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Mining Twitter to understand the cardiac rehabilitation barriers and patients’ perceptions
  1. Chayakrit Krittanawong1,
  2. Anusith Tunhasiriwet2,
  3. HongJu Zhang2,
  4. Mehmet Aydar3,
  5. Tao Sun2,
  6. Hafeez Ul Hassan Virk4,
  7. Eyal Herzog5
  1. 1 Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
  2. 2 Mayo Clinic Division of Cardiovascular Diseases, Rochester, Minnesota, USA
  3. 3 Kent State University, Stark Campus, Canton, Ohio, USA
  4. 4 Albert Einstein Healthcare Network, Philadelphia, Pennsylvania, USA
  5. 5 Icahn School of Medicine at Mount Sinai, Mount Sinai Heart, New York City, New York, USA
  1. Correspondence to Dr Chayakrit Krittanawong, Medicine, Icahn school of medicine at mount sinai, NY, New York 10023, USA; Chayakrit.Krittanawong{at}


Cardiovascular disease (CVD) is the most common cause of death worldwide. Cardiac rehabilitation (CR) is increasingly recognised as an essential part of clinical care for patients with CVD. CR is a complex intervention that encompasses a multidisciplinary approach that focuses on health education, modification of cardiovascular risk factors, exercise training, physical activity and stress management. In the current American Heart Association/American College of Cardiology guidelines, cardiac rehabilitation is a class IA recommendation for secondary prevention of acute myocardial infarction, percutaneous coronary intervention and cardiac surgery and Class II recommendation for chronic stable heart failure. Despite proven effectiveness, however, participation in traditional CR remains low. Although the reasons for participation and non-participation in CR have been well described, the use of Twitter to explore public perceptions of CR has not yet been formally reported. To the best of our knowledge, the analysis of Twitter for insights on CR is a novel investigation that is relevant for addressing significant problems related to CR awareness in the digital age.

We performed data mining of Twitter to assess patients’ perceptions regarding CR and the reasons for their participation and non-participation in CR between 23 July 2015 and 22 October 2017.

We analysed a total of 5515 Twitter messages. Tweets associated with CR were often used to self-report on health status either before or after participating in CR or contained emotional language with positive or negative comments, advertisements or updated news.

Twitter users wrote mainly positive comments about CR, suggesting the platform has the potential to disseminate both the benefits of CR and its research to the public on the worldwide scale.

  • cardiac rehabilitation
  • cardiac rehab
  • exercise training
  • cardiovascular disease
  • twitter

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  • Contributors CK, AT and MA planned the study. CK, AT, HJZ and TS conducted a review. CK performed the analysis, wrote a draft manuscript and submitted the study. HUHV and EH critically reviewed.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement There are no data in this work. No data are available.