ABSTRACT
Purpose: The COVID-19 pandemic has spurred a concurrent outbreak of false information online. Debunking false information about a health crisis is critical as misinformation can trigger protests or panic, which necessitates a better understanding of it. This exploratory study examined the effects of debunking messages on a COVID-19-related public chat on WhatsApp in Singapore. Design/methodology/approach: To understand the effects of debunking messages about COVID-19 on WhatsApp conversations, the following was studied. The relationship between source credibility (i.e. characteristics of a communicator that affect the receiver's acceptance of the message) of different debunking message types and their effects on the length of the conversation, sentiments towards various aspects of a crisis, and the information distortions in a message thread were studied. Deep learning techniques, knowledge graphs (KG), and content analyses were used to perform aspect-based sentiment analysis (ABSA) of the messages and measure information distortion. Findings: Debunking messages with higher source credibility (e.g. providing evidence from authoritative sources like health authorities) help close a discussion thread earlier. Shifts in sentiments towards some aspects of the crisis highlight the value of ABSA in monitoring the effectiveness of debunking messages. Finally, debunking messages with lower source credibility (e.g. stating that the information is false without any substantiation) are likely to increase information distortion in conversation threads. Originality/value: The study supports the importance of source credibility in debunking and an ABSA approach in analysing the effect of debunking messages during a health crisis, which have practical value for public agencies during a health crisis. Studying differences in the source credibility of debunking messages on WhatsApp is a novel shift from the existing approaches. Additionally, a novel approach to measuring information distortion using KGs was used to shed insights on how debunking can reduce information distortions. © 2022, Emerald Publishing Limited.
ABSTRACT
Introduction The standard of care for patients with multiple myeloma (MM) involves autologous hematopoietic stem cell transplantation (ASCT). Pre-ASCT mobilization chemotherapy for MM, vinorelbine and high dose cyclophosphamide (VC), has been historically given in the inpatient (IP) setting. Due to rising bed occupancy rates and patients' preferences for treatment in the ambulatory setting, our team has offered eligible patients an option to receive VC outpatient (OP) since 2018. Our study aims to audit the feasibility and safety of this initiative, and review potential healthcare-related cost savings. Methods Eligibility criteria for OP chemotherapy were developed by a multidisciplinary team based on patients' age, functional status, medical comorbidities and social factors (Figure 1). The chemotherapy regimen was modified for an OP setting (Figure 2), of which the main alteration involved changing the route of administration of intravenous (IV) mesna to a combination of IV and oral. A retrospective review was conducted for 35 MM patients (18 IP and 17 OP) who received VC for mobilisation at our center from 2018 to 2019. The patient characteristics were similar between the two groups (Table 1). Patient data were analyzed from the day of admission for VC (IP) or day 1 of VC (OP), to the day before admission for stem cell harvesting. Clinical charts were reviewed for unexpected complications and unplanned admissions. Costs incurred were calculated using the value-driven-outcome (VDO) informatics analysis of the hospital. Results There were no unexpected clinical complications or unplanned admissions in both groups. The median length of hospital stay for the IP cohort was 3 days, amounting to a saving of 51 hospital days over 2 years in the OP cohort. Median costs were 73% lower in the OP cohort (Figure 3). The difference was mainly due to certain costs not incurred in the OP setting. These included room charges and daily treatment fees (which accounted for an average of 46% and 19% of IP charges respectively). Investigation costs were also 55% lower in the OP cohort, which could be attributed to more investigations being performed in the IP setting such as screening for methicillin-resistant Staphylococcus aureus and nonurgent radiographs ordered after hours by the on-call physician upon admission. Conclusions Our findings show that OP mobilization chemotherapy for MM is safe, feasible and associated with improved bed utilization and cost savings. Other components of the stem cell transplantation process are also increasingly being transitioned from the IP to OP setting in our center as part of an ongoing paradigm shift in right-siting treatment services, which has been accelerated by the COVID-19 pandemic's strain on inpatient capacity. These results provide an affirmation of our efforts to optimize the utilization of healthcare resources. [Formula presented] Disclosures: Chng: Takeda: Consultancy;GlaxoSmithKline: Consultancy;Johnson & Johnson: Consultancy, Research Funding;Aslan: Research Funding;Antengene: Consultancy;Abbvie: Consultancy;Pfizer: Consultancy;Novartis: Research Funding;Sanofi: Consultancy;Amgen: Consultancy;BMS/Celgene: Consultancy, Research Funding.