Department of Pulmonary and Critical Care Medicine, Mayo Clinic, Jacksonville, FL, United States.
School of Information Sciences, Center for Health Informatics, University of Illinois at Urbana-Champaign, Ubana-Champaign, IL, United States.
JMIR Infodemiology. 2024 Nov 18;4:e56675. doi: 10.2196/56675.
Social media has become a vital tool for health care providers to quickly share information. However, its lack of content curation and expertise poses risks of misinformation and premature dissemination of unvalidated data, potentially leading to widespread harmful effects due to the rapid and large-scale spread of incorrect information.
We aim to determine whether social media had an undue association with the prescribing behavior of hydroxychloroquine, using the COVID-19 pandemic as the setting.
In this retrospective study, we gathered the use of hydroxychloroquine in 48 hospitals in the United States between January and December 2020. Social media data from X/Twitter was collected using Brandwatch, a commercial aggregator with access to X/Twitter's data, and focused on mentions of "hydroxychloroquine" and "Plaquenil." Tweets were categorized by sentiment (positive, negative, or neutral) using Brandwatch's sentiment analysis tool, with results classified by date. Hydroxychloroquine prescription data from the National COVID Cohort Collaborative for 2020 was used. Granger causality and linear regression models were used to examine relationships between X/Twitter mentions and prescription trends, using optimum time lags determined via vector auto-regression.
A total of 581,748 patients with confirmed COVID-19 were identified. The median daily number of positive COVID-19 cases was 1318.5 (IQR 1005.75-1940.3). Before the first confirmed COVID-19 case, hydroxychloroquine was prescribed at a median rate of 559 (IQR 339.25-728.25) new prescriptions per day. A day-of-the-week effect was noted in both prescriptions and case counts. During the pandemic in 2020, hydroxychloroquine prescriptions increased significantly, with a median of 685.5 (IQR 459.75-897.25) per day, representing a 22.6% rise from baseline. The peak occurred on April 2, 2020, with 3411 prescriptions, a 397.6% increase. Hydroxychloroquine mentions on X/Twitter peaked at 254,770 per day on April 5, 2020, compared to a baseline of 9124 mentions per day before January 21, 2020. During this study's period, 3,823,595 total tweets were recorded, with 10.09% (n=386,115) positive, 37.87% (n=1,448,030) negative, and 52.03% (n=1,989,450) neutral sentiments. A 1-day lag was identified as the optimal time for causal association between tweets and hydroxychloroquine prescriptions. Univariate analysis showed significant associations across all sentiment types, with the largest impact from positive tweets. Multivariate analysis revealed only neutral and negative tweets significantly affected next-day prescription rates.
During the first year of the COVID-19 pandemic, there was a significant association between X/Twitter mentions and the number of prescriptions of hydroxychloroquine. This study showed that X/Twitter has an association with the prescribing behavior of hydroxychloroquine. Clinicians need to be vigilant about their potential unconscious exposure to social media as a source of medical knowledge, and health systems and organizations need to be more diligent in identifying expertise, source, and quality of evidence when shared on social media platforms.
社交媒体已成为医疗保健提供者快速分享信息的重要工具。然而，由于缺乏内容策划和专业知识，存在错误信息和未经证实的数据过早传播的风险，由于错误信息的快速和大规模传播，可能会导致广泛的有害影响。
我们旨在确定社交媒体是否与羟氯喹的处方行为有不当关联，以 COVID-19 大流行作为背景。
在这项回顾性研究中，我们收集了美国 48 家医院 2020 年 1 月至 12 月期间羟氯喹的使用情况。使用 Brandwatch 从 X/Twitter 收集社交媒体数据，Brandwatch 是一家商业聚合商，可访问 X/Twitter 的数据，并重点关注“羟氯喹”和“氯喹”的提及。使用 Brandwatch 的情感分析工具对推文进行情感分类（积极、消极或中性），并根据日期对结果进行分类。使用 2020 年国家 COVID 队列协作的羟氯喹处方数据。使用向量自回归确定的最佳时滞，使用格兰杰因果关系和线性回归模型来检验 X/Twitter 提及与处方趋势之间的关系。
共确定了 581748 例确诊 COVID-19 患者。每日确诊 COVID-19 病例的中位数为 1318.5（IQR 1005.75-1940.3）。在首例确诊 COVID-19 病例之前，羟氯喹的处方率中位数为每天 559（IQR 339.25-728.25）。在日期间存在一周中各天的影响，病例数和羟氯喹的处方均有记录。在 2020 年大流行期间，羟氯喹的处方显著增加，中位数为每天 685.5（IQR 459.75-897.25），与基线相比增加了 22.6%。峰值出现在 2020 年 4 月 2 日，有 3411 张处方，增长了 397.6%。与 2020 年 1 月 21 日之前每天 9124 次的提及相比，X/Twitter 上羟氯喹的提及量在 2020 年 4 月 5 日达到了每天 254770 次的峰值。在此研究期间，共记录了 3823595 条推文，其中 10.09%（n=386115）为积极推文，37.87%（n=1448030）为消极推文，52.03%（n=1989450）为中性推文。确定 1 天的滞后时间是推文和羟氯喹处方之间因果关系的最佳时间。单变量分析显示，所有情感类型都存在显著关联，其中积极推文的影响最大。多变量分析显示，只有中性和消极推文对次日的处方率有显著影响。
在 COVID-19 大流行的第一年，X/Twitter 上的提及与羟氯喹处方数量之间存在显著关联。这项研究表明，X/Twitter 与羟氯喹的处方行为有关。临床医生需要警惕他们可能无意识地将社交媒体作为医学知识的来源，健康系统和组织在社交媒体平台上共享时需要更加努力地识别专业知识、来源和证据质量。
