The use of Twitter to facilitate sharing of clinical expertise in urology

Qualitative Study on Internet Use and Care Impact for Black Men With Prostate Cancer

Black men have a greater risk of prostate cancer as well as worse quality of life and more decisional regret after prostate cancer treatment compared to non-Hispanic White men. Furthermore, patients with prostate cancer who primarily obtain information on the internet have significantly more decisional regret compared to other information sources. Our objective was to explore the perspectives of Black patients on the use and impact of the internet for their prostate cancer care. In 2022-2023, we conducted seven virtual focus groups with Black patients with prostate cancer (n = 22). Transcripts were independently analyzed by two experienced researchers using a constant comparative method. Online sources were commonly used by participants throughout their cancer journey, although informational needs varied over time. Patient factors affected use (e.g., physical health and experience with the internet), and family members played an active role in online information-seeking. The internet was used before and after visits to the doctor. Key topics that participants searched for online included nutrition and lifestyle, treatment options, and prostate cancer in Black men. Men reported many downstream benefits with internet use including feeling more empowered in decision-making, reducing anxiety about treatment and providing greater accountability for research. However, they also reported negative impacts such as feeling overwhelmed or discouraged sorting through the information to identify high-quality content that is personally relevant, as well as increased anxiety or loss of sleep from overuse. In summary, online sources have the potential to positively impact the cancer journey by reinforcing or supplementing information from health care providers, but can be harmful if the information is poor quality, not representative, or the internet is overused.

Do Articles Shared by Academic Medicine Social Media Influencers Drive Future Citation Rates?

OBJECTIVE

To assess the role of influential figures within social media (SoMe) in driving future citations.

METHODS

All original articles published in the Journal of Urology and European Urology in 2018 were identified. For each article, number of mentions on any SoMe platform, article's Twitter reach, and total citations were collected. Article characteristics such as type of study, article topic, and open access status were identified. Total academic research output was obtained for first and last authors of included articles. Influential SoMe figures were defined as users that tweeted about included articles and had over 2000 followers. For these accounts, we collected total followers, total tweets, engagement statistics, verification status, and academic characteristics such as total citations and total prior publications. The impact of SoMe, article, and academic characteristics on future citations was assessed using panel data regression analysis.

RESULTS

We identified 394 articles with 8895 total citations and 460 SoMe influencers. On panel data regression modeling, tweets about a specific article were associated with future citations (0.17 citations per tweet about an article, P < .001). SoMe influencer characteristics were not associated with increased citations (P > .05). The following non-SoMe-associated characteristics were predictive of future citations (P < .001): study type (prospective studies received 12.9 more citations than cross-sectional studies), open access status (4.3 citations more if open access, P < .001), and previously well-published first and last authors.

CONCLUSION

While SoMe posts are associated with increased visibility and higher future citation rates, SoMe influencers do not appear to drive these outcomes. Instead, high quality and accessibility were more predictive of future citability.

Thulium fiber laser pre-settings during ureterorenoscopy: Twitter's experts' recommendations

INTRODUCTION

Thulium fiber laser (TFL) is a novel laser in the field of urology. There is no consensus for optimal parameters. As most urologists use social media, being Twitter the platform with the most dissemination in healthcare, we aim to review the preferred TFL settings chosen by the experts and, to evaluate their pros and cons.

MATERIALS AND METHODS

A Twitter review was performed from November 2019 (firsts TFL experiences in urology) until October 2021 using the hashtags: "thuliumfiber", "ThuliumFiberLaser", "TFL" "soltive", "fiberdust", "OlympusUrology", "quanta_system", "IPG_Photonics", "rocamed". Only board-certified urologists were considered. The "tweets" selected include information about TFL preferred settings for stone lithotripsy and tissue ablation. Additionally, we also seek information regarding laser technique, fiber size, laser time, stone type and equipment.

RESULTS

A total of 42 opinions were identified. The 23 endourologists have a median of 2.298 followers (range 202-10.000). Most comments were about TFL settings for kidney stone dusting (61%). There was a significant difference (p < 0.05) for kidney stone dusting settings (dusting, frequency, and power) between endourologists. Only 24% reported their fiber size, 4 reported the stone composition and 2 endourologists mentioned their type of ureteroscope. There was no discussion about technique used (burst or continuous) nor equipment. Surgery time was reported 3 times.

CONCLUSION

There is no consensus in TFL pre-settings. When a pre-setting is proposed, it should also recommend technique to be used. Settings are personal and related to multiple factors, such as training, technique, equipment and fiber size.

Association Between Twitter Mentions and Academic Citations in Otolaryngology Literature

OBJECTIVE

To evaluate the relationship between Twitter mentions and academic citations in otolaryngology literature.

STUDY DESIGN

Retrospective cross-sectional analysis.

SETTING

Altmetric Twitter mention and Google Scholar citation rosters.

METHODS

Original research articles from 10 leading otolaryngology journals were assessed 26 months after print publication. Article Twitter mentions were tracked through the Altmetric Bookmarklet, and article citation data were determined through the Google Scholar search engine. Twitter mentions and citation metrics of articles were compared through 2-tailed t test analysis (P < .05).

RESULTS

Of all articles, 50.7% (152/300) had at least 1 Twitter mention. Of all article Twitter mentions, 25% (432/1758) happened within the first week of online publication dates, while 64% (1130/1758) occurred between online and print publication dates. Articles mentioned on Twitter had 1.6-fold more Google Scholar citations (8.6 ± 0.7, mean ± SD) than articles with no Twitter mentions (5.4 ± 0.4, P < .01). A total of 8% (24/300) of publications were tweeted by their authors. Articles self-tweeted by authors were associated with an 8.4-citation increase (14.8 ± 3.1) for Google Scholar when compared with articles not shared by their authors on Twitter (6.4 ± 0.4; 2.3-fold increase, P < .01).

CONCLUSION

Most otolaryngology articles are disseminated over Twitter, with greatest Twitter activity occurring before print publication date of articles. Citations within 2 years of release are positively associated with the number of mentions on Twitter. Article Twitter mentions may augment the academic influence of otolaryngology publications.

Characterization of the #Radiology Twitter Conversation During the Global COVID-19 Pandemic

OBJECTIVE

To assess the #Radiology conversation on Twitter social media platform during the COVID-19 pandemic.

MATERIALS AND METHODS

From February 1 to December 31, 2020, all tweets with a #Radiology hashtag were identified using the healthcare social media analytics tool, Symplur Signals. Data collected included number of tweets, retweets, impressions, links, and user characteristics. Data were stratified by the presence of a COVID-19-related keyword, and a social media network analysis was further performed.

RESULTS

Of the 68,172 tweets, 10,093 contained COVID-19 content from 2809 users generating 65,513,669 impressions. More tweets with COVID-19 content contained links than without (P < 0.01). Network analysis demonstrated most users were physicians (48.10%), authoring the most tweets (40.38%), using the most mentions (32.15%), and retweeting the most (51.45%). The most impressions, however, were by healthcare organizations not providing clinical care (20,235,547 impressions, 30.89%). Users came from 80 countries, most from the United States (29.3%) and the United Kingdom (8.69%). During early March, COVID-19 dominated the #Radiology conversation, making up 54.67% of tweets the week of March 14 and 64.74% of impressions the week of March 21 compared to 13.97% of tweets and 16.76% of impressions in the remainder of the study period (P < 0.01).There was an influx of new users to the #Radiology conversation during this time period with more users tweeting about COVID-19 than not (P < 0.01).

CONCLUSION

Discussion of COVID-19 in the #Radiology community increased significantly during the early weeks of the pandemic. Real time sharing and collaboration proved a useful tool when rapid information dissemination was needed to manage an emerging pathogen.

Characterization and Comparison of the Utilization of Facebook Groups Between Public Medical Professionals and Technical Communities to Facilitate Idea Sharing and Crowdsourcing During the COVID-19 Pandemic: Cross-sectional Observational Study

BACKGROUND

Strict social distancing measures owing to the COVID-19 pandemic have led people to rely more heavily on social media, such as Facebook groups, as a means of communication and information sharing. Multiple Facebook groups have been formed by medical professionals, laypeople, and engineering or technical groups to discuss current issues and possible solutions to the current medical crisis.

OBJECTIVE

This study aimed to characterize Facebook groups formed by laypersons, medical professionals, and technical professionals, with specific focus on information dissemination and requests for crowdsourcing.

METHODS

Facebook was queried for user-created groups with the keywords "COVID," "Coronavirus," and "SARS-CoV-2" at a single time point on March 31, 2020. The characteristics of each group were recorded, including language, privacy settings, security requirements to attain membership, and membership type. For each membership type, the group with the greatest number of members was selected, and in each of these groups, the top 100 posts were identified using Facebook's algorithm. Each post was categorized and characterized (evidence-based, crowd-sourced, and whether the poster self-identified). STATA (version 13 SE, Stata Corp) was used for statistical analysis.

RESULTS

Our search yielded 257 COVID-19-related Facebook groups. Majority of the groups (n=229, 89%) were for laypersons, 26 (10%) were for medical professionals, and only 2 (1%) were for technical professionals. The number of members was significantly greater in medical groups (21,215, SD 35,040) than in layperson groups (7623, SD 19,480) (P<.01). Medical groups were significantly more likely to require security checks to attain membership (81% vs 43%; P<.001) and less likely to be public (3 vs 123; P<.001) than layperson groups. Medical groups had the highest user engagement, averaging 502 (SD 633) reactions (P<.01) and 224 (SD 311) comments (P<.01) per post. Medical professionals were more likely to use the Facebook groups for education and information sharing, including academic posts (P<.001), idea sharing (P=.003), resource sharing (P=.02) and professional opinions (P<.001), and requesting for crowdsourcing (P=.003). Layperson groups were more likely to share news (P<.001), humor and motivation (P<.001), and layperson opinions (P<.001). There was no significant difference in the number of evidence-based posts among the groups (P=.10).

CONCLUSIONS

Medical professionals utilize Facebook groups as a forum to facilitate collective intelligence (CI) and are more likely to use Facebook groups for education and information sharing, including academic posts, idea sharing, resource sharing, and professional opinions, which highlights the power of social media to facilitate CI across geographic distances. Layperson groups were more likely to share news, humor, and motivation, which suggests the utilization of Facebook groups to provide comedic relief as a coping mechanism. Further investigations are necessary to study Facebook groups' roles in facilitating CI, crowdsourcing, education, and community-building.

Guidance on the use of social media in reproductive medicine practice

The term "social media" refers to computer-mediated technologies that enable individuals and communities to gather, communicate, network, and share information. These technologies represent useful tools for enabling individual providers and their clinics to broadcast content that educates, informs, advertises, and narrates content to a larger audience. There are multiple benefits to maintaining a presence on social media, either as an individual physician or as a clinic, but several pitfalls deserve consideration as well. This guidance document does not endorse any specific cloud-based platform or service, though some are mentioned for the purposes of illustration.

'Fake News' in urology: evaluating the accuracy of articles shared on social media in genitourinary malignancies

OBJECTIVES

To evaluate the accuracy of the most popular articles on social media platforms pertaining to genitourinary malignancies, and to identify the prevalence of misinformation available to patients.

MATERIALS AND METHODS

The 10 most shared articles on popular social media platforms (Facebook, Twitter, Pinterest, and Reddit) were identified for prostate cancer, bladder cancer, kidney cancer, testis cancer, and PSA testing using a social media analysis tool (August 2017 and August 2018). Articles were reviewed for accuracy by comparing the article information against available scientific research and consensus data. They were classified as accurate, misleading or inaccurate. The Mann-Whitney U-test was used for statistical comparison.

RESULTS

Articles pertaining to prostate cancer were the most shared across all social media platforms (399 000 shares), followed by articles pertaining to kidney cancer (115 000), bladder cancer (17 894), PSA testing (8827) and testicular cancer (7045). The prevalence of inaccurate or misleading articles was high: prostate cancer, 7/10 articles; kidney, 3/10 articles; bladder, 2/10 articles; testis, 2/10 articles; and PSA testing, 1/10 articles. There was a significantly higher average number of shares for inaccurate (54 000 shares; P < 0.01) and misleading articles (7040 shares; P < 0.01) than for accurate articles (1900 shares). Inaccurate articles were 28 times more likely to be shared than factual articles.

CONCLUSION

Misleading or inaccurate information on genitourinary malignancies is commonly shared on social media. This study highlights the importance of directing patients to appropriate cancer resources and potentially argues for oversight by the medical and technology communities.

Association of Social Media Presence with Online Physician Ratings and Surgical Volume Among California Urologists: Observational Study

BACKGROUND

Urologists are increasingly using various forms of social media to promote their professional practice and attract patients. Currently, the association of social media on a urologists' practice is unknown.

OBJECTIVES

We aimed to determine whether social media presence is associated with higher online physician ratings and surgical volume among California urologists.

METHODS

We sampled 195 California urologists who were rated on the ProPublica Surgeon Scorecard website. We obtained information on professional use of online social media (Facebook, Instagram, Twitter, blog, and YouTube) in 2014 and defined social media presence as a binary variable (yes/no) for use of an individual platform or any platform. We collected data on online physician ratings across websites (Yelp, Healthgrades, Vitals, RateMD, and UCompareHealthcare) and calculated the mean physician ratings across all websites as an average weighted by the number of reviews. We then collected data on surgical volume for radical prostatectomy from the ProPublica Surgeon Scorecard website. We used multivariable linear regression to determine the association of social media presence with physician ratings and surgical volume.

RESULTS

Among our sample of 195 urologists, 62 (32%) were active on some form of social media. Social media presence on any platform was associated with a slightly higher mean physician rating (β coefficient: .3; 95% CI 0.03-0.5; P=.05). However, only YouTube was associated with higher physician ratings (β coefficient: .3; 95% CI 0.2-0.5; P=.04). Social media presence on YouTube was strongly associated with increased radical prostatectomy volume (β coefficient: 7.4; 95% CI 0.3-14.5; P=.04). Social media presence on any platform was associated with increased radical prostatectomy volume (β coefficient: 7.1; 95% CI -0.7 to 14.2; P=.05).

CONCLUSIONS

Urologists' use of social media, especially YouTube, is associated with a modest increase in physician ratings and prostatectomy volume. Although a majority of urologists are not currently active on social media, patients may be more inclined to endorse and choose subspecialist urologists who post videos of their surgical technique.

Collective intelligence in medical decision-making: a systematic scoping review

BACKGROUND

Collective intelligence, facilitated by information technology or manual techniques, refers to the collective insight of groups working on a task and has the potential to generate more accurate information or decisions than individuals can make alone. This concept is gaining traction in healthcare and has potential in enhancing diagnostic accuracy. We aim to characterize the current state of research with respect to collective intelligence in medical decision-making and describe a framework for diverse studies in this topic.

METHODS

For this systematic scoping review, we conducted a systematic search for published literature using PubMed, Embase, Web of Science, and CINAHL on August 8, 2017. We included studies that combined the insights of two or more medical experts to make decisions related to patient care. Studies that examined medical decisions such as diagnosis, treatment, and management in the context of an actual or theoretical patient case were included. We include studies of complex medical decision-making rather than identification of a visual finding, as in radiology or pathology. We differentiate between medical decisions, in which synthesis of multiple types of information is required over time, and studies of radiological scans or pathological specimens, in which objective identification of a visual finding is performed. Two reviewers performed article screening, data extraction, and final inclusion for analysis.

RESULTS

Of 3303 original articles, 15 were included. Each study examined the medical decisions of two or more individuals; however, studies were heterogeneous in their methods and outcomes. We present a framework to characterize these diverse studies, and future investigations, based on how they operationalize collective intelligence for medical decision-making: 1) how the initial decision task was completed (group vs. individual), 2) how opinions were synthesized (information technology vs. manual vs. in-person), and 3) the availability of collective intelligence to participants.

DISCUSSION

Collective intelligence in medical decision-making is gaining popularity to advance medical decision-making and holds promise to improve patient outcomes. However, heterogeneous methods and outcomes make it difficult to assess the utility of collective intelligence approaches across settings and studies. A better understanding of collective intelligence and its applications to medicine may improve medical decision-making.

Association Between Twitter Reception at a National Urology Conference and Future Publication Status

BACKGROUND

Social media is an increasingly popular means to disseminate medical research. However, it is unknown whether the extent to which content is shared mirrors conventional measures of scientific merit or impact.

OBJECTIVE

To examine whether Twitter activity (as measured by the number of "likes" and "retweets" [RTs]) relating to original research presented at a national urology meeting was associated with subsequent publication status and journal impact factor (IF).

DESIGN, SETTING, AND PARTICIPANTS

We retrospectively reviewed Twitter data obtained through the Keyhole archiving platform using the hashtag "#aua15" from May 1 through June 1, 2015 reflecting the hashtag of the American Urological Association (AUA) meeting.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

We analyzed all posts containing keywords related to research studies. Among posts reporting on newly presented studies with discernable attribution, we evaluated subsequent publication status within 45 mo, including journal IF. We compared social media reception (number of likes/RTs) by publication status, and assessed the relationship between social media reception and subsequent journal IF using Pearson's correlation.

RESULTS AND LIMITATIONS

A total of 15 303 posts were associated with #aua15 between May 1 and June 1, 2015, which reached 2 263 438 users. The median number of likes/RTs was 2 (interquartile range 1-3). We analyzed all posts receiving at least one like/RT (n = 2964) for text content related to research and identified 496 associated with new scientific studies presented at the meeting. Forty-five months following the AUA meeting, 96 studies were identifiable on PubMed (19.4%). Research with more likes/RTs at the AUA meeting were more likely to be subsequently published (p = 0.001). Among published studies, there was a modest, positive correlation between the number of likes/RTs and publication journal IF (r² = 0.36).

CONCLUSIONS

Measures of social media engagement with data presented at a national medical meeting were positively correlated with subsequent publication and journal IF after presentation.

PATIENT SUMMARY

New urological research that was shared more often at a national meeting was more likely to be published in journals that are more highly cited.