Social media insights into patient perceptions of orthognathic surgery

Abstract

Patients contemplating orthognathic surgery are increasingly turning to online forums, such as Reddit, as a supplementary source of information prior to undertaking a surgical treatment pathway. This study was designed to profile the main topics pertaining to orthognathic surgery which patients were discussing online, using data analytics methodologies and machine learning algorithms. An Application Programming Interface (API) wrapper was used to identify posts relating to orthognathic surgery on Reddit, within the/jawsurgery subreddit. The information was exported for further analysis. Topic modelling was undertaken with the Latent Dirichlet Allocation (LDA) algorithm, Valence Aware Dictionary and sEntiment Reasoner (VADER) tool was used for sentiment analysis, and a machine learning tool was used to pinpoint language cues in the posts. A total of 10265 posts were included in the analysis. These posts were categorised into one of ten topic groups based on qualitative analysis by the authors. Overall, there was positive sentiment toward orthognathic surgery within each of the topic groups within the subreddit. The topic groups which carried the highest sentiment were aesthetic change, aesthetic preferences and disagreements and, postoperative experience. Patients are actively seeking alternative sources of information regarding orthognathic surgery, particularly pertaining to the experiences of other patients. Whilst overall there is a positive sentiment toward surgery, both positive and negative experiences are posted online.

Introduction

Orthognathic surgery is a technically complex area of contemporary oral and maxillofacial surgery. Over time, and with greater awareness of orthognathic surgery and its potential, the demographic of patients seeking a combined orthodontic–surgical treatment has changed, with a more mature cohort of patients, and with decidedly precise treatment goals.

The multifaceted nature of outcomes that result from orthognathic surgery lends itself to perceptual differences between surgeons and patients, in defining what constitutes a successful surgical outcome. Furthermore, the long and complex pathway of treatment, and associated decision making, combined with the ongoing rise of the internet era, has led to a culture of independent fact-finding by prospective patients using a variety of non-clinical sources. ,,,, Patients have a desire to discuss their surgery with other patients, and this is perhaps best exemplified by the rise of online forums, which enable peer-to-peer communication in the form of posted messages, photos, or videos, which are typically publicly available to a wider audience. ,,

One of the more popular platforms for online forums is Reddit, an American-based news aggregation and discussion website. Reddit has been rated as the third most popular social media website, after Facebook and YouTube. Reddit members (usually concealed behind pseudonyms) may submit text, photos, videos, and links into ‘subreddits’, which are user-created forums based upon a particular topic. Existing social media-based research has offered useful insights into the information needs of patients, identified potential information gaps for patients undergoing procedures, and raised awareness of patient-related issues not otherwise identified during surgical consultations. ,, The purpose of this study was therefore to examine the Reddit platform using quantitative and qualitative methodologies, in order to identify common themes shared within a cohort of patients undergoing orthognathic surgery.

Methods

This research project was approved by the University of Melbourne Human Ethics Research Committee (ID: 2024-25052-59568-1). Data were collected from the/jawsurgery subreddit using the Python Reddit API Wrapper (PRAW), a Python package that allows for simple access to Reddit’s API (Application Programming Interface). This subreddit was chosen based on its relevance to the research objectives, focusing on discussions related to jaw surgery, such as experiences, advice, and outcomes. Posts were extracted along with their associated metadata, including titles, scores, numbers of comments, post IDs, author usernames, creation timestamps, URLs, and self-text (the body of the posts).

The data (10265 collected posts) were stored in comma-separated value (CSV) format for ease of handling and analysis. Initial data exploration involved loading this dataset using Pandas, a Python data analysis library. This dataset was analysed to identify the frequency of unique titles and to detect duplicate comments, ensuring the integrity of the data for subsequent analysis.

Basic preprocessing was applied to the textual data to refine it for analysis. This included removing non-alphabetical characters to focus on textual content and converting all text to lower-case to standardise the data. English stop words (such as ‘the’, ‘is’, ‘and’, and ‘but’), which are frequent but carry little semantic weight, were eliminated to reduce noise. Additionally, lemmatisation was conducted to consolidate words to their base forms, ensuring that variations of a word would be treated uniformly.

Topic modelling

This study applied the Latent Dirichlet Allocation (LDA) algorithm for topic modelling, a well-established technique in computational content analysis. Introduced by Blei et al., LDA has been widely recognised for its effectiveness in uncovering thematic structures from large datasets of textual data. A key advantage of LDA is its robust performance on datasets comprising short texts, rendering it especially suitable for analysing social media data, which typically consists of brief, varied-length documents.

In evaluating topic models, the number of topics was adjusted from 10 to 60 in increments of 10. Utilising Gensim (open-source library) a computational evaluation of the topic models was performed using coherence scores, guiding the selection of an optimal model of 10 topics. A qualitative analysis was also conduced to ensure the topics made sematic sense to domain experts.

Sentiment analysis

Building on the topic modelling analysis, sentiment analysis was performed to explore the emotional valence associated with each identified topic. This analysis was performed using the Valence Aware Dictionary and sEntiment Reasoner (VADER) sentiment analysis tool, a lexicon and rule-based sentiment analysis framework specifically attuned to sentiments expressed in social media. Each document within the dataset was assigned a compound sentiment score, a normalised, weighted composite score, encapsulating the overall sentiment of a document, ranging from-1 (most negative) to +1 (most positive). The analysis was extended to compute the average sentiment score for documents within each topic, which had been identified through the earlier LDA analysis.

A qualitative examination of the top 5 most positive and negative posts for each topic was performed, based on sentiment scores. Systematic identification and qualitative assessment of these posts allowed a deeper understanding of the underlying themes and emotional expressions that contributed to their extreme sentiment scores.

Machine learning

To further dissect the emotional undertones of each topic, a model was employed to identify words most strongly associated with positive and negative sentiments within each topic category. This approach aimed to pinpoint specific language cues that signal emotional valence in the context of the topics derived from the LDA analysis. Two models were made for both negative and positive sentiment, Term Frequency-Inverse Document Frequency (TF-IDF) vectorisation was applied to transform the text data. The TF-IDF model, configured to disregard the most common English stop words and to limit the analysis to the 5000 most relevant features, allowed quantification of the importance of words in relation to their sentiment scores. A linear regression model was then trained for each topic, using the TF-IDF vectors as predictors for the sentiment scores.

Network analysis

To better understand the relationships in the data and their potential influence on content and sentiment, basic network analysis was performed on the data using the popular and versatile Python pack NetworkX, designed for the construction, manipulation, and analysis of the structure and dynamics of complex networks. A directed graph is a type of graph where each edge has a direction, indicating a one-way relationship between two nodes (users). In this case, the direction represents posts and interaction directed at a user in the subreddit community; therefore, it can be seen as proxy for their popularity within a social network. A directed graph was created across the whole network, as well as by the 10 topics identified by the topic modelling. Therefore, 11 graphs were analysed in total. In-degree centrality statistics, which calculate how many interactions are directed at a user, were performed for each of the graphs. Furthermore, the dataset was categorised into ‘top users’ and ‘all other users’ for the purpose of analysing discourse. This was performed across all graphs, including the entire network and by topic.

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Jul 12, 2026 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Social media insights into patient perceptions of orthognathic surgery

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