title: Gordie Howe's "Miraculous Treatment": Case Study of Twitter Users' Reactions to a Sport Celebrity's Stem Cell Treatment.
abstract: BACKGROUND
  Former Detroit Red Wing Gordie Howe received stem cell (SC) treatment in Mexico in December 2014 for a stroke he suffered in October 2014. The news about his positive response to the SC treatment prompted discussion on social networks like Twitter.
  
  
  OBJECTIVE
  This study aims to provide information about discussions that took place on Twitter regarding Howe's SC treatment and SC treatment in general. In particular, this study examines whether tweets portrayed a positive or negative attitude towards Howe's SC treatment, whether or not tweets mention that the treatment is unproven, and whether the tweets mention risks associated with the SC treatment.
  
  
  METHODS
  This is an infodemiology study, harnessing big data published on the Internet for public health research and analysis of public engagement. A corpus of 2783 tweets about Howe's SC treatment was compiled using a program that collected English-language tweets from December 19, 2014 at 00:00 to February 7, 2015 at 00:00. A content analysis of the corpus was conducted using a coding framework developed through a two-stage process.
  
  
  RESULTS
  78.87% (2195/2783) of tweets mentioned improvements to Howe's health. Only one tweet explicitly mentioned that Howe's SC treatment was unproven, and 3 tweets warned that direct-to-consumer SC treatments lacked scientific evidence. In addition, 10.31% (287/2783) of tweets mentioned challenges with SC treatment that have been raised by scientists and researchers, and 3.70% (103/2783) of tweets either defined Howe as a "stem cell tourist" or claimed that his treatment was part of "stem cell tourism". In general, 71.79% (1998/2783) of tweets portrayed a positive attitude towards Howe's SC treatment.
  
  
  CONCLUSIONS
  Our study found the responses to Howe's treatment on Twitter to be overwhelmingly positive. There was far less attention paid to the lack of scientific evidence regarding the efficacy of the treatment. Unbalanced and uncritical discussion on Twitter regarding SC treatments is another example of inaccurate representations of SC treatments that may create unrealistic expectations that will facilitate the market for unproven stem cell therapies.
authors.affiliation: Health Law Institute Faculty of Law University of Alberta Edmonton, AB Canada.
authors.forename: Li
authors.identifier: 0000-0003-0463-5241
authors.initials: L
authors.lastname: Du
authors.affiliation: School of Linguistics and Language Studies Carleton University Ottawa, ON Canada.
authors.forename: Christen
authors.identifier: 0000-0002-3726-1891
authors.initials: C
authors.lastname: Rachul
authors.affiliation: Department of Computing Science University of Alberta Edmonton, AB Canada.
authors.forename: Zhaochen
authors.identifier: 0000-0003-3135-6213
authors.initials: Z
authors.lastname: Guo
authors.affiliation: Health Law Institute, Law Centre, University of Alberta Edmonton, AB Canada.
authors.forename: Timothy
authors.identifier: 0000-0001-5471-6184
authors.initials: T
authors.lastname: Caulfield
keywords: Gordie Howe; Twitter; infodemiology; infoveillance; social network; stem cell tourism; stem cell treatment