title: Finding the Patient's Voice Using Big Data: Analysis of Users' Health-Related Concerns in the ChaCha Question-and-Answer Service (2009-2012).
abstract: BACKGROUND
  The development of effective health care and public health interventions requires a comprehensive understanding of the perceptions, concerns, and stated needs of health care consumers and the public at large. Big datasets from social media and question-and-answer services provide insight into the public's health concerns and priorities without the financial, temporal, and spatial encumbrances of more traditional community-engagement methods and may prove a useful starting point for public-engagement health research (infodemiology).
  
  
  OBJECTIVE
  The objective of our study was to describe user characteristics and health-related queries of the ChaCha question-and-answer platform, and discuss how these data may be used to better understand the perceptions, concerns, and stated needs of health care consumers and the public at large.
  
  
  METHODS
  We conducted a retrospective automated textual analysis of anonymous user-generated queries submitted to ChaCha between January 2009 and November 2012. A total of 2.004 billion queries were read, of which 3.50% (70,083,796/2,004,243,249) were missing 1 or more data fields, leaving 1.934 billion complete lines of data for these analyses.
  
  
  RESULTS
  Males and females submitted roughly equal numbers of health queries, but content differed by sex. Questions from females predominantly focused on pregnancy, menstruation, and vaginal health. Questions from males predominantly focused on body image, drug use, and sexuality. Adolescents aged 12-19 years submitted more queries than any other age group. Their queries were largely centered on sexual and reproductive health, and pregnancy in particular.
  
  
  CONCLUSIONS
  The private nature of the ChaCha service provided a perfect environment for maximum frankness among users, especially among adolescents posing sensitive health questions. Adolescents' sexual health queries reveal knowledge gaps with serious, lifelong consequences. The nature of questions to the service provides opportunities for rapid understanding of health concerns and may lead to development of more effective tailored interventions.
authors.affiliation: Social Network Health Research Laboratory at the Indiana University School of Nursing, School of Medicine, Department of Emergency Medicine, Indiana University, Indianapolis, IN, United States. cspriest@iu.edu.
authors.forename: Chad
authors.identifier: http://orcid.org/0000-0002-4701-3402
authors.initials: C
authors.lastname: Priest
authors.forename: Amelia
authors.identifier: http://orcid.org/0000-0003-2557-4556
authors.initials: A
authors.lastname: Knopf
authors.forename: Doyle
authors.identifier: http://orcid.org/0000-0003-2986-9407
authors.initials: D
authors.lastname: Groves
authors.forename: Janet S
authors.identifier: http://orcid.org/0000-0003-3988-8855
authors.initials: JS
authors.lastname: Carpenter
authors.forename: Christopher
authors.identifier: http://orcid.org/0000-0002-9652-9173
authors.initials: C
authors.lastname: Furrey
authors.forename: Anand
authors.identifier: http://orcid.org/0000-0002-1156-1407
authors.initials: A
authors.lastname: Krishnan
authors.forename: Wendy R
authors.identifier: http://orcid.org/0000-0003-1779-7290
authors.initials: WR
authors.lastname: Miller
authors.forename: Julie L
authors.identifier: http://orcid.org/0000-0002-6408-1466
authors.initials: JL
authors.lastname: Otte
authors.forename: Mathew
authors.identifier: http://orcid.org/0000-0002-2990-0999
authors.initials: M
authors.lastname: Palakal
authors.forename: Sarah
authors.identifier: http://orcid.org/0000-0002-8148-0848
authors.initials: S
authors.lastname: Wiehe
authors.forename: Jeffrey
authors.identifier: http://orcid.org/0000-0002-1249-2968
authors.initials: J
authors.lastname: Wilson
mesh_terms: D000293:Adolescent; D000328:Adult; D054626:Consumer Health Information / Q000706:statistics & numerical data*; D066264:Datasets as Topic; D005260:Female; D006801:Humans; D057226:Information Seeking Behavior; D020407:Internet; D008297:Male; D011247:Pregnancy; D060728:Reproductive Health; D012189:Retrospective Studies; D012737:Sex Factors; D012725:Sexual Behavior; D061108:Social Media
keywords: ChaCha; adolescent; big data; health information seeking; infodemiology; infoveillance; patient engagement; question-and-answer service; sexual health; social meda