Abstract Objective To mine Twitter and quantitatively analyze COVID-19 symptoms self-reported by users, compare symptom distributions across studies, and create a symptom lexicon for future research. Materials and Methods We retrieved tweets using COVID-19-related keywords, and performed semiautomatic filtering to curate self-reports of positive-tested users. We extracted COVID-19-related symptoms mentioned by the users, mapped them to standard concept IDs in the Unified Medical Language System, and compared the distributions to those reported in early studies from clinical settings. Results We identified 203 positive-tested users who reported 1002 symptoms using 668 unique expressions. The most frequently-reported symptoms were fever/pyrexia (66.1%), cough (57.9%), body ache/pain (42.7%), fatigue (42.1%), headache (37.4%), and dyspnea (36.3%) amongst users who reported at least 1 symptom. Mild symptoms, such as anosmia (28.7%) and ageusia (28.1%), were frequently reported on Twitter, but not in clinical studies. Conclusion The spectrum of COVID-19 symptoms identified from Twitter may complement those identified in clinical settings.

ObjectiveTo mine Twitter to quantitatively analyze COVID-19 symptoms self-reported by users, compare symptom distributions against clinical studies, and create a symptom lexicon for the research community. Materials and methodsWe retrieved tweets using COVID-19-related keywords, and performed several layers of semi-automatic filtering to curate self-reports of positive-tested users. We extracted COVID-19-related symptoms mentioned by the users, mapped them to standard IDs, and compared the distributions with multiple studies conducted in clinical settings. ResultsWe identified 203 positive-tested users who reported 932 symptoms using 598 unique expressions. The most frequently-reported symptoms were fever/pyrexia (65%), cough (56%), body aches/pain (40%), headache (35%), fatigue (35%), and dyspnea (34%) amongst users who reported at least 1 symptom. Mild symptoms, such as anosmia (26%) and ageusia (24%) were frequently reported on Twitter, but not in clinical studies. ConclusionThe spectrum of COVID-19 symptoms identified from Twitter may complement those identified in clinical settings.

Objectives Xylazine is an α2-agonist increasingly prevalent in the illicit drug supply. Our objectives were to curate information about xylazine through social media from people who use drugs (PWUDs). Specifically, we sought to answer the following: (1) What are the demographics of Reddit subscribers reporting exposure to xylazine? (2) Is xylazine a desired additive? And (3) what adverse effects of xylazine are PWUDs experiencing? Methods Natural language processing (NLP) was used to identify mentions of “xylazine” from posts by Reddit subscribers who also posted on drug-related subreddits. Posts were qualitatively evaluated for xylazine-related themes. A survey was developed to gather additional information about the Reddit subscribers. This survey was posted on subreddits that were identified by NLP to contain xylazine-related discussions from March 2022 to October 2022. Results Seventy-six posts were extracted via NLP from 765,616 posts by 16,131 Reddit subscribers (January 2018 to August 2021). People on Reddit described xylazine as an unwanted adulterant in their opioid supply. Sixty-one participants completed the survey. Of those who disclosed their location, 25 of 50 participants (50%) reported locations in the Northeastern United States. The most common route of xylazine use was intranasal use (57%). Thirty-one of 59 (53%) reported experiencing xylazine withdrawal. Frequent adverse events reported were prolonged sedation (81%) and increased skin wounds (43%). Conclusions Among respondents on these Reddit forums, xylazine seems to be an unwanted adulterant. People who use drugs may be experiencing adverse effects such as prolonged sedation and xylazine withdrawal. This seemed to be more common in the Northeast.

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Breast cancer patients often discontinue their long-term treatments, such as hormone therapy, increasing the risk of cancer recurrence. These discontinuations are often caused by adverse patient-centered outcomes (PCOs) due to hormonal drug side effects or other factors. PCOs are not detectable through laboratory tests and are sparsely documented in electronic health records. Thus, there is a need to explore other sources of information for PCOs associated with breast cancer treatments. Social media is a promising resource, but extracting true PCOs from it first requires the accurate detection of breast cancer patients. We describe a natural language processing (NLP) architecture for automatically detecting breast cancer patients from Twitter based on their self-reports. The architecture employs breast cancer-related keywords to collect streaming data from Twitter, applies NLP patterns to pre-filter noisy posts, and then employs a machine learning classifier trained using manually-annotated data (n=5019) for distinguishing firsthand self-reports of breast cancer from other tweets. A classifier based on bidirectional encoder representations from transformers (BERT) showed human-like performance and achieved F1-score of 0.857 (inter-annotator agreement: 0.845; Cohen's kappa) for the positive class, considerably outperforming the next best classifier--a deep neural network (F1-score: 0.665). Qualitative analyses of posts from automatically-detected users revealed discussions about side effects, non-adherence, and mental health conditions, illustrating the feasibility of our social media-based approach for studying breast cancer-related PCOs from a large population.

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Objectives: Xylazine is an alpha-2 agonist increasingly prevalent in the illicit drug supply. Our objectives were to curate information about xylazine through social media from People Who Use Drugs (PWUDs). Specifically, we sought to answer the following: 1) what are the demographics of Reddit subscribers reporting exposure to xylazine? 2) is xylazine a desired additive? and 3) what adverse effects of xylazine are PWUDs experiencing? Methods: Natural Language Processing (NLP) was used to identify mentions of "xylazine" from posts by Reddit subscribers who also posted on drug-related subreddits. Posts were qualitatively evaluated for xylazine-related themes. A survey was developed to gather additional information about the Reddit subscribers. This survey was posted on subreddits that were identified by NLP to contain xylazine-related discussions from March 2022 to October 2022. Results: 76 posts mentioning xylazine were extracted via NLP from 765,616 posts by 16,131 Reddit subscribers (January 2018 to August 2021). People on Reddit described xylazine as an unwanted adulterant in their opioid supply. 61 participants completed the survey. Of those that disclosed their location, 25/50 (50%) participants reported locations in the Northeastern United States. The most common eoute of xylazine use was intranasal use (57%). 31/59 (53%) reported experiencing xylazine withdrawal. Frequent adverse events reported were prolonged sedation (81%) and increased skin wounds (43%). Conclusions: Among respondents on these Reddit forums, xylazine appears to be an unwanted adulterant. PWUDs may be experiencing adverse effects such as prolonged sedation and xylazine withdrawal. This appeared to be more common in the Northeast.

Background: Due to the high burden of chronic pain, and the detrimental public health consequences of its treatment with opioids, there is a high-priority need to identify effective alternative therapies. Social media is a potentially valuable resource for knowledge about self-reported therapies by chronic pain sufferers. Methods: We attempted to (a) verify the presence of large-scale chronic pain-related chatter on Twitter, (b) develop natural language processing and machine learning methods for automatically detecting self-disclosures, (c) collect longitudinal data posted by them, and (d) semiautomatically analyze the types of chronic pain-related information reported by them. We collected data using chronic pain-related hashtags and keywords and manually annotated 4,998 posts to indicate if they were self-reports of chronic pain experiences. We trained and evaluated several state-of-the-art supervised text classification models and deployed the best-performing classifier. We collected all publicly available posts from detected cohort members and conducted manual and natural language processing-driven descriptive analyses. Results: Interannotator agreement for the binary annotation was 0.82 (Cohen’s kappa). The RoBERTa model performed best (F 1 score: 0.84; 95% confidence interval: 0.80 to 0.89), and we used this model to classify all collected unlabeled posts. We discovered 22,795 self-reported chronic pain sufferers and collected over 3 million of their past posts. Further analyses revealed information about, but not limited to, alternative treatments, patient sentiments about treatments, side effects, and self-management strategies. Conclusion: Our social media based approach will result in an automatically growing large cohort over time, and the data can be leveraged to identify effective opioid-alternative therapies for diverse chronic pain types.