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Published: 3 December 2021
by MDPI
Abstract:
While experts have recognised the significance and necessity of social media integration in healthcare, no systematic method has been devised in Malaysia or Southeast Asia to include social media input into the hospital quality improvement process. The goal of this work is to explain how to develop a machine learning system for classifying Facebook reviews of public hospitals in Malaysia by using service quality (SERVQUAL) dimensions and sentiment analysis. We developed a Machine Learning Quality Classifier (MLQC) based on the SERVQUAL model and a Machine Learning Sentiment Analyzer (MLSA) by manually annotated multiple batches of randomly chosen reviews. Logistic regression (LR), naive Bayes (NB), support vector machine (SVM), and other methods were used to train the classifiers. The performance of each classifier was tested using 5-fold cross validation. For topic classification, the average F1-score was between 0.687 and 0.757 for all models. In a 5-fold cross validation of each SERVQUAL dimension and in sentiment analysis, SVM consistently outperformed other methods. The study demonstrates how to use supervised learning to automatically identify SERVQUAL domains and sentiments from patient experiences on a hospital’s Facebook page. Malaysian healthcare providers can gather and assess data on patient care via the use of these content analysis technology to improve hospital quality of care.
Ruba Skaik, Diana Inkpen
ACM Computing Surveys, Volume 53, pp 1-31; https://doi.org/10.1145/3422824

Abstract:
Data on social media contain a wealth of user information. Big data research of social media data may also support standard surveillance approaches and provide decision-makers with usable information. These data can be analyzed using Natural Language Processing (NLP) and Machine Learning (ML) techniques to detect signs of mental disorders that need attention, such as depression and suicide ideation. This article presents the recent trends and tools that are used in this field, the different means for data collection, and the current applications of ML and NLP in the surveillance of public mental health. We highlight the best practices and the challenges. Furthermore, we discuss the current gaps that need to be addressed and resolved.
European Journal of Investigation in Health, Psychology and Education, Volume 11, pp 1537-1554; https://doi.org/10.3390/ejihpe11040109

Abstract:
Social media platforms have become accessible resources for health data analysis. However, the advanced computational techniques involved in big data text mining and analysis are challenging for public health data analysts to apply. This study proposes and explores the feasibility of a novel yet straightforward method by regressing the outcome of interest on the aggregated influence scores for association and/or classification analyses based on generalized linear models. The method reduces the document term matrix by transforming text data into a continuous summary score, thereby reducing the data dimension substantially and easing the data sparsity issue of the term matrix. To illustrate the proposed method in detailed steps, we used three Twitter datasets on various topics: autism spectrum disorder, influenza, and violence against women. We found that our results were generally consistent with the critical factors associated with the specific public health topic in the existing literature. The proposed method could also classify tweets into different topic groups appropriately with consistent performance compared with existing text mining methods for automatic classification based on tweet contents.
Pengyuan Wang, Jie Li
Published: 19 November 2021
Journal of Healthcare Engineering, Volume 2021, pp 1-5; https://doi.org/10.1155/2021/7011205

Abstract:
This article analyzes the application process of data mining technology in the medical and health management system and uses machine learning algorithms to design a medical and health data mining system. The system collects patient’s physical health data based on wireless sensing technology and uses machine learning algorithms to analyze the data. The system uploads the collected health data to the system for cluster analysis. Finally, the method is applied to the diagnosis data mining of patients, so as to prove the effectiveness of the classification method in the medical field through examples.
Yu Zeng, Fuchao Cheng
Published: 16 November 2021
Journal of Healthcare Engineering, Volume 2021, pp 1-5; https://doi.org/10.1155/2021/2722854

Abstract:
The information defined in medical health data is researched based on machine learning-related algorithms. Also, this paper used random forest and other related algorithms to perform health data training and fitting. Research shows that the algorithm proposed in the paper can improve the progress of health data classification. The algorithm can provide technical support for the improvement of medical data classification.
Jianxia Gong, Vikrant Sihag, ,
Published: 1 November 2021
JMIR Medical Informatics, Volume 9; https://doi.org/10.2196/31142

Abstract:
Background: The recent surge in clinical and nonclinical health-related data has been accompanied by a concomitant increase in personal health data (PHD) research across multiple disciplines such as medicine, computer science, and management. There is now a need to synthesize the dynamic knowledge of PHD in various disciplines to spot potential research hotspots. Objective: The aim of this study was to reveal the knowledge evolutionary trends in PHD and detect potential research hotspots using bibliometric analysis. Methods: We collected 8281 articles published between 2009 and 2018 from the Web of Science database. The knowledge evolution analysis (KEA) framework was used to analyze the evolution of PHD research. The KEA framework is a bibliometric approach that is based on 3 knowledge networks: reference co-citation, keyword co-occurrence, and discipline co-occurrence. Results: The findings show that the focus of PHD research has evolved from medicine centric to technology centric to human centric since 2009. The most active PHD knowledge cluster is developing knowledge resources and allocating scarce resources. The field of computer science, especially the topic of artificial intelligence (AI), has been the focal point of recent empirical studies on PHD. Topics related to psychology and human factors (eg, attitude, satisfaction, education) are also receiving more attention. Conclusions: Our analysis shows that PHD research has the potential to provide value-based health care in the future. All stakeholders should be educated about AI technology to promote value generation through PHD. Moreover, technology developers and health care institutions should consider human factors to facilitate the effective adoption of PHD-related technology. These findings indicate opportunities for interdisciplinary cooperation in several PHD research areas: (1) AI applications for PHD; (2) regulatory issues and governance of PHD; (3) education of all stakeholders about AI technology; and (4) value-based health care including “allocative value,” “technology value,” and “personalized value.”
Published: 28 July 2021
JMIR mHealth and uHealth, Volume 9; https://doi.org/10.2196/27343

Abstract:
Background Digital phenotyping (also known as personal sensing, intelligent sensing, or body computing) involves the collection of biometric and personal data in situ from digital devices, such as smartphones, wearables, or social media, to measure behavior or other health indicators. The collected data are analyzed to generate moment-by-moment quantification of a person’s mental state and potentially predict future mental states. Digital phenotyping projects incorporate data from multiple sources, such as electronic health records, biometric scans, or genetic testing. As digital phenotyping tools can be used to study and predict behavior, they are of increasing interest for a range of consumer, government, and health care applications. In clinical care, digital phenotyping is expected to improve mental health diagnoses and treatment. At the same time, mental health applications of digital phenotyping present significant areas of ethical concern, particularly in terms of privacy and data protection, consent, bias, and accountability. Objective This study aims to develop consensus statements regarding key areas of ethical guidance for mental health applications of digital phenotyping in the United States. Methods We used a modified Delphi technique to identify the emerging ethical challenges posed by digital phenotyping for mental health applications and to formulate guidance for addressing these challenges. Experts in digital phenotyping, data science, mental health, law, and ethics participated as panelists in the study. The panel arrived at consensus recommendations through an iterative process involving interviews and surveys. The panelists focused primarily on clinical applications for digital phenotyping for mental health but also included recommendations regarding transparency and data protection to address potential areas of misuse of digital phenotyping data outside of the health care domain. Results The findings of this study showed strong agreement related to these ethical issues in the development of mental health applications of digital phenotyping: privacy, transparency, consent, accountability, and fairness. Consensus regarding the recommendation statements was strongest when the guidance was stated broadly enough to accommodate a range of potential applications. The privacy and data protection issues that the Delphi participants found particularly critical to address related to the perceived inadequacies of current regulations and frameworks for protecting sensitive personal information and the potential for sale and analysis of personal data outside of health systems. Conclusions The Delphi study found agreement on a number of ethical issues to prioritize in the development of digital phenotyping for mental health applications. The Delphi consensus statements identified general recommendations and principles regarding the ethical application of digital phenotyping to mental health. As digital phenotyping for mental health is implemented in clinical care, there remains a need for empirical research and consultation with relevant stakeholders to further understand and address relevant ethical issues.
Jianxia Gong, Vikrant Sihag, ,
Published: 11 June 2021
Abstract:
BACKGROUND The recent surge in clinical and nonclinical health-related data has been accompanied by a concomitant increase in personal health data (PHD) research across multiple disciplines such as medicine, computer science, and management. There is now a need to synthesize the dynamic knowledge of PHD in various disciplines to spot potential research hotspots. OBJECTIVE The aim of this study was to reveal the knowledge evolutionary trends in PHD and detect potential research hotspots using bibliometric analysis. METHODS We collected 8281 articles published between 2009 and 2018 from the Web of Science database. The knowledge evolution analysis (KEA) framework was used to analyze the evolution of PHD research. The KEA framework is a bibliometric approach that is based on 3 knowledge networks: reference co-citation, keyword co-occurrence, and discipline co-occurrence. RESULTS The findings show that the focus of PHD research has evolved from medicine centric to technology centric to human centric since 2009. The most active PHD knowledge cluster is developing knowledge resources and allocating scarce resources. The field of computer science, especially the topic of artificial intelligence (AI), has been the focal point of recent empirical studies on PHD. Topics related to psychology and human factors (eg, attitude, satisfaction, education) are also receiving more attention. CONCLUSIONS Our analysis shows that PHD research has the potential to provide value-based health care in the future. All stakeholders should be educated about AI technology to promote value generation through PHD. Moreover, technology developers and health care institutions should consider human factors to facilitate the effective adoption of PHD-related technology. These findings indicate opportunities for interdisciplinary cooperation in several PHD research areas: (1) AI applications for PHD; (2) regulatory issues and governance of PHD; (3) education of all stakeholders about AI technology; and (4) value-based health care including “allocative value,” “technology value,” and “personalized value.”
, Eran Klein, Laura Specker Sullivan, Anna Wexler, Blaise Agüera Y Arcas, Guoqiang Bi, Jose M. Carmena, Joseph J. Fins, Phoebe Friesen, Jack Gallant, et al.
Published: 29 April 2021
Neuroethics, Volume 14, pp 365-386; https://doi.org/10.1007/s12152-021-09468-6

The publisher has not yet granted permission to display this abstract.
Journal of Medical Internet Research, Volume 23; https://doi.org/10.2196/27275

Abstract:
Background Although the potential of big data analytics for health care is well recognized, evidence is lacking on its effects on public health. Objective The aim of this study was to assess the impact of the use of big data analytics on people’s health based on the health indicators and core priorities in the World Health Organization (WHO) General Programme of Work 2019/2023 and the European Programme of Work (EPW), approved and adopted by its Member States, in addition to SARS-CoV-2–related studies. Furthermore, we sought to identify the most relevant challenges and opportunities of these tools with respect to people’s health. Methods Six databases (MEDLINE, Embase, Cochrane Database of Systematic Reviews via Cochrane Library, Web of Science, Scopus, and Epistemonikos) were searched from the inception date to September 21, 2020. Systematic reviews assessing the effects of big data analytics on health indicators were included. Two authors independently performed screening, selection, data extraction, and quality assessment using the AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews 2) checklist. Results The literature search initially yielded 185 records, 35 of which met the inclusion criteria, involving more than 5,000,000 patients. Most of the included studies used patient data collected from electronic health records, hospital information systems, private patient databases, and imaging datasets, and involved the use of big data analytics for noncommunicable diseases. “Probability of dying from any of cardiovascular, cancer, diabetes or chronic renal disease” and “suicide mortality rate” were the most commonly assessed health indicators and core priorities within the WHO General Programme of Work 2019/2023 and the EPW 2020/2025. Big data analytics have shown moderate to high accuracy for the diagnosis and prediction of complications of diabetes mellitus as well as for the diagnosis and classification of mental disorders; prediction of suicide attempts and behaviors; and the diagnosis, treatment, and prediction of important clinical outcomes of several chronic diseases. Confidence in the results was rated as “critically low” for 25 reviews, as “low” for 7 reviews, and as “moderate” for 3 reviews. The most frequently identified challenges were establishment of a well-designed and structured data source, and a secure, transparent, and standardized database for patient data. Conclusions Although the overall quality of included studies was limited, big data analytics has shown moderate to high accuracy for the diagnosis of certain diseases, improvement in managing chronic diseases, and support for prompt and real-time analyses of large sets of varied input data to diagnose and predict disease outcomes. Trial Registration International Prospective Register of Systematic Reviews (PROSPERO) CRD42020214048; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=214048
, Jonathan Cave, Frances Griffiths
Published: 17 February 2021
Frontiers in Digital Health, Volume 3; https://doi.org/10.3389/fdgth.2021.598431

Abstract:
Objective: To compare the findings from a qualitative and a natural language processing (NLP) based analysis of online patient experience posts on patient experience of the effectiveness and impact of the drug Modafinil. Methods: Posts (n = 260) from 5 online social media platforms where posts were publicly available formed the dataset/corpus. Three platforms asked posters to give a numerical rating of Modafinil. Thematic analysis: data was coded and themes generated. Data were categorized into PreModafinil, Acquisition, Dosage, and PostModafinil and compared to identify each poster's own view of whether taking Modafinil was linked to an identifiable outcome. We classified this as positive, mixed, negative, or neutral and compared this with numerical ratings. NLP: Corpus text was speech tagged and keywords and key terms extracted. We identified the following entities: drug names, condition names, symptoms, actions, and side-effects. We searched for simple relationships, collocations, and co-occurrences of entities. To identify causal text, we split the corpus into PreModafinil and PostModafinil and used n-gram analysis. To evaluate sentiment, we calculated the polarity of each post between −1 (negative) and +1 (positive). NLP results were mapped to qualitative results. Results: Posters had used Modafinil for 33 different primary conditions. Eight themes were identified: the reason for taking (condition or symptom), impact of symptoms, acquisition, dosage, side effects, other interventions tried or compared to, effectiveness of Modafinil, and quality of life outcomes. Posters reported perceived effectiveness as follows: 68% positive, 12% mixed, 18% negative. Our classification was consistent with poster ratings. Of the most frequent 100 keywords/keyterms identified by term extraction 88/100 keywords and 84/100 keyterms mapped directly to the eight themes. Seven keyterms indicated negation and temporal states. Sentiment was as follows 72% positive sentiment 4% neutral 24% negative. Matching of sentiment between the qualitative and NLP methods was accurate in 64.2% of posts. If we allow for one category difference matching was accurate in 85% of posts. Conclusions: User generated patient experience is a rich resource for evaluating real world effectiveness, understanding patient perspectives, and identifying research gaps. Both methods successfully identified the entities and topics contained in the posts. In contrast to current evidence, posters with a wide range of other conditions found Modafinil effective. Perceived causality and effectiveness were identified by both methods demonstrating the potential to augment existing knowledge.
Published: 19 January 2021
Abstract:
BACKGROUND Although the potential of big data analytics for health care is well recognized, evidence is lacking on its effects on public health. OBJECTIVE The aim of this study was to assess the impact of the use of big data analytics on people’s health based on the health indicators and core priorities in the World Health Organization (WHO) General Programme of Work 2019/2023 and the European Programme of Work (EPW), approved and adopted by its Member States, in addition to SARS-CoV-2–related studies. Furthermore, we sought to identify the most relevant challenges and opportunities of these tools with respect to people’s health. METHODS Six databases (MEDLINE, Embase, Cochrane Database of Systematic Reviews via Cochrane Library, Web of Science, Scopus, and Epistemonikos) were searched from the inception date to September 21, 2020. Systematic reviews assessing the effects of big data analytics on health indicators were included. Two authors independently performed screening, selection, data extraction, and quality assessment using the AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews 2) checklist. RESULTS The literature search initially yielded 185 records, 35 of which met the inclusion criteria, involving more than 5,000,000 patients. Most of the included studies used patient data collected from electronic health records, hospital information systems, private patient databases, and imaging datasets, and involved the use of big data analytics for noncommunicable diseases. “Probability of dying from any of cardiovascular, cancer, diabetes or chronic renal disease” and “suicide mortality rate” were the most commonly assessed health indicators and core priorities within the WHO General Programme of Work 2019/2023 and the EPW 2020/2025. Big data analytics have shown moderate to high accuracy for the diagnosis and prediction of complications of diabetes mellitus as well as for the diagnosis and classification of mental disorders; prediction of suicide attempts and behaviors; and the diagnosis, treatment, and prediction of important clinical outcomes of several chronic diseases. Confidence in the results was rated as “critically low” for 25 reviews, as “low” for 7 reviews, and as “moderate” for 3 reviews. The most frequently identified challenges were establishment of a well-designed and structured data source, and a secure, transparent, and standardized database for patient data. CONCLUSIONS Although the overall quality of included studies was limited, big data analytics has shown moderate to high accuracy for the diagnosis of certain diseases, improvement in managing chronic diseases, and support for prompt and real-time analyses of large sets of varied input data to diagnose and predict disease outcomes. CLINICALTRIAL International Prospective Register of Systematic Reviews (PROSPERO) CRD42020214048; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=214048
Lu He, Tingjue Yin, Zhaoxian Hu, Yunan Chen, David A Hanauer, Kai Zheng
Journal of the American Medical Informatics Association, Volume 28, pp 1125-1134; https://doi.org/10.1093/jamia/ocaa298

Abstract:
Objective Sentiment analysis is a popular tool for analyzing health-related social media content. However, existing studies exhibit numerous methodological issues and inconsistencies with respect to research design and results reporting, which could lead to biased data, imprecise or incorrect conclusions, or incomparable results across studies. This article reports a systematic analysis of the literature with respect to such issues. The objective was to develop a standardized protocol for improving the research validity and comparability of results in future relevant studies. Materials and Methods We developed the Protocol of Analysis of senTiment in Health (PATH) based on a systematic review that analyzed common research design choices and how such choices were made, or reported, among eligible studies published 2010-2019. Results Of 409 articles screened, 89 met the inclusion criteria. A total of 16 distinctive research design choices were identified, 9 of which have significant methodological or reporting inconsistencies among the articles reviewed, ranging from how relevance of study data was determined to how the sentiment analysis tool selected was validated. Based on this result, we developed the PATH protocol that encompasses all these distinctive design choices and highlights the ones for which careful consideration and detailed reporting are particularly warranted. Conclusions A substantial degree of methodological and reporting inconsistencies exist in the extant literature that applied sentiment analysis to analyzing health-related social media data. The PATH protocol developed through this research may contribute to mitigating such issues in future relevant studies.
, William G. Dixon, Andrew Roddam, Kueiyu Joshua Lin, Gillian C. Hall, Jeffrey R. Curtis, Sabine N. Van Der Veer, Montse Soriano‐Gabarró, Juliane K. Mills, Jacqueline M. Major, et al.
Pharmacoepidemiology and Drug Safety, Volume 29, pp 1540-1549; https://doi.org/10.1002/pds.5169

The publisher has not yet granted permission to display this abstract.
BMC Medical Informatics and Decision Making, Volume 20, pp 1-25; https://doi.org/10.1186/s12911-020-01201-2

Abstract:
Background: Computer Aided Diagnostics (CAD) can support medical practitioners to make critical decisions about their patients’ disease conditions. Practitioners require access to the chain of reasoning behind CAD to build trust in the CAD advice and to supplement their own expertise. Yet, CAD systems might be based on black box machine learning models and high dimensional data sources such as electronic health records, magnetic resonance imaging scans, cardiotocograms, etc. These foundations make interpretation and explanation of the CAD advice very challenging. This challenge is recognised throughout the machine learning research community. eXplainable Artificial Intelligence (XAI) is emerging as one of the most important research areas of recent years because it addresses the interpretability and trust concerns of critical decision makers, including those in clinical and medical practice. Methods: In this work, we focus on AdaBoost, a black box model that has been widely adopted in the CAD literature. We address the challenge – to explain AdaBoost classification – with a novel algorithm that extracts simple, logical rules from AdaBoost models. Our algorithm, Adaptive-Weighted High Importance Path Snippets (Ada-WHIPS), makes use of AdaBoost’s adaptive classifier weights. Using a novel formulation, Ada-WHIPS uniquely redistributes the weights among individual decision nodes of the internal decision trees of the AdaBoost model. Then, a simple heuristic search of the weighted nodes finds a single rule that dominated the model’s decision. We compare the explanations generated by our novel approach with the state of the art in an experimental study. We evaluate the derived explanations with simple statistical tests of well-known quality measures, precision and coverage, and a novel measure stability that is better suited to the XAI setting. Results: Experiments on 9 CAD-related data sets showed that Ada-WHIPS explanations consistently generalise better (mean coverage 15%-68%) than the state of the art while remaining competitive for specificity (mean precision 80%-99%). A very small trade-off in specificity is shown to guard against over-fitting which is a known problem in the state of the art methods. Conclusions: The experimental results demonstrate the benefits of using our novel algorithm for explaining CAD AdaBoost classifiers widely found in the literature. Our tightly coupled, AdaBoost-specific approach outperforms model-agnostic explanation methods and should be considered by practitioners looking for an XAI solution for this class of models.
Yang Liu,
Journal of Medical Internet Research, Volume 22; https://doi.org/10.2196/13745

Abstract:
Maintaining a healthy weight can reduce the risk of developing many diseases, including type 2 diabetes, hypertension, and certain types of cancers. Online social media platforms are popular among people seeking social support regarding weight loss and sharing their weight loss experiences, which provides opportunities for learning about weight loss behaviors. This study aimed to investigate the extent to which the content posted by users in the r/loseit subreddit, an online community for discussing weight loss, and online interactions were associated with their weight loss in terms of the number of replies and votes that these users received. All posts that were published before January 2018 in r/loseit were collected. We focused on users who revealed their start weight, current weight, and goal weight and were active in this online community for at least 30 days. A topic modeling technique and a hierarchical clustering algorithm were used to obtain both global topics and local word semantic clusters. Finally, we used a regression model to learn the association between weight loss and topics, word semantic clusters, and online interactions. Our data comprised 477,904 posts that were published by 7660 users within a span of 7 years. We identified 25 topics, including food and drinks, calories, exercises, family members and friends, and communication. Our results showed that the start weight (β=.823; P<.001), active days (β=.017; P=.009), and median number of votes (β=.263; P=.02), mentions of exercises (β=.145; P<.001), and nutrition (β=.120; P<.001) were associated with higher weight loss. Users who lost more weight might be motivated by the negative emotions (β=−.098; P<.001) that they experienced before starting the journey of weight loss. In contrast, users who mentioned vacations (β=−.108; P=.005) and payments (β=−.112; P=.001) tended to experience relatively less weight loss. Mentions of family members (β=−.031; P=.03) and employment status (β=−.041; P=.03) were associated with less weight loss as well. Our study showed that both online interactions and offline activities were associated with weight loss, suggesting that future interventions based on existing online platforms should focus on both aspects. Our findings suggest that online personal health data can be used to learn about health-related behaviors effectively.
, Matthew Tunis, Kelsey Young, Coraline Doan, Howard Swerdfeger,
Published: 4 June 2020
Canada Communicable Disease Report, Volume 46, pp 161-168

The publisher has not yet granted permission to display this abstract.
Yongtai Liu, Chao Yan, Zhijun Yin, Zhiyu Wan, Weiyi Xia, Murat Kantarcioglu, Yevgeniy Vorobeychik, Ellen Wright Clayton, Bradley A Malin
AMIA ... Annual Symposium proceedings. AMIA Symposium, Volume 2019, pp 607-616

The publisher has not yet granted permission to display this abstract.
Robin Huang, , Mary Ann Nicdao, Mary Mikaheal, Tanya Baldacchino, Annabelle Albeos, Kathy Petoumenos, Kamal Sud, Jinman Kim
Journal of the American Medical Informatics Association, Volume 27, pp 185-193; https://doi.org/10.1093/jamia/ocz183

Abstract:
Objective To investigate the relationship between emotion sharing and technically troubled dialysis (TTD) in a remote patient monitoring (RPM) setting. Materials and Methods A custom software system was developed for home hemodialysis patients to use in an RPM setting, with focus on emoticon sharing and sentiment analysis of patients’ text data. We analyzed the outcome of emoticon and sentiment against TTD. Logistic regression was used to assess the relationship between patients’ emotions (emoticon and sentiment) and TTD. Results Usage data were collected from January 1, 2015 to June 1, 2018 from 156 patients that actively used the app system, with a total of 31 159 dialysis sessions recorded. Overall, 122 patients (78%) made use of the emoticon feature while 146 patients (94%) wrote at least 1 or more session notes for sentiment analysis. In total, 4087 (13%) sessions were classified as TTD. In the multivariate model, when compared to sessions with self-reported very happy emoticons, those with sad emoticons showed significantly higher associations to TTD (aOR 4.97; 95% CI 4.13–5.99; P = < .001). Similarly, negative sentiments also revealed significant associations to TTD (aOR 1.56; 95% CI 1.22–2; P = .003) when compared to positive sentiments. Discussion The distribution of emoticons varied greatly when compared to sentiment analysis outcomes due to the differences in the design features. The emoticon feature was generally easier to understand and quicker to input while the sentiment analysis required patients to manually input their personal thoughts. Conclusion Patients on home hemodialysis actively expressed their emotions during RPM. Negative emotions were found to have significant associations with TTD. The use of emoticons and sentimental analysis may be used as a predictive indicator for prolonged TTD.
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