Identifying barriers to patient acceptance of active surveillance: content analysis of online patient communications.

Authors

Mark V Mishra, Department of Radiation Oncology, University of Maryland
Michele Bennett, Wool Laboratories Inc.
Armon Vincent, Wool Laboratories Inc.
Olivia T Lee, Department of Urology, University of California Davis
Costas D Lallas, Department of Urology, Thomas Jefferson UniversityFollow
Edouard J Trabulsi, Department of Urology, Thomas Jefferson UniversityFollow
Leonard G Gomella, Department of Urology, Thomas Jefferson UniversityFollow
Adam P Dicker, Department of Radiation Oncology, University of MarylandFollow
Timothy N Showalter, Department of Radiation Oncology, University of VirginiaFollow

Document Type

Article

Publication Date

9-1-2013

Comments

This article has been peer reviewed. It was published in: PLoS One.

2013; 8(9): e68563.

The published version is available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3770634/. DOI: 10.1371/journal.pone.0068563

Abstract

OBJECTIVES: Qualitative research aimed at identifying patient acceptance of active surveillance (AS) has been identified as a public health research priority. The primary objective of this study was to determine if analysis of a large-sample of anonymous internet conversations (ICs) could be utilized to identify unmet public needs regarding AS.

METHODS: English-language ICs regarding prostate cancer (PC) treatment with AS from 2002-12 were identified using a novel internet search methodology. Web spiders were developed to mine, aggregate, and analyze content from the world-wide-web for ICs centered on AS. Collection of ICs was not restricted to any specific geographic region of origin. NLP was used to evaluate content and perform a sentiment analysis. Conversations were scored as positive, negative, or neutral. A sentiment index (SI) was subsequently calculated according to the following formula to compare temporal trends in public sentiment towards AS: [(# Positive IC/#Total IC)-(#Negative IC/#Total IC) x 100].

RESULTS: A total of 464 ICs were identified. Sentiment increased from -13 to +2 over the study period. The increase sentiment has been driven by increased patient emphasis on quality-of-life factors and endorsement of AS by national medical organizations. Unmet needs identified in these ICs include: a gap between quantitative data regarding long-term outcomes with AS vs. conventional treatments, desire for treatment information from an unbiased specialist, and absence of public role models managed with AS.

CONCLUSIONS: This study demonstrates the potential utility of online patient communications to provide insight into patient preferences and decision-making. Based on our findings, we recommend that multidisciplinary clinics consider including an unbiased specialist to present treatment options and that future decision tools for AS include quantitative data regarding outcomes after AS.

Recommended Citation

Mishra, Mark V; Bennett, Michele; Vincent, Armon; Lee, Olivia T; Lallas, Costas D; Trabulsi, Edouard J; Gomella, Leonard G; Dicker, Adam P; and Showalter, Timothy N, "Identifying barriers to patient acceptance of active surveillance: content analysis of online patient communications." (2013). Department of Urology Faculty Papers. Paper 23.
https://jdc.jefferson.edu/urologyfp/23

PubMed ID

24039699