Social Media and the Dissemination of Research: Insights from the Most Widely Circulated Articles in Plastic Surgery

Hashtags in Plastic Surgery: A Sentiment Analysis of over 1 Million Tweets

BACKGROUND

Current literature has sparse recommendations that guide social networking practices in plastic surgery. To address this, we used natural language processing and sentiment analysis to investigate the differences in plastic surgery-related terms and hashtags on Twitter.

METHODS

Over 1 million tweets containing keywords #plasticsurgery, #cosmeticsurgery, and their non-hashtagged versions plastic surgery and cosmetic surgery were collected from the Twitter Gardenhose feed spanning from 2012 to 2016. We extracted the average happiness/positivity (h-avg) using hedonometrics and created word-shift graphs to determine influential words.

RESULTS

The most popular keywords were plastic and cosmetic surgery, comprising more than 90% of the sample. The positivity scores for plastic surgery, cosmetic surgery, #plasticsurgery, and #cosmeticsurgery were 5.72, 6.00, 6.17, and 6.18, respectively. Compared to plastic surgery, the term cosmetic surgery was more positive because it lacked antagonistic words, such as "fake," "ugly," "bad," "fails," and "wrong." For similar reasons, #plasticsurgery and #cosmeticsurgery were more positively associated than their non-hashtagged counterparts.

CONCLUSION

Plastic surgery-related hashtags are more positively associated than their non-hashtagged versions. The language associated with such hashtags suggests a different user profile than the public and, given their underutilization, remain viable channels for professionals to achieve their diverse social media goals.

LEVEL OF EVIDENCE V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Shaping Social Media: Is Twitter an Equitable tool for Professional Development?

PURPOSE

Twitter has become a powerful tool for professional development in academia. However, studies from the general population suggest that racialized and gender biases disproportionately empower male and white users. We characterized the demographics of Twitter influencers in Canadian healthcare.

METHODS

We used the Right Relevance Insight API algorithm to identify Twitter influencers in the healthcare, healthcare research, and health policy domains, and to generated normalized influencer scores based on user connections and engagement. We used facial recognition software to approximate the influencers' race and sex.

RESULTS

The majority of influencers identified were white (84%) and/or male (60%). Males had significantly higher influencer scores than females (65.1 ± 8.0 vs. 61.2 ± 6.2, P < 0.05) in health policy. We did not identify any sex- or race-associated disparities among influencers in healthcare or healthcare research.

CONCLUSION

Male users have significantly higher levels of influence in health policy on Twitter. Given the importance of Twitter as a tool for professional development, it is crucial that institutional leaders and policymakers are aware of potential inequities in user reach. Future studies should evaluate additional factors shaping user influence in healthcare on Twitter, with a focus on equity, diversity, and trustworthiness.

Twitter Buzz and Citations: Who's Tweeting Matters for Plastic Surgery Literature

Background

Plastic surgery and social media have become inextricably linked through patient procurement, practice growth, and academic exposure. Other surgical fields have demonstrated that tweeting is positively correlated with increased citations. This study aimed to elucidate the effect of Twitter on traditional bibliometrics in plastic surgery and parse out the kinds of tweets that are most correlated with citations.

Methods

Articles from May to October of 2018 from Plastic and Reconstructive Surgery and Aesthetic Surgery Journal were analyzed to determine the citation count, number and backgrounds of Twitter users tweeting about the article, and total tweets. Multiple linear regression was performed to correlate these variables to citation count.

Results

A total of 369 articles were analyzed. Plastic and Reconstructive Surgery had significantly more average tweets per article compared to Aesthetic Surgery Journal (21.8 versus 10.2, P < 0.001), Additionally, a number of tweets (r = 0.45, P < 0.001) and reaching more total followers (r = 0.48, P < 0.001) were both positively correlated with citations. Multiple linear regression demonstrated that tweets from self-identified scientists were positively correlated with citations (r = 0.99, P = 0.001). Tweets from science communicators had no correlation with citations (r = -0.012, P = 0.726). Tweets coming domestically from the country of the author were also associated with more citations (r = 0.164, P = 0.013).

Conclusions

Twitter activity, including the number of followers reached, for an article is positively correlated with citations. Interestingly, the kind of person tweeting affected the citations as well. Domestic tweets and those from scientists were associated with more citations. This implies that Twitter can be an effective form of academic dissemination, provided the "right" Twitter users are promoting the article.

Promoting Publications Through Plastic Surgery Journal Instagram Accounts: Is It Worth It?

PURPOSE

Journals are increasingly using social media to increase article engagement. We aim to determine the impact of Instagram promotion on, and identify social media tools that effectively enhance, plastic surgery article engagement and impact.

METHODS

Instagram accounts for Plastic and Reconstructive Surgery, Annals of Plastic Surgery, Aesthetic Surgery Journal, and Aesthetic Plastic Surgery were reviewed for posts published by February 8, 2022. Open access journal articles were excluded. Post caption word count and number of likes, tagged accounts, and hashtags were recorded. Inclusion of videos, article links, or author introductions was noted. All articles from journal issues published between the dates of the first and last posts promoting articles were reviewed. Altmetric data approximated article engagement. Citation numbers from the National Institutes of Health iCite tool approximated impact. Differences in engagement and impact of articles with and without Instagram promotion were compared by Mann-Whitney U tests. Univariate and multivariable regressions identified factors predictive of more engagement (Altmetric Attention Score, ≥5) and citations (≥7).

RESULTS

A total of 5037 articles were included, with 675 (13.4%) promoted on Instagram. Of posts featuring articles, 274 (40.6%) included videos, 469 (69.5%) included article links, and 123 included (18.2%) author introductions. Promoted articles had higher median Altmetric Attention Scores and citations (P < 0.001). On multivariable analysis, using more hashtags predicted higher article Altmetric Attention Scores (odds ratio [OR], 1.85; P = 0.002) and more citations (OR, 1.90; P < 0.001). Including article links (OR, 3.52; P < 0.001) and tagging more accounts (OR, 1.64; P = 0.022) predicted higher Altmetric Attention Scores. Including author introductions negatively predicted Altmetric Attention Scores (OR, 0.46; P < 0.001) and citations (OR, 0.65; P = 0.047). Caption word count had no significant impact on article engagement or impact.

CONCLUSIONS

Instagram promotion increases plastic surgery article engagement and impact. Journals should use more hashtags, tag more accounts, and include manuscript links to increase article metrics. We recommend that authors promote on journal social media to maximize article reach, engagement, and citations, which positively impacts research productivity with minimal additional effort in designing Instagram content.

#COVID19 and #Breastcancer: A Qualitative Analysis of Tweets

Rapid and efficient communication regarding quickly evolving medical information was paramount for healthcare providers and patients throughout the COVID-19 pandemic. Over the last several years, social media platforms such as Twitter have emerged as important tools for health promotion, virtual learning among healthcare providers, and patient support. We conducted a qualitative thematic content analysis on tweets using the hashtags #BreastSurgery, #BreastCancer, #BreastOncology, #Pandemic, and #COVID19. Advocacy organizations were the most frequent authors of tweets captured in this dataset, and most tweets came from the United States of America (64%). Seventy-three codes were generated from the data, and, through iterative, inductive analysis, three major themes were developed: patient hesitancy and vulnerability, increased efforts in knowledge sharing, and evolving best practices. We found that Twitter was an effective way to share evolving best practices, education, and collective experiences among key stakeholders. As Twitter is increasingly used as a tool for health promotion and knowledge translation, a better understanding of how key stakeholders engage with healthcare-related topics on the platform can help optimize the use of this powerful tool.

Research Promotion is Associated with Broader Influence and Higher Impact of Plastic Surgery Publications

BACKGROUND

Social media has altered the mechanisms by which published research is disseminated and accessed. The objective of this study was to measure the effect of promotion on research article dissemination, influence, and impact in Plastic and Reconstructive Surgery.

METHODS

All articles published in Plastic and Reconstructive Surgery from January 1, 2016-December 31, 2018 were obtained and reviewed to determine inclusion/exclusion and for the Altmetric Attention Score (AAS), citations, relative citation rate (RCR), and 16 unique promotional tags (journal club, editor's pick, press release, patient safety, etc.) as indexed on the Plastic and Reconstructive Surgery website. 1,502 articles were included in the analysis. Statistical analysis was completed using descriptive statistics, Pearson's correlations, and Student t-tests where appropriate with a predetermined level of significance of p≤0.05.

RESULTS

A total of 637 articles (42.4%) had a promotional tag, while 252 (16.8%) had multiple tags. Articles with promotional tags had higher AAS (30.35 vs 8.22; p<0.001), more citations (11.96 vs 8.47; p<0.001), and a higher RCR (2.97 vs 2.06; p<0.001) compared to articles without a tag. Articles with multiple tags had higher AAS (50.17 vs 17.39; p<0.001), more citations (15.78 vs 9.47; p<0.001), and a higher RCR (3.67 vs 2.51; p<0.001) compared to articles with only one tag. As the number of tags increased for an article, AAS (p<0.001), citation count (p<0.001), and RCR (p<0.001) likewise increased.

CONCLUSIONS

This analysis strongly suggests that promotion of research articles is associated with significantly wider dissemination, broader visibility, and more subsequent citations in the literature.

The Use of Twitter by Medical Journals: Systematic Review of the Literature

BACKGROUND

Medical journals use Twitter to engage and disseminate their research articles and implement a range of strategies to maximize reach and impact.

OBJECTIVE

This study aims to systematically review the literature to synthesize and describe the different Twitter strategies used by medical journals and their effectiveness on journal impact and readership metrics.

METHODS

A systematic search of the literature before February 2020 in four electronic databases (PubMed, Web of Science, Scopus, and ScienceDirect) was conducted. Articles were reviewed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines.

RESULTS

The search identified 44 original research studies that evaluated Twitter strategies implemented by medical journals and analyzed the relationship between Twitter metrics and alternative and citation-based metrics. The key findings suggest that promoting publications on Twitter improves citation-based and alternative metrics for academic medical journals. Moreover, implementing different Twitter strategies maximizes the amount of attention that publications and journals receive. The four key Twitter strategies implemented by many medical journals are tweeting the title and link of the article, infographics, podcasts, and hosting monthly internet-based journal clubs. Each strategy was successful in promoting the publications. However, different metrics were used to measure success.

CONCLUSIONS

Four key Twitter strategies are implemented by medical journals: tweeting the title and link of the article, infographics, podcasts, and hosting monthly internet-based journal clubs. In this review, each strategy was successful in promoting publications but used different metrics to measure success. Thus, it is difficult to conclude which strategy is most effective. In addition, the four strategies have different costs and effects on dissemination and readership. We recommend that journals and researchers incorporate a combination of Twitter strategies to maximize research impact and capture audiences with a variety of learning methods.

The Online Attention to Cleft Lip and Palate Research: An Altmetric Analysis

OBJECTIVES

To identify research articles related to cleft lip and/or cleft palate (CL/P) that generated the highest online attention.

METHODS

Altmetric Explorer was used to identify the 100 articles with the highest Altmetric Attention Score (AAS). Descriptive and correlation statistics were performed to study the characteristics of these articles in relation to their publication data, research type and domain, number of Mendeley readers, and dimensions citations. Citation counts were extracted from Scopus and Google Scholar.

RESULTS

The median AAS for the top 100 outputs was 22 (range from 12 to 458). The outputs were mostly discussed on Twitter (median = 8; range = 0-131). Topics discussing treatment and care for patients with CL/P accounted for 38% of the articles with the highest AAS followed by etiology and risk factors (32%). The majority of articles originated from the USA (46%) followed by Europe (16%) and the United Kingdom (15%). No significant differences were observed in AAS among different study designs, topic domains, journals' ranking and impact factor, and the number of citations in Scopus and Google Scholar.

CONCLUSIONS

Researchers should consider use of social platforms to disseminate their work among scholars and nonscholars. Altmetrics can be combined with traditional metrics for a more comprehensive assessment of research impact.

Factors associated with high Altmetric Attention Score in dermatology research

BACKGROUND

Alternative metrics are emerging scores to assess the impact of research beyond the academic environment.

OBJECTIVE

To analyse whether a correlation exists between manuscript characteristics and alternative citation metrics.

MATERIALS AND METHODS

This bibliometric analysis included original articles published in the five journals with the highest impact factors during 2019. We extracted the following characteristics from each record: journal, publication month, title, number of authors, type of institution, type of publication, research topic, number of references, financial support, free/open access status and literature citations. The main measure was the identification of variables of higher social attention (measured by the Altmetric Attention Score ≥25) using binary logistic regression. Model performance was assessed by the change in the area under the curve (AUC).

RESULTS

A total of 840 manuscripts were included. The Altmetric scores across all five journals ranged from 0 to 465 (mean 12.51 ± 33.7; median 3). The most prevalent topic was skin cancer, and the study design was clinical science. The scientific journal (P < 0.001), the presence of conflicts of interest (OR 2.2 [95%CI 1.3-3.7]; P = 0.002) and open access status OR 3.2 [95%CI 1.6-6.7]; P = 0.002) were found as independent predictors of high Altmetric scores.

CONCLUSIONS

Our study suggests an article´s social recognition may be dependent on some manuscript characteristics, thus providing useful information on the dissemination of dermatology research to the general public.

Altmetric Attention Score: Evaluating the Social Media Impact of Burn Research

Traditional measures of scholarly impact (i.e., impact factor, citation rate) do not account for the role of social media in knowledge dissemination. The Altmetric Attention Score (AAS) tracks the online sharing activity of articles on platforms such as Twitter and Facebook. All 285 original scientific articles published in Journal of Burn Care & Research and Burns from January to December 2017 were obtained from official journal websites. Article characteristics extracted include: AAS; number of Twitter, Facebook, and news outlet mentions; subject of study and study design; number of citations; number of authors and academic institutions; and others. The average AAS for all articles was 6.1 (SD: 48; Range: 0 to 611) in which 156 (55%) of those had Twitter mentions. The mean AAS for Journal of Burn Care & Research and Burns were 7.7 (SD: 54; Range: 0 to 536) and 5.3 (SD: 45; Range: 0 to 611), respectively. There was a weak, positive correlation between AAS and citation count for all articles (ρ = 0.12; p = 0.049), and this finding was consistent for Journal of Burn Care & Research (ρ = 0.21; p = 0.039) and Burns (ρ = 0.15; p = 0.038) individually. The weak correlation between the two metrics supports that AAS and citation count capture the attention of different audiences. In addition, studies discussing skin grafting were associated with higher average AAS (β: 29 [95% CI: 4.2 to 54]; p = 0.022). Overall, our findings support using both AAS and traditional bibliometrics to assess article impact.

Examining the Correlation between Altmetric Score and Citations in the Plastic Surgery Literature

BACKGROUND

Social media are transforming the dissemination of published research. This influence brought the advent of a new metric, altmetrics, which seeks to quantify the influence of research in real time based on an article's attention online. This study aims to determine the correlation between altmetrics ratings for articles with traditional bibliometrics of impact factor and citation rate.

METHODS

The 10 most cited articles in the top 15 plastic surgery journals were determined for 2013 and 2016. The 2013 articles allow for a 5-year lag time, whereas 2016 data provide another timepoint for comparison. Altmetric scores and citation count were collected for each article. Impact factor and Twitter account age were determined for each journal. Statistical analysis was completed using descriptive statistics, and Pearson and Spearman correlation coefficients.

RESULTS

In both 2013 and 2016, there was a weak positive correlation between citations and Altmetric score (r = 0.2620, p = 0.0012; r = 0.3564, p < 0.0001, respectively) and between impact factor and the Altmetric score (r = 0.2419, p = 0.0040; r = 0.3887, p = < 0.0001, respectively). Twitter was the main contributor to the Altmetric score in both 2013 and 2016.

CONCLUSIONS

Altmetric scores and traditional bibliometrics are not strongly correlated with one another in the plastic surgery literature at this point in time. Still, the short- and long-term impact of a publication might be determined through the combined analysis of citation count, impact factor, and Altmetric scores.

Journal of Pediatric Surgery: Effects of an automated social media strategy for knowledge dissemination

BACKGROUND/PURPOSE

With increasing publications, it's hard to keep up with surgical literature. Social media is a valuable educational resource with global reach. We sought to analyze the impact of an automated social media strategy for the Journal of Pediatric Surgery (JPS).

METHODS

Analytics for March-August 2019 were retrospectively reviewed for automated posts using a SocialPilot queue from the journal's RSS feed. Descriptive and inferential statistics were utilized to analyze performance, including journal article views.

RESULTS

One hundred sixty-five posts amassed 512,316 impressions and 9,795 article views. Facebook had greater overall impact (p < 0.01). Twitter was stronger when adjusted by number of followers (p < 0.01). Engagements and article views had strong correlation between platforms (p < 0.01). Day of the week had limited impact. Photographs were the preferred content format (p < 0.05). Topic had the highest effect on performance (p < 0.05) - with colorectal, EA/TEF, and general pediatric surgery leading to higher reach and engagement. ECMO/CDH was the least popular. Comments and shares were negligible.

CONCLUSIONS

We reached 3,105 users, with 59 article views per post. Topic had the strongest effect on performance. For comparison, custom infographics reached 7,368 users and averaged 101 article views. Alternative knowledge dissemination strategies are likely needed to foster online discussion and build more robust forums for collaboration.

TYPE OF STUDY

Retrospective, Non-clinical Study.

LEVEL OF EVIDENCE

Level III.

Analysis of #PlasticSurgery in Europe: An Opportunity for Education and Leadership

BACKGROUND

Prior studies demonstrate that social media are used by plastic surgeons to educate and engage. The hashtag #PlasticSurgery has been studied previously and is embraced by American plastic surgeons and journals; however, no studies have examined its use or adoption across Europe.

METHODS

A retrospective analysis of 800 tweets containing the words "plastic surgery" or the hashtag #PlasticSurgery in four of the most spoken European languages worldwide excluding English (Spanish, #CirugiaPlastica; French, #ChirurgiePlastique; Portuguese, #CirurgiaPlastica; and German, #PlastischeChirurgie) was performed. The following were assessed: identity of author, subject matter, use of the hashtag #PlasticSurgery in each language, whether posts by surgeons and academic institutions were self-promotional or educational, and whether a link to a journal article or a reference in PubMed was provided.

RESULTS

Seventeen percent and 3 percent of analyzed tweets came from plastic surgeons or academic institutions, respectively; only 17.5 percent of them were for educational purpose. None of them had any digital link to a peer-reviewed article or a scientific journal.

CONCLUSIONS

This study demonstrates the low participation of plastic surgeons and academic institutions in social media (especially for education) in four of the major world languages. Social media should be considered in Europe as an opportunity to increase leadership, improve education, and spread knowledge of plastic surgery by board-certified plastic surgeons.