Nastasi Anthony, Bryant Tyler, Canner Joseph K, Dredze Mark, Camp Melissa S, Nagarajan Neeraja
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA.
Johns Hopkins Surgery Center for Outcomes Research (JSCOR), Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
J Cancer Educ. 2018 Jun;33(3):695-702. doi: 10.1007/s13187-017-1168-9.
There is ongoing debate regarding the best mammography screening practices. Twitter has become a powerful tool for disseminating medical news and fostering healthcare conversations; however, little work has been done examining these conversations in the context of how users are sharing evidence and discussing current guidelines for breast cancer screening. To characterize the Twitter conversation on mammography and assess the quality of evidence used as well as opinions regarding current screening guidelines, individual tweets using mammography-related hashtags were prospectively pulled from Twitter from 5 November 2015 to 11 December 2015. Content analysis was performed on the tweets by abstracting data related to user demographics, content, evidence use, and guideline opinions. Standard descriptive statistics were used to summarize the results. Comparisons were made by demographics, tweet type (testable claim, advice, personal experience, etc.), and user type (non-healthcare, physician, cancer specialist, etc.). The primary outcomes were how users are tweeting about breast cancer screening, the quality of evidence they are using, and their opinions regarding guidelines. The most frequent user type of the 1345 tweets was "non-healthcare" with 323 tweets (32.5%). Physicians had 1.87 times higher odds (95% CI, 0.69-5.07) of providing explicit support with a reference and 11.70 times higher odds (95% CI, 3.41-40.13) of posting a tweet likely to be supported by the scientific community compared to non-healthcare users. Only 2.9% of guideline tweets approved of the guidelines while 14.6% claimed to be confused by them. Non-healthcare users comprise a significant proportion of participants in mammography conversations, with tweets often containing claims that are false, not explicitly backed by scientific evidence, and in favor of alternative "natural" breast cancer prevention and treatment. Furthermore, users appear to have low approval and confusion regarding screening guidelines. These findings suggest that more efforts are needed to educate and disseminate accurate information to the general public regarding breast cancer prevention modalities, emphasizing the safety of mammography and the harms of replacing conventional prevention and treatment modalities with unsubstantiated alternatives.
关于最佳的乳腺钼靶筛查实践存在持续的争论。推特已成为传播医学新闻和促进医疗保健对话的强大工具；然而，在用户如何分享证据以及讨论乳腺癌筛查现行指南的背景下，对这些对话的研究工作做得很少。为了描述推特上关于乳腺钼靶的对话，评估所使用证据的质量以及对现行筛查指南的看法，从2015年11月5日至2015年12月11日，前瞻性地从推特上提取使用了与乳腺钼靶相关主题标签的个人推文。通过提取与用户人口统计学、内容、证据使用和指南意见相关的数据，对推文进行内容分析。使用标准描述性统计来总结结果。按人口统计学、推文类型（可检验的主张、建议、个人经历等）和用户类型（非医疗保健人员、医生、癌症专家等）进行比较。主要结果是用户如何在推特上谈论乳腺癌筛查、他们所使用证据的质量以及他们对指南的看法。在1345条推文中，最常见的用户类型是“非医疗保健人员”，有323条推文（占32.5%）。与非医疗保健用户相比，医生提供有参考文献的明确支持的几率高1.87倍（95%置信区间，0.69 - 5.07），发布可能得到科学界支持的推文的几率高11.70倍（95%置信区间，3.41 - 40.13）。只有2.9%的关于指南的推文认可这些指南，而14.6%的推文声称对其感到困惑。非医疗保健用户在乳腺钼靶对话的参与者中占很大比例，其推文往往包含虚假的主张，没有科学证据的明确支持，并且支持替代性的“自然”乳腺癌预防和治疗方法。此外，用户对筛查指南的认可度似乎较低且感到困惑。这些发现表明，需要做出更多努力，向公众宣传和传播关于乳腺癌预防方式的准确信息，强调乳腺钼靶的安全性以及用未经证实的替代方法取代传统预防和治疗方式的危害。
