A Social Media Listening Study to Understand the Unmet Needs and Quality of Life in Adult and Pediatric Amblyopia Patients

Functional consequences of amblyopia and its impact on health-related quality of life

Amblyopia (lazy eye) is the most common cause of monocular vision loss, affecting up to 4% of children and often persisting into adulthood. While treating the visual acuity deficit is often the focus of treatment, there is a pressing need for researchers, educators, and clinicians to understand the effects of amblyopia that extend beyond visual acuity. This review article highlights recent advances in understanding the impact of amblyopia on everyday life functioning. Amblyopia can significantly interfere with contrast sensitivity, attention, reading, eye-hand coordination, body composition, physical activity, and health-related quality of life. A deeper understanding of the functional consequences of amblyopia can be applied to patient management and inform amblyopia treatment, as well as support research into more effective interventions to prevent or rehabilitate deficits that can hinder children's physical, social, and academic success.

Analyzing social media conversations to gain insights into the experiences of patients with hereditary angioedema

Background: Hereditary angioedema (HAE) is a rare genetic disease characterized by recurrent, unpredictable, painful, and potentially life-threatening angioedema attacks, which substantially impair patients' quality of life. Gathering patients' perspectives is important to understand lived experiences, the patient journey, and preferences to determine optimal HAE management. Social media platforms have become important mediums through which patient and carer groups share experiences and advice. Objective: We conducted the first social media listening (SML) study in an HAE setting to identify and characterize the experiences of patients with HAE to better understand disease and treatment burden and their unmet needs. Methods: This was a retrospective analysis of social media content that relates to the experience of individuals with HAE from January 2018 to October 2023. We used keyword-based searches of social media platforms to identify posts that relate to burdens, unmet needs, and other themes shared by patients, caregivers, or health-care professionals. After anonymization and removal of duplicates, content was extracted and categorized by subject matter experts for qualitative and quantitative analysis according to themes. Results: Of 6,012 posts collected, 892 were identified as relevant patient-mentioned posts. Of these, 459 posts related to burden; the most common topic was disease burden and discussed symptoms such as persistent swelling, painful attacks, and frequent attacks. Other burden-related topics included health service, medication, and injections. Unmet needs were discussed in 270 posts; the most common were treatment-related needs such as insurance denials, inadequate medication availability, and treatment costs. Other unmet needs related to education, health service, and diagnosis. Conclusion: Evaluation of the lived experience of patients with HAE and their caregivers via SML can be a valuable tool to aid optimizing HAE management. Our findings add to existing evidence that the disease burden is still a considerable issue for patients with HAE, who continue to have unmet treatment needs.

The Shadow Price of Uncertainty: Consequences of Unpredictable Insurance Coverage for Access, Care, and Financial Security

Policy Points Health insurance reform in the United States has fostered enrollment to promote access to care and reduce financial insecurity. However, enrollees' inability to reliably predict what insurance will cover (a.k.a. "coverage uncertainty") impedes these goals, often as much as being uninsured. The Patient Protection and Affordable Care Act initially expanded enrollment and reduced coverage uncertainty. After the mid-2010s, trends in coverage uncertainty plateaued, and it now impedes access to care for four times as many households as lack of health insurance. A variety of policies can moderate coverage uncertainty, but other popular reform strategies exacerbate it instead. Our findings suggest that structural reforms represent the most promising remedial strategies, particularly those that can enhance support for households negotiating coverage denials with insurers.

CONTEXT

Health insurance reform in the United States has focused on expanding enrollment, a goal inhibited by complex insurance provisions. Research documents this complexity and shows how it increases consumers' challenges in anticipating needs and making informed choices, potentially deterring policy purchases. Little is known about how coverage uncertainty impacts those who have insurance.

METHODS

Drawing on a multiwave survey with nationally representative data, we assessed consumer experiences and expectations in 2009, 2014, and 2021. Respondents identified (a) worries about the reliability of health insurance coverage, and (b) experiences of insurance not covering major medical expenses. Respondents also reported on three health care-related experiences-whether they delayed access to needed care, had been unable to effectively care for chronic health conditions, or felt anxious about future medical expenses. We estimated regressions associating metrics of coverage uncertainty with the three health care-related outcomes, controlling for socioeconomic status and other household characteristics.

FINDINGS

Of American households, 32% reported intense worry about coverage reliability in 2009. This declined to 27% in 2014, then rebounded to 31% in 2021. Experiences of coverage shortfalls followed a similar pattern, declining from 27% to 17%, then rising back to 21%. Coverage uncertainty has statistically significant associations with all three outcomes, with access being the most sensitive to low-level uncertainty. By 2021, coverage uncertainty deterred timely access in care for one in five American households, five times as many as among the uninsured.

CONCLUSIONS

Coverage uncertainty has become the predominant barrier to timely access. It also disrupts care for chronic conditions and exacerbates anxiety over medical expenses. These harms can be reduced. However, several popular health care reform strategies instead exacerbate coverage uncertainty. We explicate these overlooked cross-policy connections and identify alternative strategies that could moderate the impact of coverage uncertainty in the United States.

Social media listening study to understand the journey and unmet needs of patients living with post-stroke spasticity

PURPOSE

Stroke survivors may develop spasticity (post-stroke spasticity [PSS]) that can challenge activity and participation. Recognising the needs and expectations of people with PSS is crucial for enhancing care. This study is the first to employ social media listening to explore the experiences, unmet needs, and quality of life (QoL) of people with PSS.

MATERIALS AND METHODS

A subset of 417 patient-centric PSS-related posts published on major social media platforms was identified for analysis from 31 600 retrieved.

RESULTS

Posts mainly discussed patient journey (centred around treatment options and management techniques), the impact of PSS on QoL, and patient interactions with healthcare practitioners (HCPs). Widely used treatment options had associated negative sentiments due to perceived inefficacy and lack of long-term effectiveness (botulinum neurotoxin) or side effects (oral anti-spasticity medications). Perceptions of treatment options and expected treatment outcomes influenced satisfaction with treatment and HCP interactions. Poor perceived treatment efficacy generally resulted in dissatisfaction with HCP interactions and seeking peer opinions online. Identified unmet needs focused on need for satisfactory treatment options, well-informed HCPs, and better patient education.

CONCLUSIONS

The study highlights the need for improved education for patients, caregivers, and HCPs regarding PSS and better communication between patients and HCPs to manage treatment expectations.

An Analysis of Pediatric Ophthalmology Content on Instagram

PURPOSE

To analyze pediatric ophthalmology-related information on Instagram (Meta Platforms, Inc).

METHODS

A cross-sectional study queried 112 common eye terms and conditions from the American Association for Pediatric Ophthalmology and Strabismus website as hashtags on Instagram. A categorical classification system was used to analyze the top 9 posts per hashtag for likes, comments, views, and engagement level ratio (ELR). Posts were further characterized by author and content type.

RESULTS

Analysis of the top 901 posts that met our inclusion criteria revealed a cumulative 424,608 likes, 15,793 comments, and 2,873,042 views. Authors had a total of 76,076,455 followers. Patients/families created the greatest number of posts (37.6%), followed by companies (20.2%), other (14.9%), medical organizations (12.3%), international ophthalmologists (6.1%), optometrists (5.9%), and American Board of Ophthalmology-certified ophthalmologists (3.0%). Content was mostly patient experience (42.4%), followed by educational (29.7%), self-promotional (13.5%), other (10.5%), and career-related (3.8%). Companies authored the highest number of educational posts (23.5%), followed by medical institutions (20.9%), other (19.4%), international ophthalmologists (13.8%), optometrists (13.4%), and American Board of Ophthalmology-certified ophthalmologists (4.5%) and patients (4.5%).

CONCLUSIONS

Although pediatric ophthalmology content presented by board-certified ophthalmology Instagram authors had a greater number of followers than most other author categories, ophthalmologist authors on Instagram are still underrepresented. Additional research is warranted to help promote ophthalmologist-authored posts. [J Pediatr Ophthalmol Strabismus. 2025;62(1):50-56.].

A social media listening study of patients' experiences relating to metabolic dysfunction-associated steatotic liver disease: The LISTEN-MASLD study

INTRODUCTION AND OBJECTIVES

Patients increasingly use social media to share and access health-related information and experiences. This study employed social media listening to gain patient-centric insights into metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD).

MATERIALS AND METHOD

Publicly available social media data was collected between November 4th, 2020, and November 4th, 2022, about MASLD from eight countries: Brazil, China, France, Germany, Japan, South Korea, Spain, and the United Kingdom. The analysis involved capturing patient conversations on their journey stages (causes-risk factors, symptoms, diagnosis, and treatment), unmet needs, and impact on patient's quality of life (QoL) from various social media platforms to gain insights associated with MASLD.

RESULTS

A total of 1600 patient-centric posts were analyzed. The patient journey was the most prevalent topic (92 %) mentioned, followed by comorbidities (38 %) and interactions with HCPs (26 %, health care professionals). Key causes discussed included unhealthy diet (39 %) and overweight/obese (32 %), while the most mentioned symptoms were fatigue (20 %) and pain or abdominal discomfort (20 %). Ultrasound (n=170/553, 31 %) was the most used diagnosis, followed by blood tests (n=130/553, 24 %) and liver function tests (n=91/553, 16 %). Lifestyle management techniques were mainly the standard of care, followed by treatment (n=270/1061, 25 %) and follow-ups with HCPs (n=133/1061, 13 %). Over half (54 %) of the QoL discussion (n=104/192) focused on patients' comorbidities, and 27 % on disease severity, indicating that having MASLD in moderate to severe form with comorbidities significantly affects patients' quality of life. An emotional analysis revealed that patients were worried and frustrated about their condition but were also hopeful and determined to improve their health. Nearly 38 % of the posts mentioned that patients were emotionally affected by negative feelings, especially those with multiple comorbidities. Lack of access to knowledgeable HCPs and treatment options were the most frequently discussed unmet needs.

CONCLUSIONS

This analysis of NAFLD patient experiences introduces a unique approach for deriving insights into patients' experiences and their impact on QoL. These insights have the potential to complement conventional methods and foster patient-centric research.

Factors Affecting Surgical Success Rates in Pediatric Horizontal Strabismus Surgery

INTRODUCTION

Horizontal strabismus is a binocular alignment disorder that can lead to significant complications in childhood, such as visual impairment and amblyopia. This study aimed to evaluate the success rates of horizontal strabismus surgery in pediatric patients and to identify the factors affecting surgical outcomes. Specifically, it examined the relationship between surgical success and factors such as age, deviation angle, and amblyopia in pediatric horizontal strabismus cases.

METHODS

The medical records of 95 patients diagnosed with horizontal strabismus and treated surgically between 2016 and 2022 were reviewed. Surgical success was defined by a postoperative deviation angle of less than 10 prism diopters (PD). Visual acuity and deviation angles were measured before and after surgery, and the data were analyzed statistically.

RESULTS

Among the cases, 49 (51.5%) were diagnosed with esotropia and 46 (48.5%) with exotropia. One year after surgery, the overall success rate was recorded at 73.6%. The success rates were 77.6% in the esotropia group and 69.6% in the exotropia group, with no statistically significant difference between the groups (p=0.515). In age-based analyses, the surgical success rate was 73.8% in patients aged 0-9 years and 73.5% in those aged 10-18 years. Patients with a deviation angle greater than 45 PD had a success rate of 61.5%, while those with an angle below 45 PD achieved a success rate of 82.1% (p<0.05). Surgical success was observed in 50% of patients with amblyopia and 80.9% of those without amblyopia. Improvement in visual acuity was observed in 5.5% of non-amblyopic patients and in 22.7% of amblyopic patients; however, this improvement was not statistically correlated with surgical success.

CONCLUSIONS

This study revealed that factors such as the deviation angle and the presence of amblyopia affected the success rate of horizontal strabismus surgery. Surgical success rates did not differ significantly between esotropia and exotropia cases. Consistent with existing literature, patients with larger deviation angles and amblyopia were found to have lower surgical success rates.

Exploring a method for extracting concerns of multiple breast cancer patients in the domain of patient narratives using BERT and its optimization by domain adaptation using masked language modeling

Narratives posted on the internet by patients contain a vast amount of information about various concerns. This study aimed to extract multiple concerns from interviews with breast cancer patients using the natural language processing (NLP) model bidirectional encoder representations from transformers (BERT). A total of 508 interview transcriptions of breast cancer patients written in Japanese were labeled with five types of concern labels: "treatment," "physical," "psychological," "work/financial," and "family/friends." The labeled texts were used to create a multi-label classifier by fine-tuning a pre-trained BERT model. Prior to fine-tuning, we also created several classifiers with domain adaptation using (1) breast cancer patients' blog articles and (2) breast cancer patients' interview transcriptions. The performance of the classifiers was evaluated in terms of precision through 5-fold cross-validation. The multi-label classifiers with only fine-tuning had precision values of over 0.80 for "physical" and "work/financial" out of the five concerns. On the other hand, precision for "treatment" was low at approximately 0.25. However, for the classifiers using domain adaptation, the precision of this label took a range of 0.40-0.51, with some cases improving by more than 0.2. This study showed combining domain adaptation with a multi-label classifier on target data made it possible to efficiently extract multiple concerns from interviews.

Effects of environmental enrichment on GLUT expression in the visual cortex of amblyopic rats

OBJECTIVE

To investigate the potential changes of glucose metabolism and glucose transporter protein (GLUT) in the visual cortex of formally deprived amblyopic rats, as well as the effects of enriched environments on the levels of nerve conduction and glucose metabolism in the visual cortex of amblyopic rats.

METHODS

36 rats were randomly divided into three groups: CON + SE (n = 12), MD + SE (n = 12) and MD + EE (n = 12). The right eyelids of both MD + SE and MD + EE groups were sutured. After successful modelling, the MD + EE group was maintained in an enriched environment, and the other two groups were kept in the same environment. Pattern visual evoked potentials (PVEP) was used to confirm models' effect, glucose metabolism was analyzed by Micro-PET/CT (18F-FDG), and the protein as well as mRNA expression levels of GLUT were detected by Western Blot and quantitative RT-PCR (quantitative Reverse Transcription-Polymerase Chain Reaction) analyses, site of GLUT expression by immunofluorescence (IF).

RESULTS

After suture modelling, both the MD + EE and MD + SE groups objective visual nerve conduction function decreased, the glucose metabolism in the visual cortex was markedly lower. After the enriched environment intervention, it recovered in the MD + EE group. The expression levels of GLUT1 and GLUT3 were increased in the MD + EE group in comparison with the MD + SE group. GLUT1 was primarily expressed on astrocytes and endothelial cells, but GLUT3 was mainly expressed on neurons.

CONCLUSION

Enrichment of the environment exhibited a therapeutic effect on amblyopia, which could be related to the enhancement of glucose metabolism and GLUT expression in the visual cortex.

Social Listening in Gout: Impact of Proactive vs. Reactive Management on Self-Reported Emotional States

INTRODUCTION

This study aimed to characterize patient-reported outcomes from social media conversations in the gout community. The impact of management strategy differences on the community's emotional states was explored.

METHODS

We analyzed two social media sources using a variety of natural language processing techniques. We isolated conversations with a high probability of discussing disease management (score > 0.99). These conversations were stratified by management type: proactive or reactive. The polarity (positivity/negativity) of language and emotions conveyed in statements shared by community members was assessed by management type.

RESULTS

Among the statements related to management, reactive management (e.g., urgent care) was mentioned in 0.5% of statements, and proactive management (e.g., primary care) was mentioned in 0.6% of statements. Reactive management statements had a significantly larger proportion of negative words (59%) than did proactive management statements (44%); "fear" occurred more frequently with reactive statements, whereas "trust" predominated in proactive statements. Allopurinol was the most common medication in proactive management statements, whereas reactive management had significantly higher counts of prednisone/steroid mentions.

CONCLUSIONS

A unique aspect of examining gout-related social media conversations is the ability to better understand the intersection of clinical management and emotional impacts in the gout community. The effect of social media statements was significantly stratified by management type for gout community members, where proactive management statements were characterized by more positive language than reactive management statements. These results suggest that proactive disease management may result in more positive mental and emotional experiences in patients with gout.

Patient Perception and Self-Reported Outcomes with Presbyopia-Correcting Intraocular Lenses (PCIOLs): A Social Media Listening Study

INTRODUCTION

Presbyopia-correcting intraocular lens (PCIOL) implantation is a popular treatment option for cataract surgery patients who desire spectacle independence. This study aimed to understand patient perception and outcomes with PCIOLs by analyzing patient social media posts.

METHODS

This was a non-interventional retrospective study that used predefined search strings to identify publicly available social media data discussing patient perceptions and outcomes with seven PCIOLs (three trifocal, one multifocal with continuous range of vision, and three extended depth-of-focus [EDOF] PCIOLs). Relevant posts were searched from Reddit, YouTube, and Facebook and patient forums Patient.info, Medicine.net, Optiker-Forum, and Medizin Forum from September 2020 to October 2022 in four languages (English, German, French, and Spanish).

RESULTS

A total of 2237 posts were included, all in English, with 68% of posts identified on Patient.info. The themes most discussed by patients were quality of vision (69% of total posts), patient experience after PCIOL implantation (30%), patient perception before PCIOL implantation (26%), and visual disturbances (24%). Most discussed PCIOLs were Vivity® (58% of total posts), PanOptix® (38%), Synergy® (26%), and Symfony® (13%). Patient perception of PCIOLs was most frequently influenced by healthcare professionals, online reading, and online videos (31%, 18%, and 15% of posts, respectively). A total of 215 posts (10% of total) discussed glasses use after PCIOL surgery: for EDOF and trifocal/multifocal PCIOLs, 37% and 56% of posts discussing glasses use stated being glasses free, respectively. A total of 537 posts discussed visual disturbances: halos/rings (66%) and starbursts (36%) were the most discussed visual disturbances for all lens types. Being glasses free after PCIOL implantation appeared to be a key driver of patient satisfaction.

CONCLUSION

Social media provides a rich source of information on patient perception, experience, and overall satisfaction of PCIOLs that can be used to complement and guide the collection of further evidence generated through controlled trials.

Amblyopia-A novel virtual round table to explore the caregiver perspective

PURPOSE

A survey aimed to capture the caregiver's perspective on the impact of amblyopia and its treatment on the child and family, as well as caregivers' views on the design and feasibility of clinical trials investigating dichoptic binocular therapies for amblyopia.

METHODS

Parents of amblyopic children, patient advocates and healthcare professionals took part in a moderated, structured discussion on a novel virtual advisory-board platform.

RESULTS

Seven parents of children with amblyopia, two patient organisation representatives, one ophthalmologist and one optometrist participated in the survey. A total of 645 posts were entered on the platform over a 14-day period in September 2021. There was widespread agreement that the management of amblyopia poses more of a burden on the child and family than the condition itself, with treatment burden accentuated when treatment is unsuccessful. Parents expressed uncertainty and frustration in relation to the duration of patching, success of patching and alternative treatment options, and felt there was inadequate readily available, easy-to-understand information on the condition. Parents reported that a new treatment for amblyopia, such as dichoptic binocular therapy using video games, should be safe, non-invasive and engaging compared with an eye patch. Treating at home, potentially for a shorter treatment duration, and with an entertaining game were the main reasons parents would join a clinical study with this type of novel therapy. However, due to a limited critical period treatment window, parents would feel more comfortable joining a clinical trial if traditional therapies were offered in conjunction with those under investigation.

CONCLUSION

Patient perspectives and the role of caregivers in the acceptance of any interventional treatments are increasingly recognised. Understanding how amblyopia and its treatment impacts a child and family should be an important premise to guide therapy and evaluate treatment value, both in clinical trials and in routine medical practice.

Qualitative Exploration of the Visual Function Impairments and Health-Related Quality of Life Impacts of Amblyopia in Adult and Pediatric Populations

INTRODUCTION

Amblyopia is a reduction in vision in one or both eyes due to impaired development of the visual pathway. This study explored the experience of amblyopia and treatment from the patient, caregiver, and clinician perspectives.

METHODS

A targeted literature review, including a review of social media listening (SML) studies, was conducted. Next, qualitative interviews were conducted with amblyopia patients, caregivers of children with amblyopia, and ophthalmologists with experience treating patients with amblyopia. The findings informed the development of a disease model. Amblyopia clinical experts provided input at key stages.

RESULTS

Twelve data sources were reviewed, including qualitative studies in the literature and SML studies. Overall, 133 patients/caregivers were interviewed (23 adults, 16 adolescents, 47 child-caregiver dyads), plus 10 ophthalmologists from the United States, France, and Germany. Reduced visual acuity, impaired depth perception, impaired peripheral vision, and double vision were the most frequently reported symptoms. Amblyopia impacted daily activities (reading, using digital devices), the ability to move around, school/work (productivity, seeing the board in class), emotional well-being (frustration, sadness), and social functioning (difficulty socializing). Treatments, including patching and corrective lens, also impacted daily activities (using digital devices, sports/leisure), mobility (bumping into things), and work/school (tasks taking longer) as well as emotional well-being (embarrassment), and social functioning (bullying/stigma).

CONCLUSION

The findings contribute valuable insights into the adult and pediatric experience of amblyopia from a multi-stakeholder perspective. The findings were used to critically assess existing clinical outcome assessments and supported the development of patient- and observer-reported outcome measures for use in amblyopia clinical trials.