Society for Vascular Surgery best practice recommendations for use of social media

The Prevalence of Financial Conflict of Interest Disclosures by Endovascular Specialists on X (Twitter)

PURPOSE

To evaluate conflicts of interest (COIs) among interventional radiologists and related specialties who mention specific devices or companies on the social media (SoMe) platform X, formerly Twitter.

MATERIALS AND METHODS

In total, 13,809 posts between October 7, 2021, and December 31, 2021, on X were evaluated. Posts by U.S. interventional radiologists and related specialties who mentioned a specific device or company were identified. A positive COI was defined as receiving a payment from the device manufacturer or company within 36 months prior to posting. The Center for Medicare & Medicaid Services Open Payment database was used to identify financial payments. The prevalence and value of COIs were assessed and compared between posts mentioning a device or company and a paired control group using descriptive statistics and chi-squared tests and independent t tests.

RESULTS

Eighty posts containing the mention of 100 specific devices or companies were evaluated. COIs were present in 53% (53/100). When mentioning a specific device or product, 40% interventional radiologists had a COI, compared with 62% neurosurgeons. Physicians who mentioned a specific device or company were 3.7 times more likely to have a positive COI relative to the paired control group (53/100 vs 14/100; P < .001). Of the 31 physicians with a COI, the median physician received $2,270. None of the positive COIs were disclosed.

CONCLUSIONS

Physicians posting on SoMe about a specific device or company were more likely to have a financial COI than authors of posts not mentioning a specific device or company. No disclosure of any COI was present in the posts, limiting followers' ability to weigh potential bias.

Development of a Medical Social Media Ethics Scale and Assessment of #IRad, #CardioTwitter, and #MedTwitter Posts: Mixed Methods Study

BACKGROUND

Social media posts by clinicians are not bound by the same rules as peer-reviewed publications, raising ethical concerns that have not been extensively characterized or quantified.

OBJECTIVE

We aim to develop a scale to assess ethical issues on medical social media (SoMe) and use it to determine the prevalence of these issues among posts with 3 different hashtags: #MedTwitter, #IRad, and #CardioTwitter.

METHODS

A scale was developed based on previous descriptions of professionalism and validated via semistructured cognitive interviewing with a sample of 11 clinicians and trainees, interrater agreement, and correlation of 100 posts. The final scale assessed social media posts in 6 domains. This was used to analyze 1500 Twitter posts, 500 each from the 3 hashtags. Analysis of posts was limited to original Twitter posts in English made by health care professionals in North America. The prevalence of potential issues was determined using descriptive statistics and compared across hashtags using the Fisher exact and χ2 tests with Yates correction.

RESULTS

The final scale was considered reflective of potential ethical issues of SoMe by participants. There was good interrater agreement (Cohen κ=0.620, P<.01) and moderate to strong positive interrater correlation (=0.602, P<.001). The 6 scale domains showed minimal to no interrelation (Cronbach α=0.206). Ethical concerns across all hashtags had a prevalence of 1.5% or less except the conflict of interest concerns on #IRad, which had a prevalence of 3.6% (n=18). Compared to #MedTwitter, posts with specialty-specific hashtags had more patient privacy and conflict of interest concerns.

CONCLUSIONS

The SoMe professionalism scale we developed reliably reflects potential ethical issues. Ethical issues on SoMe are rare but important and vary in prevalence across medical communities.

Social media and academic surgical research dissemination

Academic research dissemination has evolved tremendously throughout the 20th and early 21st centuries. With the advent of new technology and remote communication, the fast and efficient sharing of ideas has spread worldwide and has been appropriately embraced by academic surgical researchers. The use of social media by surgeons has expanded our ability to share hypotheses and published works that lead to higher degrees of collaboration than previously possible. The strengths of social media use for research dissemination in surgery include immediate collaboration on a global scale, faster dissemination of results previously hindered by the publishing process, open peer review from a wider audience, and enhancing the experience of academic meetings. However, social media use for research dissemination is not perfect and is hindered by lack of author verification, public misinterpretation, and lack of standardized enforceable professional guidelines. To combat these potential pitfalls, surgical societies should prioritize specific and intervenable guidelines for surgeons regarding the appropriate use of social media for research dissemination.