Characterizing the Discussion of Antibiotics in the Twittersphere: What is the Bigger Picture?

Background User content posted through Twitter has been used for biosurveillance, to characterize public perception of health-related topics, and as a means of distributing information to the general public. Most of the existing work surrounding Twitter and health care has shown Twitter to be an effective medium for these problems but more could be done to provide finer and more efficient access to all pertinent data. Given the diversity of user-generated content, small samples or summary presentations of the data arguably omit a large part of the virtual discussion taking place in the Twittersphere. Still, managing, processing, and querying large amounts of Twitter data is not a trivial task. This work describes tools and techniques capable of handling larger sets of Twitter data and demonstrates their use with the issue of antibiotics. Objective This work has two principle objectives: (1) to provide an open-source means to efficiently explore all collected tweets and query health-related topics on Twitter, specifically, questions such as what users are saying and how messages are spread, and (2) to characterize the larger discourse taking place on Twitter with respect to antibiotics. Methods Open-source software suites Hadoop, Flume, and Hive were used to collect and query a large number of Twitter posts. To classify tweets by topic, a deep network classifier was trained using a limited number of manually classified tweets. The particular machine learning approach used also allowed the use of a large number of unclassified tweets to increase performance. Results Query-based analysis of the collected tweets revealed that a large number of users contributed to the online discussion and that a frequent topic mentioned was resistance. A number of prominent events related to antibiotics led to a number of spikes in activity but these were short in duration. The category-based classifier developed was able to correctly classify 70% of manually labeled tweets (using a 10-fold cross validation procedure and 9 classes). The classifier also performed well when evaluated on a per category basis. Conclusions Using existing tools such as Hive, Flume, Hadoop, and machine learning techniques, it is possible to construct tools and workflows to collect and query large amounts of Twitter data to characterize the larger discussion taking place on Twitter with respect to a particular health-related topic. Furthermore, using newer machine learning techniques and a limited number of manually labeled tweets, an entire body of collected tweets can be classified to indicate what topics are driving the virtual, online discussion. The resulting classifier can also be used to efficiently explore collected tweets by category and search for messages of interest or exemplary content.