Mind the Gap: Social media analysis of 38,609 posts highlights discrepancies between clinical focus and patient priorities in neurosurgical care.

OBJECTIVE

To analyze social media discussions among cranial neurosurgical patients to identify prevalent concerns, emotional patterns, and quality of life impacts that may not be fully captured in traditional clinical assessments.

METHODS

We analyzed 38,609 neurosurgery-related posts from Reddit using natural language processing and the Valence Aware Dictionary and sEntiment Reasoner (VADER) sentiment analysis tool. Posts were categorized into clinical domains (symptoms, conditions, procedures, treatments, complications, quality of life, and clinical course), with sentiment scores calculated for each category. Co-occurrence analysis identified significant term associations. Statistical comparisons used Mann-Whitney U tests with Benjamini-Hochberg correction.

RESULTS

Patient discussions predominantly focused on symptoms (63.56 % of posts) and quality of life impacts (45.93 %), with work/education concerns (25.99 %) and headache-related complaints (32.10 %) being most prevalent. Cognitive symptoms appeared in 19.78 % of posts, while epilepsy-related terms dominated condition discussions (23.04 %). Sentiment analysis revealed a significant contrast between symptom discussions (mean sentiment: -0.007) and treatment discussions (0.056, effect size d = 0.27, p < 0.001), with medication/therapy discussions showing the most positive sentiment across all categories. Surgical procedure discussions, while infrequent (7.41 %), maintained positive sentiment (0.031), suggesting patients may find reassurance in definitive interventions. Quality of life concerns showed substantial prevalence but received limited attention in clinical literature, with transportation/independence issues (10.09 %) and financial/insurance concerns (6.91 %) showing significant associations with treatment and procedure discussions, respectively. Anxiety terms demonstrated the strongest association with clinical course discussions (φ = 0.093), while condition-specific terminology showed robust co-occurrence patterns (e.g., "Chiari-malformation," φ = 0.69).

CONCLUSIONS

This analysis reveals important disparities between traditional clinical priorities and patient-reported concerns in neurosurgical care. The negative sentiment surrounding symptom discussions contrasted with treatment optimism suggests opportunities for improved symptom management approaches. The high prevalence of work, education, and independence concerns highlights the need for comprehensive support services addressing functional outcomes. Implementation of enhanced symptom management strategies, psychological support services, and structured rehabilitation programs may help bridge the gap between clinical care and patient priorities in neurosurgical practice.