Objectives. To understand how Twitter bots and trolls (“bots”) promote online health content. Methods. We compared bots’ to average users’ rates of vaccine-relevant messages, which we collected online from July 2014 through September 2017. We estimated the likelihood that users were bots, comparing proportions of polarized and antivaccine tweets across user types. We conducted a content analysis of a Twitter hashtag associated with Russian troll activity. Results. Compared with average users, Russian trolls (χ²(1) = 102.0; P < .001), sophisticated bots (χ²(1) = 28.6; P < .001), and “content polluters” (χ²(1) = 7.0; P < .001) tweeted about vaccination at higher rates. Whereas content polluters posted more antivaccine content (χ²(1) = 11.18; P < .001), Russian trolls amplified both sides. Unidentifiable accounts were more polarized (χ²(1) = 12.1; P < .001) and antivaccine (χ²(1) = 35.9; P < .001). Analysis of the Russian troll hashtag showed that its messages were more political and divisive. Conclusions. Whereas bots that spread malware and unsolicited content disseminated antivaccine messages, Russian trolls promoted discord. Accounts masquerading as legitimate users create false equivalency, eroding public consensus on vaccination. Public Health Implications. Directly confronting vaccine skeptics enables bots to legitimize the vaccine debate. More research is needed to determine how best to combat bot-driven content.

Social media have been proposed as a data source for influenza surveillance because they have the potential to offer real-time access to millions of short, geographically localized messages containing information regarding personal well-being. However, accuracy of social media surveillance systems declines with media attention because media attention increases “chatter” – messages that are about influenza but that do not pertain to an actual infection – masking signs of true influenza prevalence. This paper summarizes our recently developed influenza infection detection algorithm that automatically distinguishes relevant tweets from other chatter, and we describe our current influenza surveillance system which was actively deployed during the full 2012-2013 influenza season. Our objective was to analyze the performance of this system during the most recent 2012–2013 influenza season and to analyze the performance at multiple levels of geographic granularity, unlike past studies that focused on national or regional surveillance. Our system’s influenza prevalence estimates were strongly correlated with surveillance data from the Centers for Disease Control and Prevention for the United States (r = 0.93, p < 0.001) as well as surveillance data from the Department of Health and Mental Hygiene of New York City (r = 0.88, p < 0.001). Our system detected the weekly change in direction (increasing or decreasing) of influenza prevalence with 85% accuracy, a nearly twofold increase over a simpler model, demonstrating the utility of explicitly distinguishing infection tweets from other chatter.

Accurate disease forecasts are imperative when preparing for influenza epidemic outbreaks; nevertheless, these forecasts are often limited by the time required to collect new, accurate data. In this paper, we show that data from the microblogging community Twitter significantly improves influenza forecasting. Most prior influenza forecast models are tested against historical influenza-like illness (ILI) data from the U.S. Centers for Disease Control and Prevention (CDC). These data are released with a one-week lag and are often initially inaccurate until the CDC revises them weeks later. Since previous studies utilize the final, revised data in evaluation, their evaluations do not properly determine the effectiveness of forecasting. Our experiments using ILI data available at the time of the forecast show that models incorporating data derived from Twitter can reduce forecasting error by 17-30% over a baseline that only uses historical data. For a given level of accuracy, using Twitter data produces forecasts that are two to four weeks ahead of baseline models. Additionally, we find that models using Twitter data are, on average, better predictors of influenza prevalence than are models using data from Google Flu Trends, the leading web data source.

Faculty diversity is a longstanding challenge in the US. However, we lack a quantitative and systemic understanding of how the career transitions into assistant professor positions of PhD scientists from underrepresented minority (URM) and well-represented (WR) racial/ethnic backgrounds compare. Between 1980 and 2013, the number of PhD graduates from URM backgrounds increased by a factor of 9.3, compared with a 2.6-fold increase in the number of PhD graduates from WR groups. However, the number of scientists from URM backgrounds hired as assistant professors in medical school basic science departments was not related to the number of potential candidates (R²=0.12, p>0.07), whereas there was a strong correlation between these two numbers for scientists from WR backgrounds (R²=0.48, p<0.0001). We built and validated a conceptual system dynamics model based on these data that explained 79% of the variance in the hiring of assistant professors and posited no hiring discrimination. Simulations show that, given current transition rates of scientists from URM backgrounds to faculty positions, faculty diversity would not increase significantly through the year 2080 even in the context of an exponential growth in the population of PhD graduates from URM backgrounds, or significant increases in the number of faculty positions. Instead, the simulations showed that diversity increased as more postdoctoral candidates from URM backgrounds transitioned onto the market and were hired.