Tommy Jiang1, Vadim Osadchiy2, James M Weinberger3, Michael H Zheng4, Michael H Owen5, Sarah A Leonard6, Jesse N Mills7, Naveen Kachroo8, Sriram V Eleswarapu9. 1. University of California Los Angeles David Geffen School of Medicine, 12222, Division of Andrology, Department of Urology, Los Angeles, California, United States; tommy.jiang@berkeley.edu. 2. University of California Los Angeles David Geffen School of Medicine, 12222, Division of Andrology, Department of Urology, Los Angeles, California, United States; VOsadchiy@mednet.ucla.edu. 3. University of California Los Angeles David Geffen School of Medicine, 12222, Division of Andrology, Department of Urology, Los Angeles, California, United States; JMWeinberger@mednet.ucla.edu. 4. University of California Berkeley, 1438, Department of Statistics, Berkeley, California, United States; mhz1996@gmail.com. 5. University of Iowa, Department of Computer Science, Iowa City, United States; m.harry.owen@gmail.com. 6. Carleton College, 6092, College of Letters and Sciences, Northfield, Minnesota, United States; motency@gmail.com. 7. University of California Los Angeles David Geffen School of Medicine, 12222, Division of Andrology, Department of Urology, Los Angeles, California, United States; JNMills@mednet.ucla.edu. 8. Cleveland Clinic, 2569, Glickman Urological and Kidney Institute, 9500 Euclid Ave, Cleveland, Ohio, United States, 44195-5243; drnaveenkachroo@hotmail.co.uk. 9. University of California Los Angeles David Geffen School of Medicine, 12222, Division of Andrology, Department of Urology, Los Angeles, California, United States; seleswarapu@mednet.ucla.edu.
Abstract
BACKGROUND: Pandemic restrictions have changed how patients approach symptomatic kidney stones. We used a mixed-methods, digital ethnographic approach to evaluate social media discussions about patient concerns and preferences for urolithiasis care during the COVID-19 pandemic. MATERIALS AND METHODS: We retrospectively analyzed kidney stone-related discussions on a large social media platform using qualitative analysis and natural language processing-based sentiment analysis. Posts were mined for demographic details, treatments pursued, and health care encounters. Pre-COVID (1/1/2020-2/29/2020) and COVID (3/1/2020-6/1/2020) posts were extracted from the popular online Reddit discussion board, "r/KidneyStones," which is dedicated to discussions related to urolithiasis. RESULTS: We extracted n=649 posts (250 pre-COVID, 399 COVID); 150 from each cohort underwent thematic analysis and data extraction. Quantitative sentiment analysis was performed on 418 posts (179 pre-COVID, 239 COVID) that described stone-related decision-making prior to intervention. Notable discussion themes during COVID focused on barriers to care and concerns about stone management. Discussants exhibited more negative and anxious tones during COVID, based on sentiment analysis (P<0.01). Patient preferences shifted away from in-person visits and procedures (P<0.001). Mean reported stone size among those visiting ER increased from 5.1 mm to 10.5 mm (P<0.001). The proportion of discussants preferring conservative management with stones ≥10 mm increased (12.5% pre-COVID versus 26% during COVID, P=0.002). Opioid mentions increased from 9% to 27% of posts (P<0.001) and were most associated with conservative management discussions. CONCLUSIONS: Online discussion forums provide contemporaneous insight into patients' experiences during a time when traditional patient-centered research methodologies are limited due to social distancing. During the pandemic, patients with symptomatic kidney stones expressed anxiety regarding outpatient encounters and reluctance toward procedural intervention. Patients opted instead for at-home conservative treatment beyond clinical guidelines and reserved ER visits for larger stones, potentially causing self-harm. Opioid discussions proliferated, an alarming consequence of the pandemic.
BACKGROUND: Pandemic restrictions have changed how patients approach symptomatic kidney stones. We used a mixed-methods, digital ethnographic approach to evaluate social media discussions about patient concerns and preferences for urolithiasis care during the COVID-19 pandemic. MATERIALS AND METHODS: We retrospectively analyzed kidney stone-related discussions on a large social media platform using qualitative analysis and natural language processing-based sentiment analysis. Posts were mined for demographic details, treatments pursued, and health care encounters. Pre-COVID (1/1/2020-2/29/2020) and COVID (3/1/2020-6/1/2020) posts were extracted from the popular online Reddit discussion board, "r/KidneyStones," which is dedicated to discussions related to urolithiasis. RESULTS: We extracted n=649 posts (250 pre-COVID, 399 COVID); 150 from each cohort underwent thematic analysis and data extraction. Quantitative sentiment analysis was performed on 418 posts (179 pre-COVID, 239 COVID) that described stone-related decision-making prior to intervention. Notable discussion themes during COVID focused on barriers to care and concerns about stone management. Discussants exhibited more negative and anxious tones during COVID, based on sentiment analysis (P<0.01). Patient preferences shifted away from in-person visits and procedures (P<0.001). Mean reported stone size among those visiting ER increased from 5.1 mm to 10.5 mm (P<0.001). The proportion of discussants preferring conservative management with stones ≥10 mm increased (12.5% pre-COVID versus 26% during COVID, P=0.002). Opioid mentions increased from 9% to 27% of posts (P<0.001) and were most associated with conservative management discussions. CONCLUSIONS: Online discussion forums provide contemporaneous insight into patients' experiences during a time when traditional patient-centered research methodologies are limited due to social distancing. During the pandemic, patients with symptomatic kidney stones expressed anxiety regarding outpatient encounters and reluctance toward procedural intervention. Patients opted instead for at-home conservative treatment beyond clinical guidelines and reserved ER visits for larger stones, potentially causing self-harm. Opioid discussions proliferated, an alarming consequence of the pandemic.
Authors: Patrick Lewicki; Camilo Arenas-Gallo; Spyridon P Basourakos; Nahid Punjani; Siv Venkat; Douglas S Scherr; Jim C Hu; Jonathan E Shoag Journal: Front Oncol Date: 2021-05-07 Impact factor: 6.244
Authors: Patrick Lewicki; Spyridon P Basourakos; Bashir Al Hussein Al Awamlh; Xian Wu; Jim C Hu; Peter N Schlegel; Jonathan E Shoag Journal: Eur Urol Open Sci Date: 2021-05-27