Social media for arthritis-related comparative effectiveness and safety research and the impact of direct-to-consumer advertising

Jeffrey R Curtis,Kaitlin O’Hara,W Benjamin Nowell,James Willig,Lang Chen,Monika Safford,Ronit Gal-Levy,Roee Sa’Adon,Joseph Coe,Phillip Higginbotham

doi:10.1186/s13075-017-1251-y

Abstract

BackgroundSocial media may complement traditional data sources to answer comparative effectiveness/safety questions after medication licensure.MethodsThe Treato platform was used to analyze all publicly available social media data including Facebook, blogs, and discussion boards for posts mentioning inflammatory arthritis (e.g. rheumatoid, psoriatic). Safety events were self-reported by patients and mapped to medical ontologies, resolving synonyms. Disease and symptom-related treatment indications were manually redacted. The units of analysis were unique terms in posts. Pre-specified conditions (e.g. herpes zoster (HZ)) were selected based upon safety signals from clinical trials and reported as pairwise odds ratios (ORs); drugs were compared with Fisher’s exact test. Empirically identified events were analyzed using disproportionality analysis and reported as relative reporting ratios (RRRs). The accuracy of a natural language processing (NLP) classifier to identify cases of shingles associated with arthritis medications was assessed.ResultsAs of October 2015, there were 785,656 arthritis-related posts. Posts were predominantly US posts (75%) from patient authors (87%) under 40 years of age (61%). For HZ posts (n = 1815), ORs were significantly increased with tofacitinib versus other rheumatoid arthritis therapies. ORs for mentions of perforated bowel (n = 13) were higher with tocilizumab versus other therapies. RRRs associated with tofacitinib were highest in conditions related to baldness and hair regrowth, infections and cancer. The NLP classifier had a positive predictive value of 91% to identify HZ. There was a threefold increase in posts following television direct-to-consumer advertisement (p = 0.04); posts expressing medication safety concerns were significantly more frequent than favorable posts.ConclusionSocial media is a challenging yet promising data source that may complement traditional approaches for comparative effectiveness research for new medications.

Highlights

Social media may complement traditional data sources to answer comparative effectiveness/safety questions after medication licensure
Data source We used the Treato [5] technology to analyze all publicly-available social media data including Facebook, blogs, and discussion boards for posts mentioning inflammatory arthritis and specific mentions of four medications used for rheumatoid arthritis (RA)
Based upon data from Symplur, the most common sources for social media mentions of RA on Twitter included a mix of professional patient advocacy organizations and individual patients

Summary

Introduction

Social media may complement traditional data sources to answer comparative effectiveness/safety questions after medication licensure. Social media is a burgeoning form of communication used by an increasingly large segment of the population. Social media is a vehicle for interactive communication where the producers of content (e.g. patients) can be the consumers of content [1, 2]. Social media can be seen as an equalizer, giving everyday people access to individuals and institutions with whom they would be unlikely to communicate otherwise. Social media permits the exchange of information and support to and between large numbers of people [3]. Despite its uptake by large segments of the population, the use of social media in healthcare has been less well-characterized. A variety of uses have been explored, ranging from conveying health information to messaging health promotion that is intended to motivate change in health behavior

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