Using Twitter as a Data Source for Studying Public Communication about Cardiovascular Health

Person-to-person communication is one of the most persuasive ways people deliver and receive information. Until recently, this communication was impossible to collect and study. Now, social media networks, such as Twitter, allow researchers to systematically witness public communication about health, including cardiovascular disease. Twitter is used by more than 300 million people who have generated several billion Tweets, yet little work has focused on the potential applications of these data for studying public attitudes and behaviors associated with cardiovascular health.

In a study published online by JAMA Cardiology, Raina M. Merchant, M.D., M.S.H.P., of the University of Pennsylvania, Philadelphia, and colleagues examined the volume and content of Tweets associated with cardiovascular disease as well as the characteristics of Twitter users.

For this study, the researchers used Twitter to access a random sample of Tweets associated with cardiovascular disease from July 2009 to February 2015. Tweets were characterized relative to estimated user demographics. A random subset of 2,500 Tweets was hand-coded for content and modifiers.

From an initial sample of 10 billion Tweets, the authors identified 4.9 million with terms associated with cardiovascular disease; 550,338 were in English and originated from a U.S. county. Diabetes and heart attack represented more than 200,000 Tweets each, while the topic of heart failure returned fewer than 10,000 Tweets. Users who Tweeted about cardiovascular disease were more likely to be older than the general population of Twitter users (average age, 28.7 vs 25.4 years) and less likely to be male (47.3 percent vs 48.8 percent). Most Tweets (2,338 of 2,500 [93.5 percent]) were associated with a health topic; common themes of Tweets included risk factors (42 percent), awareness (23 percent), and management (22 percent) of cardiovascular disease.

"This study has 3 main findings. First, we identified a large volume of U.S.-based Tweets about cardiovascular disease. Second, we were able to characterize the volume, content, style, and sender of these Tweets, demonstrating the ability to identify signal from noise. Third, we found that the data available on Twitter reflect real-time changes in discussion of a disease topic," the authors write.

"Twitter may be useful for studying public communication about cardiovascular disease. The use of Twitter for clinical research is still in its infancy. Its value and direct applications remain to be seen and warrant further exploration."

Sinnenberg L, DiSilvestro CL, Mancheno C, et al.
Twitter as a Potential Data Source for Cardiovascular Disease Research.
JAMA Cardiol. Published online September 28, 2016. doi:10.1001/jamacardio.2016.3029.

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