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. 2014 Jan 14;16(1):e10.
doi: 10.2196/jmir.2875.

Sources of information and behavioral patterns in online health forums: observational study

Fabian Sudau  1 , Tim Friede, Jens Grabowski, Janka Koschack, Philip Makedonski, Wolfgang Himmel
Affiliations

Sources of information and behavioral patterns in online health forums: observational study

Fabian Sudau et al. J Med Internet Res. .

Erratum in

Abstract

Background: Increasing numbers of patients are raising their voice in online forums. This shift is welcome as an act of patient autonomy, reflected in the term "expert patient". At the same time, there is considerable concern that patients can be easily misguided by pseudoscientific research and debate. Little is known about the sources of information used in health-related online forums, how users apply this information, and how they behave in such forums.

Objective: The intent of the study was to identify (1) the sources of information used in online health-related forums, and (2) the roles and behavior of active forum visitors in introducing and disseminating this information.

Methods: This observational study used the largest German multiple sclerosis (MS) online forum as a database, analyzing the user debate about the recently proposed and controversial Chronic Cerebrospinal Venous Insufficiency (CCSVI) hypothesis. After extracting all posts and then filtering relevant CCSVI posts between 01 January 2008 and 17 August 2012, we first identified hyperlinks to scientific publications and other information sources used or referenced in the posts. Employing k-means clustering, we then analyzed the users' preference for sources of information and their general posting habits.

Results: Of 139,912 posts from 11,997 threads, 8628 posts discussed or at least mentioned CCSVI. We detected hyperlinks pointing to CCSVI-related scientific publications in 31 posts. In contrast, 2829 different URLs were posted to the forum, most frequently referring to social media, such as YouTube or Facebook. We identified a total of 6 different roles of hyperlink posters including Social Media Fans, Organization Followers, and Balanced Source Users. Apart from the large and nonspecific residual category of the "average user", several specific behavior patterns were identified, such as the small but relevant groups of CCSVI-Focused Responders or CCSVI Activators.

Conclusions: The bulk of the observed contributions were not based on scientific results, but on various social media sources. These sources seem to contain mostly opinions and personal experience. A small group of people with distinct behavioral patterns played a core role in fuelling the discussion about CCSVI.

Keywords: CCSVI; Internet utilization; data mining; information dissemination; multiple sclerosis; social media; social networks.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
A screenshot of a forum post.
Figure 2
Figure 2
Timeline of posted hyperlinks for each domain class.
Figure 3
Figure 3
Flowchart of the sampling procedure for clusterings.
Figure 4
Figure 4
Venn diagram showing the user sets used in the clusterings.
Figure 5
Figure 5
Reference use clusters with number of users in each cluster (n=64 included cases).
Figure 6
Figure 6
Radar chart showing aggregated domain class use of each cluster (the user vectors belonging to the cluster are summed up). Each cluster vector is a normalized to be a unit vector. The length of a spoke is proportional to the value it represents.
Figure 7
Figure 7
Posting behavior, according to the second clustering, with number of users in each cluster (n=171 included cases).
Figure 8
Figure 8
Radar chart showing feature means (overall users within a cluster) of the contribution behavior clusters. The means are min-max-normalized to a [0;1] range. The length of a spoke is proportional to the value it represents.
See this image and copyright information in PMC

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