Communication vs evidence: What hinders the outreach of science during an infodemic? A narrative review

Production and use of rapid responses during the COVID-19 pandemic in Quebec (Canada): perspectives from evidence synthesis producers and decision makers

BACKGROUND

The COVID-19 pandemic has required evidence to be made available more rapidly than usual, in order to meet the needs of decision makers in a timely manner. These exceptional circumstances have caused significant challenges for organizations and teams responsible for evidence synthesis. They had to adapt to provide rapid responses to support decision-making. This study aimed to document (1) the challenges and adaptations made to produce rapid responses during the pandemic, (2) their perceived usefulness, reported use and factors influencing their use and (3) the methodological adaptations made to produce rapid responses.

METHODS

A qualitative study was conducted in 2021 with eight organizations in the health and social services system in Quebec (Canada), including three institutes with a provincial mandate. Data collection included focus groups (n = 9 groups in 8 organizations with 64 participants), interviews with decision makers (n = 12), and a document analysis of COVID-19 rapid responses (n = 128). A thematic analysis of qualitative data (objectives 1 and 2) and a descriptive analysis of documents (objective 3) were conducted.

RESULTS

The results highlight the teams and organizations' agility to deal with the many challenges encountered during the pandemic (e.g., increased their workloads, adoption of new technological tools or work processes, improved collaboration, development of scientific monitoring, adaptation of evidence synthesis methodologies and products). The challenge of balancing rigor and speed was reported by teams and organizations. When available at the right time, rapid responses have been reported as a useful tool for informing or justifying decisions in a context of uncertainty. Several factors that may influence their use were identified (e.g., clearly identify needs, interactions with producers, perceived rigor and credibility, precise and feasible recommendations). Certain trends in the methodological approaches used to speed up the evidence synthesis process were identified.

CONCLUSIONS

This study documented rapid responses producers' experiences during the COVID-19 pandemic in Quebec, and decision makers who requested, consulted, or used these products. Potential areas of improvements are identified such as reinforce coordination, improve communication loops, clarify guidelines or methodological benchmarks, and enhance utility of rapid response products for decision makers.

Social media as a mechanism of dissemination and knowledge translation among health professions educators: a scoping review

Health professions educators often use social media to share knowledge; however, it is unclear what specific dissemination and knowledge translation (KT) processes are occurring and the implications of this sharing for health professions education (HPE). This study explored how educators have used social media as a mechanism of dissemination and KT in the literature. A critical scoping review methodology, informed by Engeström's Activity Theory, was employed. Twelve databases were searched and studies that: (a) addressed health professions educators; (b) described the use of social media for dissemination or KT; (c) focused on a regulated health profession; (d) focused on undergraduate or graduate education; and (e) were published in English or French between 2011 and 2021 were included. Data were analyzed using numerical and qualitative content analyses. Of the 4859 articles screened, 37 were eligible for inclusion. Social media may facilitate knowledge sharing in HPE, but there is a lack of conceptual clarity on what is meant by 'dissemination' and 'KT'. Who is responsible for sharing knowledge, what knowledge is being shared, and the target audiences are not always clear. Multiple factors (e.g., affordances, opportunity costs) influence how social media is used as a mechanism of dissemination, and it remains unclear whether and how it is used as a mechanism of KT. Concepts like KT and dissemination, which are often borrowed from other disciplines, must be critically evaluated for their relevance and suitability if they are to be appropriately applied to HPE and in particular to social media. Educators looking to use social media to teach students about KT should consider whether this use of technology truly aligns with their stated learning outcomes.

Infodemic: Challenges and solutions in topic discovery and data process

BACKGROUND

The Coronavirus Disease 2019 (COVID-19) pandemic was a huge shock to society, and the ensuing information problems had a huge impact on society at the same time. The urgent need to understand the Infodemic, i.e., the importance of the spread of false information related to the epidemic, has been highlighted. However, while there is a growing interest in this phenomenon, studies on the topic discovery, data collection, and data preparation phases of the information analysis process have been lacking.

OBJECTIVE

Since the epidemic is unprecedented and has not ended to this day, we aimed to examine the existing Infodemic-related literature from January 2019 to December 2022.

METHODS

We have systematically searched ScienceDirect and IEEE Xplore databases with some search limitations. From the searched literature we selected titles, abstracts and keywords, and limitations sections. We conducted an extensive structured literature search and analysis by filtering the literature and sorting out the available information.

RESULTS

A total of 47 papers ended up meeting the requirements of this review. Researchers in all of these literatures encountered different challenges, most of which were focused on the data collection step, with few challenges encountered in the data preparation phase and almost none in the topic discovery section. The challenges were mainly divided into the points of how to collect data quickly, how to get the required data samples, how to filter the data, what to do if the data set is too small, how to pick the right classifier and how to deal with topic drift and diversity. In addition, researchers have proposed partial solutions to the challenges, and we have also proposed possible solutions.

CONCLUSIONS

This review found that Infodemic is a rapidly growing research area that attracts the interest of researchers from different disciplines. The number of studies in this field has increased significantly in recent years, with researchers from different countries, including the United States, India, and China. Infodemic topic discovery, data collection, and data preparation are not easy, and each step faces different challenges. While there is some research in this emerging field, there are still many challenges that need to be addressed. These findings highlight the need for more articles to address these issues and fill these gaps.

Defining Misinformation and Related Terms in Health-Related Literature: Scoping Review

BACKGROUND

Misinformation poses a serious challenge to clinical and policy decision-making in the health field. The COVID-19 pandemic amplified interest in misinformation and related terms and witnessed a proliferation of definitions.

OBJECTIVE

We aim to assess the definitions of misinformation and related terms used in health-related literature.

METHODS

We conducted a scoping review of systematic reviews by searching Ovid MEDLINE, Embase, Cochrane, and Epistemonikos databases for articles published within the last 5 years up till March 2023. Eligible studies were systematic reviews that stated misinformation or related terms as part of their objectives, conducted a systematic search of at least one database, and reported at least 1 definition for misinformation or related terms. We extracted definitions for the terms misinformation, disinformation, fake news, infodemic, and malinformation. Within each definition, we identified concepts and mapped them across misinformation-related terms.

RESULTS

We included 41 eligible systematic reviews, out of which 32 (78%) reviews addressed the topic of public health emergencies (including the COVID-19 pandemic) and contained 75 definitions for misinformation and related terms. The definitions consisted of 20 for misinformation, 19 for disinformation, 10 for fake news, 24 for infodemic, and 2 for malinformation. "False/inaccurate/incorrect" was mentioned in 15 of 20 definitions of misinformation, 13 of 19 definitions of disinformation, 5 of 10 definitions of fake news, 6 of 24 definitions of infodemic, and 0 of 2 definitions of malinformation. Infodemic had 19 of 24 definitions addressing "information overload" and malinformation had 2 of 2 definitions with "accurate" and 1 definition "used in the wrong context." Out of all the definitions, 56 (75%) were referenced from other sources.

CONCLUSIONS

While the definitions of misinformation and related terms in the health field had inconstancies and variability, they were largely consistent. Inconstancies related to the intentionality in misinformation definitions (7 definitions mention "unintentional," while 5 definitions have "intentional"). They also related to the content of infodemic (9 definitions mention "valid and invalid info," while 6 definitions have "false/inaccurate/incorrect"). The inclusion of concepts such as "intentional" may be difficult to operationalize as it is difficult to ascertain one's intentions. This scoping review has the strength of using a systematic method for retrieving articles but does not cover all definitions in the extant literature outside the field of health. This scoping review of the health literature identified several definitions for misinformation and related terms, which showed variability and included concepts that are difficult to operationalize. Health practitioners need to exert caution before labeling a piece of information as misinformation or any other related term and only do so after ascertaining accurateness and sometimes intentionality. Additional efforts are needed to allow future consensus around clear and operational definitions.

Infodemic in Public health a reemerging public health threat: a scoping review

BACKGROUND

Infodemic is a neologism of 'information' and 'epidemic' coined in the year 2003. Evidence mapping is a technique to appraise the literature which enables the extent of research activity in a specific area to be discovered. The main objective of this evidence synthesis presents the outcomes of an evidence map that was directed to know the extent of Infodemics and its effects on public health.  Methods: The following methods were used to construct this evidence synthesis: Phase I. Construct a Broad Question Referring to the Field of Analysis. Phase II; Defining Key Variables to Be Mapped, identifying the characters of each variable and Outline Inclusion and Exclusion Criteria for the variables. Phase III: Literature search. Phase IV: Screening and Charting the Appropriate Evidence within the Synthesis.  Results:  Authors identified 55 records through database searching, after screening for duplicates, 53 records screened at title/abstract level of which, 16 records were removed because of lack of complete article or articles were not in English. 37 articles were eligible for full text screening, 37 full-text articles were than assessed for eligibility and only 22 articles were included as per inclusion criteria with an interrater Outcome Kappa value: 0.91. The strength of agreement was considered to be 'excellent'.  Conclusions: This synthesis focused majorly on the gaps in the research focused on infodemic. The two main gaps identified were lack of systematically conducted research and poor digital health literacy. As infodemic is a new phenomenon with respect to the COVID-19 pandemic it was an eye opener at different levels of public health, furthermore this evidence map points out areas for further research on the impact of infodemic.

Understanding Factors Influencing Polio Vaccine Uptake in Ghana-Developing Meaningful Community Mobilization and Engagement Strategies in Collaboration with Religious Leaders

This qualitative study explores how religious leaders in Ghana view polio and polio vaccine-related knowledge and perceptions of the community members. It also examines the personal characteristics of those who are most likely to accept or reject the vaccine. On the basis of the findings, this study provides a set of evidence-based recommendations to support religious leaders' efforts to create polio vaccine demand in their communities. The study is based on focus group discussions conducted with religious leaders from various geographic locations across Ghana. The discussions were transcribed verbatim and analyzed thematically. Twenty religious leaders, including Christian, Muslim, and leaders of traditional African religions, participated in the study. The findings show that both religious leaders and community members lack knowledge and have multiple culturally and religiously influenced explanations for polio. In addition, the findings reveal that vaccine safety and efficacy are linked to emotional narratives, and receiving the polio vaccine is not a social norm in all communities. Educated mothers in urban settings were identified as those most receptive to the polio vaccine. To create polio vaccine demand, religious leaders need to combat misinformation and the negative perceptions about the vaccine. Recommendations include conveying high-quality information to community members, developing tactics to address culturally and religiously sensitive matters, using emotionally inspired personal accounts to enhance positive attitudes toward polio vaccines and act as catalysts for positive social norms towards the polio vaccine. Educated mothers from urban areas can be engaged as champions in vaccine demand creation.

Systematic reviews of convalescent plasma in COVID-19 continue to be poorly conducted and reported: a systematic review

OBJECTIVES

To suggest possible approaches to combatting the impact of the COVID-19 infodemic to prevent research waste in future health emergencies and in everyday research and practice.

STUDY DESIGN AND SETTING

Systematic review. The Epistemonikos database was searched in June 2021 for systematic reviews on the effectiveness of convalescent plasma for COVID-19. Two reviewers independently screened the retrieved references with disagreements resolved by discussion. Data extraction was completed by one reviewer with a proportion checked by a second. We used the Assessment of Multiple Systematic Reviews to assess the quality of conduct and reporting of included reviews.

RESULTS

Fifty one systematic reviews are included with 193 individual studies included within the systematic reviews. There was considerable duplication of effort; multiple reviews were conducted at the same time with inconsistencies in the evidence included. The reviews were of low methodological quality, poorly reported, and did not adhere to preferred reporting items for systematic reviews and meta-analysis guidance.

CONCLUSION

Researchers need to conduct, appraise, interpret, and disseminate systematic reviews better. All in the research community (researchers, peer-reviewers, journal editors, funders, decision makers, clinicians, journalists, and the public) need to work together to facilitate the conduct of robust systematic reviews that are published and communicated in a timely manner, reducing research duplication and waste, increasing transparency and accessibility of all systematic reviews.

Vegan nutrition: a preliminary guide for health professionals

Since the beginning of the 21st century, interest in vegan diets has been rapidly increasing in most countries. Misconceptions about vegan diets are widespread among the general population and health professionals. Vegan diets can be health-promoting and may offer certain important advantages compared to typical Western (and other mainstream) eating patterns. However, adequate dietary sources/supplements of nutrients of focus specific to vegan diets should be identified and communicated. Without supplements/fortified foods, severe vitamin B12 deficiency may occur. Other potential nutrients of focus are calcium, vitamin D, iodine, omega-3 fatty acids, iron, zinc, selenium, vitamin A, and protein. Ensuring adequate nutrient status is particularly important during pregnancy, lactation, infancy, and childhood. Health professionals are often expected to be able to provide advice on the topic of vegan nutrition, but a precise and practical vegan nutrition guide for health professionals is lacking. Consequently, it is important and urgent to provide such a set of dietary recommendations. It is the aim of this article to provide vegan nutrition guidelines, based on current evidence, which can easily be communicated to vegan patients/clients, with the goal of ensuring adequate nutrient status in vegans.

Impact of a Long Lockdown on Mental Health and the Role of Media Use: Web-Based Survey Study

BACKGROUND

Due to the COVID-19 pandemic, the Czech population experienced a second lockdown lasting for about half a year, restricting free movement and imposing social isolation. However, it is not known whether the impact of this long lockdown resulted in habituation to the adverse situation or in the traumatization of the Czech population, and whether the media and specific media use contributed to these effects.

OBJECTIVE

The aim of this study was to elucidate the effect of the long lockdown on the mental health of the Czech population, and the role of exposure to COVID-19 news reports and specific forms of media news use in mental health.

METHODS

We conducted two consecutive surveys in the early (November 2020) and late (March/April 2021) phases of the nationwide lockdown on the same nationally representative group of Czech adults (N=1777) participating in a longitudinal panel study.

RESULTS

Our findings showed that the self-reported symptoms of anxiety and depression increased in the second observation period, confirming the negative effect of the pandemic lockdown as it unfolded, suggesting that restrictive measures and continuous exposure to a collective stressor did not result in the strengthening of resilience but rather in ongoing traumatization. The results also suggest a negative role of the media's coverage of the COVID-19 pandemic in mental health during the early, and particularly late, phases of the lockdown. Furthermore, we found several risk and protective factors of specific media news use. The media practice in news consumption connected to social media use was the strongest predictor of exacerbated mental health symptoms, particularly in the late phase of the lockdown. Moreover, news media use characterized by internalization of information learned from the news, as well as negative attitudes toward media news, were associated with higher levels of anxiety and depression. Conversely, the use of infotainment, together with an in-depth and contextual style of reading news articles, were related to improvement of mental health.

CONCLUSIONS

Our study showed that the long lockdown resulted in traumatization rather than habituation, and in more pronounced effects (both negative and positive) of media use in mental health.

COVID-19 and the Infodemic: An Overview of the Role and Impact of Social Media, the Evolution of Medical Knowledge, and Emerging Problems

The infodemic is an important component of the cyber-risk in regard to the poor and uncontrolled dissemination of information related to the COVID-19 pandemic. The purpose of this study was to perform a narrative review based on three points of view to allow for an overall picture of this issue. The points of view focused on: (a) the volume of use of social media (a key element of the infodemic) and the position of international health domain bodies; (b) the evolution of scientific production in the life sciences; (c) emerging issues. The research methodology was based on Google and PubMed searches and a qualification process based on a standard checklist and an evaluation of eligibility based on parameters with five score levels applied by two experts (plus one in case of discrepancy). The three points of view stressed the key role of social media as a dissemination tool of the infodemic among citizens. The impact on citizens depends on various social factors and involves indirect (e.g., vaccine avoidance) and direct risks such as mental problems and the risk of suicide. The widespread diffusion of social media, conveyed by mobile technologies, also suggests their use as countermeasures, calibrated based on citizens’ level of both technological and health literacy. Effective and promising countermeasures in this direction are based both on initiatives of contact by apps or SMS and the collection of data based on surveys and finalized to the particular intervention. The review also suggests as further areas of in-depth research: (a) to combat high-level infodemic produced by scientific publications that are not yet official (preprint) or that have undergone peer review with bias/distortion; (b) focusing on the impact of the infodemic considering its spread in different languages.

The COVID-19 Infodemic: Mechanism, Impact, and Counter-Measures—A Review of Reviews

The acceptability of appropriate SARS-CoV-2 pandemic measures including vaccinations is currently being hampered due to significant misinformation all over the globe, also known as the “infodemic” within the pandemic. We asked the following two research questions: (1) What is the current extent of the global infodemic preventing populations from receiving adequate healthcare including COVID-vaccinations? (2) Which are appropriate countermeasures to manage the infodemic in order to guarantee adequate healthcare in the SARS-CoV-2 pandemic? Pubmed and Cochrane Library were accessed on 29 October 2021 and searched for reviews and systematic reviews on “COVID-19” and “infodemic”. The literature identified was analyzed with methods of qualitative research focusing on (1) mechanism, (2) impact, and (3) countermeasures to confront the infodemic. The world-wide infodemic is being recognized as a multifaceted problem beyond health and human rights, extending into global political spheres such as societal cohesion and security. The mechanism of the COVID-19 infodemic involves specific factors related to the situation, sender, instrument, and recipient. Although freedom of expression and the right to seek, receive, and impart information through any media is a fundamental human right, the infodemic has a substantial impact on health, another fundamental human right, by causing stress, deception, violence, and harm. Mixed-synergistic pre-impact, trans-impact, and post-impact countermeasures can be taken; the most important is building and maintaining trust.