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Infodemics.pptx
1. INFODEMICS AND HEALTH MISINFORMATION:
A SYSTEMATIC REVIEW OF REVIEWS
@davidnovillo
David Novillo Ortiz
David Novillo-Ortiz
Regional Adviser, Data and Digital Health
Division of Country Health Policies and Systems
World Health Organization, regional office for Europe
dnovillo@who.int
6. 6
The practical and factual relationship between “infodemic” and SARS-CoV-2 pandemic
High volume of academic
research and publications
The “NEJM” remarkable
case
Prompt and timely
recognition by the WHO
Series of international
call into action
Are they all reliable? Elevated number of
retracted data
CDC + ECDC +
States actions
Series of actions
against “infodemic”
FACTS AND PRACTICAL CONTEXTUALIZATION
7. Global partnership
with States for
infodemic management
Collaboration with
universities and research
institutes
Diverse number of
trainings in
infodemic
management
Production of
high-quality
evidence-based
scientific research
Numerous actions have been taken up lately to overcome the harm that the rapid and severe spread of untrustworthy informationmay rise
WHO ACTIONS TO FIGHT “INFODEMIC”
8. Title
Date Date Date Date
Date
Our research team questioned four main topics:
AS FAR AS EVIDENCE-BASED RESEARCH ASSOCIATED WITH “INFODEMIC”
“To what extent are evidence-based studies addressing peculiarities and singularities associated with
infodemics?”
“What type of information on the topic of infodemics are published in systematic reviews?”
“What main challenges, opportunities and recommendations addressing infodemics did systematic review authors
highlight?”
“What is the methodological and reporting quality of published systematic reviews conveying research
questions related to infodemic?”
9. METHODOLOGY
Selection of
systematic or
mini-reviews
Protocol
preparation and
submission
Search strategy
Study selection
(Two phases)
Data extraction
Quality
assessment
Evidence
synthesis and
analysis
Based on the PICO format
Available evidence correlated to infodemics, misinformation,
disinformation, health communication, information overload
and fake news
PROSPERO Designed by specialists and a
Cochrane librarian
Qualitative data extraction AMSTAR 2 tool GRADE appraoch
Following standard guidelines
11. 11
Massive academic
attention to understand
better the dynamic of
“infodemic”
RESULTS AND MAIN FINDINGS
Based on our four main guiding questions, we found:
1. “To what extent are evidence-based studies addressing peculiarities and singularities associated with infodemics?”
2. “What type of information on the topic of infodemics are published in systematic reviews?”
Diverse type of
information has been
published (categorized
into 5 major areas)
12. Subtitle
Text Text
RESULTS AND MAIN FINDINGS
Text
• In total, 1034 primary studies were included;
• Twelve infectious diseases were directly associated
with the terms defined;
• Three major topics (vaccination hesitancy, disaster
communication and disease outbreaks) were
reported among included systematic reviews
Source: Borges do Nascimento, 2022
13. • Based on semantic similarity of reviews’ highlights, we classified and categorized reviews’ findings into six major
categories:
1. Effects of infodemics, misinformation, disinformation and fake news;
2. Source of health misinformation propagation ;
3. Proportion of health misinformation on social media;
4. Adequate use of social media;
5. Corrective interventions;
6. Overall quality of publications during infodemics.
10
6
4
8
4
3
Frequency of cited categories
1 2 3 4 5 6
RESULTS AND MAIN FINDINGS
Source: Borges do Nascimento, 2022
14. RESULTS AND MAIN FINDINGS
1. Effects of infodemics, misinformation,
disinformation and fake news;
2. Source of health misinformation propagation;
3. Proportion of health misinformation on social
media;
4. Adequate use of social media;
5. Corrective interventions;
6. Overall quality of publications during
infodemics.
Source: Borges do Nascimento, 2022
15. 15
Massive academic
attention to understand
better the dynamic of
“infodemic”
Based on our four main guiding questions, we found:
3. “What main challenges, opportunities and recommendations addressing infodemics did systematic review authors
highlight?”
Diverse type of
information has been
published
Great list for “problem
seekers” and “problem
solvers”
RESULTS AND MAIN FINDINGS
16. RESULTS AND MAIN FINDINGS – Main opportunities
Notable
and
urgent
needs
Evaluate the impacts of infodemics holistically
Understand the finest mechanisms to counteract infodemic
Analyze the effectiveness and potential superiority of social media over
traditional media
Assess the relationship between infodemic and mental sickening
Explore the impacts of infodemic in other diseases
17. How to associate high-quality
systematic reviews and the need for
fast studies
How the knowledge can be used in
clinical practice
Implementation of partnerships with
multiple stakeholders
Unlimited opportunities
RESULTS AND MAIN FINDINGS – Main opportunities
18. RESULTS AND MAIN FINDINGS – Main challenges
Studies
overlapping
Follow-up
real time
updates
Low
quality of
studies
Training for
healthcare
professionals
Creation of
interconnect
ed and
reliable
platforms
Populational
awareness
Regulatory
challenges
Difficulties to
study
information per
si
Upcoming
technologies/apps
Social
awareness
Real actions
from
authorities
Fight
radical
groups
Source: Borges do Nascimento, 2022
19. 19
Massive academic
attention to understand
better the dynamic of
“infodemic”
RESULTS AND MAIN FINDINGS
Based on our four main guiding questions, we found:
4. “What is the methodological and reporting quality of published systematic reviews conveying research questions related to
infodemic?”
Diverse type of
information has been
published
Improvement is more
than needed
Great list for “problem
seekers” and “problem
solvers”
20. RESULTS AND MAIN FINDINGS
DIRECT EFFECT ON THE QUALITY OF THE EVIDENCE
Source: Borges do Nascimento, 2022
21. 01 02 03 04 05
The mental, social, political, and economic distress related to
infodemic is real!
And take-away messages
CONCLUSIONS
Presently, there is an unmeasurable number of possibilities to
use the best information can offer for us, in a safe and effective
way.
22. 01 02 03 04 05
Borges do Nascimento IJ, Pizarro AB, Almeida JM, Azzopardi-Muscat N, Gonçalves MA, Björklund M, Novillo-Ortiz D. Infodemics and health
misinformation: a systematic review of reviews. Bull World Health Organ. 2022 Sep 1;100(9):544-561. doi: 10.2471/BLT.21.287654. Epub 2022 Jun 30.
PMID: 36062247; PMCID: PMC9421549.
Government of Western Australia. Library. How to guides (OPH): How to do a systematic review. (1055).
https://scgophlibrary.health.wa.gov.au/c.php?g=573283&p=3952946
REFERENCES
23. Israel J Borges do Nascimento Ana Beatriz Pizzaro Jussara M Almeida Natasha Azzopardi-Muscat
Without them we could not have reached so far
People who contributed to this project
Marcos André Gonçalves Maria Björklund
24. Email
@Twitter
LinkedIn
Name / Title
Regional Adviser, Data and Digital Health
Division of Country Health Policies and Systems
World Health Organization, regional office for Europe
Thank you
For more information, please contact:
David Novillo-Ortiz
Regional Adviser, Data and Digital Health
Division of Country Health Policies and Systems
World Health Organization, regional office for Europe
dnovillo@who.int
@davidnovillo
David Novillo-Ortiz
Editor's Notes
§ 1 Basic introduction – Important to state that this presentation regards to a paper recently pubished at the Bulletin of the World Health Organization, as a part of actions promoted by the World Health Organization against infodemics.
§ None of the researchers involved in this study has any conflicts of interest to declare.
§ Here is the heading of the paper about to be presented.
§ The study was published on September 1st, 2023.
§ This slide is simply prepare to guide our presentation, which will contain a brief contextualization of the topic, a short explanation of the methodology utilized in the study, and our main results and discussions raised by the group.
§ After the COVID-19 pandemic, a bunch of words (with probably correlated meaning) became quite popular.
§ It is worthwhile saying that although similar, these words are not the same. Therefore, by “infodemic” we mean the rapid and far-reaching spread of both accurate and inaccurate information about something, such as a disease. The word is a portmanteau of "information" and "epidemic." As facts, rumors, and fears mix and disperse, it becomes difficult to learn essential information about an issue. In addition, “disinformation” became similarly popular, relating to the existence of false information, while “misinformation” regards to the existence and dissemination of misleading information to the population. In all those different contexts, “fake news” appears as a modulator term in the world of “infodemics”, related to the false or misleading information presented as news.
§ Regardless the type of nomination, these social events significantly affects the functioning of healthcare systems worldwide.
§ Notably, during the COVID-19 pandemic, a lot of information had been published. And that makes us question “are they all reliable?”, “are they all safe to be set a the main resource of information?”
§ And the honest answer is “no”! A great example of unreliable information, sometimes published in top-ranked scientific journals, is the NEJM case, which Ivermectin was primarily considered a great medicine against COVID-19 in the early stage of the pandemic. However, after massive number of attacks and questionning, the paper was retracted due to limited evidence and lack of experimentals proofs.
§ Attempting to avoid the increase of “unreliable scientific information publication”, several health authorities worldwide (such as the CDC, ECDC, and States) started to create programs and actions to counteract the rapid spreading of misleading, false, or inconclusive scientific information, particularly for more socially vulnerable populations.
§ The WHO would not stay out of this actions, and timely recognized the danger of “infodemics” and launched a series of actions against it.
§ Importantly, the WHO has created global partnerships with associated States for infodemic management, which member States have recognized the importance and need of an infodemic response through resolutions and responding to calls for actions. The WHO created partnerships across all societies to respond to the COVID-19 infodemic and had developed country tools for infodemic management that can be used now and for future infodemics.
§ In addition, during the COVID-19 pandemic, WHO had worked with the UN family, tech sector, media, civil society and other amplifying communities to understand concerns, co-develop messages, extend the reach of health information, and to respond to the information needs of communities. WHO also worked with academia to develop a public health research agenda for infodemic management, and with a diverse group of experts to develop a competency framework and training in infodemic management.
§ The WHO has championed universal access to credible health information and built resilience to misinformation for people worldwide. At the same time, more efforts has been needed to better understand the scale of the infodemic, and impact of strategies used to manage it, in order to develop new toolkits for countries. Through regional networks, such as the Africa Infodemic Response Alliance, WHO has fostered new approaches to meet changing needs for an evolving health emergency infodemic response. This is providing a foundation for further collaborations to also improve preparedness and early detection of emerging and resurgent health threats.
§ An additional activity and axys of the actions governed by the WHO associates with the creation of partnerships across the society to strengthen the scientific discipline of infodemiology. The purpose is to build and deliver sustainable tools that health authorities and communities can use to prevent and overcome the harmful impacts caused by infodemics.
Through partnerships, WHO works to bolster digital capabilities and leverage social inoculation principles to foster higher digital and health literacy, build resilience to misinformation, and deliver innovative ways to reach communities with reliable health information. And our study is part of this research and innovation core set.
§ By the time of execution of this project, some questions about infodemics was wafting in the air and it included the four guiding question presented in the slide:
1. “To what extent are evidence-based studies addressing peculiarities and singularities associated with infodemics?”
2. “What type of information on the topic of infodemics are published in systematic reviews?”
3. “What main challenges, opportunities and recommendations addressing infodemics did systematic review authors highlight?”
4. “What is the methodological and reporting quality of published systematic reviews conveying research questions related to infodemic?”
And holistically this four guiding questions were considered as extremely important points to be systematically evaluated.
§ For answering the previously presented questions, we carried out a systematic review of systematic reviews, to obtain the best evidence available in the four core areas before mentioned highlighted.
§ A systematic review is a synthesis method of the evidence on a clearly presented topic using critical methods to identify, define and assess research on the topic. A systematic review extracts and interprets data from published studies on the topic, then analyzes, describes, and summarizes interpretations into a refined conclusion.
§ In short aspects, a group of articles is selected based on pre-selected words and identifiers, which posteriorly are selected in two phases (title and abstract screening and full text evaluation). The shortlisted and eligible studies undergo data extraction, quality assessment, and are finally summarized using evidence synthesis methods and assessment tools.
§ Graphically, the entire process can be summarized as this.
§ Regading our first two review questions (“To what extent are evidence-based studies addressing peculiarities and singularities associated with infodemics?” and “What type of information on the topic of infodemics are published in systematic reviews?”), we found a massive attention by the academia to understand the dynamic of infodemic and a diverse type of information recently published.
§ We identified 9008 records and after removing 443 duplicates, we screened 8565 studies of which 111 were eligible for full-text assessment. Of these, we excluded 80 studies due to the shown reasons. Finally, we included 31 systematic reviews, of which 17 studies were published between 2018 and 2022, three awaiting classification (we were unable to retrieve full text during our review) and 11 ongoing reviews.
§ Out of 17 published systematic reviews, 14 were published after the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak.The published reviews included 1034 primary studies covering 12 infectious diseases and three major topics (vaccination hesitancy, disaster communication and disease outbreaks) related to infodemics, misinformation, disinformation, fake news or any other variation of these terms. The included reviews covered 19 official scientific databases.
§ We categorized in the findings from included studies into five major semantic grous + the assessment of overall quality of publications during infodemics
§ In red, there are the most important points to be cited, for each major category created.
§ Give special emphasis to the important action of infodemic on people’s mental health, as it increase social fear, panic, stress, and the development of mental disorders.
§ We investigated the challenges, opportunities, and raised potential recommendations for addressing infodemics, as our third review question associated to this assessment.
§ In short terms, there is a wide list of opportunities to be cited.
Below, it is extracted the opportunities listed throughout the paper.
Main opportunities:
•Further focus on different aspects of the impact and reliability of SARS-CoV-2-related or any other health emergency information.
• There is a need to balance the gold standard systematic reviews with faster pragmatic studies.
• How to precisely combat the determinants of health misinformation during pandemics and subsequent infodemics across different social media platforms.
• Opportunities of studies comparing the use of social media interventions with traditional methods in the dissemination of clinical practice guidelines.
• Researchers could analyse communication patterns between citizens and frontline workers in the public health context, which may be useful
to design counter-misinformation campaigns and awareness interventions.
• A multidisciplinary specialist team could concentrate on the analysis of governmental and organizational interventions to control misinformation
at the level of policies, regulatory mechanisms and communication strategies.
• Studies should address the impact of fake news on social media and its influence on mental health and overall health.
• Future studies should examine how social media users process the emerging infectious diseases-related information they receive.
• Focus should be given to how users evaluate the validity and accuracy of such information and how they decide whether they will share the
information with their social media contacts.
• Further interdisciplinary research should be warranted to identify effective and tailored interventions to counter the spread of health-related
misinformation online.
§ In short terms, there is a wide list of opportunities to be cited.
Below, it is extracted the opportunities listed throughout the paper.
Main opportunities:
•Further focus on different aspects of the impact and reliability of SARS-CoV-2-related or any other health emergency information.
• There is a need to balance the gold standard systematic reviews with faster pragmatic studies.
• How to precisely combat the determinants of health misinformation during pandemics and subsequent infodemics across different social media platforms.
• Opportunities of studies comparing the use of social media interventions with traditional methods in the dissemination of clinical practice guidelines.
• Researchers could analyse communication patterns between citizens and frontline workers in the public health context, which may be useful
to design counter-misinformation campaigns and awareness interventions.
• A multidisciplinary specialist team could concentrate on the analysis of governmental and organizational interventions to control misinformation
at the level of policies, regulatory mechanisms and communication strategies.
• Studies should address the impact of fake news on social media and its influence on mental health and overall health.
• Future studies should examine how social media users process the emerging infectious diseases-related information they receive.
• Focus should be given to how users evaluate the validity and accuracy of such information and how they decide whether they will share the
information with their social media contacts.
• Further interdisciplinary research should be warranted to identify effective and tailored interventions to counter the spread of health-related
misinformation online.
It is a reality that to achieve greater results in combating infodemics, it is crucial to fight against:
• Overlap of studies covering the same topic.
• Overall low quality of studies and the excessive and inordinate media attention given to these studies.
• Creation and use of reliable health-related information and scientific evidence considering real-time updates.
• Inadequate orientation of the population and medical providers into wrong pharmacological and non-pharmacological interventions.
• New trends in personal content creation are constantly emerging, such as TikTok, which represent new challenges for regulation.
• Further understanding the economic impact of misinformation, the difference in distribution of health misinformation in low- and high-income
countries and the real impact of antivaccine activism groups.
• Decisive and pro-active actions are required from government authorities and social media developers to avoid the destruction of positive
achievements that social media has already promoted.
• The difficulty of characterizing and evaluating the quality of the information on social media.
§ Lastly, we investigated the methodological and reporting quality of published literature related to infodemic.
§ Turned out that 16 reviews (94.1%) scored as having critically low quality across most major domains. Only one review showed a moderate risk of bias for most domains. Meta-analysis was conducted in only two reviews, which used appropriate statistical methods and considered the potential impact of risk of bias in each of the primary studies. All themes had low quality, except the proportion of health-related misinformation which had very low quality of evidence.
§ Based on the available evidence, people are feeling mental, social, political and/or economic distress due to misleading and false health-related content on social media during pandemics, health emergencies and humanitarian crises.
§ Although the literature exponentially increases during health emergencies, the quality of publications remains critically low.
§ Future studies need improved study design and reporting. Local, national and international efforts should seek effective counteractive measures against the production of misinformative materials on social media. Future research should investigate the effectiveness and safety of computer-driven corrective and interventional measures against health misinformation, disinformation and fake news and tailor ways to share health-related content on social media platforms without distorted messaging.
§ Big data analytics provide public health and health care with powerful instruments to gather and analyze large volumes of heterogeneous data.
§ Although research in this field has been growing exponentially in the last decade, the overall quality of evidence is found to be low to moderate.
§ High variability of results was observed across different ML techniques and approaches, even for the same disease or condition.
§ The diversity of big data tools and ML algorithms require proper standardization of protocols and comparative approaches, and the process of tuning the hyperparameters of the algorithms is not uniformly reported.
§ Important characteristics essential for replicability and external validation were not frequently available.
