Facebook: An Innovative Influenza Pandemic Early Warning System
description
Transcript of Facebook: An Innovative Influenza Pandemic Early Warning System
Facebook: An Innovative Influenza Pandemic Early Warning System
Presented by Chen Luo (MBCHB 4) Supervisors: Dr Chris Paton and Dr Robyn Whittaker
Background
• No introduction needed. Influenza is a serious disease – 250,000 – 500 000 deaths worldwide/yr among the
vulnerable (WHO 2003)
– Lost productivity: $71-167 billion (USA)– Here to stay. Rapidly evolving virus – swine flu
• Current surveillance – clinical and virology based on network of primary health doctors
• Disadvantages: 1-2 week reporting lag and health infrastructure
• Facebook 150 million worldwide user base
Literature Review
• Databases searched: MEDLINE, EMBASE, SCOPUS, ISI Web of Knowledge, INSPEC
• Latest news: Google blog search and Google• Hand searching of all relevant articles• 2 prong standardized search strategy used
– 1) Social Networks AND influenza– 2) Web Surveillance AND influenza
• 305 articles– 1) 0 articles– 2) 6 articles
MEDLINE Search
• 1 (OSN or (social network* adj2 (site* or service or provider* or website* or online)) or facebook or myspace or orkut or bebo or friendster or hi5) (295)
• 2 Disease Outbreaks/ (50100)• 3 Influenza, Human/ (20693)• 4 (flu or ILI or influenza like illness or influenza-like-illness or influenza-like
illness) (7406)• 5 2 or 3 or 4 (71592)• 6 1 and 5 (0)• 7 ((Web or internet or net or online) adj3 (Data Collection or survey or
questionnaire* or research or feedback or surveillance or experiment)) (3519)
• 8 5 and 7 (43)
Different Approaches
• 1) Syndromic Surveillance: indirect measure of influenza– Google Flu Trends: health seeking search terms– Global Public Health Intelligence Network: automated algorithm for
news reports
• 2) Primary Doctor (GP) web-based reporting – REALFLU sentinel GP electronic ILI report
• 3) Web-based self-reporting– Pioneer: Great Influenza Survey (GIS) – Netherlands
• 2003-2004 Flu season, 13 300 active participants• Initial demographic questionnaire• Weekly ILI symptoms questionnaire via email• Average correlation: GIS vs Sentinel GP
Gripenet
• Superseded GIS – 2006-2007 Flu season– Netherlands (19,623), Belgium (7,025), Portugal (3118) participants
Influenza Tracking Project
• Inspired by Citizen Science movement• Pilot study – summer studentship• Improve on previous research by
– 1) Simplification: lay person, easy to use– 2) Using social networks to increase participation– 3) Collecting location (IP data) to track influenza globally
• Similar model used: initial demographic questionnaire and weekly symptom questionnaire but a twist – Facebook application
1. Simplification
• Problem: 13 ILI symptoms asked in GIS/Gripenet– Runny nose? Sore throat? Muscle pain? Abdominal pain? Nausea? Sudden Fever (No/Yes/Don’t
Know), How high was the fever? Cough? Headache? Chest pain? Diarrhea? Cold Shivers? Irritated Eyes?
• Complicated case definition; by “experts”– Definition of ILI: Fever > 38C started suddenly plus headache or muscle pain, plus at least one
respiratory symptom
• No current consensus on case definitions• Solution: Thursky (2003): Symptom Triad – Fever (subjective),
cough and fatigue – Effective: more sensitive and specific than CDC. Sensitivity (43.5-
75.1%), specificity (46.6-80.3%) and PPV (23.3-59.7%). – Simple
2. Organic Growth
• GIS/Gripenet used: TV, radio interviews, information posted to Universities/schools and even competitions (!)
• Participant growth dependant on expensive media campaign
• Student = poor• But! Facebook applications engineered to spread.. Like..
(Annoying) Fortune cookie
• Programmed application to be “viral”• Via “newsfeeds”• “Invitations”• “Profile badges”
• Demonstrated later
3. IP Data
• Information which tells you city/country where internet accessed
• Worldwide real time surveillance
How we build the program
• Programming was relatively straight forward– API (Application Program Interface): access to Facebook functions
with just a line of code– Official resources like the Developer Centre provides
documentation and examples– Open source: PHP and MYSQLI – (Inelegantly) program the application based on freely availiable
PHP or MYSQL tutorials on the net– Design is based on copying and pasting Facebook CSS
• Google = best friend
The website
• Website for explanation• www.influenzatracking.com
• Mass media exposure to get “critical mass” for viral spread like a nuclear reaction
IP address automatically stored
Invitations for “viral” spread
Profile Badges for “viral” spread
Newsfeeds (like a newspaper/stalker report of what your friends in your social network are doing) for “viral” spread
Weekly email notification
• Referred by mass media/blogs
Summary Slide
www.influenzatracking.comMedia
Exposure
Sign up
Flu Symptoms Questionnaire
Weekly email reminders
“Viral” Spread mechanisms
Beta Results
• Beta-testing started in 28/06/09• Beta testers - 73 participants• 52 participants filled more than 1 questionnaire• 71% conversion rate• Demographics:
– Age: 30 yrs old (mean)– Gender: 37 M 36 F– Education: 83% of users had tertiary or postgraduate degree– Vaccination: 37% vaccination rate
• 26 application “fans”
Beta Results
• Median days between questionnaire: 8.0• Future calculation:
– No of ILI/no. of total participants in a city/country– World map
• This presentation marks the end of beta-testing and the start of the PR drive public
Plans for the Future
• Mass PR drive• Please join! www.influenzatracking.com• Please do blog/spread the word!
• Research partnerships:– Epidemiologist– Biostatistician– If you can help in any way– [email protected]
Thank you for listening!
• Any questions?