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Monday, October 17, 2011

QD: News Every Day--Tweets track vaccination rates and attitudes

A researcher has used social media to track attitudes about vaccination and how they correlate with vaccination rates, in the process creating a novel model to track a variety of disease states.

The study adds to a growing body of evidence that social networking can be used to track diseases and other natural disasters that affect public health. Earlier this year, researchers used Twitter to track rapidly-evolving public sentiment about H1N1 influenza, and found that tweets correlated with actual disease activity. Before that, researchers analyzed how Twitter was used to disseminate information (and misinformation) about flu trends.

In the latest study, published at PLoS Computational Biology, a biology professor at Penn State University compiled 477,768 tweets with vaccination-related phrases from August 2009, when news of a new H1N1 vaccine first was made public, and continued through January 2010.

According to a press release, students rated a sample of about 10% of tweets as positive, negative, neutral or irrelevant. The human-rated tweets were used to program a computer algorithm to analyze the remaining 90% of tweets, leaving 318,379 tweets expressing either positive, negative or neutral sentiments about the H1N1 vaccine. (Tweets found to have nothing to do with H1N1, such as messages about another vaccine entirely, were discarded.)

Of the remaining messages, 255,828 were classified as neutral, 26,667 as negative, and 35,884 as positive. Starting from late August 2009, there was a steady increase in the number of relevant tweets until early November 2009, after which the number dropped back to previous levels.

Negative expressions spiked during the time period when the vaccine was first announced. Later, more-positive sentiments emerged when the vaccine was first shipped across the United States. The researcher also tracked spikes of negative tweets that corresponded to periods of vaccine recall.

Also, the researcher modeled how social media users with either negative or positive sentiments about the H1N1 vaccine followed like-minded people. The public-health message is that if anti-vaccination communities online translate to real-world geographic pockets, it creates a greater risk of local outbreaks.

"By definition, herd immunity only works if unvaccinated, unprotected individuals are distributed sparsely throughout the population, buffered from the disease by vaccinated individuals," the researcher said. "Unfortunately, the data from Twitter seem to indicate that the buffer of protection cannot be counted on if these clusters exist in real, geographical space."

Because Twitter users often include a location in their profiles, the researcher could correlate tweets with Centers for Disease Control and Prevention data to determine how vaccination attitudes correlated with estimated vaccination rates. The highest positive-sentiment users were from New England, which had the highest H1N1 vaccination rate.

The method could be used to guide public-health initiatives, the researcher said. Targeted campaigns could be designed according to which region needs more prevention education, as well as predict how many doses of a vaccine will be required in a particular area.

The researcher plans to use his unique social-media analysis to study other diseases, such as obesity, hypertension, and heart disease. It's already known that obese people are more likely to be associated with one another in real life.

John Snow would have been proud. Recall that he was the first epidemiologist, who in 1854 traced cholera in London back to a single source, a water pump used by the populace. He hypothesized that a single pump was responsible for more than 500 deaths by drawing a map that compared the locations of cholera deaths and the locations of water pumps throughout the city (perhaps making him the first user of Foursquare. Snow had to talk to people directly to gather his data, and would have been amazed at how advances in communication are helping modern scientists track disease.

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Blog log

Members of the American College of Physicians contribute posts from their own sites to ACP Internist and ACP Hospitalist. Contributors include:

Albert Fuchs, MD
Albert Fuchs, MD, FACP, graduated from the University of California, Los Angeles School of Medicine, where he also did his internal medicine training. Certified by the American Board of Internal Medicine, Dr. Fuchs spent three years as a full-time faculty member at UCLA School of Medicine before opening his private practice in Beverly Hills in 2000.

Zackary Berger
Zackary Berger, MD, ACP Member, is a primary care doctor and general internist in the Division of General Internal Medicine at Johns Hopkins. His research interests include doctor-patient communication, bioethics, and systematic reviews.

CasesBlog
Ves Dimov, MD, ACP Member, is an allergist/immunologist and Assistant Professor of Medicine and Pediatrics at the University of Chicago, where he evaluates and treats both pediatric and adult patients.

David Katz, MD
David L. Katz, MD, MPH, FACP, is an internationally renowned authority on nutrition, weight management, and the prevention of chronic disease, and an internationally recognized leader in integrative medicine and patient-centered care.

db's Medical Rants
Robert M. Centor, MD, FACP, contributes short essays contemplating medicine and the health care system.

DrDialogue
Juliet K. Mavromatis, MD, FACP, provides a conversation about health topics for patients and health professionals.

Dr. Mintz' Blog
Matthew Mintz, MD, FACP, has practiced internal medicine for more than a decade and is an Associate Professor of Medicine at an academic medical center on the East Coast. His time is split between teaching medical students and residents, and caring for patients.

Everything Health
Toni Brayer, MD, FACP, blogs about the rapid changes in science, medicine, health and healing in the 21st century.

FutureDocs
Vineet Arora, MD, FACP, is Associate Program Director for the Internal Medicine Residency and Assistant Dean of Scholarship & Discovery at the Pritzker School of Medicine for the University of Chicago. Her education and research focus is on resident duty hours, patient handoffs, medical professionalism, and quality of hospital care. She is also an academic hospitalist.

Glass Hospital
John H. Schumann, MD, FACP, provides transparency on the workings of medical practice and the complexities of hospital care, illuminates the emotional and cognitive aspects of caregiving and decision-making from the perspective of an active primary care physician, and offers behind-the-scenes portraits of hospital sanctums and the people who inhabit them.

Gut Check
Ryan Madanick, MD, ACP Member, is a gastroenterologist at the University of North Carolina School of Medicine, and the Program Director for the GI & Hepatology Fellowship Program. He specializes in diseases of the esophagus, with a strong interest in the diagnosis and treatment of patients who have difficult-to-manage esophageal problems such as refractory GERD, heartburn, and chest pain.

I'm dok
ACP Member Mike Aref, MD, PhD, ACP Member, is an academic hospitalist with an interest in basic and clinical science and education, with interests in noninvasive monitoring and diagnostic testing using novel bedside imaging modalities, diagnostic reasoning, medical informatics, new medical education modalities, pre-code/code management, palliative care, patient-physician communication, quality improvement, and quantitative biomedical imaging.

Informatics Professor
William Hersh, MD, FACP, Professor and Chair, Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, posts his thoughts on various topics related to biomedical and health informatics.

Just Oncology
Richard Just, MD, ACP Member, has 36 years in clinical practice of hematology and medical oncology. His blog is a joint publication with Gregg Masters, MPH.

KevinMD
Kevin Pho, MD, ACP Member, offers one of the Web's definitive sites for influential health commentary.

MD Whistleblower
Michael Kirsch, MD, FACP, addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.

Medical Lessons
Elaine Schattner, MD, ACP Member, shares her ideas on education, ethics in medicine, health care news and culture. Her views on medicine are informed by her past experiences in caring for patients, as a researcher in cancer immunology, and as a patient who's had breast cancer.

More Musings
Rob Lamberts, MD, ACP Member, a med-peds and general practice internist, returns with "volume 2" of his personal musings about medicine, life, armadillos and Sasquatch at More Musings (of a Distractible Kind).

Musing of an Internist
Justin Penn, MD, ACP Associate Member, attended medical school at the University of Washington School of Medicine and trained in internal medicine at the University of Rochester, where he is serving as Chief Resident.

Prescriptions
David M. Sack, MD, FACP, practices general gastroenterology at a small community hospital in Connecticut. His blog is a series of musings on medicine, medical care, the health care system and medical ethics, in no particular order.

Reflections of a Grady Doctor
Kimberly Manning, MD, FACP, reflects on the personal side of being a doctor in a community hospital in Atlanta.

Technology in (Medical) Education
Neil Mehta, MBBS, MS, FACP, is interested in use of technology in education, social media and networking, practice management and evidence-based medicine tools, personal information and knowledge management.

White Coat Underground
Peter A. Lipson, MD, ACP Member, is a practicing internist and teaching physician in Southeast Michigan. The blog, which has been around in various forms since 2007, offers musings on the intersection of science, medicine, and culture.

Other blogs of note:

American Journal of Medicine
Also known as the Green Journal, the American Journal of Medicine publishes original clinical articles of interest to physicians in internal medicine and its subspecialities, both in academia and community-based practice.

Clinical Correlations
A collaborative medical blog started by Neil Shapiro, MD, ACP Member, associate program director at New York University Medical Center's internal medicine residency program. Faculty, residents and students contribute case studies, mystery quizzes, news, commentary and more.

Interact MD
Michael Benjamin, MD, ACP member, doesn't accept industry money so he can create an independent, clinician-reviewed space on the Internet for physicians to report and comment on the medical news of the day.

PLoS Blog
The Public Library of Science's open access materials include a blog.

White Coat Rants
One of the most popular anonymous blogs written by an emergency room physician.

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