Using artificial intelligence (AI) to analyze large amounts of information from social media platforms generated some novel insights into public perceptions about statins, results of a new study show.

The study, which used AI to analyze discussions about statins on the social media platform Reddit, corroborated previously documented reasons for statin hesitancy, including adverse effect profiles, and general disenfranchisement with healthcare.

But it also found novel points of discourse including linking statins to COVID-19 outcomes, and the role of cholesterol, statins, and the ketogenic diet.

"We used AI to tell us what is being discussed about statins on social media and to quantify the information in topics that people think are important," senior study author Fatima Rodriguez, MD, MPH, Stanford University School of Medicine, Stanford, California, told theheart.org | Medscape Cardiology.

"Some of the themes were surprising to us. While we expected discussion on side effects, we were surprised to see so much discussion refuting the idea that increased levels of LDL were detrimental. There were also a large amount of posts on statin use being correlated to COVID outcomes. Our findings show how widespread this misinformation is," she said.

"As a preventative cardiologist I spend a lot of my time trying to get patients to take statins, but patients often rely on social media for information, and this can contain a lot of misinformation.

"People tend to be more honest on online forums than they are in the doctor's office, so they are probably asking the questions and having discussions on subjects they really care about. So, understanding what is being discussed on social media is very valuable information for us as clinicians."

The study was published online April 24 in JAMA Network Open.

The researchers analyzed all statin-related discussions on Reddit that were dated between January 1, 2009, and July 12, 2022. Statin- and cholesterol-focused communities were identified to create a list of statin-related discussions. An AI pipeline was developed to cluster these discussions into specific topics and overarching thematic groups.

A total of 10,233 unique statin-related discussions and 5,188 unique authors were identified. A total of 100 discussion topics were identified and classified into six overarching thematic groups: (1) ketogenic diets, diabetes, supplements, and statins; (2) statin adverse effects; (3) statin hesitancy; (4) clinical trial appraisals; (5) pharmaceutical industry bias and statins; and (6) red yeast rice and statins.

Several examples of statin-related misinformation were identified, including distrust of the hypothesis that LDL-C has a causal association with heart disease. Discussions included quotes such as "I think LDL is pretty much irrelevant. Your HDL and triglycerides are far more important."

Other topics suggested that certain natural supplements would be an acceptable alternative to statins. Quotes included: "Red yeast rice is a statin basically, by the way," and "statins are basically mycotoxins and deplete you of fat-soluble nutrients, like coQ10, vit D, K, A and E, and in all likelihood through these depletions worsen cardiovascular health."

The researchers also looked at temporal trends and found that these sorts of discussions have increased over time.

One of the common themes identified was using the ketogenic diet phenomenon as an argument against increased cholesterol levels being bad for health.

Rodriguez elaborated: "People think the ketogenic diet is healthy as they lose weight on it. And as it can be associated with a small increase in LDL cholesterol there was a lot of opinion that this meant increasing LDL was a good thing."

The researchers also conducted a sentiment analysis, which designated topics as positive, negative or neutral with regard to statins.

"We found that almost no topic was positive. Everything was either neutral or negative.This is pretty consistent with what we are seeing around hesitancy in clinical practice, but you would think that maybe a few people may have a positive view on statins," Rodriguez commented.

"One of the problems with statins and lowering cholesterol is that it takes a long time to see a benefit, but this misinformation will result in some people not taking their medication," she added.

Rodriguez noted that in this study AI is augmenting, not replacing, what clinicians and researchers do. "But it is a valuable tool to scan a large volume of information, and we have shown here it can generate new insights that we may not have thought of.It's important to know what's out there so we can try and combat it."

She pointed out that patients don't read the medical literature showing the benefits of statins but rather rely on social media for their information.

"We need to understand all sorts of patient engagement and use the same tools to combat this misinformation. We have a responsibility to try and stop dangerous and false information from being propagated," she commented.

"These drugs are clearly not dangerous when used in line with clinical guidelines and they have been proven to have multiple benefits again and again, but we don't see those kinds of discussions in the community at all. We as clinicians need to use social media and AI to give out the right information. This could start to combat all the misinformation out there."

JAMA Network Open. Published online April 24, 2023. Full text

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Statin Misinformation on Social Media Flagged by AI - Medscape