To compare menopause-related symptoms discussed in user-generated online posts with those documented in electronic health record (EHR) clinical notes.
Approach:
Data Sources: Analysis utilized a sample of EHR clinical notes from UCSF and top posts from the Reddit menopause forum.
Data Analysis: Latent Dirichlet allocation was used to explore themes, followed by classification using a prespecified taxonomy of medically recognized symptom domains.
Statistical Methods: Percentage distributions by domain were calculated and differences assessed using χ2 tests.
Key Findings:
Cognitive impairment, emotional well-being, and weight change were discussed more frequently in online posts than in EHR notes.
Hot flashes, night sweats, hormone replacement therapy, and lifestyle changes were documented more in EHR notes.
No significant differences were found for sleep disturbances, hormonal skin and hair changes, and bone and joint health.
Interpretation:
Patient-generated discussions highlight psychosocial and cognitive experiences more than clinical documentation, while EHR records focus on vasomotor symptoms and treatments.
A large Epic Cosmos analysis linked vaginal estrogen prescribing with lower rates of sepsis, hospital admission, and death following recurrent urinary tract infection, but researchers cautioned that prescribing may also mark broader differences in care.
