title: Social Media Use in Chronic Disease: A Systematic Review and Novel Taxonomy.
abstract: OBJECTIVE
  The purpose of this study is to evaluate clinical outcomes from applications of contemporary social media in chronic disease; to develop a conceptual taxonomy to categorize, summarize, and then analyze the current evidence base; and to suggest a framework for future studies on this topic.
  
  
  METHODS
  We performed a systematic review of MEDLINE via PubMed (January 2000 to January 2015) of studies reporting clinical outcomes on leading contemporary social media (ie, Facebook, Twitter, Wikipedia, YouTube) use in 10 chronic diseases. Two reviewers independently performed data extraction and quality assessment; characterization of study outcomes as positive, negative, neutral, or undefined impact; and inductive, thematic analysis to develop our taxonomy.
  
  
  RESULTS
  Of 378 citations identified, 42 studies examining the use of Facebook (n = 16), blogs (n = 13), Twitter (n = 8), wikis (n = 5), and YouTube (n = 4) on outcomes in cancer (n = 14), depression (n = 13), obesity (n = 9), diabetes (n = 4), heart disease (n = 3), stroke (n = 2), and chronic lower respiratory tract infection (n = 1) were included. Studies were classified as support (n = 16), patient education (n = 10), disease modification (n = 6), disease management (n = 5), and diagnosis (n = 5) within our taxonomy. The overall impact of social media on chronic disease was variable, with 48% of studies indicating benefit, 45% neutral or undefined, and 7% suggesting harm. Among studies that showed benefit, 85% used either Facebook or blogs, and 40% were based within the domain of support.
  
  
  CONCLUSIONS
  Using social media to provide social, emotional, or experiential support in chronic disease, especially with Facebook and blogs, appears most likely to improve patient care.
authors.affiliation: Brigham and Women's Hospital, Boston, Mass. Electronic address: rpatel41@partners.org.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Patel
authors.affiliation: Department of Family Medicine and Institute for Health Policy and Innovation, University of Michigan, Ann Arbor.
authors.forename: Tammy
authors.initials: T
authors.lastname: Chang
authors.affiliation: University of California, San Francisco.
authors.forename: S Ryan
authors.initials: SR
authors.lastname: Greysen
authors.affiliation: The Patient Safety Enhancement Program, Hospital Outcomes Program of Excellence, and the Center for Clinical Management Research, University of Michigan Health System, Ann Arbor VA Medical Center, Ann Arbor.
authors.forename: Vineet
authors.initials: V
authors.lastname: Chopra
mesh_terms: D002908:Chronic Disease / Q000523:psychology*; D002965:Classification; D006801:Humans; D061108:Social Media / Q000706:statistics & numerical data*
keywords: Chronic disease; Social media; Social media taxonomy; Taxonomy