying and understanding barriers and facilitators that impact different populations and identifying opportunities for strengthening systems. However, a universally accepted approach for such assessments in public health and health emergencies is currently lacking. This paper contributes to the literature by synthesizing current knowledge on assessment tools and fr
背景:随着数字信息共享渠道、内容民主化和信息获取的进步,以及信息交流的社会变迁,我们所处的信息环境日益复杂。人们如何处理和管理这些信息涉及多个决定因素,这些决定因素可能影响信息寻求、健康行为和公共卫生。了解重点人群的信息环境动态及其对社区和个人的影响,对从事公共卫生和突发卫生事件工作的人员至关重要。目的:本研究旨在概述与公共卫生和突发卫生事件有关的信息环境评估的方法和实施情况。方法:我们对信息环境评估的方法和实施进行了快速的范围审查。研究遵循乔安娜布里格斯研究所关于进行系统范围审查的指导,我们的报告符合PRISMA(系统审查和荟萃分析的首选报告项目)范围审查指南。我们收录了英语语言中的学术文献和灰色文献。由于这是一个新兴领域,额外的步骤是由一个非正式专家组提供意见,以确定任何进一步的工具或方法。包括评估、描述或讨论评估信息环境的方法的研究。我们排除了信息环境不是主要焦点,或者只关注单个组件的论文。两位作者(BKW和SVM)独立筛选纳入结果。结果:通过结构化文献和互联网搜索,共确定了17份出版物,另外5份来自非正式专家组。审查强调了评估所涵盖领域的广度和数量上的重大变化,包括信息需求、寻求、获取、生产、参与、信息质量和覆盖范围。一些评估采用了全面的、面向系统的方法,审查了个人层面以外影响信息的因素,以涵盖更广泛的系统动态,而其他评估的范围则明显狭窄。结论:2019冠状病毒病大流行加强了人们对了解信息环境如何影响人们获取、参与和根据卫生信息采取行动的能力的兴趣。评估信息环境是确定和了解影响不同人群的障碍和促进因素以及确定加强系统的机会的关键步骤。然而,目前在公共卫生和突发卫生事件中缺乏一种普遍接受的评估方法。本文通过综合当前评估工具和框架的知识来补充文献,为该领域的未来研究和发展提供基础。
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引用次数: 0
Monitoring Opioid-Related Social Media Chatter Using Natural Language Processing and Large Language Models: Temporal Analysis. 使用自然语言处理和大语言模型监测阿片类药物相关的社交媒体聊天:时间分析。
IF 2.3 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-11-04 DOI: 10.2196/77279
Grigori Sidorov, Muhammad Ahmad, Pierpaolo Basile, Muhammad Waqas, Rita Orji, Ildar Batyrshin

Background: Opioid overdose is a global public health emergency, with the United States experiencing high rates of morbidity and mortality due to prescription and illicit opioid use. Traditional public health monitoring systems often fail to provide real-time insights, limiting their capacity for early detection and intervention. Social media platforms, especially Reddit, offer a promising alternative for timely toxicovigilance due to the abundance of user-generated, real-time content.

Objective: This study aimed to explore the use of Reddit as a real-time, high-volume source for toxicovigilance and develop an automated system that can classify and analyze opioid-related social media posts to detect behavioral patterns and monitor the evolution of public discourse on opioid use.

Methods: To investigate evolving social media discourse around opioid use, we collected a large-scale dataset from Reddit spanning 6 years, from January 1, 2018, to December 30, 2023. Using a comprehensive opioid lexicon-including formal drug names, street slang, common misspellings, and abbreviations-we filtered relevant posts for further analysis. A subset of these data was manually annotated according to well-defined annotation guidelines into 4 categories: self-misuse, external misuse, information, and unrelated, with distributions of 37.21%, 27.25%, 27.57%, and 7.97%, respectively. To automate the classification of opioid-related chatter, we developed a robust natural language processing pipeline leveraging classical machine learning algorithms, deep learning models, and transformer-based architecture, and fine-tuned a state-of-the-art large language model (LLM; OpenAI GPT-3.5 Turbo). In the final stage, the trained LLM was deployed on an unlabeled dataset comprising 74,975 additional Reddit chatter posts. This enabled a detailed temporal analysis of opioid-related discussions, aligned with 6 years of opioid-related death records from the Centers for Disease Control and Prevention (CDC). For this study, self-misuse and external misuse were merged into a misuse category for direct comparison with the CDC's mortality data, examining whether trends in social media discourse on opioid misuse reflect patterns in real-world mortality statistics.

Results: The fine-tuned GPT-3.5 Turbo model achieved the highest classification accuracy of 0.93, outperforming the baseline (random forest 0.85) by representing a performance improvement of 9.14% over the machine learning model. The temporal analysis of the unlabeled data revealed evolving trends in opioid-related discussions, indicating shifts in user behavior and overdose-related chatter over time. To quantify this relationship, we calculated the Pearson correlation coefficient between misuse-related posts and CDC death records (r=0.854). This correlation was statistically significant (P<.001), indicating a strong positive relationship betwe

背景:阿片类药物过量是全球突发公共卫生事件,美国因处方和非法使用阿片类药物而发病率和死亡率很高。传统的公共卫生监测系统往往不能提供实时信息,限制了其早期发现和干预的能力。社交媒体平台,尤其是Reddit,由于用户生成的实时内容丰富,为及时的毒物警戒提供了一个有希望的替代方案。目的:本研究旨在探索Reddit作为一个实时、高容量的毒物警戒来源,并开发一个自动化系统,可以对阿片类药物相关的社交媒体帖子进行分类和分析,以检测行为模式,并监测阿片类药物使用公共话语的演变。方法:为了调查围绕阿片类药物使用的社交媒体话语的演变,我们从Reddit上收集了从2018年1月1日到2023年12月30日的6年大规模数据集。我们使用了一个全面的阿片类药物词典——包括正式的药物名称、街头俚语、常见的拼写错误和缩写——过滤了相关的帖子,以便进一步分析。根据明确的标注准则,将这些数据的子集手工标注为4类:自我误用、外部误用、信息和不相关,其分布分别为37.21%、27.25%、27.57%和7.97%。为了自动分类阿片类药物相关的喋喋,我们开发了一个强大的自然语言处理管道,利用经典的机器学习算法、深度学习模型和基于变压器的架构,并微调了一个最先进的大型语言模型(LLM; OpenAI GPT-3.5 Turbo)。在最后阶段,训练有素的LLM被部署在一个未标记的数据集上,该数据集包括74,975个额外的Reddit聊天帖子。这使得对阿片类药物相关讨论进行了详细的时间分析,并与疾病控制和预防中心(CDC) 6年的阿片类药物相关死亡记录保持一致。在这项研究中,自我滥用和外部滥用被合并为滥用类别,直接与疾病预防控制中心的死亡率数据进行比较,研究社交媒体关于阿片类药物滥用的话语趋势是否反映了现实世界死亡率统计数据的模式。结果:经过微调的GPT-3.5 Turbo模型达到了最高的分类精度0.93,优于基线(随机森林0.85),比机器学习模型的性能提高了9.14%。对未标记数据的时间分析揭示了阿片类药物相关讨论的演变趋势,表明随着时间的推移,用户行为和过量相关的喋喋不休发生了变化。为了量化这种关系,我们计算了滥用相关帖子与CDC死亡记录之间的Pearson相关系数(r=0.854)。结论:这项研究证明了将先进的自然语言处理技术和法学硕士与社交媒体数据结合起来支持实时公共卫生监测的潜力。Reddit为识别阿片类药物使用和过量风险的新趋势提供了一个有价值的平台。拟议的系统为研究人员、临床医生和政策制定者提供了一个主动的工具,以更好地理解和应对阿片类药物危机。
{"title":"Monitoring Opioid-Related Social Media Chatter Using Natural Language Processing and Large Language Models: Temporal Analysis.","authors":"Grigori Sidorov, Muhammad Ahmad, Pierpaolo Basile, Muhammad Waqas, Rita Orji, Ildar Batyrshin","doi":"10.2196/77279","DOIUrl":"10.2196/77279","url":null,"abstract":"<p><strong>Background: </strong>Opioid overdose is a global public health emergency, with the United States experiencing high rates of morbidity and mortality due to prescription and illicit opioid use. Traditional public health monitoring systems often fail to provide real-time insights, limiting their capacity for early detection and intervention. Social media platforms, especially Reddit, offer a promising alternative for timely toxicovigilance due to the abundance of user-generated, real-time content.</p><p><strong>Objective: </strong>This study aimed to explore the use of Reddit as a real-time, high-volume source for toxicovigilance and develop an automated system that can classify and analyze opioid-related social media posts to detect behavioral patterns and monitor the evolution of public discourse on opioid use.</p><p><strong>Methods: </strong>To investigate evolving social media discourse around opioid use, we collected a large-scale dataset from Reddit spanning 6 years, from January 1, 2018, to December 30, 2023. Using a comprehensive opioid lexicon-including formal drug names, street slang, common misspellings, and abbreviations-we filtered relevant posts for further analysis. A subset of these data was manually annotated according to well-defined annotation guidelines into 4 categories: self-misuse, external misuse, information, and unrelated, with distributions of 37.21%, 27.25%, 27.57%, and 7.97%, respectively. To automate the classification of opioid-related chatter, we developed a robust natural language processing pipeline leveraging classical machine learning algorithms, deep learning models, and transformer-based architecture, and fine-tuned a state-of-the-art large language model (LLM; OpenAI GPT-3.5 Turbo). In the final stage, the trained LLM was deployed on an unlabeled dataset comprising 74,975 additional Reddit chatter posts. This enabled a detailed temporal analysis of opioid-related discussions, aligned with 6 years of opioid-related death records from the Centers for Disease Control and Prevention (CDC). For this study, self-misuse and external misuse were merged into a misuse category for direct comparison with the CDC's mortality data, examining whether trends in social media discourse on opioid misuse reflect patterns in real-world mortality statistics.</p><p><strong>Results: </strong>The fine-tuned GPT-3.5 Turbo model achieved the highest classification accuracy of 0.93, outperforming the baseline (random forest 0.85) by representing a performance improvement of 9.14% over the machine learning model. The temporal analysis of the unlabeled data revealed evolving trends in opioid-related discussions, indicating shifts in user behavior and overdose-related chatter over time. To quantify this relationship, we calculated the Pearson correlation coefficient between misuse-related posts and CDC death records (r=0.854). This correlation was statistically significant (P<.001), indicating a strong positive relationship betwe","PeriodicalId":73554,"journal":{"name":"JMIR infodemiology","volume":"5 ","pages":"e77279"},"PeriodicalIF":2.3,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12585000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Quality Assessment of Health Information on Social Media During a Public Health Crisis: Infodemiology Study. 公共卫生危机期间社交媒体健康信息质量评估:信息流行病学研究。
IF 2.3 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-10-24 DOI: 10.2196/70756
Rozita Haghighi, Mohsen Farhadloo

Background: The quality of health information on social media is a major concern, especially during the early stages of public health crises. While the quality of the results of the popular search engines related to particular diseases has been analyzed in the literature, the quality of health-related information on social media, such as X (formerly Twitter), during the early stages of a public health crisis has not been addressed.

Objective: This study aims to evaluate the quality of health-related information on social media during the early stages of a public health crisis.

Methods: A cross-sectional analysis was conducted on health-related tweets in the early stages of the most recent public health crisis (the COVID-19 pandemic). The study analyzed the top 100 websites that were most frequently retweeted in the early stages of the crisis, categorizing them by content type, website affiliation, and exclusivity. Quality and reliability were assessed using the DISCERN and JAMA (Journal of the American Medical Association) benchmarks.

Results: Our analyses showed that 95% (95/100) of the websites met only 2 of the 4 JAMA quality criteria. DISCERN scores revealed that 81% (81/100) of the websites were evaluated as low scores, and only 11% (11/100) of the websites were evaluated as high scores. The analysis revealed significant disparities in the quality and reliability of health information across different website affiliations, content types, and exclusivity.

Conclusions: This study highlights a significant issue with the quality, reliability, and transparency of online health-related information during a public health challenge. The extensive shortcomings observed across frequently shared websites on Twitter highlight the critical need for continuous evaluation and improvement of online health content during the early stages of future health crises. Without consistent oversight and improvement, we risk repeating the same shortcomings in future, potentially more challenging situations.

背景:社交媒体上卫生信息的质量是一个主要问题,特别是在公共卫生危机的早期阶段。虽然文献中分析了与特定疾病相关的流行搜索引擎的结果质量,但在公共卫生危机的早期阶段,社交媒体(如X(以前的Twitter))上与健康相关的信息的质量尚未得到解决。目的:本研究旨在评估公共卫生危机早期阶段社交媒体上健康相关信息的质量。方法:对最近一次公共卫生危机(COVID-19大流行)早期与健康相关的推文进行横断面分析。该研究分析了在危机早期转发频率最高的100家网站,并根据内容类型、网站隶属关系和独家性对它们进行了分类。使用DISCERN和JAMA(美国医学协会杂志)基准评估质量和可靠性。结果:我们的分析显示95%(95/100)的网站仅符合4项JAMA质量标准中的2项。DISCERN分数显示,81%(81/100)的网站被评为低分,只有11%(11/100)的网站被评为高分。分析显示,在不同的网站隶属关系、内容类型和专用性之间,健康信息的质量和可靠性存在显著差异。结论:本研究突出了在公共卫生挑战期间在线健康相关信息的质量、可靠性和透明度方面的一个重要问题。在Twitter上经常共享的网站上观察到的广泛缺陷突出表明,在未来健康危机的早期阶段,迫切需要不断评估和改进在线健康内容。如果没有持续的监督和改进,我们就有可能在未来重复同样的缺点,可能面临更大的挑战。
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引用次数: 0
Correction: Quality Assessment of Videos About Dengue Fever on Douyin: Cross-Sectional Study. 更正:抖音登革热视频质量评价:横断面研究。
IF 2.3 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-10-20 DOI: 10.2196/85305
Youlian Zhou, Liang Yang, Li Luo, Lianghai Cao, Jun Qiu
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引用次数: 0
Vaccination Conversations on X in Spanish and Catalan: Qualitative Content Analysis. 西班牙语和加泰罗尼亚语关于X的疫苗接种对话:定性内容分析。
IF 2.3 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-10-14 DOI: 10.2196/67942
Agnes Huguet-Feixa, Wasim Ahmed, Eva Artigues-Barberà, Joaquim Sol, Pere Godoy, Marta Ortega Bravo

Background: The analysis of social networks should be considered by institutions and governments alongside surveys and other conventional methods for assessing public attitudes toward vaccines. X (formerly known as Twitter) has emerged as a significant source for studying vaccine hesitancy.

Objective: The aim of the study is to examine the main arguments and narratives in favor and against vaccination expressed in Spanish- and Catalan-language posts, comments, and opinions on the social media platform X.

Methods: Spanish and Catalan posts were collected from X using NodeXL Pro between March and December 2021, resulting in 479,734 posts. For qualitative analysis, a random subsample of 384 tweets was selected using Cochran's formula (95% confidence and ±5% margin of error). A bespoke code frame was developed in collaboration with medical and social media experts, and posts were translated into English. Intercoder reliability, assessed on 20% of the sample, yielded 93.4% agreement and a Cohen κ of 0.92.

Results: A total of 479,734 posts were retrieved from 29,706 users. After an inductive review of the data, six themes were identified, which formed the basis of our code frame: (theme 1) vaccine acquisition and distribution, (theme 2) vaccine skepticism and criticism, (theme 3) provaccination stance, (theme 4) global COVID-19 situation, (theme 5) vaccine politics and international relations, and (theme 6) miscellaneous news and posts. Vaccine skepticism and criticism was the most frequent theme (93/384, 24.2%), whereas vaccine politics and international relations was the least (25/384, 6.5%). We observed that while some posts supported vaccination, others expressed concerns about vaccine safety and efficacy, promoted conspiracy theories, disseminated misinformation, or opposed scientific consensus. Challenges related to vaccine acquisition and distribution within specific countries were also identified, along with political and economic factors, such as the politicization of vaccines, which hindered equitable distribution between vaccine-producing and vaccine-needing countries. Additionally, the pandemic's social impact fostered community support initiatives and solidarity.

Conclusions: Our findings can inform measures to promote vaccine acceptance and reinforce trust in health care systems, professionals, and scientific perspectives, thereby improving vaccination coverage. These insights may serve as a foundation for developing sociopolitical strategies to enhance vaccination management and address future pandemics or new vaccination campaigns.

背景:机构和政府在评估公众对疫苗态度的调查和其他传统方法之外,还应考虑对社会网络的分析。X(以前称为Twitter)已成为研究疫苗犹豫的重要来源。目的:本研究的目的是研究社交媒体平台X上西班牙语和加泰罗尼亚语帖子、评论和观点中表达的支持和反对接种疫苗的主要论点和叙述。方法:使用NodeXL Pro收集2021年3月至12月期间X上的西班牙语和加泰罗尼亚语帖子,共479,734个帖子。为了进行定性分析,使用科克伦公式(95%置信度和±5%的误差范围)选择了384条推文的随机子样本。与医疗和社交媒体专家合作制定了定制代码框架,并将帖子翻译成英文。在20%的样本中评估的互码器可靠性产生了93.4%的一致性和0.92的科恩κ。结果:从29,706个用户中检索到479,734个帖子。在对数据进行归纳后,我们确定了六个主题,这些主题构成了我们代码框架的基础:(主题1)疫苗获取和分发,(主题2)疫苗怀疑和批评,(主题3)接种立场,(主题4)全球COVID-19形势,(主题5)疫苗政治和国际关系,(主题6)杂项新闻和帖子。疫苗怀疑和批评是最常见的主题(93/384,24.2%),而疫苗政治和国际关系是最少的(25/384,6.5%)。我们观察到,虽然一些帖子支持疫苗接种,但其他帖子表达了对疫苗安全性和有效性的担忧,宣传阴谋论,传播错误信息,或反对科学共识。还确定了与特定国家内疫苗获取和分发有关的挑战,以及政治和经济因素,如疫苗政治化,这些因素阻碍了疫苗生产国和疫苗需求国之间的公平分配。此外,大流行病的社会影响促进了社区支持倡议和团结。结论:我们的发现可以为促进疫苗接受和加强对卫生保健系统、专业人员和科学观点的信任的措施提供信息,从而提高疫苗接种覆盖率。这些见解可以作为制定社会政治战略的基础,以加强疫苗接种管理和应对未来的大流行或新的疫苗接种运动。
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引用次数: 0
Hand, Foot, and Mouth Disease Risk Prediction in Southern China: Time Series Study Integrating Web-Based Search and Epidemiological Surveillance Data. 中国南方手足口病风险预测:整合网络搜索和流行病学监测数据的时间序列研究
IF 2.3 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-10-09 DOI: 10.2196/75434
Yixiong Chen, Xue Zhang, Sheng Zhang, Wenjie Han, Ziqi Wang, Jian Chen, Jinfeng Liu, Jingru Feng, Jiayi Shi, Haoyu Long, Zicheng Cao, Jie Zhang, Yuan Li, Xiangjun Du, Xindong Zhang, Meng Ren

Background: Hand, foot, and mouth disease (HFMD) is a global health concern requiring a risk assessment framework based on systematic factors analysis for prevention and control.

Objective: This study aims to construct a comprehensive HFMD risk assessment framework by integrating multisource data, including historical incidence information, environmental parameters, and web-based search behavior data, to improve predictive performance.

Methods: We integrated multisource data (HFMD cases, meteorology, air pollution, Baidu Index, and public health measures) from Bao'an District of Shenzhen city in Southern China (2014-2023). Correlation analysis was used to assess the associations between HFMD incidence and systematic factors. The impacts of environmental factors were analyzed using the Distributed Lag Nonlinear Model. Seasonal Autoregressive Integrated Moving Average model and advanced machine learning methods were used to predict HFMD 1-4 weeks ahead. Risk levels for the 1- to 4-week-ahead forecasts were determined by comparing the predicted weekly incidence against predefined thresholds.

Results: From 2014 to 2023, Bao'an District reported a total of 118,826 cases of HFMD. Environmental and search behavior factors (excluding sulfur dioxide) were significantly associated with HFMD incidence in nonlinear patterns. For 1-week-ahead prediction, Seasonal Autoregressive Integrated Moving Average using case data alone performed best (R²=0.95, r=0.98, mean absolute error=53.34, and root-mean-square error=99.31). For 2- to 4-week-ahead forecasting, machine learning models incorporating web-based and environmental data showed superior performance (R²=0.83, 0.75, and 0.64; r=0.92, 0.87, and 0.80; mean absolute error=87.84, 112.41, and 132.47; and root-mean-square error=185.08, 229.13, and 276.81). The predicted HFMD risk levels matched the observed levels with accuracies of 96%, 87%, 88%, and 83%, respectively.

Conclusions: The epidemic dynamics of HFMD are influenced by multiple factors in a nonlinear manner. Integrating multisource data, particularly web-based search behavior, significantly enhances the accuracy of short- and midterm forecasts and risk assessment. This approach offers practical insights for developing digital surveillance and early warning systems in public health.

背景:手足口病(手足口病)是全球性的健康问题,需要基于系统因素分析的风险评估框架进行预防和控制。目的:通过整合历史发病信息、环境参数、网络搜索行为数据等多源数据,构建手足口病综合风险评估框架,提高预测效果。方法:对2014-2023年深圳市宝安区手足口病病例、气象、空气污染、百度指数和公共卫生措施等多源数据进行综合分析。相关分析用于评估手足口病发病率与系统因素之间的关系。采用分布滞后非线性模型分析了环境因素的影响。使用季节性自回归综合移动平均模型和先进的机器学习方法提前1-4周预测手足口病。通过将预测的每周发病率与预定义阈值进行比较,确定1- 4周预测的风险水平。结果:2014 - 2023年,宝安区共报告手足口病118826例。环境和搜索行为因素(不包括二氧化硫)与手足口病发病率呈非线性显著相关。对于1周预测,单独使用病例数据的季节性自回归综合移动平均线表现最佳(R²=0.95,R =0.98,平均绝对误差=53.34,均方根误差=99.31)。对于2- 4周的预测,结合网络和环境数据的机器学习模型表现出优越的性能(R²=0.83、0.75和0.64;R =0.92、0.87和0.80;平均绝对误差=87.84、112.41和132.47;均方根误差=185.08、229.13和276.81)。预测的手足口病风险水平与观察到的水平相吻合,准确率分别为96%、87%、88%和83%。结论:手足口病流行动态受多种因素非线性影响。整合多源数据,特别是基于网络的搜索行为,可以显著提高中短期预测和风险评估的准确性。这种方法为开发公共卫生领域的数字监测和早期预警系统提供了实际见解。
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JMIR infodemiology
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