Meaning Extraction Method Research Articles

Exploring adult hearing aid user experiences: meaning extraction methods, content patterns, and associations with demographic and outcome variables

Objective Employing automated language analysis, specifically Meaning Extraction Method (MEM) and Principal Component Analysis (PCA), to identify key factors in open-text responses about hearing aid experiences. Design Exploratory, cross-sectional design, using an online questionnaire. Responses to a single open-ended question were analysed using MEM, PCA, regression, and correlation analyses. Study sample Participants (n = 538) included adult hearing aid users sampled from the Hearing Tracker website community and Lexie Hearing user databases in the United States. Results The MEM-derived items revealed six factors related to hearing aid experiences: (1) life change, (2) social situation, (3) quality of life, (4) impact and speech understanding, (5) communication and interaction, and (6) music and environmental sounds. IOI-HA item 3 had the most statistically significant correlations with PCA factors. Quantile regression revealed that factors one and two significantly predicted the IOI-HA total score. Positive correlations were observed between self-reported hearing difficulty and factors one, four, and five, as well as between factor one and general health and factor two and physical activity. Conclusion Natural language analysis of open-ended textual responses can offer valuable insights into hearing aid users’ experiences. Future studies should aim to refine this methodology to enhance clinical relevance and generalisability.

Understanding Pediatric Experiences With Symptomatic Varicoceles: Mixed Methods Study of an Online Varicocele Community.

Varicoceles affect up to 30% of postpubertal adolescent males. Studying this population remains difficult due to this topic's sensitive nature. Using the popularity of social media in this cohort and natural language processing (NLP) techniques, our aim was to identify perceptions of adolescent males on an internet varicocele forum to inform how physicians may better evaluate and counsel this pediatric population. We aimed to characterize themes of discussion and specific concerns expressed by adolescents using a mixed methods approach involving quantitative NLP and qualitative annotation of an online varicocele community. We extracted posts from the Reddit community "r/varicocele" (5100 members) with criteria of discussant age ≤21 years and word count >20. We used qualitative thematic analysis and the validated constant comparative method, as well as an NLP technique called the meaning extraction method with principal component analysis (MEM/PCA), to identify discussion themes. Two investigators independently interrogated 150 randomly selected posts to further characterize content based on NLP-identified themes and calculated the Kaiser-Meyer-Olkin (KMO) statistic and the Bartlett test. Both quantitative and qualitative approaches were then compared to identify key themes of discussion. A total of 1103 posts met eligibility criteria from July 2015 to June 2022. Among the 150 randomly selected posts, MEM/PCA and qualitative thematic analysis separately revealed key themes: an overview of varicocele (40/150, 27%), management (29/150, 19%), postprocedural experience (28/150, 19%), seeking community (26/150, 17%) and second opinions after visiting a physician (27/150, 18%). Quantitative analysis also identified "hypogonadism" and "semen analysis" as concerns when discussing their condition. The KMO statistic was >0.60 and the Bartlett test was <0.01, indicating the appropriateness of MEM/PCA. The mean age was 17.5 (SD 2.2; range 14-21) years, and there were trends toward higher-grade (40/45, 89% had a grade of ≥2) and left-sided varicoceles. Urologists were the topic of over 50% (53/82) of discussions among discussants, and varicocelectomy remained the intervention receiving the most interest. A total of 60% (90/150) of discussants described symptomatic varicoceles, with 62 of 90 reporting pain, 24 of 90 reporting hypogonadism symptoms, and 45 of 90 reporting aesthetics as the primary concern. We applied a mixed methods approach to identify uncensored concerns of adolescents with varicoceles. Both qualitative and quantitative approaches identified that adolescents often turned to social media as an adjunct to doctors' visits and to seek peer support. This population prioritized symptom control, with an emphasis on pain, aesthetics, sexual function, and hypogonadism. These data highlight how each adolescent may approach varicoceles uniquely, informing urologists how to better interface with this pediatric population. Additionally, these data may highlight the key drivers of decision-making when electing for procedural management of varicoceles.

Checking Multiple Boxes: Themes Associated With Bicultural Identities

Multicultural individuals frequently feel they must check multiple boxes when responding to identity questions. In this investigation, we collected narratives from 402 bicultural individuals about their experiences with multicultural identities and used automated text-analytic tools to examine the valence of the narratives (sentiment analysis) and the most prevalent themes used (Meaning Extraction Method). In addition, we examined the relationships between the narratives and the two dimensions of Bicultural Identity Integration (BII) scales, Harmony and Blendedness. Findings suggested that the narratives were more emotionally positive than negative, and there were six most common themes. Furthermore, themes were significantly associated with BII scales. Our analyses provide deeper insights into the nature of bicultural identity using naturalistic language data.

Investigating Patient Satisfaction Through Web-Based Reviews of Norwegian Dentists: Quantitative Study Using the Meaning Extraction Method.

Challenging encounters in health care professions, including in dentistry, are relatively common. Challenging encounters can be defined as stressful or emotional situations involving patients that could impact both treatment outcomes and patients' experiences. Through written web-based reviews, patients can share their experiences with health care providers, and these posts can be a useful source for investigating patient satisfaction and their experiences of challenging encounters. This study aims to identify dominant themes from patient-written, web-based reviews of dentists and investigate how these themes are related to patient satisfaction with dental treatment. The study data consisted of 11,764 reviews written by dental patients, which included 1- to 5-star ratings on overall satisfaction and free-text comments. The free-text comments were analyzed using Linguistic Inquiry and Word Count software, and the meaning extraction method was used to group words into thematic categories. These themes were used as variables in a multilevel logistic regression analysis to predict patient satisfaction. Eight themes emerged from the analyses, of which 6 (75%)-explanation (odds ratio [OR] 2.56, 95% CI 2.16-3.04; P<.001), assurance (OR 3.61, 95% CI 2.57-5.06; P<.001), performance assessment (OR 2.17, 95% CI 1.84-2.55; P<.001), professional advice (OR 1.81, 95% CI 1.55-2.13; P<.001), facilities (OR 1.78, 95% CI 1.08-2.91; P=.02), and recommendation (OR 1.31, 95% CI 1.12-1.53; P<.001)-increased the odds of high patient satisfaction. The remaining themes (2/8, 25%)-consequences of treatment need (OR 0.24, 95% CI 0.20-0.29; P<.001) and patient-centered care (OR 0.62, 95% CI 0.52-0.74; P<.001)-reduced the odds of high patient satisfaction. The meaning extraction method is an interesting approach to explore patients' written accounts of encounters with dental health professionals. The experiences described by patients provide insight into key elements related to patient satisfaction that can be used in the education of dental health professionals and to improve the provision of dental health services.

Identifying Targets for Innovation in Amazon Reviews of Bedwetting Alarms: Thematic Analysis.

Nocturnal enuresis (NE) is a frequent diagnosis in pediatric and adolescent populations with an estimated prevalence of around 15% at the age of 6 years. NE can have a substantial impact on multiple health domains. Bedwetting alarms, which typically consist of a sensor and moisture-activated alarm, are a common treatment. This study aimed to determine areas of satisfaction versus dissatisfaction reported by the parents and caregivers of children using current bedwetting alarms. Using the search term "bedwetting alarms" on the Amazon marketplace, products with >300 reviews were included. For each product, the 5 reviews ranked the "most helpful" for each star category were selected for analysis. Meaning extraction method was applied to identify major themes and subthemes. A percent skew was calculated by summing the total number of mentions of each subtheme,+1 for a positive mention, 0 for a neutral mention, and -1 for a negative mention, and dividing this total by the number of reviews in which that particular subtheme was observed. Subanalyses were performed for age and gender. Of 136 products identified, 10 were evaluated based on the selection criteria. The main themes identified across products were long-term concerns, marketing, alarm systems, and device mechanics and features. The subthemes identified as future targets for innovation included alarm accuracy, volume variability, durability, user-friendliness, and adaptability to girls. In general, durability, alarm accuracy, and comfort were the most negatively skewed subthemes (with a negative skew of -23.6%, -20.0%, and -12.4% respectively), which are indicative of potential areas for improvement. Effectiveness was the only substantially positively skewed subtheme (16.8%). Alarm sound and device features were positively skewed for older children, whereas ease of use had a negative skew for younger children. Girls and their caretakers reported negative experiences with devices that featured cords, arm bands, and sensor pads. This analysis provides an innovation roadmap for future device design to improve patient and caregiver satisfaction and compliance with bedwetting alarms. Our results highlight the need for additional options in alarm sound features, as children of different ages have divergent preferences in this domain. Additionally, girls and their parents and caretakers provided more negative overall reviews regarding the range of current device features compared to boys, indicating a potential focus area for future development. The percent skew showed that subthemes were often more negatively skewed toward girls, with the ease of use being -10.7% skewed for boys versus -20.5% for girls, and comfort being -7.1% skewed for boys versus -29.4% for girls. Put together, this review highlights multiple device features that are targets for innovation to ensure translational efficacy regardless of age, gender, or specific family needs.

MP18-02 "TORN BETWEEN MICROSURGERY AND EMBOLIZATION -- PLEASE HELP": APPLICATION OF NATURAL LANGUAGE PROCESSING TO UNDERSTAND ADOLESCENTS' PERCEPTIONS ON AN ANONYMOUS VARICOCELE INTERNET FORUM

You have accessJournal of UrologyCME1 Apr 2023MP18-02 "TORN BETWEEN MICROSURGERY AND EMBOLIZATION -- PLEASE HELP": APPLICATION OF NATURAL LANGUAGE PROCESSING TO UNDERSTAND ADOLESCENTS' PERCEPTIONS ON AN ANONYMOUS VARICOCELE INTERNET FORUM Grace E. Sollender, Tommy Jiang, Vadim Osadchiy, Ilana Finkelshtein, Michael H. Zheng, Jennifer S. Singer, and Sriram V. Eleswarapu Grace E. SollenderGrace E. Sollender More articles by this author , Tommy JiangTommy Jiang More articles by this author , Vadim OsadchiyVadim Osadchiy More articles by this author , Ilana FinkelshteinIlana Finkelshtein More articles by this author , Michael H. ZhengMichael H. Zheng More articles by this author , Jennifer S. SingerJennifer S. Singer More articles by this author , and Sriram V. EleswarapuSriram V. Eleswarapu More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003238.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Varicoceles affect up to 30% of postpubertal adolescent males. Studying this population remains difficult due to this topic’s sensitive nature. Using the popularity of social media in this cohort & natural language processing (NLP) techniques, our aim was to identify perceptions of adolescent males on an internet varicocele forum to inform how physicians may better evaluate & counsel this pediatric population. METHODS: We extracted posts from the Reddit community r/Varicocele (5100 members) from founding to 6/2022 with criteria of discussant age ≤21 & word count >20. We employed qualitative thematic analysis using validated constant comparative method & an NLP technique called the meaning extraction method with principal component analysis (MEM/PCA) to identify discussion themes. We then interrogated 150 random posts to further characterize content based on NLP-identified themes & calculated Kaiser-Meyer-Olkin (KMO) statistic & Bartlett’s test. RESULTS: 1103 posts met eligibility criteria. MEM/PCA & qualitative thematic analysis separately revealed key themes: varicocele overview (27%), management (19%), post-procedural experience (19%), seeking community (17%) & second opinion after visiting a physician (18%). KMO>0.60 & Bartlett’s test <0.01 indicated appropriateness for MEM/PCA. Mean age was 17.5 y/o (range 14-21) trending toward higher grade (89% were 2+), left-sided varicoceles. Figure 1 describes provider & procedure type most commented on by discussants. 60% of discussants described symptomatic varicoceles (90/150) with 69% (62/90) reporting pain, 27% (24/90) reporting hypogonadism symptoms & 50% (45/90) reporting aesthetic as the primary concern. CONCLUSIONS: We applied a mixed methods approach to identify uncensored concerns of adolescents with varicoceles. Adolescents often turned to social media as an adjunct to doctors’ visits & to seek peer support. This population prioritized symptom control with emphasis on pain, aesthetics, sexual function & hypogonadism. This data highlights how adolescents may approach varicoceles uniquely, informing urologists how to better interface with this pediatric population. Limitations include self-reported, non-standardized data & skew toward higher grade varicocele. Source of Funding: NA © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e222 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Grace E. Sollender More articles by this author Tommy Jiang More articles by this author Vadim Osadchiy More articles by this author Ilana Finkelshtein More articles by this author Michael H. Zheng More articles by this author Jennifer S. Singer More articles by this author Sriram V. Eleswarapu More articles by this author Expand All Advertisement PDF downloadLoading ...

Swirling currents

Abstract Understanding how humans relate to and think about nonhuman nature has never been more important. To begin exploring that question, our study compares literature (nature-writing) that explicitly addresses this relationship with literature of the same genre that does not address nonhuman nature (creative nonfiction) using the tools of digital humanities and ecological analysis. We used Linguistic Inquiry and Word Count (LIWC) and Meaning Extraction Method (MEM) to examine 228 texts. Resulting scores were then examined for gradients, patterns, and trends across texts using principal components analysis (PCA). Overall, we found that nature writing texts scored higher in analytical and authenticity scores; were associated with psychological processes such as perception, cognition, politics, and power; and were typified by individual word choice clouds associated with clusters of text such as tree/human/see/time/form/place than non-nature creative nonfiction. This analysis serves as a foundation for understanding the genre of nature-writing and the ways that humans think about nonhuman nature.

MP46-05 CHARACTERIZING ONLINE TESTICULAR CANCER DISCUSSIONS WITH QUANTITATIVE THEMATIC ANALYSIS

You have accessJournal of UrologyCME1 May 2022MP46-05 CHARACTERIZING ONLINE TESTICULAR CANCER DISCUSSIONS WITH QUANTITATIVE THEMATIC ANALYSIS Krishna Ravivarapu, Alexander Small, Micah Levy, Chih Peng Chin, Evan Garden, Osama Al-Alao, Joseph Sewell Araya, and Michael Palese Krishna RavivarapuKrishna Ravivarapu More articles by this author , Alexander SmallAlexander Small More articles by this author , Micah LevyMicah Levy More articles by this author , Chih Peng ChinChih Peng Chin More articles by this author , Evan GardenEvan Garden More articles by this author , Osama Al-AlaoOsama Al-Alao More articles by this author , Joseph Sewell ArayaJoseph Sewell Araya More articles by this author , and Michael PaleseMichael Palese More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002612.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Patients are increasingly turning to the internet to crowdsource community support and medical advice. This is especially true for younger patient populations like those affected by testicular cancer. Extracting information from online discussions can facilitate better counseling and care by giving providers insights into prevailing concerns, common misconceptions, and shared emotions. We aim to use quantitative natural language processing methodology to identify key themes of discussion in one of the internet’s largest testicular cancer forums. METHODS: We extracted three years of posts (08/2016 to 08/2019) and comments (01/2017 to 12/2019) from the 3,593 member Reddit community r/testicularcancer. The dataset was analyzed by a meaning extraction method followed by principal component analysis (MEM/PCA) to computationally distill major themes of discussion (Figure 1). Kaiser-Meyer-Olkin Measure of Sampling Adequacy (>0.60) and Bartlett’s test of sphericity (<0.001) indicate that the data is suitable for MEM/PCA. RESULTS: 17,423 posts and comments were analyzed with MEM/PCA to generate five major themes of discussion, ranked by prevalence: 1) chemotherapy and side effects 2) medical evaluation after self-identifying an anomaly, 3) cancer diagnosis and surgery, 4) blood test result discussion of specific tumor markers, and 5) medical decision-making. Users seeking medical advice, such as questions about self-identified testicular anomalies (“lump” 5.2%), are consistently referred to medical evaluation (“urologist” 6.3%, “oncologist” 5.3%). Posts can be very technical, referring to forms of testicular cancer (“seminoma” 4.1%, “embryonal [carcinoma]” 1.1%, “teratoma” 1.1%, “yolk [sac] carcinoma” 0.6%, and “choriocarcinoma” 0.3%) as well as specific tumor markers (“AFP” 1.5%, “HCG” 1.1%, “LDH” 0.6%). Regarding “chemotherapy” (17.5%), “hair [loss]” (2.4%) is a major concern. CONCLUSIONS: Social media forums allow patients to express unbiased and uninhibited thoughts and concerns. These anecdotes can collectively influence patient attitudes and approaches. Therefore, it is important for providers to be aware of the key topics of discussion on social media to connect better with their patients, improving shared decision-making, patient satisfaction, and care. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e774 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Krishna Ravivarapu More articles by this author Alexander Small More articles by this author Micah Levy More articles by this author Chih Peng Chin More articles by this author Evan Garden More articles by this author Osama Al-Alao More articles by this author Joseph Sewell Araya More articles by this author Michael Palese More articles by this author Expand All Advertisement PDF DownloadLoading ...

MP21-05 PERCEPTIONS OF MARIJUANA USE ON MALE HEALTH AMONG REDDIT USERS: NATURAL LANGUAGE PROCESSING AND THEMATIC ANALYSIS

You have accessJournal of UrologyCME1 May 2022MP21-05 PERCEPTIONS OF MARIJUANA USE ON MALE HEALTH AMONG REDDIT USERS: NATURAL LANGUAGE PROCESSING AND THEMATIC ANALYSIS Gary Shahinyan, Ming-Yeah Hu, Tommy Jiang, Vadim Osadchiy, John Sigalos, Jesse Mills, Naveen Kachroo, and Sriram Eleswarapu Gary ShahinyanGary Shahinyan More articles by this author , Ming-Yeah HuMing-Yeah Hu More articles by this author , Tommy JiangTommy Jiang More articles by this author , Vadim OsadchiyVadim Osadchiy More articles by this author , John SigalosJohn Sigalos More articles by this author , Jesse MillsJesse Mills More articles by this author , Naveen KachrooNaveen Kachroo More articles by this author , and Sriram EleswarapuSriram Eleswarapu More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002554.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: With the legalization of marijuana and the potential upsurge in use, people are increasingly likely to explore its relationship with their health. The effects of marijuana on fertility and sexual function are poorly understood, though recent evidence suggest a potential spermatoxic effect of marijuana. This uncertainty, along with patient hesitancy to discuss substance use with providers, lead men to seek advice from anonymous internet forums. This study aims to characterize the linguistic themes surrounding the discussion of marijuana use and men’s health on these forums in order to provide insight into lay perceptions of marijuana use on topics in men’s health. METHODS: Using a Google cloud-based platform for data extraction (BigQuery), we extracted all posts from the Reddit forums r/ErectileDysfunction, r/Testosterone, r/MensHealth, r/Sex, and r/NoFap during 8/2018-8/2019. Posts that included synonyms of marijuana and were related to men’s sexual health were included. We manually analyzed 243 posts and qualitatively derived themes from each post around men’s health and sexual dysfunction. A quantitative analysis utilizing a natural language processing (NLP) methodology called the Meaning Extraction Method with principal component analysis (MEM/PCA) was also performed. RESULTS: Mean user age was 23.8 years. MEM/PCA revealed a thematic cluster including the words marijuana, weed, level, issue, body, mental, low, results, physical, high, stress, normal. The qualitative analysis is shown in Figure 1. CONCLUSIONS: The relevant posts express uncertainty about the effects of marijuana and seek more information regarding how it relates to topics such as erectile dysfunction, testosterone levels, and sexual function. Moreover, posts express conflicting experiences such as marijuana both improving or reducing libido. These data emphasize that while there is limited research on the effects of marijuana use on men’s health, urology providers should be open and prepared to address questions regarding marijuana use, especially in younger men concerned about their sexual health. Source of Funding: N/A © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e328 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Gary Shahinyan More articles by this author Ming-Yeah Hu More articles by this author Tommy Jiang More articles by this author Vadim Osadchiy More articles by this author John Sigalos More articles by this author Jesse Mills More articles by this author Naveen Kachroo More articles by this author Sriram Eleswarapu More articles by this author Expand All Advertisement PDF DownloadLoading ...

Quantitative Patient-Reported Experience Measures Derived From Natural Language Processing Have a Normal Distribution and No Ceiling Effect.

Patient-reported experience measures have the potential to guide improvement in health care delivery. Many patient-reported experience measures are limited by the presence of strong ceiling effects that limit their analytical utility. We used natural language processing to develop 2 new methods of evaluating patient experience using text comments and associated ordinal and categorical ratings of willingness to recommend from 1390 patients receiving specialty or nonspecialty care at our offices. One method used multivariable analysis based on linguistic factors to derive a formula to estimate the ordinal likelihood to recommend. The other method used the meaning extraction method of thematic analysis to identify words associated with categorical ratings of likelihood to recommend with which we created an equation to compute an experience score. We measured normality of the 2 score distributions and ceiling effects. Spearman rank-order correlation analysis identified 36 emotional and linguistic constructs associated with ordinal rating of likelihood to recommend, 9 of which were independently associated in multivariable analysis. The calculation derived from this model corresponded with the original ordinal rating with an accuracy within 0.06 units on a 0 to 10 scale. This score and the score developed from thematic analysis both had a relatively normal distribution and limited or no ceiling effect. Quantitative ratings of patient experience developed using natural language processing of text comments can have relatively normal distributions and no ceiling effect.

Patient Experiences at California Crisis Pregnancy Centers: A Mixed-Methods Analysis of Online Crowd-Sourced Reviews, 2010-2019.

Crisis pregnancy centers (CPCs) are nonprofit antiabortion organizations that claim provision of pregnancy resources. With the Reproduction Freedom, Accountability, Comprehensive Care, and Transparency Act repealed, CPCs are no longer mandated to share information on state-funded family planning and abortion services. As patients increasingly seek healthcare guidance online, we evaluated crowd-sourced reviews of CPCs using the social networking site Yelp. CPCs were identified with the CPC Map, a geo-based location resource. Of California's 145 CPCs, 84% had Yelp pages, and 619 reviews (2010-2019) were extracted. Thematic codes were individually applied to 220 excerpts and then analyzed in detail using thematic analysis to capture emergent themes related to motivations for and experiences of CPCs. To ensure thematic saturation, we applied a natural language-processing technique called the meaning extraction method to computationally derive themes of discussion from all of the extracted posts. Motivations to seek care from CPCs included pregnancy confirmation, gaps in healthcare coverage, parenting and emotional support, and abortion care. A review of experiences reveal that CPC faith-based practice garnered both positive- and negative-based experiences. Reviewers also articulated inaccurate medical information, lack of transparency, and reduced options at CPCs. This is the first study to analyze California CPCs using a social media platform. Pregnant patients turn to social media to share experiences about pregnancy resources, to find healthcare providers, and to increase transparency of services. This content provides valuable insight into the concerns of pregnant patients and offers an intimate view of California CPCs at a time when no federal regulations are in place.

MP21-09 TOPIC MODELING AND SENTIMENT ANALYSIS OF SOCIAL MEDIA MALE INFERTILITY DISCUSSIONS

You have accessJournal of UrologyInfertility: Epidemiology & Evaluation I (MP21)1 Sep 2021MP21-09 TOPIC MODELING AND SENTIMENT ANALYSIS OF SOCIAL MEDIA MALE INFERTILITY DISCUSSIONS Krishna Ravivarapu, Alexander Small, Evan Garden, Micah Levy, Osama Al-Alao, and Michael Palese Krishna RavivarapuKrishna Ravivarapu More articles by this author , Alexander SmallAlexander Small More articles by this author , Evan GardenEvan Garden More articles by this author , Micah LevyMicah Levy More articles by this author , Osama Al-AlaoOsama Al-Alao More articles by this author , and Michael PaleseMichael Palese More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002006.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Anonymous social media forums allow uninhibited and unbiased patient expression of prevailing concerns, attitudes, and experiences. For a sensitive condition like male-factor infertility, insights into online discussions can augment understanding of patient concerns. We used quantitative natural language processing (NLP) methods to identify key themes on one of the internet’s largest male infertility forums. METHODS: We extracted three years of posts (08/2016-08/2019) and comments (01/2017-12/2019) from the 3,063 member Reddit community r/maleinfertility. We employed a meaning extraction method followed by principal component analysis (MEM/PCA) to computationally distill major themes of discussion and compare the relative prevalence of discussion topics. Kaiser-Meyer-Olkin Measure of Sampling Adequacy (KMO>0.60) and Bartlett’s test of sphericity (p<0.001) indicated that the data is suitable for MEM/PCA. Furthermore, we calculated a sentiment score using the Valence Aware Dictionary for Sentiment Reasoning (VADER) model. RESULTS: 4,609 posts and comments were analyzed with MEM/PCA to generate five major themes of discussion ranked by prevalence (Figure 1). Posts are made to clarify specific semen analysis parameters (count 11.3%, motility 8.2%, morphology 6.4%). IVF 13.1% is mentioned more frequently than ICSI 5.4% or IUI 5.3% (p<0.001). Treatment effectiveness (chance 5.2%, luck 7.9%) and cost (expensive 1.7%) are discussed concurrently. Low testosterone (7.1%) is a major concern, leading to discussion of Clomid (4.6%), HCG (2.2%) and TRT (1.2%). Infertility also takes a toll on mental health with frequent mentions of concern 6.7%, worry 3.0%, and stress 2.1%. Suggestions for increasing fertility include lifestyle changes (vitamins 3.8%, diet 2.3%, exercise 2.0%, weight 2.0%), using ice (2.1%) to cool testicles and wearing loose clothes (1.2%). VADER sentiment analysis revealed that there were more positive-sentiment entries than negative-sentiment (3,675 vs. 934, p<0.001). CONCLUSIONS: This quantitative analysis of anonymous male infertility internet discussion is a step towards increased understanding of the complete patient experience. Providers can use this knowledge to better engage with patients in clinic and online. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e349-e349 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Krishna Ravivarapu More articles by this author Alexander Small More articles by this author Evan Garden More articles by this author Micah Levy More articles by this author Osama Al-Alao More articles by this author Michael Palese More articles by this author Expand All Advertisement Loading ...

Dimensions of Self-Expression in Facebook Status Updates

We describe the dimensions along which Facebook users tend to express themselves via status updates using the semi-automated text analysis approach, the Meaning Extraction Method (MEM). First, we examined dimensions of self-expression in all status updates from a sample of four million Facebook users from four English-speaking countries (the United States, Canada, the United Kingdom, and Australia) in order to examine how these countries vary in their self-expressions. All four countries showed a basic three-component structure, indicating that the medium is a stronger influence than country characteristics or demographics on how people use Facebook status updates. In each country, people vary in terms of the extent to which they use Informal Speech, share Positive Events, and discuss School in their Facebook status updates. Together, these factors tell us how users differ in their self-expression, and thus illustrate meaningful use cases for the product: Talking about what’s going on tends to be positive, and people vary in terms of the extent to which their status updates are short, slangy emotional expressions and topics regarding school. The specific words that define these factors showed subtle differences across countries: The use of profanity indicates fewer school words (but only in Australia), whereas the UK shows greater use of slang terms (rather than profanity) when speaking informally. The MEM also identified English-language dialects as a meaningful dimension along which the countries varied. In sum, beyond simply indicating topicality of posts, this study provides insight into how status updates are used for self-expression. We discuss several theoretical frameworks that could produce these results, and more broadly discuss the generation of theoretical frameworks from wholly empirical data (such as naturalistic Internet speech) using the MEM.

Using crowdsourced medicine to manage uncertainty on Reddit: The case of COVID-19 long-haulers

ObjectiveCauses of and treatments for long-COVID syndrome remain unknown. Drawing on uncertainty management theory (UMT), this study elucidates the communicative nature of crowdsourced medicine as a means by which COVID “long-haulers” respond to their poorly understood illness. Methods31,892 posts on the long-haulers subreddit (r/covidlonghaulers) were analyzed, starting with its creation date, July 24th, 2020, until January 7, 2021. The Meaning Extraction Method was used to identify clusters of words that mathematically group together across the text observations. ResultsAnalyses yielded 16 distinct factors of words, which we thematized based on their composition, the data, and UMT. The 16 themes encompassed symptoms (e.g., pain, respiratory, sensory), diagnostic concerns (testing, diagnosis), broad health concerns (immunity, physical activity, diet), chronicity, support, identity, and anxiety. ConclusionFindings provide a succinct, yet robust set of themes reflecting the information-seeking (i.e., “This is happening to me”) and support-seeking functions of long-haulers’ talk (i.e., “Is this happening to you?”). Findings have implications for collective uncertainty management, online crowdsourcing, and patient advocacy. Practice implicationsWe recommend that health care providers employ sensitivity when addressing the anxiety that long-haulers are experiencing while also validating that their physical symptoms are real. Online communities help long-haulers manage their uncertainty.

The Meaning Extraction Method: An Approach to Evaluate Content Patterns From Large-Scale Language Data

Qualitative content analyses often rely on a top-down approach to understand themes in a collection of texts. A codebook prescribes how humans should judge if a text fits a theme based on rules and judgment criteria. Qualitative approaches are challenging because they require many resources (e.g., coders, training, rounds of coding), can be affected by researcher or coder bias, may miss meaningful patterns that deviate from the codebook, and often use a subsample of the data. A complementary, bottom-up approach—the Meaning Extraction Method—has been popular in social psychology but rarely applied to communication research. This paper outlines the value of the Meaning Extraction Method, concluding with a guide to conduct analyses of content and themes from massive and complete datasets, quantitatively. The Meaning Extraction Method is performed on a public and published archive of pet adoption profiles to demonstrate the approach. Considerations for communication research are offered.

All immigrants are not alike: Intersectionality matters in views of immigrant groups

In two studies, we investigated how intersecting social categories shape views of immigrants in the United States. In Study 1, we analyzed 310 attributes generated by 92 participants for the category of immigrant and 30 additional immigrant groups with intersecting social categories (e.g. “undocumented immigrant”) reflecting various levels of social status. Using the Meaning Extraction Method (MEM) and factor analysis to examine shared meanings, we identified five factors; further comparative analyses of immigrant groups focused on the first two factors (Vulnerable vs. Hardworking, Drain vs. Asset). The importance of legal status for judgments on these two factors was evident in comparisons of the generic immigrant with four specific legal intersections. An examination of all 31 groups of immigrants showed that higher status groups were perceived as Hardworking (less Vulnerable) and high national Assets (low Drain), while lower status groups varied in Vulnerability perceptions but were generally thought to be Drains on the nation rather than Assets. In Study 2, 270 participants evaluated intersectional immigrant social categories that differed in combinations of higher status (privileged) and lower status (marginalized) social group memberships, using scales based on the terms identified by the factors in Study 1. Participants rated immigrant groups with two privileged statuses as less vulnerable and more likely to be an asset to the nation than immigrant groups with two marginalized or mixed statuses. The utility of a bottom-up intersectional approach to assess stereotype content of immigrant groups is discussed.

Low Testosterone on Social Media: Application of Natural Language Processing to Understand Patients' Perceptions of Hypogonadism and Its Treatment.

BackgroundDespite the results of the Testosterone Trials, physicians remain uncomfortable treating men with hypogonadism. Discouraged, men increasingly turn to social media to discuss medical concerns.ObjectiveThe goal of the research was to apply natural language processing (NLP) techniques to social media posts for identification of themes of discussion regarding low testosterone and testosterone replacement therapy (TRT) in order to inform how physicians may better evaluate and counsel patients.MethodsWe retrospectively extracted posts from the Reddit community r/Testosterone from December 2015 through May 2019. We applied an NLP technique called the meaning extraction method with principal component analysis (MEM/PCA) to computationally derive discussion themes. We then performed a prospective analysis of Twitter data (tweets) that contained the terms low testosterone, low T, and testosterone replacement from June through September 2019.ResultsA total of 199,335 Reddit posts and 6659 tweets were analyzed. MEM/PCA revealed dominant themes of discussion: symptoms of hypogonadism, seeing a doctor, results of laboratory tests, derogatory comments and insults, TRT medications, and cardiovascular risk. More than 25% of Reddit posts contained the term doctor, and more than 5% urologist.ConclusionsThis study represents the first NLP evaluation of the social media landscape surrounding hypogonadism and TRT. Although physicians traditionally limit their practices to within their clinic walls, the ubiquity of social media demands that physicians understand what patients discuss online. Physicians may do well to bring up online discussions during clinic consultations for low testosterone to pull back the curtain and dispel myths.

Understanding breast cancer survivors’ information-seeking behaviours and overall experiences: a comparison of themes derived from social media posts and focus groups

Objective Using two different analysis techniques, this study explored differences and similarities in information-seeking discourse and overall breast cancer experiences between posters to a Reddit board and breast cancer survivor focus groups. Design This study incorporates two qualitative methods for determining themes in breast cancer survivors’ information-seeking behaviours and overall cancer experiences. First, posts from a breast cancer-specific Reddit community were extracted and analysed using the meaning extraction method (MEM) to determine core themes. Then, investigators performed a thematic analysis of two focus groups of breast cancer survivors (N = 18). Finally, themes derived from each analysis method were compared. Main Outcome Measures Outcome measures include themes extracted from Reddit posts and themes generated from breast cancer survivor focus groups. Results Findings between qualitative methodologies represent similar yet nuanced themes in survivors’ discourse. The MEM resulted in seven themes: diagnosis, treatment process, social support, existentialism, risk, information-seeking and surgery. Focus groups revealed the same initial four MEM themes plus the following: disclosure, coping and fears. Conclusions The MEM is a cost-effective research mechanism for informing common themes of experiences of cancer patients and survivors and may offer initial data to guide psychosocial oncology research design and recruitment.

Is It All in My Head? Self-reported Psychogenic Erectile Dysfunction and Depression Are Common Among Young Men Seeking Advice on Social Media

To characterize themes of discussion and specific concerns expressed by users of an internet erectile dysfunction (ED) community using a mixed-methodology approach involving quantitative natural language processing (NLP) and qualitative annotation of content. We extracted posts and responses from the Reddit community r/ErectileDysfunction (3100 members) during June 2018 to May 2019. We applied an NLP technique called the meaning extraction method with principal component analysis to computationally identify themes of discussion. We manually annotated a subset (30%) of posts based on NLP-derived themes to evaluate specific content. We analyzed 329 posts and 1702 responses. Meaning extraction method with principal component analysis identified key themes: hypogonadism symptoms, masturbation/sex, evaluation/treatment, alternative therapies, and partner factors (posts); and performance anxiety, hypogonadism evaluation, pornography, and pharmacotherapy (responses). Subset annotation of 100 posts revealed a median author age of 24 years (Interquartile Range (IQR): 20-31). 48% of discussants believed their ED was psychogenic, 38% reported depressive symptoms, and 2% mentioned self-harm/suicidality either attributed to or associated with their ED. 28% of discussants reported seeing a health care professional for ED, and 20% attempted abstinence from pornography/masturbation as a self-prescribed intervention. Social media platforms like Reddit empower young men to discuss ED concerns. Fewer than one-third reported seeing a doctor for ED, suggesting that men turn to peers on the internet first, despite risk of misinformation. A majority attributed symptoms to psychological etiologies and excess pornography/masturbation. Depression, self-harm, and suicide emerged as potent concerns. These data underscore the importance of engaging proactively with young men, both in the consultation room and online.

MP45-03 LOW TESTOSTERONE ON SOCIAL MEDIA

INTRODUCTION AND OBJECTIVE: Despite the results of the Testosterone Trials, physicians continue to be uncomfortable treating men with hypogonadism. Discouraged, men increasingly turn to social media—an environment where anecdotes predominate and advertising masquerades as advice—to discuss medical concerns. Here, we apply quantitative natural language processing (NLP) to social media posts to identify themes of discussion regarding low testosterone and testosterone replacement therapy (TRT) to inform how physicians may better evaluate and counsel men with hypogonadism. METHODS: We retrospectively extracted posts from the Reddit community r/Testosterone from 12/2015-5/2019. We applied an NLP technique called the meaning extraction method (MEM) with principal component analysis (PCA) to computationally derive themes of discussion (Fig. 1). We then performed a prospective, cross-platform analysis of Twitter data (tweets) that contained the terms “low T,” “low testosterone,” and “testosterone replacement” from 6/2019-9/2019 using MEM. Kaiser-Meyer-Olkin (KMO) statistic, Bartlett’s test, and word frequencies were calculated for each data set. RESULTS: 199,335 Reddit posts and 6,659 tweets were analyzed. MEM revealed dominant themes of discussion, including: symptoms of hypogonadism (Reddit and Twitter); cardiovascular risk (Twitter); TRT administration, lifestyle interventions, lab test results, and seeing a doctor (Reddit). KMO >0.60 and Bartlett’s test <0.01 for all data, indicating appropriateness for MEM/PCA. >25% of Reddit posts contained the term “doctor” and >5% of posts refer to a “urologist.” >1% of all social media posts contained the terms “prostate” or “cancer.” CONCLUSIONS: Analysis of over 200,000 discrete social media posts revealed dominant themes of discussion, including those related to cardiovascular risk and seeing a physician. In the era of social media, physicians may do well to bring up online discussions during clinic consultations to pull back the curtain and dispel myths.Source of Funding: Research Scholar Award from the Urology Care Foundation & American Urological Association.