Candidate for the Lee B. Lusted Student Prize Competition
Purpose: Twitter, a microblogging service with over 500 million users, has been used to predict stock market fluctuations, monitor disease spread, and foment political uprising. We used Twitter to understand public sentiment and media coverage of the recent, unfinalized USPSTF recommendations against prostate cancer screening.
Methods: We used a mixed methods design to capture data from postings on Twitter, called “tweets.” Using the search term “prostate cancer,” we analyzed 3027 consecutive tweets obtained from an archiving program in the 24 hour period beginning with the first article posted about the USPSTF report. We developed a coding system to assess sentiment expressed in tweets and their associated articles, which demonstrated agreement between two independent reviewers.
Results: In the hour of the first article tweeted about the report, there was a 47% rise in tweets about prostate cancer and an additional 19% increase the next hour, before returning to baseline overnight and sharply increasing (85%) again the following morning. Of all coded tweets, 2042 (67%) were about the panel's report. Users tweeting about the report had a median 4811 tweets and 481 followers. No opinions were expressed in 1840 (91%) of these tweets: 1626 simply tweeted articles, 113 indicated controversy or initiated discussion, 40 used humor, 39 indicated shock or confusion, and 32 drew special attention to the report. Of the 192 (9%) that expressed an opinion, 22% were against screening and 78% were for screening. Functional links were present in 1754 tweets, from which we identified 90 unique articles about the report: 56 neutral, 17 against screening, and 17 in favor of screening. Some of these articles were posted more frequently than others: 999 (57%) total articles were neutral, 643 (37%) were against screening, and 112 (6.4%) were in favor of screening. Tweets and articles against screening reached a total of 63,379 and 2,931,791 followers, respectively, while those in favor of screening reached 193,913 and 207,814 followers, respectively.
Conclusions: Analysis of Twitter feeds posted shortly after the USPSTF's announcement demonstrated an outpouring of user sentiment in favor of prostate cancer screening, despite the fact that most posted articles were against screening. Policy makers who rely on public opinion may look increasingly to social media to gauge public sentiment, influence public attitudes and, ultimately, change policy.
See more of: The 34th Annual Meeting of the Society for Medical Decision Making