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      Ethical Issues in Using Twitter for Public Health Surveillance and Research: Developing a Taxonomy of Ethical Concepts From the Research Literature

      brief-report
      , PhD 1 ,
      (Reviewer), (Reviewer)
      Journal of Medical Internet Research
      JMIR Publications Inc.
      social media, twitter messaging, ethics

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          Abstract

          Background

          The rise of social media and microblogging platforms in recent years, in conjunction with the development of techniques for the processing and analysis of “big data”, has provided significant opportunities for public health surveillance using user-generated content. However, relatively little attention has been focused on developing ethically appropriate approaches to working with these new data sources.

          Objective

          Based on a review of the literature, this study seeks to develop a taxonomy of public health surveillance-related ethical concepts that emerge when using Twitter data, with a view to: (1) explicitly identifying a set of potential ethical issues and concerns that may arise when researchers work with Twitter data, and (2) providing a starting point for the formation of a set of best practices for public health surveillance through the development of an empirically derived taxonomy of ethical concepts.

          Methods

          We searched Medline, Compendex, PsycINFO, and the Philosopher’s Index using a set of keywords selected to identify Twitter-related research papers that reference ethical concepts. Our initial set of queries identified 342 references across the four bibliographic databases. We screened titles and abstracts of these references using our inclusion/exclusion criteria, eliminating duplicates and unavailable papers, until 49 references remained. We then read the full text of these 49 articles and discarded 36, resulting in a final inclusion set of 13 articles. Ethical concepts were then identified in each of these 13 articles. Finally, based on a close reading of the text, a taxonomy of ethical concepts was constructed based on ethical concepts discovered in the papers.

          Results

          From these 13 articles, we iteratively generated a taxonomy of ethical concepts consisting of 10 top level categories: privacy, informed consent, ethical theory, institutional review board (IRB)/regulation, traditional research vs Twitter research, geographical information, researcher lurking, economic value of personal information, medical exceptionalism, and benefit of identifying socially harmful medical conditions.

          Conclusions

          In summary, based on a review of the literature, we present a provisional taxonomy of public health surveillance-related ethical concepts that emerge when using Twitter data.

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          Most cited references23

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          Social and news media enable estimation of epidemiological patterns early in the 2010 Haitian cholera outbreak.

          During infectious disease outbreaks, data collected through health institutions and official reporting structures may not be available for weeks, hindering early epidemiologic assessment. By contrast, data from informal media are typically available in near real-time and could provide earlier estimates of epidemic dynamics. We assessed correlation of volume of cholera-related HealthMap news media reports, Twitter postings, and government cholera cases reported in the first 100 days of the 2010 Haitian cholera outbreak. Trends in volume of informal sources significantly correlated in time with official case data and was available up to 2 weeks earlier. Estimates of the reproductive number ranged from 1.54 to 6.89 (informal sources) and 1.27 to 3.72 (official sources) during the initial outbreak growth period, and 1.04 to 1.51 (informal) and 1.06 to 1.73 (official) when Hurricane Tomas afflicted Haiti. Informal data can be used complementarily with official data in an outbreak setting to get timely estimates of disease dynamics.
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            Predicting postpartum changes in emotion and behavior via social media

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              • Article: not found

              Public health surveillance of dental pain via Twitter.

              On Twitter, people answer the question, "What are you doing right now?" in no more than 140 characters. We investigated the content of Twitter posts meeting search criteria relating to dental pain. A set of 1000 tweets was randomly selected from 4859 tweets over 7 non-consecutive days. The content was coded using pre-established, non-mutually-exclusive categories, including the experience of dental pain, actions taken or contemplated in response to a toothache, impact on daily life, and advice sought from the Twitter community. After excluding ambiguous tweets, spam, and repeat users, we analyzed 772 tweets and calculated frequencies. Of the sample of 772 tweets, 83% (n = 640) were primarily categorized as a general statement of dental pain, 22% (n = 170) as an action taken or contemplated, and 15% (n = 112) as describing an impact on daily activities. Among the actions taken or contemplated, 44% (n = 74) reported seeing a dentist, 43% (n = 73) took an analgesic or antibiotic medication, and 14% (n = 24) actively sought advice from the Twitter community. Twitter users extensively share health information relating to dental pain, including actions taken to relieve pain and the impact of pain. This new medium may provide an opportunity for dental professionals to disseminate health information.
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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J. Med. Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications Inc. (Toronto, Canada )
                1439-4456
                1438-8871
                December 2014
                22 December 2014
                : 16
                : 12
                : e290
                Affiliations
                [1] 1University of California San Diego Department of Family and Preventive Medicine La Jolla, CAUnited States
                Author notes
                Corresponding Author: Mike Conway mike.conway@ 123456utah.edu
                Author information
                http://orcid.org/0000-0002-3209-8108
                Article
                v16i12e290
                10.2196/jmir.3617
                4285736
                25533619
                f575f6b5-1224-4ce8-afd9-e9b78bb1bf0c
                ©Mike Conway. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 22.12.2014.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 18 June 2014
                : 19 August 2014
                : 28 October 2014
                Categories
                Short Paper
                Short Paper

                Medicine
                social media,twitter messaging,ethics
                Medicine
                social media, twitter messaging, ethics

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