Emanuel Rebecca H K, Docherty Paul D, Lunt Helen, Campbell Rebecca E
Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand.
Institute for Technical Medicine, Furtwangen University, Villingen-Schwenningen, Germany.
Phys Eng Sci Med. 2025 Apr 14. doi: 10.1007/s13246-025-01539-9.
Polycystic ovary syndrome (PCOS) is a heterogenous condition that is estimated to effect up to 21% of reproductive aged people with ovaries. In previous work, a dataset of PCOS features was derived from approximately 100,000 PCOS subreddit users via machine learning. In this study, an exploration of treatment response within the PCOS subreddit was undertaken with the derived dataset. The treatment or symptom features in the dataset had sentiment labels indicating when a treatment was perceived to improve or worsen a condition or symptom. When different features were mentioned within two sentences of each other without conflicting sentiment, it could be assumed that they were related. This assumption allowed for a broad analysis of the perceived effect of popular treatments on the most frequently mentioned symptoms. In general, lifestyle changes and supplements were the most positively regarded, while contraceptives were frequently associated with considerable negative sentiment. For PCOS weight loss, unspecified dieting (RR 5.19, 95% CI 3.28-8.19, n = 99) and intermittent fasting (RR 33.50, 95% CI 8.54-131.34, n = 69) were the most successful interventions. Inositol was associated with a large range of favourable outcomes and was one of the few treatments associated with improved mental health [depression (RR 4.25, 95% CI 1.72-10.51, n = 21), anxiety (RR 5.83, 95% CI 2.76-12.35, n = 41) and mood issues (RR 25.00, 95% CI 3.65-171.10, n = 26)]. Combined oral contraceptive pills as a whole were strongly associated with adverse effects such as worsening depression (RR 0.06, 95% CI 0.02-0.25, n = 33), anxiety (RR 0.10, 95% CI 0.03-0.36, n = 23), fatigue (RR 0, n = 45) and low libido (RR 0.03, 95% CI 0.01-0.24, n = 30). However, combined contraceptives with anti-androgenic progestins were associated with more favourable experiences. This study demonstrates the utility of machine learning to derive measurable patient experience data from an internet forum. While patient experience data derived using machine learning is not a substitute for traditional clinical trials, it is useful for mass validation and hypothesis generation. This paper may serve as the first exploration into this category of clinical internet forum research.
多囊卵巢综合征（PCOS）是一种异质性疾病，据估计，在有卵巢的育龄人群中，其发病率高达21%。在之前的研究中，通过机器学习从大约10万名PCOS相关子版块用户中获取了一个PCOS特征数据集。在本研究中，利用该数据集对PCOS子版块内的治疗反应进行了探索。数据集中的治疗或症状特征带有情感标签，表明某种治疗被认为是改善还是恶化了某种疾病或症状。当在彼此相邻的两句话中提到不同特征且情感不冲突时，可以假定它们是相关的。这一假设使得能够对常用治疗方法对最常提及症状的感知效果进行广泛分析。总体而言，生活方式改变和补充剂最受好评，而避孕药则常常与相当负面的情感相关联。对于PCOS导致的体重减轻，未明确说明的节食（风险比率[RR]5.19，95%置信区间[CI]3.28 - 8.19，n = 99）和间歇性禁食（RR 33.50，95% CI 8.54 - 131.34，n = 69）是最成功的干预措施。肌醇与一系列良好结果相关，并且是少数与心理健康改善相关的治疗方法之一[抑郁症（RR 4.25，95% CI 1.72 - 10.51，n = 21）、焦虑症（RR 5.83，95% CI 2.76 - 12.35，n = 41）和情绪问题（RR 25.00，95% CI 3.65 - 171.10，n = 26）]。复方口服避孕药总体上与不良反应密切相关，如抑郁症加重（RR 0.06，95% CI 0.02 - 0.25，n = 33）、焦虑症加重（RR 0.10，95% CI 0.03 - 0.36，n = 23）、疲劳（RR 0，n = 45）和性欲减退（RR 0.03，95% CI 0.01 - 0.24，n = 30）。然而，含有抗雄激素孕激素的复方避孕药与更有利的体验相关。本研究证明了机器学习从互联网论坛中获取可测量的患者体验数据的实用性。虽然通过机器学习获得的患者体验数据不能替代传统临床试验，但它对于大规模验证和假设生成是有用的。本文可作为对这类临床互联网论坛研究的首次探索。
