Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jun 12, 2020
Date Accepted: Aug 3, 2020
Low testosterone on social media: Application of natural language processing to understand patients’ perceptions of hypogonadism and its treatment
ABSTRACT
Background:
Despite the results of the Testosterone Trials, physicians remain uncomfortable treating men with hypogonadism. Discouraged, men increasingly turn to social media to discuss medical concerns.
Objective:
To apply natural language processing (NLP) techniques to social media posts for identification of themes of discussion regarding low testosterone and testosterone replacement therapy (TRT) in order to inform how physicians may better evaluate and counsel patients.
Methods:
We retrospectively extracted posts from the Reddit community r/Testosterone from December 2015 through May 2019. We applied an NLP technique called the meaning extraction method with principal component analysis (MEM/PCA) to computationally derive discussion themes. We then performed a prospective analysis of Twitter data (tweets) that contained the terms “low testosterone,” “low T,” and “testosterone replacement” from June through September 2019.
Results:
199,335 Reddit posts and 6,659 tweets were analyzed. MEM/PCA revealed dominant themes of discussion: symptoms of hypogonadism, seeing a doctor, results of laboratory tests, derogatory comments and insults, TRT medications, and cardiovascular risk. Over 25% of Reddit posts contained “doctor,” over 5% “urologist.”
Conclusions:
This study represents the first NLP evaluation of the social media landscape surrounding hypogonadism and TRT. Though physicians traditionally limit their practices to within their clinic walls, the ubiquity of social media demands that physicians understand what patients discuss online. Physicians may do well to bring up online discussions during clinic consultations for low testosterone, to pull back the curtain and dispel myths.
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