Does Direct-to-Consumer Advertising Lead To Stimulated Reporting of Adverse Events in Social Media?
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This document summarizes a study examining whether direct-to-consumer advertising leads to stimulated adverse event reporting on social media. The study analyzed over 4,000 potential adverse event reports related to 58 pharmaceutical products mentioned on Twitter between 2014-2015. It found higher rates of potential adverse event reports per 1,000 Twitter users and per 1,000 product mentions in the United States compared to the United Kingdom, Canada, and Australia. The study aims to understand the relationship between direct-to-consumer advertising and adverse event reporting on social media.
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Does Direct-to-Consumer Advertising Lead To Stimulated Reporting of Adverse Events in Social Media?
- 1. NabarunDasgupta,CarriePierce,ChristopherMenone,KateO’Brien,MelissaJordan,CarlyWinokur, MichaelGilbert,Clark Freifeld,HaroldRodriguez,ChiBahk,JohnBrownstein August25, 2015 –ICPEBoston Slidesavailablenow @epidemico Does Direct-to-ConsumerAdvertising LeadtoStimulated ReportingofAdverse Eventsin SocialMedia?
- 2. 01. USA A public-privatepartnershipenteringYear 2. TheWEB-RADR projectis supportedbythe InnovativeMedicinesInitiativeJoint Undertaking(IMI JU)undergrant agreementn° 115632,resourcesof which arecomposedof financialcontributionfrom theEuropean Union'sSeventhFrameworkProgramme (FP7/2007-2013)andEFPIAcompanies’in kind contribution. 02. EUROPE GSK hasbeena development partnerto extendthetechnology platformto meet the standardsof regulatedsoftwarefor thelastyear andhalf. 03. INDUSTRY Disclosures Funding Sources FDA hasbeenfunding theresearch intothe technologyfor3 years throughthe Office of the Chief Scientist. EPIDEMICO, Inc.+ EPIDEMICO, Ltd. Authorsare employeesorconsultants.Epidemico iscommercializingaspectsof thissoftwareplatform. Epidemicois a whollyownsubsidiaryof BoozAllenHamilton.
- 3. Dyspareunia Influenza Diabetes Weight loss Atrial fibrillation Psoriasis COPD COPD IBS Smoking cessation Diabetes Depression Arthritis Arthritis Fibromyalgia Arthritis Depression ED Atrial fibrillation ED 2014 Direct-to-Consumer Spending Includesbroadcast, print, outdoor, and B2B Source: Medical Marketing & Media DTC Report 2015 Osphena Tamiflu Invokana Belviq Xarelto Humira Symbicort Breo Ellipta Linzess Chantix Lyrica Abilify Celebrex Humira Lyrica Xeljanz Latuda Viagra Eliquis Cialis $0M $50M $100M $150M $200M $250M
- 4. SCIENTISTS: TAVARES G, FAISAL A. PLOS ONE. 2013 PMID: 23843945 JOURNALISTS: REYES J SIMMONS L, FALLON S FOR WIRED, OCTOBER 2013 ARTISTS: KEIFER C & POELL J, ONFORMATIVE
- 6. Remove false positives (optional) Hypothesis generation Automated processes to identifyevents and clean data Collect public social mediadata Synthesis of information from other sources Acquire Curate Causation StatisticsFilter D A T A P R O C E S S O V E R V I E W
- 8. Geotag Geographyidentified if availableusing GoogleAPI 4 3 2 1 Consolidate Multiplicatecopies& postsfrom sameuser consolidated (PIIremoved) Translate Internetvernacularto MedDRAv18 preferred terms Identify Events AutomatedNLP Bayesian classifier Machinelearning A U T O M A T E D P R O C E S S E S
- 9. Spelling VariationsCombined or invented wordsImplied phrasesInternet Vernacular Translation lost their eyesight seeing weird color seeing weird colour doublevision uldn’t see double vision blind googley eyed blurry vision changes in viscross eyed seeing weird vision change blindness cross visionvisual snow googly eyed seeing doub making me eat like a mouse anorexic st appetite #notevenhungry appetite is nonexistent apetite surpressed didn’t get hungry dont want to eat killed my apetite miss feeling hung killed my appetite can’t eat lost apetite lost my appetite no appetitey lack of apetite stomach small lost teh appetite never hnever want to eat cant eat coucrosseyed blurry apetite surpressed killed my apetite lost apetite lack of apetite lost teh appetite Typos seeing weird color seeing weird colour googley eyed googly eyed #notevenhungry no appetitey making me eat like a mouse never want to eat
- 10. Visual impairment MedDRA 10047571 Visual impairment SNOMED 397540003 Decreased appetite MedDRA 10061428 Loss of appetite SNOMED 79890006 making me eat like a mouse anorexic st appetite #notevenhungry appetite is nonexistent apetite surpressed didn’t get hungry dont want to eat miss feeling hung killed my appetite can’t eat lost apetite lost my appetite no appetitey lack of apetite stomach small lost teh appetite never hnever want to eat cant eat lost their eyesight seeing weird color seeing weird colour doublevision uldn’t see double vision blind googley eyed blurry vision changes in viscross eyed seeing weird vision change blindness cross visionvisual snow googly eyed seeing doub coucrosseyed blurry killed my apetite
- 11. P r o t o - A E P o s t s w i t h R e s e m b l a n c e t o A d v e r s e E v e n t s
- 12. Manually classified to identifyAEs Precision - Positive predictive value Recall - Sensitivity Posts mentioning medical products 57M 380k 68% 88% S Y S T E M P E R F O R M A N C E
- 13. Methods - PublicTwitterposts - 58products (see appendix) - Feb’14toJul ‘15(18 months) - Geotagged - Englishlanguage DataSource - Time ofdaypatterns - USvs.AU/CA/UK - DTCRxproducts (withTV ads) Design - RateofProto-AEsper1000 Mentions - RateofProto-AEsper1M Twitter users - Poissonmodelsbycountry Statistics - Effectofnon-TV advertising uniformbetweencountries Assumptions M E T H O D S
- 14. RemoveSpam, news, coupons 67% of posts were spam Consolidate multiplicate copies 35% Excludingliteral duplicates and retweets Keep postswith in-scope geography Keep posts from US, UK, CA, AU Identifiable geographyfor 55% of Proto-AEs Import Twitter Posts All DTCproducts LimittoEnglish Language Only6 posts with unknownlanguage Identify Postswith Proto-AEs Automated classifier Exclude Chantix/Champix DTCadvertising allowed in non-UScountries 1,245,530 408,867 338,263 218,512 11,265 5,535 4,499 D A T A P R O C E S S I N G
- 15. Tweetsper15MinuteIncrement 0 5,000 10,000 15,000 20,000 25,000 30,000 All Public Twitter Posts Mentions (spam & bots removed) Proto-AEs 0:00 4:00 8:00 12:00 16:00 20:00 24:00 Hour of the Day (local time) Daytime Television Prime TimeEvening News
- 16. Tweetsper15MinuteIncrement 0 1,000 2,000 3,000 4,000 5,000 6,000 7,000All Mentions TV Discussions Rate of Proto-AEs per 100 Mentions LOESS - Proto-AE Rate per 100 Mentions 0:00 4:00 8:00 12:00 16:00 20:00 24:00 Hour of the Day (local time) Daytime Television Prime TimeEvening News All mentions Television
- 17. Tweetsper15MinuteIncrement 0 50 100 150 200 250 300 350 0:00 4:00 8:00 12:00 16:00 20:00 Proto-AEs 0:00 24:00 Hour of the Day (local time) Daytime Television Prime Time
- 20. Results 64.8 (60.2, 69.7) 83.7 (72.8, 96.3) 111.5 (92.8, 134.0) 89.0 (78.9, 100.3) Canada Australia United States United Kingdom R A T E S p e r 1 M T w i t t e r U s e r s 18 month study period
- 21. Results 31.6 (30.0, 33.2) 31.7 (27.5, 36.4) 39.2 (32.0, 48.0) 25.5 (22.7, 28.6) Canada Australia United States United Kingdom R A T E S p e r 1 0 0 0 M e n t i o n s 18 month study period
- 22. Missing Geotags Only used half of Mentions. Causality Can patients assess reliably? Falsepositives Can we improve precision? DifferingPopulations Tweeters vs. Disease vs. Rx ChoiceofDenominators How mature is our understanding? Whatis the bias amongthosewho allow location disclosure? Define methods to measureprobability of realworld significance Thepopulations to whomthe ads are targeted are likely to be older than most Twitter users. Manualcurationcanimprove positive predictive value. Use different denominatorsto understand the nuances. L I M I T A T I O N S
- 23. CarrieMike Aranka Ciara Nabarun Wenjie Harold John Robin Chi Sue Kelly Kate Clark Chris Robin Derek Matt Essam Melissa Kyra Nico Lou Carly Lucas
- 24. @epidemico @WEBRADR demo.medwatcher.org nabarun@epidemico.com C O N T A C T U S
- 25. No DTC tv ads juxtapid|amyvid|seretide|incivek|incivo|copaxone|saphris|sycrest|avonex gleevec|doxil|aptiom|viread|firmagon|tarceva|kapvay|zmax|aranesp|xenazine tetrabenazine|vantas|vascepa|natroba All products with DTC Cialis Lyrica Gardasil Cymbalta Chantix Champix Abilify Viagra Humira Botox Celebrex Xarelto Enbrel Latuda Advair Seretide Zostavax Victoza Orencia Pradaxa Symbicort Crestor Stelara Breo Ellipta Restasis Januvia Spiriva Xeljanz Incivek Incivo Axiron Copaxone Eliquis Prolia Invokana Farxiga Intuniv Saphris Avonex Anoro Ellipta Gleevec Exelon Patch Exelon Doxil Aptiom Viread Firmagon Tarceva Kapvay Zmax Aranesp Xenazine Tetrabenazine Vantas Vascepa Juxtapid Amyvid Natroba
Editor's Notes
- A total of 18,906 ads appeared in the 504-hour sample, including 907 OTC drug ads (4.8%) and 428 prescription (Rx) drug ads (2.3%), which together occupied about 8% of all commercial airtime. Although OTC drug ads were more common, Rx drug ads on average were significantly longer. Our findings suggest that Americans who watch average amounts of television may be exposed to more than 30 hours of direct-to-consumer drug advertisements each year, far surpassing their exposure to other forms of health communication. For every one pharma ad, you will see 6 car ads.
- Direct-to-consumer drug ads appeared most frequently during news programs and soap operas and during the middle-afternoon and early-evening hours. J Health Commun. 2004 Nov-Dec;9(6):491-7. Summer 2001 Direct-to-consumer drug advertisements on network television: an exploration of quantity, frequency, and placement. Brownfield ED1, Bernhardt JM, Phan JL, Williams MV, Parker RM.
- Mike, Matt, Nico, Melissa, Carly, Essam, Derek, Lucas, Kyra, Lou