Enriched Audience Engagement Through Twitter: Should More Academic Radiology Departments Seize the Opportunity?

The Role of Twitter in Radiology Medical Education and Research: A Review of Current Practices and Drawbacks

The trends in society have provided favourable conditions for the rapid growth of radiology on social media, specifically there has been an expanding presence on Twitter. Currently, simple searches on Twitter yield a plethora of radiology education resources, that may be suited for medical students, residents or practicing radiologists. Educators have many tools at their disposal to deliver effective teaching. Over time, strategies such as including images and scrollable stacks often are more successful at gaining popularity or clicks online. Journals and authors can use Twitter to promote their new scientific work and potentially reach audiences they couldn't have prior. Attendees at conferences can get involved in the conversation by tweeting about the meeting and engaging with other attendees with mutual interests. Interested medical students, residents and even practicing radiologists can use Twitter as a means of networking and connecting with other scholars all around the globe. Within its glory, Twitter does carry some drawbacks including privacy concerns, equality, and risk of misinformation. Above all, the future of Twitter is bright and promising for all who are currently on it and plan to use it for their education, research, or professional advancement.

An Exploratory Study of Medical Journal's Twitter Use: Metadata, Networks, and Content Analyses

BACKGROUND

An increasing number of medical journals are using social media to promote themselves and communicate with their readers. However, little is known about how medical journals use Twitter and what their social media management strategies are.

OBJECTIVE

This study aimed to understand how medical journals use Twitter from a global standpoint. We conducted a broad, in-depth analysis of all the available Twitter accounts of medical journals indexed by major indexing services, with a particular focus on their social networks and content.

METHODS

The Twitter profiles and metadata of medical journals were analyzed along with the social networks on their Twitter accounts.

RESULTS

The results showed that overall, publishers used different strategies regarding Twitter adoption, Twitter use patterns, and their subsequent decisions. The following specific findings were noted: journals with Twitter accounts had a significantly higher number of publications and a greater impact than their counterparts; subscription journals had a slightly higher Twitter adoption rate (2%) than open access journals; journals with higher impact had more followers; and prestigious journals rarely followed other lesser-known journals on social media. In addition, an in-depth analysis of 2000 randomly selected tweets from 4 prestigious journals revealed that The Lancet had dedicated considerable effort to communicating with people about health information and fulfilling its social responsibility by organizing committees and activities to engage with a broad range of health-related issues; The New England Journal of Medicine and the Journal of the American Medical Association focused on promoting research articles and attempting to maximize the visibility of their research articles; and the British Medical Journal provided copious amounts of health information and discussed various health-related social problems to increase social awareness of the field of medicine.

CONCLUSIONS

Our study used various perspectives to investigate how medical journals use Twitter and explored the Twitter management strategies of 4 of the most prestigious journals. Our study provides a detailed understanding of medical journals' use of Twitter from various perspectives and can help publishers, journals, and researchers to better use Twitter for their respective purposes.

A Gamified Social Media-Based Head and Neck Radiology Education Initiative of the American Society of Head and Neck Radiology: Viewership and Engagement Trends at 3 Years

BACKGROUND AND PURPOSE

Social media has made inroads in medical education. We report the creation and 3-year (2018-2021) longitudinal assessment of the American Society of Head and Neck Radiology Case of the Week (#ASHNRCOTW), assessing viewership, engagement, and impact of the coronavirus disease 2019 (COVID-19) pandemic on this Twitter-based education initiative.

MATERIALS AND METHODS

Unknown cases were tweeted from the American Society of Head and Neck Radiology account weekly. Tweet impressions (number of times seen), engagements (number of interactions), and new followers were tabulated. A social media marketing platform identified worldwide distribution of Twitter followers. Summary and t test statistics were performed.

RESULTS

#ASHNRCOTW was highly visible with 2,082,280 impressions and 203,137 engagements. There were significantly greater mean case impressions (9917 versus 6346), mean case engagements (1305 versus 474), case engagement rates (13.06% versus 7.76%), mean answer impressions (8760 versus 5556), mean answer engagements (908 versus 436), answer engagement rates (10.38% versus 7.87%), mean total (case + answer) impressions (18,677 versus 11,912), mean total engagements (2214 versus 910), and total engagement rates (11.79% versus 7.69%) for cases published after the pandemic started (all P values < .001). There was a significant increase in monthly new followers after starting #ASHNRCOTW (mean, 134 versus 6; P < .001) and significantly increased monthly new followers after the pandemic started compared with prepandemic (mean, 178 versus 101; P = .003). The American Society of Head and Neck Radiology has 7564 Twitter followers throughout 130 countries (66% outside the United States).

CONCLUSIONS

Social media affords substantial visibility, engagement, and global outreach for radiology education. #ASHNRCOTW viewership and engagement increased significantly during the COVID-19 pandemic.

Radiology on Instagram: Analysis of Public Accounts and Identified Areas for Content Creation

RATIONALE AND OBJECTIVES

Radiology social media research has focused on Twitter, Facebook, and YouTube, with minimal attention to Instagram, which may be a natural platform for engagement. We evaluated features of public radiology-related Instagram accounts.

MATERIALS AND METHODS

Instagram accounts were searched using the term "radiology." Two independent raters used a coding system developed through initial content review to categorize account user types and post aims over the study month (October 2019). Multivariate linear regressions were performed.

RESULTS

49 Instagram accounts and their 459 posts were retrieved. Users had median 117 total posts (interquartile range 43-203), 9 posts during the study month (1-16), 3079 followers (695-19,600), and 106 followed users (50-351). Most users were radiologists (41%, most commonly academic), radiology practices (12%, most commonly academic) and 10% radiology professional societies. The 459 posts had median 178 likes (interquartile range 51-353) and 2 comments (0-5); single videos had median 4693 views (2183-6080). 75% of posts were radiology images or videos (of these, 29% MRI, 28% CT). 65% of posts were clinical imaging cases (most commonly neuroradiology). Seven posts violated HIPAA regulations, all originating outside the U.S. When controlling for number of account followers, posts by radiology society (β = -130.6, p = 0.017) and practice accounts (β = -90.6, p = 0.049) had fewer post likes. An artwork post was the only significant predictor of greater post likes (β = +866.2, p < 0.001) and comments (β = +14.3, p < 0.001).

CONCLUSION

Instagram is commonly used by academic radiologists to present clinical imaging cases. Radiologists should consider opportunities for greater application of this unique image-based social media platform.

General Surgery Twitter during COVID-19: Tweets, Trends, and Implications for Recruitment Strategies

BACKGROUND

The COVID-19 pandemic has disrupted traditional resident recruitment practices, requiring virtual interviews and new forms of outreach. Social media, such as Twitter, is one tool programs can use to connect with applicants. This study sought to assess changes in Twitter use during the COVID-19 pandemic among general surgery programs.

METHODS

Twitter and residency program websites were queried for public Twitter accounts related to general surgery residency programs. Publicly available tweets for available accounts were reviewed for all posts for the period March 15, 2019-November 25, 2020. Thematic analysis of each tweet was performed, and engagement was determined by likes and retweets on each tweet.

RESULTS

The number of programs with active Twitter accounts increased after the onset of COVID-19 pandemic, as did the number of tweets, likes-, and retweets-per-tweet. There was a significant increase in the number of tweets regarding resident promotion, program promotion, and virtual event promotion. Tweets received more likes-per-tweet if the subject was program promotion and resident promotion than tweets regarding virtual events. All results were statistically significant (P < .05).

DISCUSSION

Twitter use and engagement with residency programs have increased significantly since pandemic onset. Engagement is highest for tweets regarding program and resident promotion as measured by likes-per-tweet and highest for program promotion and virtual events as measured by retweets-per-tweet. Given the nearly nationwide increase in Twitter engagement after pandemic onset, programs should consider the impact of Twitter as a means of communication with applicants and program branding.

Role of social and non-social online media: how to properly leverage your internet presence for professional development and research

The internet has become an integral component of daily life, with its content broadly grouped into social media and non-social online content. The use of social media, comprising interactive information sharing and networking tools, has proliferated in radiology, with as many as 85% of radiologists utilizing social media and adoption by both private and academic practices. In radiology, social media has been used to increase patient and public awareness of the specialty, establish a professional brand, share scholarly activity, aid in professional development and recruitment, improve communication, and increase engagement during scientific meetings. Organizations like the Society of Abdominal Radiology have increased the visibility of abdominal and pelvic radiology through their activity on social media; however, individual radiologists are integral to this function as well. In this article, we outline a stepwise approach to the individual use of social media, with practical tips for radiologists interested in effectively engaging the plethora of social media and non-social online content available. We also briefly discuss an approach to performing research using publicly available online media.

Using Facebook Live to Advocate Breast Cancer Screening

With current conflicting and confusing screening mammography guidelines between major medical organizations, radiologists have an opportunity to educate and advocate for patients using the power of social media. The authors provide a brief overview on the impact of social media in radiology, in particular Facebook, as well as challenges encountered by radiologists as they establish an online presence, and how to effectively use Facebook Live to advocate for screening mammography.

#Neurosurgery: A Temporal and Content Analysis of Academic Neurosurgery on Twitter

BACKGROUND

Social media has become ubiquitous in modern medicine. Academic neurosurgery has increased adoption to promote individual and departmental accomplishments, engage with patients, and foster collaboration. We sought to quantitatively evaluate the adoption of one of the most used social media platforms, Twitter, within academic neurosurgery.

METHODS

A quantitative and qualitative analysis of Twitter use across 118 academic neurosurgery departments with residency programs in the United States was performed in March 2019 and March 2021. We collated Twitter handles, Doximity residency ranking (a peer-determined ranking system), geographic location, and Twitter demographics (tweets, followers, likes, and tweet content) from before and after the coronavirus disease 2019 (COVID-19) pandemic. Tweet content was characterized by reviewers over a predetermined 6-month period. Linear regression and parametric/nonparametric tests were used for analysis.

RESULTS

Departmental accounts grew 3.7 accounts per year between 2009 and 2019 (R² = 0.96), but 43 accounts (130%) were added between 2019 (n = 33) and 2021 (n = 76). This growth, coinciding with the COVID-19 pandemic, changed the model from linear to exponential growth (R² = 0.97). The highest-ranking programs based on Doximity were significantly more likely to have an account (P < 0.001) and have more followers (P < 0.0001). Tweet content analysis revealed prioritization of faculty/resident activity (mean 49.9%) throughout the quartiles.

CONCLUSIONS

We demonstrate rapid uptake in Twitter use among U.S. academic neurosurgical departments, accelerated by COVID-19. With the impact of COVID-19, it is clear that there will be continued rapid adoption of this platform within neurosurgery, and future studies should explore the outcomes of peer collaboration, patient engagement, and dissemination of medical information.

A critical review on altmetrics: can we measure the social impact factor?

Altmetrics measure the digital attention received by a research output. They allow us to gauge the immediate social impact of an article by taking real-time measurements of how it circulates in the Internet. While there are several companies offering attention scores, the most extensive are Altmetric.com (Altmetric Attention Score—AAS) and Plum X (Plum Print). As this is an emerging topic, many medical specialities have tried to establish if there is a relationship between an article’s altmetric data and the citations it subsequently receives. The results have varied depending on the research field. In radiology, the social network most used is Twitter and the subspeciality with the highest AAS is neuroimaging. This article will review the process involved from the start when an article is published through to finally obtaining its altmetric score. It will also address the relationship between altmetrics and more traditional approaches focusing on citations in radiology and will discuss the advantages and limitations of these new impact indicators.

Radiology on Reddit: A Content Analysis and Opportunity for Radiologist Engagement and Education

OBJECTIVE

Social media use in radiology has been well documented, primarily pertaining to Twitter and Facebook. We evaluated radiology-related posts and users on Reddit, a popular platform with users who post and discuss content in a message-board format.

METHODS

Two subreddits were reviewed: r/radiology (top 100 posts) and r/medicine (search queries: radiology, x-ray, CT scan, MRI, ultrasound, PET scan, and mammogram). Post aims and user types were categorized. Kruskal-Wallis H and post-hoc pairwise Mann-Whitney U tests were performed to assess user and post types associated with greater post comments and points.

RESULTS

A total of 323 posts submitted by 258 unique users over a 9 year period with a median of 21 comments (range 0-568) and 119 points (0-1877) were reviewed. These were most commonly posted by physicians (41%), radiologic technologists (18%), and medical students (12%). Radiologists represented 30% of physicians and 12% of all users. Posts by physicians had significantly higher median comments and points than half of other user categories (P = <0.01-0.04). Most posts related to imaging case presentations (25%), comedic content (18%), and imaging appropriateness (10%). The most common radiology subspecialties featured were musculoskeletal (26%), neuroradiology (22%), abdominal (21%), and cardiothoracic (20%). Although only 1% of posts featured wellness and burnout, they had significantly higher median comments and points than 14 of 15 and 15 of 15 other post categories, respectively (P = <0.01-0.03).

CONCLUSION

Reddit hosts a diverse community providing an interface for education, consultation, and humor. Radiologists represent a small, although impactful, portion of this community and should embrace Reddit as an avenue for engagement.

Social media in interventional radiology

INTRODUCTION

Social media provides opportunities for Interventional Radiologists to share research, communicate with colleagues, provide health information and advertise their clinical practice. This study aims to examine the online and social media presence of currently practicing Australian Interventional Radiologists.

METHODS

Systematic Google searches were undertaken in May 2019 and updated in May 2020 to identify practicing Interventional Radiologists in Australia. Comprehensive searches of practice websites and social media platforms (Facebook, LinkedIn, Twitter, ResearchGate, YouTube) were undertaken for each Interventional Radiologist.

RESULTS

There were 265 Interventional Radiologists identified as currently practising in Australia, including 209 Interventional Radiologists (excluding Interventional Neuroradiologists), 49 Interventional Neuroradiologists and 7 that practise across both Interventional Radiology and Interventional Neuroradiology. 72% of Interventional Radiologists had at least one social media account, with LinkedIn the most widely used social media platform (60%). There was a significant negative correlation between the total number of social media accounts and years in practice (P = 0.04). Across the states, a higher population per IR was positively correlated with a higher average number of social media accounts per IR (P = 0.04). Interventional Neuroradiologists had a significantly higher average number of social media accounts compared to Interventional Radiologists (1.94 vs 1.29, P < 0.01).

CONCLUSIONS

Most Australian Interventional Radiologists have a readily identifiable social media presence. There is potential for further utilisation of social media for academic, educational and business purposes.

Radiology in the News: A Content Analysis of Radiology-Related Information Retrieved From Google Alerts

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Google Alerts highlighted a diverse set of topics present in online media.

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Most links were directly to non-radiology lay press, but <1% of links over the 6-month period sent the user directly to a primary peer-reviewed medical journal article.

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The most common topics were market trends, promotional, COVID-19, and artificial intelligence.

Introduction

Radiology topics receive substantial online media attention, with prior studies focusing on social media platform coverage. We used Google Alerts, a content change detection and notification service, to prospectively analyze new radiology-related content appearing on the internet.

Materials and Methods

An automated notification was created on Google Alerts for the search term “radiology,” sending the user emails with up to 3 new links daily. All links from November 2019 through April 2020 were assessed by 2 of 3 independent raters using a coding system to classify the content source and primary topic of discussion. The top 5 primary topics were retrospectively evaluated to identify prevalent subcategories. Content viewing restrictions were documented.

Results

526 links were accessed. The majority (68%) of links were created by non-radiology lay press, followed by radiology-related lay press (28%), university-based publications (2%), and professional society websites (2%). The primary topic of these links most frequently related to market trends (28%), promotional material (20%), COVID-19 (13%), artificial intelligence (8%), and new technology or equipment (5%). 15% of links discussed a topic sourced from another article, such as a peer-reviewed journal, though only 2 linked directly to the journal itself. 8% of links had content viewing restrictions.

Conclusion

New radiology content was largely disseminated via non-radiology news sources; radiologists should therefore ensure their research and viewpoints are presented in these outlets. Google Alerts may be a useful tool to stay abreast of the most current public radiology subject matters, especially during these times of social isolation and rapidly evolving clinical practice.

Evaluation of Social Media Presence of Otolaryngology Residency Programs in the United States

Importance

Over two-thirds of the adult population in the United States use Facebook. Despite the high interest in and use of social media by the general public, the presence and accessibility of health care organizations on social media has not yet been fully evaluated.

Objective

To determine the use and popularity of social media among otolaryngology residency programs in the United States.

Design, Setting, and Participants

A cross-sectional study of the presence of accredited otolaryngology residency programs in the United States in an internet data repository was conducted. Programs were stratified by Doximity Residency Navigator reputation rankings (dividing programs into quartiles) and US News & World Report (comparing programs affiliated with hospitals ranked in the top 50 vs programs affiliated with unranked hospitals). Social media sites and activity for each program were assessed using internet searches. The study was conducted in April 2017.

Results

Among 101 otolaryngology residency programs, 30 were found to have social media sites (29.7%). Facebook and Twitter were the most commonly used services, with 25 (24.8%) and 14 (13.9%) accounts, respectively. Based on Doximity Residency Navigator rankings, programs in the first quartile were more likely to have Facebook profiles than programs in the fourth quartile (42.3% vs 12.0%; absolute difference, 30%; 95% CI, 2.9% to 52.6%). First- and second-quartile programs showed increased Facebook activity. There was greater Twitter presence in first- vs fourth-quartile programs (19.2% vs 8.0%; absolute difference, 11.2%; 95% CI, -11.6% to 33.0%). Higher-quartile programs were more active on Twitter and exhibited increased numbers of likes and followers. Analysis of US News & World Report rankings revealed that ranked programs had higher rates of presence, activity, and popularity on both Facebook and Twitter. However, these were smaller differences than seen when comparing Doximity Residency Navigator rankings. Correlation between the 2 ranking systems was indicated (Spearman ρ = 0.59; 95% CI, 0.34 to 0.76).

Conclusions and Relevance

This study suggests that otolaryngology residency programs with higher Doximity Residency Navigator reputation rankings have a stronger presence on social media. Smaller trends were observed for programs in the top 50 US News & World Report rankings. Overall, social media use among otolaryngology programs seems relatively low, and this may present an opportunity to increase communication with the public via these technologies.

Embracing social media in the era of work-life integration

Radiology practices are leveraging social media for networking, education, branding, and marketing. This change inherently requires radiologists to increase their engagement in social media and may negatively affect work-life integration and contribute to radiologist burnout. In this article, we describe specific strategies that radiology practices may deploy to help balance work-life integration.

Use of social media in the Department of Radiology at Johns Hopkins Aramco Healthcare in Saudi Arabia

PURPOSE

The objective of this study was to evaluate the use of social media in the Radiology Department at Johns Hopkins Aramco Healthcare in Saudi Arabia.

METHODS

The research was a cross-sectional study in which 90 workers from the staff personnel of the Radiology Department at Johns Hopkins Aramco Healthcare were invited to a web-based survey using Google Forms. Fifty-seven participants responded to the survey (63%). Basic descriptive statistics were used to analyze the responses.

RESULTS

More than half of the participants (54.8%) were technologists. The majority of the respondents (61.4%) had a Bachelor's degree, and 50.8% of them had more than 10 years of experience. Also, 36.8% of the participants were between 30 and 40 years old, and 57.9 of them were males. Similarly, most of the participants (61.4%) were from Saudi Arabia. Additionally, the most frequently used application was WhatsApp (59.6%). Likewise, almost half of the participants (47.4%) managed social media multiple times a day and more than half of them used these tools to communicate with friends (68.4%) and family members (61.4%). As well, 12% of the respondents employed these media to study and 20% used them for professional reasons. Also, 38.6% of respondents had no barriers to use social media. However, the rest considered that time, private matters, negative replies, lack of information and experience, and uncertainty about the usefulness of social media were barriers.

CONCLUSION

According to the survey, most of the personnel of the Radiology Department at Johns Hopkins Aramco Healthcare often used WhatsApp to communicate with family (61.4%) and friends (68.4%), and less than half of them employed these tools for educational purposes (21.1%) and professional issues (35.1%). Additionally, participants considered that there were some barriers related to the use of these tools.

Electronic and Social Media-based Radiology Learning Initiative: Development, Implementation, Viewership Trends, and Assessment at 1 Year

RATIONALE AND OBJECTIVES

We report the development of a new "Case of the Day" (COTD) educational initiative using email, social media (SoMe), and a website to disseminate content, as well as its trends in viewership and assessment of utility for the first year of implementation.

MATERIALS/METHODS

Using an image-rich format, a new unknown case was disseminated to radiology trainees and attendings at our institution by email twice per week, including history, salient images, and follow-up questions. Simultaneously, content was externally disseminated on Twitter and a publicly viewable departmental website. On subsequent days, the answer was posted via email, Twitter, and website in the form of a brief YouTube video lecture. Viewership data were collected over the first 12 months (July 1, 2016 to June 30, 2017), and an anonymous survey of participants was performed.

RESULTS

Sixty-five COTDs had complete viewership data and were included in our analysis, yielding 4911 "case" email views (mean = 76), 3798 "answer" email views (mean = 58), 68,034 "case" Twitter impressions (mean = 1047), 75,724 "answer" Twitter impressions (mean = 1164), 5465 "case" Twitter engagements (mean = 84), and 5307 "answer" Twitter engagements (mean = 82). COTD YouTube video lectures garnered 3657 views (mean = 61) amounting to 10,358 minutes of total viewing time. Viewers were very satisfied with COTD quality, with 97% (n = 63) reporting the quality as "good" or "excellent."

CONCLUSIONS

Email and SoMe can serve as effective tools for disseminating radiology educational content. SoMe offers substantial external visibility and branding potential for programs.

Radiologists' Usage of Social Media: Results of the RANSOM Survey

The growing use of social media is transforming the way health care professionals (HCPs) are communicating. In this changing environment, it could be useful to outline the usage of social media by radiologists in all its facets and on an international level. The main objective of the RANSOM survey was to investigate how radiologists are using social media and what is their attitude towards them. The second goal was to discern differences in tendencies among American and European radiologists. An international survey was launched on SurveyMonkey ( https://www.surveymonkey.com ) asking questions about the platforms they prefer, about the advantages, disadvantages, and risks, and about the main incentives and barriers to use social media. A total of 477 radiologists participated in the survey, of which 277 from Europe and 127 from North America. The results show that 85 % of all survey participants are using social media, mostly for a mixture of private and professional reasons. Facebook is the most popular platform for general purposes, whereas LinkedIn and Twitter are more popular for professional usage. The most important reason for not using social media is an unwillingness to mix private and professional matters. Eighty-two percent of all participants are aware of the educational opportunities offered by social media. The survey results underline the need to increase radiologists' skills in using social media efficiently and safely. There is also a need to create clear guidelines regarding the online and social media presence of radiologists to maximize the potential benefits of engaging with social media.

Social Media Utilization at an Academic Radiology Practice

RATIONALE AND OBJECTIVES

We report social media (SoMe) utilization trends at an academic radiology department, highlighting differences between trainees and faculty and between Baby Boomers versus Generation X and Millennials.

MATERIALS AND METHODS

An anonymous online survey regarding SoMe utilization and SoMe-based educational curriculum was distributed to all radiologists (trainees and faculty) in our department. Regular chi-square, ordered (Mantel-Haenszel) chi-square, and Fischer exact tests were performed.

RESULTS

The survey instrument was sent to 172 radiologists with a 65% completion rate (N = 112). Eighty-three percent (n = 92) of the respondents use SoMe, with Facebook (67%, n = 75), YouTube (57%, n = 64), Instagram (26%, n = 29), and Twitter (21%, n = 23) as the most commonly used platforms. Eighty-one percent (n = 91) use SoMe for 30 minutes or less per day. Thirty-five percent (n = 39) reported previously using SoMe for educational purposes, although 66% (n = 73) would be willing to join SoMe for educational activities. The faculty are more likely than trainees to avoid using SoMe (30% vs 9%, P < 0.03). Trainees are more likely than faculty to find an electronic case-based curriculum valuable (95% vs 83%, P < 0.05) and are willing to spend more time on cases (P < 0.01). Baby Boomers are less interested in joining SoMe for educational activities than Generation X and Millennials (24% vs 73%, P = 0.0001).

CONCLUSIONS

Generation gaps between trainees and faculty, as well as between Generation X and Millennials versus Baby Boomers, exist with regard to the use of SoMe, which may be underutilized in radiology education.

Alternative Metrics ("Altmetrics") for Assessing Article Impact in Popular General Radiology Journals

RATIONALE AND OBJECTIVES

Emerging alternative metrics leverage social media and other online platforms to provide immediate measures of biomedical articles' reach among diverse public audiences. We aimed to compare traditional citation and alternative impact metrics for articles in popular general radiology journals.

MATERIALS AND METHODS

All 892 original investigations published in 2013 issues of Academic Radiology, American Journal of Roentgenology, Journal of the American College of Radiology, and Radiology were included. Each article's content was classified as imaging vs nonimaging. Traditional journal citations to articles were obtained from Web of Science. Each article's Altmetric Attention Score (Altmetric), representing weighted mentions across a variety of online platforms, was obtained from Altmetric.com. Statistical assessment included the McNemar test, the Mann-Whitney test, and the Pearson correlation.

RESULTS

Mean and median traditional citation counts were 10.7 ± 15.4 and 5 vs 3.3 ± 13.3 and 0 for Altmetric. Among all articles, 96.4% had ≥1 traditional citation vs 41.8% for Altmetric (P < 0.001). Online platforms for which at least 5% of the articles were represented included Mendeley (42.8%), Twitter (34.2%), Facebook (10.7%), and news outlets (8.4%). Citations and Altmetric were weakly correlated (r = 0.20), with only a 25.0% overlap in terms of articles within their top 10th percentiles. Traditional citations were higher for articles with imaging vs nonimaging content (11.5 ± 16.2 vs 6.9 ± 9.8, P < 0.001), but Altmetric scores were higher in articles with nonimaging content (5.1 ± 11.1 vs 2.8 ± 13.7, P = 0.006).

CONCLUSIONS

Although overall online attention to radiology journal content was low, alternative metrics exhibited unique trends, particularly for nonclinical articles, and may provide a complementary measure of radiology research impact compared to traditional citation counts.

Tweet for the cure: A snapshot of Twitter usage by 3 U.S. oncologic professional societies

Purpose

Medical societies are incorporating Twitter to communicate with their members and connect with patients. This study compares the online presence of 3 major oncologic societies.

Methods and materials

All available tweets in 2014 by the American Society for Radiation Oncology (ASTRO), American Society of Clinical Oncology (ASCO), and Society of Surgical Oncology (SSO) were collected. We analyzed whether posts were original content or retweets. The monthly tweet rate was followed to assess trends. We created 2 new metrics, supporter ratio and tweet density, to correlate online presence and engagement with offline membership breadth. The supporter ratio is the number of people following the organization divided by the number of registered members of each society. The tweet density is the total number of posts divided by the number of registered members of each society.

Results

In February 2015, ASCO, ASTRO, and SSO had 36,385; 10,899; and 2721 members, respectively. ASCO's Twitter handle had 33,974 followers, with a supporter ratio of 0.93. A total of 2563 original tweets and 1416 retweets were estimated, which represents a tweet density of 0.11. @ASTRO_org had 5445 followers and a supporter ratio of 0.50. In 2014, ASTRO posted 415 original content tweets and 9 retweets, with a tweet density of 0.039. SSO had a supporter ratio of 0.91 on the basis of 2481 followers. In 2014, SSO posted 207 original tweets and 190 retweets, with a tweet density of 0.15. An increase in tweets and retweets was seen during the month of each society's annual meeting. ASTRO's 61% increase in September 2014 was smaller than SSO's 462% and ASCO's 84%.

Conclusion

ASTRO's use of Twitter lags behind ASCO and SSO. Although all 3 societies show increased Twitter use during their annual meetings, they should work toward more meaningful engagement throughout the year. The new metrics of tweet density and supporter ratio will serve as benchmarks for member engagement in future studies.

What Do Patients Tweet About Their Mammography Experience?

RATIONALE AND OBJECTIVE

The purpose of this study was to evaluate themes related to patients' experience in undergoing mammography, as expressed on Twitter.

METHODS

A total of 464 tweets from July to December 2015 containing the hashtag #mammogram and relating to a patient's experience in undergoing mammography were reviewed.

RESULTS

Of the tweets, 45.5% occurred before the mammogram compared to 49.6% that occurred afterward (remainder of tweets indeterminate). However, in patients undergoing their first mammogram, 32.8% occurred before the examination, whereas in those undergoing follow-up mammogram, 53.0% occurred before the examination. Identified themes included breast compression (24.4%), advising other patients to undergo screening (23.9%), recognition of the health importance of the examination (18.8%), the act of waiting (10.1%), relief regarding results (9.7%), reflection that the examination was not that bad (9.1%), generalized apprehension regarding the examination (8.2%), interactions with staff (8.0%), the gown (5.0%), examination costs or access (3.4%), offering or reaching out for online support from other patients (3.2%), perception of screening as a sign of aging (2.4%), and the waiting room or waiting room amenities (1.3%). Of the tweets, 31.9% contained humor, of which 56.1% related to compression. Themes that were more common in patients undergoing their first, rather than follow-up, mammogram included breast compression (16.4% vs 9.1%, respectively) and that the test was not that bad (26.2% vs 7.6%, respectively).

CONCLUSION

Online social media provides a platform for women to share their experiences and reactions in undergoing mammography, including humor, positive reflections, and encouragement of others to undergo the examination. Social media thus warrants further evaluation as a potential tool to help foster greater adherence to screening guidelines.

Use of Twitter Polls to Determine Public Opinion Regarding Content Presented at a Major National Specialty Society Meeting

PURPOSE

The aim of this study was to evaluate the feasibility of using Twitter polls to assess public opinion regarding session content at a national specialty society meeting.

METHODS

Twitter polls allow users to embed multiple-choice questions within tweets and automatically aggregate responses. Two radiologists attending the 2016 annual meeting of the ACR posted a Twitter poll containing the hashtag #ACR2016 during 10 meeting sessions addressing socioeconomics/advocacy, patient experience, and social media/informatics (20 polls total). Each poll contained a question asking for an opinion regarding the session's content. Polls were open for responses for 24 hours.

RESULTS

The average number of responses per poll was significantly higher for the user with the larger number of Twitter followers (24.3 ± 14.4 versus 11.2 ± 9.8, P = .015). A total of 57% of respondents agreed that radiologists' payments should shift to value-based payments, and 86% agreed that radiologists should routinely survey their patients to monitor quality; however, 83% disagreed with basing physician payments on patient satisfaction scores. A total of 85% disagreed that the artificial intelligence supercomputer Watson will entirely replace radiologists. A total of 76% agreed that social media can drive business at less cost than standard marketing. A total of 56% agreed with the direction of the ACR's advocacy and regulatory efforts, whereas 74% considered the ACR's advocacy efforts to be moderately or very useful for their practice. A total of 50% planned to change their practice on the basis of keynote remarks by Dr Ezekiel Emanuel.

CONCLUSIONS

Twitter polls provide a free and easy infrastructure to potentially capture global public sentiment during the course of a medical society meeting. Their use may enrich and promote discussions of key session content.

The Use of Twitter by Radiology Journals: An Analysis of Twitter Activity and Impact Factor

PURPOSE

Medical journals use social media as a means to disseminate new research and interact with readers. The microblogging site Twitter is one such platform. The aim of this study was to analyze the recent use of Twitter by the leading radiology journals.

METHODS

The top 50 journals by Impact Factor were included. Twitter profiles associated with these journals, or their corresponding societies, were identified. Whether each journal used other social media platforms was also recorded. Each Twitter profile was analyzed over a one-year period, with data collected via Twitonomy software. Klout scores of social media influence were calculated. Results were analyzed in SPSS using Student's t test, Fisher contingency tables, and Pearson correlations to identify any association between social media interaction and Impact Factors of journals.

RESULTS

Fourteen journals (28%) had dedicated Twitter profiles. Of the 36 journals without dedicated Twitter profiles, 25 (50%) were associated with societies that had profiles, leaving 11 (22%) journals without a presence on Twitter. The mean Impact Factor of all journals was 3.1 ± 1.41 (range, 1.7-6.9). Journals with Twitter profiles had higher Impact Factors than those without (mean, 3.37 vs 2.14; P < .001). There was no statistically significant difference between the Impact Factors of the journals with dedicated Twitter profiles and those associated with affiliated societies (P = .47). Since joining Twitter, 7 of the 11 journals (64%) experienced increases in Impact Factor. A greater number of Twitter followers was correlated with higher journal Impact Factor (R² = 0.581, P = .029).

CONCLUSIONS

The investigators assessed the prevalence and activity of the leading radiology journals on Twitter. Radiology journals with Twitter profiles have higher Impact Factors than those without profiles, and the number of followers of a journal's Twitter profile is positively associated with Impact Factor.

The use of social media to supplement resident medical education - the SMART-ME initiative

BACKGROUND

Residents work at variable times and are often unable to attend all scheduled educational sessions. Therefore, new asynchronistic approaches to learning are essential in ensuring exposure to a comprehensive education. Social media tools may be especially useful, because they are accessed at times convenient for the learner.

OBJECTIVE

Assess if the use of Twitter for medical education impacts the attitude and behavior of residents toward using social media for medical education.

DESIGN

Preintervention and postintervention surveys. Internal medicine resident physicians were surveyed before the launch of a residency-specific Twitter webpage on August 1, 2013, and again 135 days later, to determine their use of the Twitter application and web page, as well as other social media for medical education.

PARTICIPANTS

Residents at an internal medicine urban academic training program.

MAIN MEASURES

All residents within our training program were administered web-based surveys. The surveys assessed resident views and their frequency of use of social media for medical education purposes, and consisted of 10 Likert scale questions. Each answer consisted of a datapoint on a 1-5 scale (1=not useful, 3=useful, 5=very useful). The final survey question was open-ended and asked for general comments.

KEY RESULTS

Thirty-five of 50 residents (70%) completed the presurvey and 40 (80%) participated in the postsurvey. At baseline, 34 out of 35 residents used social media and nine specifically used Twitter. Twenty-seven (77%) used social media for medical education; however, only three used Twitter for educational purposes. After the establishment of the Twitter page, the percentage of residents using social media for educational purposes increased (34 of 40 residents, 85%), and 22 used Twitter for this purpose (p<0.001 for the change). The percentage of residents using the application at least once a week also increased from 11.4 to 60.0% (p<0.001). Almost all residents (38 of 40) felt that social media could be useful as a medical education tool, which slightly increased from 30 out of 35 in the preintervention survey (p=0.01).

CONCLUSION

Residents believe social media could be used for medical education. After we launched a Twitter page for medical education, there was a significant increase in the use and frequency of Twitter for resident medical education over the ensuing 6 months. Further research should be performed to see if social media can impact overall medical knowledge and patient care, and whether longer term use is maintained.