Disruptive technologies in health information landscapes: The case of diabetes and HbA1c



This technical session, building on theories of disruptive technologies, offers a demonstration of strategic network analysis tools that are currently little discussed in the literatures relating to information analysis. Panel members will stimulate debate by addressing the topical subject of blogosphere analysis from contrasting and complementary viewpoints relating to competitive intelligence and marketing, information seeking and use, network analysis and the concept of disruptive technologies. The range of expertise represented by the multidisciplinary makeup of the panel will help ensure a richly informative and lively session. In addition, the session will provide a forum for discussion about the role of weblogs in the communication of specialized information to both lay and expert communities, as well as a discussion about approaches and techniques for blogosphere analysis in general.

Information Landscapes for Diabetes and HbA1c

The session reports on the first two phases of an ongoing project analyzing and comparing two information landscapes, those of traditional, peer-reviewed research and of the blogosphere. The blogosphere (the name given to the aggregate of weblogs published by millions of individuals and organizations) continues to be an emerging information source for both the lay public and experts in all domains. The roles and functions of information providers must evolve to include deeper understandings of the influence of opinion-based information sources, such as blogs, and how these interact with traditional sources, such as peer-reviewed publications, in defining public knowledge around important issues. Gaining greater understanding of this dynamic will inform the scholarship of information searching and services. New frameworks are needed in order to keep the information professions relevant as aids to organizational management and decision-making.

Using diabetes as a case study we examine the evolution of physician knowledge and public opinion related to the relevance and importance of a particular measurement – glycated hemoglobin (HbA1c) – in the management of diabetes. The knowledge of physicians is measured using research information accessible via the biomedical literature, indexed in databases such as MEDLINE, and published recommendations, complemented by information gleaned from interviews with physicians in Canada. Public opinion is measured using quantitative and qualitative analysis of the blogosphere. An important component of the blogosphere analysis will be to present a visualization of word and topic relationships via lexical maps of the subject. A consideration of these two knowledge bases facilitates identifying the primary messages distributed by the medical profession and assessing how these messages are perceived and interpreted by the public. Gaps between medical and lay perspectives will be investigated.

Diabetes mellitus (in particular Type II diabetes) is the subject of an increasingly intense clinical research focus, particularly related to ongoing disease management strategies. This has been matched by an increase in activity by the public health and health promotion research communities. At the same time as this clinical interest has been increasing, the rise of weblogs makes it possible to gain a deeper perspective of the understanding that patient/public populations have of current best practices in Type II diabetes disease management. The blogosphere represents a unique source of opinion and attitudes that provides the analyst with a vast, mostly untapped source of data for analysis and comparison.

The traditional method of monitoring the progression of diabetes in patients has been through the practice of self-testing of blood sugar. One result of the increased research into effective disease management strategies has been an effort to prioritize the regular measurement of HbA1c, which is considered by some to be a superior/more accurate measure of disease state than traditional blood sugar testing. This project will compare the professional opinion about best practices in diabetes disease management related to HbA1c testing with current public perspectives on the subject as expressed by individuals in the blogosphere. In addition, the project will seek to establish best practices for comparative analysis using both traditional means (literature review, interviews, and expert analysis) and an innovative approach to the analysis of large, unstructured text databases.

Our larger project involves a further scientometric analysis of the current published literature concerning the role of HbA1c testing in monitoring glucose levels in diabetic individuals. Comparing the results of this exploration with those of the more traditional literature review will highlight differences between analytic strategies, as both types of analysis draw on the same body of evidence. Gaps that appear as a result of the differences in analytical technique will be investigated and considered with respect to the findings of the blogosphere analysis.

A chronic condition, diabetes requires long-term management. Greater awareness of public understanding of disease management strategies will improve decision-making among medical professionals. In today's interconnected, online world, insight and understanding derived from traditional means (e.g., biomedical research literature) can be significantly and effectively complemented by new information sources such as the blogosphere when such sources are rigorously analysed. To be effective, the medical professions must acknowledge the public's increasing access to medical information and recognize the interpretive role played by laypersons' information exchange. The knowledge sources and analytical strategies used by information professionals must likewise evolve to keep pace with the demands presented by both Web 2.0 communication tools and emerging technologies for content analysis.