What People Say About Cleft Lip and/or Palate on YouTube: A Thematic and Sentiment Analysis of User Comments

<section id="abstract" class="compound" property="abstract" typeof="Text" role="doc-abstract" epub:type="abstract" style="clear: both; margin: 0px; line-height: 1.2; font-family: Times; font-size: 16px; text-align: justify;"><section id="abs-sec-1" style="clear: both; margin: 0.4em 0px 0px;">Objective

To analyze YouTube comments related to cleft lip and/or palate (CL/P) using an infodemiology approach, and to identify prominent themes, emotional patterns, and opportunity/risk areas within the online information ecosystem.

</section><section id="abs-sec-2" style="clear: both; margin: 0.6em 0px;">Design

A large-scale, mixed-methods cultural infodemiology study. Manual thematic analysis findings were integrated with structural topic modeling (STM) outputs and lexicon-based sentiment analysis (AFINN, NRC) through data triangulation.

</section><section id="abs-sec-3" style="clear: both; margin: 0.6em 0px;">Setting

Publicly available CL/P-related YouTube videos and user comments.

</section><section id="abs-sec-4" style="clear: both; margin: 0.6em 0px;">Patients, Participants

No patients were recruited; only publicly available comments were analyzed.

</section><section id="abs-sec-5" style="clear: both; margin: 0.6em 0px;">Interventions

Not applicable.

</section><section id="abs-sec-6" style="clear: both; margin: 0.6em 0px;">Main Outcome Measures

Themes derived from STM and manual coding; frequencies of NRC emotion categories; AFINN sentiment scores; word-frequency/word-cloud findings.

</section><section id="abs-sec-7" style="clear: both; margin: 0.6em 0px;">Results

A total of 10 550 videos and 23 922 comments were analyzed. In sentiment analysis, positive, joy, and trust categories were predominant, while fear was more prominent among negative emotions. According to AFINN, the overall mean sentiment score across the study period was 1.158, indicating a generally positive trend. Analyses identified 10 main themes and 33 subthemes; prominent themes included psychosocial burden and identity, stigma and bullying, parenting/caregiving burden, a multi-stage treatment process, functional difficulties (speech-feeding-hearing), information seeking, access/cost issues, and misinformation/myth-based explanations.

</section><section id="abs-sec-8" style="clear: both; margin: 0.6em 0px;">Conclusions

YouTube comments constitute an ecosystem that is both supportive and risk-prone in the context of CL/P. The development of brief, evidence-based video series, standardized “myth–fact” content, clear signposting to trusted resources, and early referral mechanisms for severe psychological distress signals is recommended. In addition, strengthening the visibility of such content through engagement-promoting campaigns may be effective in increasing public awareness.

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