Accepted for/Published in: JMIR Formative Research
Date Submitted: Jun 20, 2023
Open Peer Review Period: Jun 20, 2023 - Aug 15, 2023
Date Accepted: Jun 27, 2024
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Application of a natural language processing approach to understand adolescents’ perceptions of varicoceles
ABSTRACT
Background:
Varicoceles affect up to 30% of postpubertal adolescent males. Studying this population remains difficult due to this topic’s sensitive nature. Using the popularity of social media in this cohort and natural language processing (NLP) techniques, our aim was to identify perceptions of adolescent males on an internet varicocele forum to inform how physicians may better evaluate and counsel this pediatric population.
Objective:
To characterize themes of discussion and specific concerns expressed by adolescents using a mixed methods approach involving quantitative NLP and qualitative annotation of an online varicocele community.
Methods:
We extracted posts from the Reddit community r/Varicocele (5100 members) from founding to 6/2022 with criteria of discussant age ≤21 & word count >20. We employed qualitative thematic analysis using validated constant comparative method & an NLP technique called the meaning extraction method with principal component analysis (MEM/PCA) to identify discussion themes. We then interrogated 150 random posts to further characterize content based on NLP identified themes and calculated Kaiser-Meyer-Olkin (KMO) statistic and Bartlett’s test.
Results:
1103 posts met eligibility criteria. MEM/PCA and qualitative thematic analysis separately revealed key themes: varicocele overview (27%), management (19%), post-procedural experience (19%), seeking community (17%) & second opinion after visiting a physician (18%). KMO>0.60 & Bartlett’s test <0.01 indicated appropriateness for MEM/PCA. Mean age was 17.5 y/o (range 14-21) trending toward higher grade (89% were 2+), left-sided varicoceles. Urologists account for over 50% of discussions among discussants and varicocelectomy remains the intervention of most intrigue. 60% of discussants described symptomatic varicoceles (90/150) with 69% (62/90) reporting pain, 27% (24/90) reporting hypogonadism symptoms and 50% (45/90) reporting aesthetic as the primary concern.
Conclusions:
We applied a mixed methods approach to identify uncensored concerns of adolescents with varicoceles. Adolescents often turned to social media as an adjunct to doctors’ visits and to seek peer support. This population prioritized symptom control with emphasis on pain, aesthetics, sexual function and hypogonadism. This data highlights how adolescents may approach varicoceles uniquely, informing urologists how to better interface with this pediatric population. Clinical Trial: N/A
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