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
{"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}
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.
{"title":"Quality Assessment of Health Information on Social Media During a Public Health Crisis: Infodemiology Study.","authors":"Rozita Haghighi, Mohsen Farhadloo","doi":"10.2196/70756","DOIUrl":"10.2196/70756","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>This study aims to evaluate the quality of health-related information on social media during the early stages of a public health crisis.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":73554,"journal":{"name":"JMIR infodemiology","volume":"5 ","pages":"e70756"},"PeriodicalIF":2.3,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12551971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369109","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}
Youlian Zhou, Liang Yang, Li Luo, Lianghai Cao, Jun Qiu
{"title":"Correction: Quality Assessment of Videos About Dengue Fever on Douyin: Cross-Sectional Study.","authors":"Youlian Zhou, Liang Yang, Li Luo, Lianghai Cao, Jun Qiu","doi":"10.2196/85305","DOIUrl":"10.2196/85305","url":null,"abstract":"","PeriodicalId":73554,"journal":{"name":"JMIR infodemiology","volume":"5 ","pages":"e85305"},"PeriodicalIF":2.3,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12537961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338295","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}
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.
{"title":"Vaccination Conversations on X in Spanish and Catalan: Qualitative Content Analysis.","authors":"Agnes Huguet-Feixa, Wasim Ahmed, Eva Artigues-Barberà, Joaquim Sol, Pere Godoy, Marta Ortega Bravo","doi":"10.2196/67942","DOIUrl":"10.2196/67942","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":73554,"journal":{"name":"JMIR infodemiology","volume":"5 ","pages":"e67942"},"PeriodicalIF":2.3,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12569495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287849","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}
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.
{"title":"Hand, Foot, and Mouth Disease Risk Prediction in Southern China: Time Series Study Integrating Web-Based Search and Epidemiological Surveillance Data.","authors":"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","doi":"10.2196/75434","DOIUrl":"10.2196/75434","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":73554,"journal":{"name":"JMIR infodemiology","volume":"5 ","pages":"e75434"},"PeriodicalIF":2.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12510436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260041","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}
Charles Desgagné, Jordan J Levett, Lior M Elkaim, John Antoniou
<p><strong>Background: </strong>The advent of robotic total knee arthroplasty (TKA) in the field of orthopedics has caused much discussion on social media. As social media grows, its platforms are becoming an increasingly popular medium for health care-related discussions.</p><p><strong>Objective: </strong>This study aimed to better understand the current public discussion about robotic TKA on social media. We aimed to characterize these discussions by analyzing their contributors, the general sentiment, the temporal trends, and the content.</p><p><strong>Methods: </strong>A comprehensive search of the Twitter database for academic research was performed from inception (March 2006) to April 1, 2023, to identify all tweets related to robotic TKA. General data regarding the tweets and the accounts were retrieved. ChatGPT-4o (OpenAI) was used to categorize the post's content and the accounts into different categories developed via iterative testing. The content was categorized using a rule-based classification algorithm developed using Python to assign categories based on keyword presence, phrase matching, and syntactic patterns. Regarding the accounts, an automated keyword-based rule engine was implemented in Python to classify accounts based on the account's name and description. We used a lexicon-based natural language processing Python library, via ChatGPT-4o, to assign a sentiment to the tweets and conducted subgroup sentiment analysis.</p><p><strong>Results: </strong>A total of 2000 tweets were retrieved for analysis. Account analysis revealed that the most prevalent account categories were "medical professionals" (619/2000, 31.0%), "patients and community" (274/2000, 13.7%), and "media and publications" (268/2000, 13.4%). Content analysis revealed that the most prevalent tweet themes were "technology and innovation" (550/2000, 27.5%), "advertising and promotion" (176/2000, 8.8%), and "research and data" (172/2000, 8.6%). Sentiment analysis showed that 61.6% (1231/2000) of the tweets had a positive sentiment, while 9.2% (183/2000) were neutral, and 29.3% (586/2000) had a negative sentiment. Accounts categorized as "institutions" had the highest prevalence of positive sentiment (165/229, 72.1%), while accounts categorized as "media and publications" had the highest prevalence of negative sentiment (88/268, 32.8%). The number of tweets relating to robotic TKA has been steadily rising since 2016, with a peak incidence of 402 (20.1%) tweets published in 2022.</p><p><strong>Conclusions: </strong>The increased number of tweets with a positive sentiment suggests a positive outlook toward robotic TKA. Institutions had the highest prevalence of positive sentiment, suggesting a possible bias toward positive reporting of robotic TKA, likely for commercial reasons. Media and publications had the highest prevalence of negative sentiment, which may represent skepticism and bias toward negative reporting on robotic technologies in health care. Medical profes
{"title":"Social Media Discussions About Robotic Total Knee Arthroplasty: Cross-Sectional Analysis.","authors":"Charles Desgagné, Jordan J Levett, Lior M Elkaim, John Antoniou","doi":"10.2196/69883","DOIUrl":"10.2196/69883","url":null,"abstract":"<p><strong>Background: </strong>The advent of robotic total knee arthroplasty (TKA) in the field of orthopedics has caused much discussion on social media. As social media grows, its platforms are becoming an increasingly popular medium for health care-related discussions.</p><p><strong>Objective: </strong>This study aimed to better understand the current public discussion about robotic TKA on social media. We aimed to characterize these discussions by analyzing their contributors, the general sentiment, the temporal trends, and the content.</p><p><strong>Methods: </strong>A comprehensive search of the Twitter database for academic research was performed from inception (March 2006) to April 1, 2023, to identify all tweets related to robotic TKA. General data regarding the tweets and the accounts were retrieved. ChatGPT-4o (OpenAI) was used to categorize the post's content and the accounts into different categories developed via iterative testing. The content was categorized using a rule-based classification algorithm developed using Python to assign categories based on keyword presence, phrase matching, and syntactic patterns. Regarding the accounts, an automated keyword-based rule engine was implemented in Python to classify accounts based on the account's name and description. We used a lexicon-based natural language processing Python library, via ChatGPT-4o, to assign a sentiment to the tweets and conducted subgroup sentiment analysis.</p><p><strong>Results: </strong>A total of 2000 tweets were retrieved for analysis. Account analysis revealed that the most prevalent account categories were \"medical professionals\" (619/2000, 31.0%), \"patients and community\" (274/2000, 13.7%), and \"media and publications\" (268/2000, 13.4%). Content analysis revealed that the most prevalent tweet themes were \"technology and innovation\" (550/2000, 27.5%), \"advertising and promotion\" (176/2000, 8.8%), and \"research and data\" (172/2000, 8.6%). Sentiment analysis showed that 61.6% (1231/2000) of the tweets had a positive sentiment, while 9.2% (183/2000) were neutral, and 29.3% (586/2000) had a negative sentiment. Accounts categorized as \"institutions\" had the highest prevalence of positive sentiment (165/229, 72.1%), while accounts categorized as \"media and publications\" had the highest prevalence of negative sentiment (88/268, 32.8%). The number of tweets relating to robotic TKA has been steadily rising since 2016, with a peak incidence of 402 (20.1%) tweets published in 2022.</p><p><strong>Conclusions: </strong>The increased number of tweets with a positive sentiment suggests a positive outlook toward robotic TKA. Institutions had the highest prevalence of positive sentiment, suggesting a possible bias toward positive reporting of robotic TKA, likely for commercial reasons. Media and publications had the highest prevalence of negative sentiment, which may represent skepticism and bias toward negative reporting on robotic technologies in health care. Medical profes","PeriodicalId":73554,"journal":{"name":"JMIR infodemiology","volume":"5 ","pages":"e69883"},"PeriodicalIF":2.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12510438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260087","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}
D David Thomas, Linglin Xu, Brian Yu, Octavio Alanis, John Adamek, Imani Canton, Xuan Lin, Yan Luo, Sean P Mullen
<p><strong>Background: </strong>Social media is a prominent way in which health information is spread. The accuracy and credibility of such sources range widely, with misleading statements, misreported results of studies, and a lack of references causing health misinformation to become a growing problem. However, previous research on health misinformation related to topics including vaccines, nutrition, and cancer has excluded physical activity despite it being highly searched for and discussed online.</p><p><strong>Objective: </strong>This systematic review was designed to synthesize the existing literature focused on physical activity misinformation on social media in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines.</p><p><strong>Methods: </strong>Keyword searches were conducted in PubMed, the Cochrane Library, Web of Science, and Scopus databases for records published between January 2016 and May 2025. This search strategy yielded 9039 articles. Titles and abstracts were screened by independent reviewers, resulting in 168 (1.86%) articles selected for full-text review. After further review, 33 (19.6%) articles met the inclusion criteria and were used in the final synthesis.</p><p><strong>Results: </strong>For the 33 studies selected, topics included physical rehabilitation and therapeutic exercise recommendations (n=15, 45%), general physical activity and messaging (n=6, 18%), exercising with a specific condition (n=4, 12%), women's health (n=3, 9%), weight loss (n=2, 6%), exercise testing (n=1, 3%), "immune boosting exercise" (n=1, 3%), and workplace sitting versus standing guidelines (n=1, 3%). The social media platforms YouTube (n=13, 39%), TikTok (n=7, 21%), Facebook (n=2, 6%), Instagram (n=1, 3%), and Pinterest (n=1, 3%) were studied, whereas other articles (n=9, 27%) analyzed content that had not explicitly been posted to social media but could be shared widely online. In total, 4 (12%) studies reported research that proactively engaged participants, and the remaining 29 (88%) studies analyzed readily available online content, including social media, news articles, websites, and blogs. Furthermore, 27 (82%) studies reported at least 1 measure of misinformation prevalence, whereas 21 (64%) reported a metric of reach, and 6 (18%) studies reported a measure of misinformation spread.</p><p><strong>Conclusions: </strong>Our findings indicate that research on social media physical activity misinformation spans a diverse array of physical activity topics, with YouTube being the most studied platform due to its widespread use and ease of content evaluation. This review also highlights the prevalence of low-quality information across various platforms and a lack of longitudinal investigations. Our review underscores the need for multifaceted research approaches and suggests several strategies to combat misinformation, including improved messaging, high-quality information dissemination b
{"title":"Physical Activity Misinformation on Social Media: Systematic Review.","authors":"D David Thomas, Linglin Xu, Brian Yu, Octavio Alanis, John Adamek, Imani Canton, Xuan Lin, Yan Luo, Sean P Mullen","doi":"10.2196/62760","DOIUrl":"10.2196/62760","url":null,"abstract":"<p><strong>Background: </strong>Social media is a prominent way in which health information is spread. The accuracy and credibility of such sources range widely, with misleading statements, misreported results of studies, and a lack of references causing health misinformation to become a growing problem. However, previous research on health misinformation related to topics including vaccines, nutrition, and cancer has excluded physical activity despite it being highly searched for and discussed online.</p><p><strong>Objective: </strong>This systematic review was designed to synthesize the existing literature focused on physical activity misinformation on social media in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines.</p><p><strong>Methods: </strong>Keyword searches were conducted in PubMed, the Cochrane Library, Web of Science, and Scopus databases for records published between January 2016 and May 2025. This search strategy yielded 9039 articles. Titles and abstracts were screened by independent reviewers, resulting in 168 (1.86%) articles selected for full-text review. After further review, 33 (19.6%) articles met the inclusion criteria and were used in the final synthesis.</p><p><strong>Results: </strong>For the 33 studies selected, topics included physical rehabilitation and therapeutic exercise recommendations (n=15, 45%), general physical activity and messaging (n=6, 18%), exercising with a specific condition (n=4, 12%), women's health (n=3, 9%), weight loss (n=2, 6%), exercise testing (n=1, 3%), \"immune boosting exercise\" (n=1, 3%), and workplace sitting versus standing guidelines (n=1, 3%). The social media platforms YouTube (n=13, 39%), TikTok (n=7, 21%), Facebook (n=2, 6%), Instagram (n=1, 3%), and Pinterest (n=1, 3%) were studied, whereas other articles (n=9, 27%) analyzed content that had not explicitly been posted to social media but could be shared widely online. In total, 4 (12%) studies reported research that proactively engaged participants, and the remaining 29 (88%) studies analyzed readily available online content, including social media, news articles, websites, and blogs. Furthermore, 27 (82%) studies reported at least 1 measure of misinformation prevalence, whereas 21 (64%) reported a metric of reach, and 6 (18%) studies reported a measure of misinformation spread.</p><p><strong>Conclusions: </strong>Our findings indicate that research on social media physical activity misinformation spans a diverse array of physical activity topics, with YouTube being the most studied platform due to its widespread use and ease of content evaluation. This review also highlights the prevalence of low-quality information across various platforms and a lack of longitudinal investigations. Our review underscores the need for multifaceted research approaches and suggests several strategies to combat misinformation, including improved messaging, high-quality information dissemination b","PeriodicalId":73554,"journal":{"name":"JMIR infodemiology","volume":"5 ","pages":"e62760"},"PeriodicalIF":2.3,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12547344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254039","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}
Consuelo Castillo-Toledo, Carolina Donat-Vargas, María Montero-Torres, Francisco J Lara-Abelenda, Fernando Mora, Melchor Alvarez-Mon, Javier Quintero, Miguel Ángel Álvarez-Mon
Background: Cannabis is the third most consumed drug worldwide, with its use linked to a high number of substance use disorders, particularly among young men. Associated mortality causes include traffic accidents and cardiovascular diseases. The global expansion of cannabis legalization has sparked debates about its impact on risk perception, with risk perception decreasing in countries with permissive laws. Social media analysis, such as on Twitter (subsequently rebranded as X), is a useful tool for studying these perceptions and their variation by geographic region.
Objective: This study aims to analyze Twitter users' perceptions of cannabis use and legalization, taking into account the geographic location of the tweets.
Methods: A mixed methods approach was used to analyze cannabis-related tweets on Twitter, using keywords such as "cannabis," "marijuana," and "hashish." Tweets were collected from January 1, 2018, to April 30, 2022, in English and Spanish, and only those with at least 10 retweets were included. The content analysis involved an inductive-deductive approach, resulting in the classification of tweets into thematic categories, including discussions on legalization.
Results: The tweet analysis showed that in America, Europe, and Asia, political discussions about cannabis were the most common topic, while personal testimonies dominated in Oceania and Africa. In all continents, personal experiences with cannabis use were mostly positive, with Oceania recording the highest percentage (1642/2695, 60.93%). Regarding legalization, Oceania also led with the highest percentage of tweets in favor (1836/2695, 68.13%), followed by America and Africa, while support in Europe and Asia was slightly lower, with about half of the tweets in favor.
Conclusions: The political debate has been the most frequently mentioned topic, reflecting the current situation in which legislative changes are being discussed in many countries. The predominance of opinions in favor of legalization, combined with the prevalence of positive experiences expressed about cannabis, suggests that the health risks associated with cannabis use are being underestimated in the public debate.
{"title":"Global Influence of Cannabis Legalization on Social Media Discourse: Mixed Methods Study.","authors":"Consuelo Castillo-Toledo, Carolina Donat-Vargas, María Montero-Torres, Francisco J Lara-Abelenda, Fernando Mora, Melchor Alvarez-Mon, Javier Quintero, Miguel Ángel Álvarez-Mon","doi":"10.2196/65319","DOIUrl":"10.2196/65319","url":null,"abstract":"<p><strong>Background: </strong>Cannabis is the third most consumed drug worldwide, with its use linked to a high number of substance use disorders, particularly among young men. Associated mortality causes include traffic accidents and cardiovascular diseases. The global expansion of cannabis legalization has sparked debates about its impact on risk perception, with risk perception decreasing in countries with permissive laws. Social media analysis, such as on Twitter (subsequently rebranded as X), is a useful tool for studying these perceptions and their variation by geographic region.</p><p><strong>Objective: </strong>This study aims to analyze Twitter users' perceptions of cannabis use and legalization, taking into account the geographic location of the tweets.</p><p><strong>Methods: </strong>A mixed methods approach was used to analyze cannabis-related tweets on Twitter, using keywords such as \"cannabis,\" \"marijuana,\" and \"hashish.\" Tweets were collected from January 1, 2018, to April 30, 2022, in English and Spanish, and only those with at least 10 retweets were included. The content analysis involved an inductive-deductive approach, resulting in the classification of tweets into thematic categories, including discussions on legalization.</p><p><strong>Results: </strong>The tweet analysis showed that in America, Europe, and Asia, political discussions about cannabis were the most common topic, while personal testimonies dominated in Oceania and Africa. In all continents, personal experiences with cannabis use were mostly positive, with Oceania recording the highest percentage (1642/2695, 60.93%). Regarding legalization, Oceania also led with the highest percentage of tweets in favor (1836/2695, 68.13%), followed by America and Africa, while support in Europe and Asia was slightly lower, with about half of the tweets in favor.</p><p><strong>Conclusions: </strong>The political debate has been the most frequently mentioned topic, reflecting the current situation in which legislative changes are being discussed in many countries. The predominance of opinions in favor of legalization, combined with the prevalence of positive experiences expressed about cannabis, suggests that the health risks associated with cannabis use are being underestimated in the public debate.</p>","PeriodicalId":73554,"journal":{"name":"JMIR infodemiology","volume":"5 ","pages":"e65319"},"PeriodicalIF":2.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194076","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}
Youlian Zhou, Liang Yang, Li Luo, Lianghai Cao, Jun Qiu
Background: Dengue fever has evolved into a significant public health concern. In recent years, short-video platforms such as Douyin have emerged as prominent media for the dissemination of health education content. Nevertheless, there is a paucity of research investigating the quality of health education content on Douyin.
Objective: This study aimed to evaluate the quality of dengue videos on Douyin.
Methods: A comprehensive collection of short videos pertaining to dengue fever was retrieved from the popular social media platform, Douyin, at a designated point in time. A systematic analysis was then performed to extract the characteristics of these videos. To ensure a comprehensive evaluation, three distinct scoring tools were used: the DISCERN scoring tool, the JAMA benchmarking criteria, and the GQS method. Subsequently, an in-depth investigation was undertaken into the relationship between video features and quality.
Results: A total of 156 videos were included in the analysis, 81 of which (51.9%) were posted by physicians, constituting the most active category of contributor. The selected videos pertaining to dengue fever received a total of 718,228 likes and 126,400 comments. The video sources were categorized into four distinct classifications: news agencies, organizations, physicians, and individuals. Individuals obtained the highest number of video likes, comments, and saves. However, the findings of the study demonstrated that physicians, organizations, and news agencies posted videos are of higher quality when compared with individuals. The integrity of the video content was analyzed, and the results showed a higher percentage of videos received a score of zero points for outcomes, management, and assessment, with 69 (45%), 57 (37%), and 41 (26%), respectively. The median Total DISCERN scores, JAMA, and GQS of the 156 dengue-related videos under consideration were 26 (out of a total of 80 points), 2 (out of a total of 4 points), and 3 (out of a total of 5 points), respectively. Spearman correlation analysis was conducted, revealing a positive correlation between video duration and video quality. Conversely, a negative correlation was observed between the following variables: video comments and video quality, and the number of days since posting and video quality.
Conclusions: This study demonstrates that the quality of short dengue-related health information videos on Douyin is substandard. Videos uploaded by medical professionals were among the highest in terms of quality, yet their videos were not as popular. It is recommended that in future, physicians employ more accessible language incorporating visual elements to enhance the appeal and dissemination of their videos. Future research could explore how to achieve a balance between professionalism and entertainment to promote user acceptance of high-quality content. Moreov
{"title":"Quality Assessment of Videos About Dengue Fever on Douyin: Cross-Sectional Study.","authors":"Youlian Zhou, Liang Yang, Li Luo, Lianghai Cao, Jun Qiu","doi":"10.2196/76474","DOIUrl":"10.2196/76474","url":null,"abstract":"<p><strong>Background: </strong>Dengue fever has evolved into a significant public health concern. In recent years, short-video platforms such as Douyin have emerged as prominent media for the dissemination of health education content. Nevertheless, there is a paucity of research investigating the quality of health education content on Douyin.</p><p><strong>Objective: </strong>This study aimed to evaluate the quality of dengue videos on Douyin.</p><p><strong>Methods: </strong>A comprehensive collection of short videos pertaining to dengue fever was retrieved from the popular social media platform, Douyin, at a designated point in time. A systematic analysis was then performed to extract the characteristics of these videos. To ensure a comprehensive evaluation, three distinct scoring tools were used: the DISCERN scoring tool, the JAMA benchmarking criteria, and the GQS method. Subsequently, an in-depth investigation was undertaken into the relationship between video features and quality.</p><p><strong>Results: </strong>A total of 156 videos were included in the analysis, 81 of which (51.9%) were posted by physicians, constituting the most active category of contributor. The selected videos pertaining to dengue fever received a total of 718,228 likes and 126,400 comments. The video sources were categorized into four distinct classifications: news agencies, organizations, physicians, and individuals. Individuals obtained the highest number of video likes, comments, and saves. However, the findings of the study demonstrated that physicians, organizations, and news agencies posted videos are of higher quality when compared with individuals. The integrity of the video content was analyzed, and the results showed a higher percentage of videos received a score of zero points for outcomes, management, and assessment, with 69 (45%), 57 (37%), and 41 (26%), respectively. The median Total DISCERN scores, JAMA, and GQS of the 156 dengue-related videos under consideration were 26 (out of a total of 80 points), 2 (out of a total of 4 points), and 3 (out of a total of 5 points), respectively. Spearman correlation analysis was conducted, revealing a positive correlation between video duration and video quality. Conversely, a negative correlation was observed between the following variables: video comments and video quality, and the number of days since posting and video quality.</p><p><strong>Conclusions: </strong>This study demonstrates that the quality of short dengue-related health information videos on Douyin is substandard. Videos uploaded by medical professionals were among the highest in terms of quality, yet their videos were not as popular. It is recommended that in future, physicians employ more accessible language incorporating visual elements to enhance the appeal and dissemination of their videos. Future research could explore how to achieve a balance between professionalism and entertainment to promote user acceptance of high-quality content. Moreov","PeriodicalId":73554,"journal":{"name":"JMIR infodemiology","volume":"5 ","pages":"e76474"},"PeriodicalIF":2.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180056","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}
Abigail Paradise Vit, Daniel Fraidin, Yaniv S Ovadia
<p><strong>Background: </strong>Stillbirth, the loss of a fetus after the 20th week of pregnancy, affects about 1 in 160 deliveries in the United States and nearly 1 in 70 globally. It profoundly affects parents, often resulting in grief, depression, anxiety, and posttraumatic stress disorder, exacerbated by societal stigma and a lack of public awareness. However, no comprehensive analysis has explored social media discussions of stillbirth.</p><p><strong>Objective: </strong>This study aimed to analyze stillbirth-related content on Instagram and X (formerly Twitter) by (1) identifying dominant themes using topic modeling, evaluated using latent Dirichlet allocation, non-negative matrix factorization (NMF), and BERTopic; (2) detecting influential hashtags via co-occurrence network analysis; (3) examining sentiments and emotions using transformer-based models; (4) categorizing visual representations of stillbirth on Instagram (Meta) through manual image analysis with a predefined codebook; and (5) screening for misinformation relating to stillbirth on X.</p><p><strong>Methods: </strong>Stillbirth-related posts were collected via RapidAPI (N=27,395), with Instagram posts (#stillbirth: n=7415; #stillbirthawareness: n=8312; 2023-2024) and X posts (#stillbirth: n=11,668; 2020-2024) analyzed using Python 3.12.7 (Python Software Foundation), with NetworkX for hashtag co-occurrence networks and the PageRank algorithm; comparative analyses were restricted to 2023-2024 due to Instagram application programming interface constraints. Topic modeling was evaluated using latent Dirichlet allocation, NMF, and BERTopic, with coherence scores guiding our model selection. Sentiment and emotion were analyzed using transformer-based RoBERTa and DistilRoBERTa. Misinformation screening was applied to X posts. On Instagram, 2 representative image samples (n=366) were manually categorized using a predefined codebook, with the interrater reliability being assessed using Cohen Kappa.</p><p><strong>Results: </strong>Health-related hashtags (eg, #COVID19) appeared more frequently on X. Topic modeling showed that NMF achieved the highest coherence scores (#stillbirthawareness=0.624 and #stillbirth=0.846 on Instagram, #stillbirth=0.816 on X). Medical misinformation appeared in 27.8% (149/536) of tweets linking COVID-19 vaccines to stillbirth. In the image analysis, "Image of text" was most common, followed by remembrance visuals (eg, gravesites and stillborn infants). The interrater reliability was strong, κ=0.837 (95% CI 0.773-0.891) and κ=0.821 (95% CI 0.755-0.879), with high Pearson correlation (r=0.999; P<.001) and no significant difference (χ²7=12.4; P=.09). The sentiment analysis found that positive sentiments exceeded negative sentiments. The emotion analysis showed that fear and sadness were dominant, with fear being more prevalent on X.</p><p><strong>Conclusions: </strong>Instagram emphasizes emotional expression while X focuses on public health and informational conte
{"title":"Stillbirth Discourse on Instagram and X (Formerly Twitter): Content Analysis.","authors":"Abigail Paradise Vit, Daniel Fraidin, Yaniv S Ovadia","doi":"10.2196/73980","DOIUrl":"10.2196/73980","url":null,"abstract":"<p><strong>Background: </strong>Stillbirth, the loss of a fetus after the 20th week of pregnancy, affects about 1 in 160 deliveries in the United States and nearly 1 in 70 globally. It profoundly affects parents, often resulting in grief, depression, anxiety, and posttraumatic stress disorder, exacerbated by societal stigma and a lack of public awareness. However, no comprehensive analysis has explored social media discussions of stillbirth.</p><p><strong>Objective: </strong>This study aimed to analyze stillbirth-related content on Instagram and X (formerly Twitter) by (1) identifying dominant themes using topic modeling, evaluated using latent Dirichlet allocation, non-negative matrix factorization (NMF), and BERTopic; (2) detecting influential hashtags via co-occurrence network analysis; (3) examining sentiments and emotions using transformer-based models; (4) categorizing visual representations of stillbirth on Instagram (Meta) through manual image analysis with a predefined codebook; and (5) screening for misinformation relating to stillbirth on X.</p><p><strong>Methods: </strong>Stillbirth-related posts were collected via RapidAPI (N=27,395), with Instagram posts (#stillbirth: n=7415; #stillbirthawareness: n=8312; 2023-2024) and X posts (#stillbirth: n=11,668; 2020-2024) analyzed using Python 3.12.7 (Python Software Foundation), with NetworkX for hashtag co-occurrence networks and the PageRank algorithm; comparative analyses were restricted to 2023-2024 due to Instagram application programming interface constraints. Topic modeling was evaluated using latent Dirichlet allocation, NMF, and BERTopic, with coherence scores guiding our model selection. Sentiment and emotion were analyzed using transformer-based RoBERTa and DistilRoBERTa. Misinformation screening was applied to X posts. On Instagram, 2 representative image samples (n=366) were manually categorized using a predefined codebook, with the interrater reliability being assessed using Cohen Kappa.</p><p><strong>Results: </strong>Health-related hashtags (eg, #COVID19) appeared more frequently on X. Topic modeling showed that NMF achieved the highest coherence scores (#stillbirthawareness=0.624 and #stillbirth=0.846 on Instagram, #stillbirth=0.816 on X). Medical misinformation appeared in 27.8% (149/536) of tweets linking COVID-19 vaccines to stillbirth. In the image analysis, \"Image of text\" was most common, followed by remembrance visuals (eg, gravesites and stillborn infants). The interrater reliability was strong, κ=0.837 (95% CI 0.773-0.891) and κ=0.821 (95% CI 0.755-0.879), with high Pearson correlation (r=0.999; P<.001) and no significant difference (χ²7=12.4; P=.09). The sentiment analysis found that positive sentiments exceeded negative sentiments. The emotion analysis showed that fear and sadness were dominant, with fear being more prevalent on X.</p><p><strong>Conclusions: </strong>Instagram emphasizes emotional expression while X focuses on public health and informational conte","PeriodicalId":73554,"journal":{"name":"JMIR infodemiology","volume":"5 ","pages":"e73980"},"PeriodicalIF":2.3,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180010","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}