{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:55:11Z","timestamp":1777881311106,"version":"3.51.4"},"reference-count":64,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sage Open"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:p>The COVID-19 pandemic has driven the transition from face-to-face visits to virtual care delivery. In this study, we explore patients\u2019 perceptions of the benefits and challenges of using virtual primary care technologies during the pandemic, using machine learning approaches. A cross-sectional survey was conducted in August 2020 in Italy, Sweden, Germany, and the UK. Latent Dirichlet Allocation was used to identify themes of two open-ended questions. Comparisons between participant characteristics were made using Wilcoxon rank-sum test. 6,331 participants were included (51.7% female; 42.4% +55\u2009years; 60.5% white ethnicity; 86.6% low literacy). The benefits extracted included: primary care delivery, infection control, reducing contacts, virtual care, timeliness, patient-doctor interaction, convenience, and safety. Participants from Sweden were most likely to mention \u201cprimary care delivery\u201d (UK p\u2009=\u2009.007, IT p\u2009=\u2009.03, DE p\u2009&lt;\u2009.001), from the UK \u201cvirtual care\u201d (SE p\u2009&lt;\u2009.001, IT p\u2009&lt;\u2009.001, DE p\u2009&lt;\u2009.001) and from Italy \u201cpatient-doctor interaction\u201d (UK p\u2009&lt;\u2009.001, SE p\u2009&lt;\u2009.001, DE p\u2009&lt;\u2009.001). The challenges included: diagnostic difficulties, physical examination, digital health risks, technical challenges, virtual care, data security and protection, and lack of personal contact. \u201cDiagnostic difficulties\u201d was most significantly mentioned in Sweden (UK p\u2009=\u2009.009, IT p\u2009&lt;\u2009.001, DE p\u2009&lt;\u2009.001), \u201cvirtual care\u201d in the UK (IT p\u2009=\u2009.02, SE p\u2009=\u2009.001, DE p\u2009&lt;\u2009.001), and \u201cdata security and protection\u201d in Germany (UK p\u2009&lt;\u2009.001, IT p\u2009=\u2009.019, SE p\u2009&lt;\u2009.001). Our study reinforces the feasibility of using machine learning to explore large qualitative datasets. Our findings contribute to a better identification of the lessons learned during the pandemic and inform improvements in policy and practice.<\/jats:p>","DOI":"10.1177\/21582440241263147","type":"journal-article","created":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T02:21:35Z","timestamp":1723774895000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessing Public Perceptions of Virtual Primary Care During the COVID-19 Pandemic in the UK, Germany, Sweden, and Italy: A Topic Modeling Approach"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6597-4178","authenticated-orcid":false,"given":"Felix","family":"Machleid","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, Charite\u2019 Campus Mitte, Charite\u2019\u2013 Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin, Humboldt-Universitat zu Berlin, and Berlin Institute of Health, Berlin, Germany"},{"name":"Berlin Institute of Health at Charit\u00e9\u2013 Universit\u00e4tsmedizin Berlin, Berlin, Germany"},{"name":"Institute of Global Health Innovation, Imperial College London, London, UK"}]},{"given":"Roberto Fernandez","family":"Crespo","sequence":"additional","affiliation":[{"name":"Institute of Global Health Innovation, Imperial College London, London, UK"}]},{"given":"Kelsey","family":"Flott","sequence":"additional","affiliation":[{"name":"Institute of Global Health Innovation, Imperial College London, London, UK"}]},{"given":"Saira","family":"Ghafur","sequence":"additional","affiliation":[{"name":"Institute of Global Health Innovation, Imperial College London, London, UK"}]},{"given":"Ara","family":"Darzi","sequence":"additional","affiliation":[{"name":"Institute of Global Health Innovation, Imperial College London, London, UK"},{"name":"Department of Surgery & Cancer, Imperial College London, London, UK"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5509-4580","authenticated-orcid":false,"given":"Erik","family":"Mayer","sequence":"additional","affiliation":[{"name":"Institute of Global Health Innovation, Imperial College London, London, UK"},{"name":"Department of Surgery & Cancer, Imperial College London, London, UK"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7107-7211","authenticated-orcid":false,"given":"Ana Luisa","family":"Neves","sequence":"additional","affiliation":[{"name":"Institute of Global Health Innovation, Imperial College London, London, UK"},{"name":"Department of Primary Care and Public Health, Imperial College London, London, UK"}]}],"member":"179","published-online":{"date-parts":[[2024,8,15]]},"reference":[{"key":"bibr1-21582440241263147","doi-asserted-by":"publisher","DOI":"10.1145\/2348283.2348454"},{"key":"bibr2-21582440241263147","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-13657-3_43"},{"key":"bibr3-21582440241263147","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp18X694853"},{"key":"bibr4-21582440241263147","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2016.0045"},{"key":"bibr5-21582440241263147","unstructured":"Bertelsmann Stiftung. 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