Disease-specific hashtags and the creation of Twitter medical communities in hematology and oncology

Pediatric Cancer Communication on Twitter: Natural Language Processing and Qualitative Content Analysis

BACKGROUND

During the COVID-19 pandemic, Twitter (recently rebranded as "X") was the most widely used social media platform with over 2 million cancer-related tweets. The increasing use of social media among patients and family members, providers, and organizations has allowed for novel methods of studying cancer communication.

OBJECTIVE

This study aimed to examine pediatric cancer-related tweets to capture the experiences of patients and survivors of cancer, their caregivers, medical providers, and other stakeholders. We assessed the public sentiment and content of tweets related to pediatric cancer over a time period representative of the COVID-19 pandemic.

METHODS

All English-language tweets related to pediatric cancer posted from December 11, 2019, to May 7, 2022, globally, were obtained using the Twitter application programming interface. Sentiment analyses were computed based on Bing, AFINN, and NRC lexicons. We conducted a supplemental nonlexicon-based sentiment analysis with ChatGPT (version 3.0) to validate our findings with a random subset of 150 tweets. We conducted a qualitative content analysis to manually code the content of a random subset of 800 tweets.

RESULTS

A total of 161,135 unique tweets related to pediatric cancer were identified. Sentiment analyses showed that there were more positive words than negative words. Via the Bing lexicon, the most common positive words were support, love, amazing, heaven, and happy, and the most common negative words were grief, risk, hard, abuse, and miss. Via the NRC lexicon, most tweets were categorized under sentiment types of positive, trust, and joy. Overall positive sentiment was consistent across lexicons and confirmed with supplemental ChatGPT (version 3.0) analysis. Percent agreement between raters for qualitative coding was 91%, and the top 10 codes were awareness, personal experiences, research, caregiver experiences, patient experiences, policy and the law, treatment, end of life, pharmaceuticals and drugs, and survivorship. Qualitative content analysis showed that Twitter users commonly used the social media platform to promote public awareness of pediatric cancer and to share personal experiences with pediatric cancer from the perspective of patients or survivors and their caregivers. Twitter was frequently used for health knowledge dissemination of research findings and federal policies that support treatment and affordable medical care.

CONCLUSIONS

Twitter may serve as an effective means for researchers to examine pediatric cancer communication and public sentiment around the globe. Despite the public mental health crisis during the COVID-19 pandemic, overall sentiments of pediatric cancer-related tweets were positive. Content of pediatric cancer tweets focused on health and treatment information, social support, and raising awareness of pediatric cancer.

A Scoping Review of Physician Advocacy on Twitter

Twitter has been adopted by physicians across most medical specialties; it allows for the wide dissemination of information and calls to action, brings new stakeholders into collations, promotes academic engagement, and fosters collaboration between academia and private practice. In this review of the literature, we briefly outline the state of advocacy in health care and summarize current Twitter-based advocacy efforts in the major specialties of health care, identifying both successful strategies as well as gaps in Twitter advocacy research. Relevant articles were obtained via PubMed and Google Scholar searches using the phrases "Twitter advocacy healthcare," "[specialty name] Twitter" and "[specialty name] Twitter advocacy." Several overarching themes were found to be widely utilized in specialty-specific discussions of Twitter advocacy efforts: organizing under a specific hashtag, fostering dialogue between stakeholders, and tweeting using personalized, action-oriented language. Fields such as pediatrics, heme/onc, ENT, and ophthalmology have most thoroughly embraced the desire to learn how to most effectively advocate on Twitter. Other fields such as OBGYN, cardiology, and surgery have less academic focus on online advocacy. Outside of advocacy efforts, the research and academic benefits of Twitter are well described in nearly every specialty. In conclusion, while clinicians are encouraged to advocate online, only broad strategies for online engagement are currently offered. Additional research into the details of how to successfully create an online profile and Twitter presence is needed to ensure all physicians are able to maximize their advocacy efforts, with clarification of the goals and objectives of this engagement also required.

Development and dissemination of structured hashtags for radiation oncology: Two-Year trends

Purpose

For radiation oncology, social media is a favored communication platform, but it uses non-structured hashtags, which limits communication. In this work, we created a set of structured hashtags with key opinion leaders in radiation oncology, and we report on their use after two years post-deployment.

Materials/Methods

Hashtags were created, voted on, and refined by crowdsourcing 38 international experts, including physicians, physicists, patients, and organizations from North America, Europe, and Australia. The finalized hashtag set was shared with the radiation oncology community in September 2019. The number of tweets for each hashtag was quantified via Symplur through December 2021. For the top five tweeted hashtags, we captured the number of yearly tweets in the pre-deployment and post-deployment periods from 09/01/2019 to 08/31/2021.

Results

The initial 2019 list contained 39 hashtags organized into nine categories. The top five hashtags by total number of tweets were: #Radonc, #PallOnc, #MedPhys, #SurvOnc, and #SuppOnc. Six hashtags had less than 10 total tweets and were eliminated. Post-deployment, there was an increase in the yearly tweets, with the following number of tweets by the second year post-deployment: #RadOnc (98,189 tweets), #MedPhys (15,858 tweets), and #SurvOnc (6,361 tweets). Two popular radiation oncology-related hashtags were added because of increased use: #DEIinRO (1,603 tweets by year 2) and #WomenWhoCurie (7,212 tweets by year 2). Over the two years, hashtags were used mostly by physicians (131,625 tweets, 34.8%).

Conclusion

We created and tracked structured social media hashtags in radiation oncology. These hashtags disseminate information among a diverse oncologic community. To maintain relevance, regular updates are needed.

#Laryngology: A Standardized Hashtag Ontology

BACKGROUND

In the past decade, there has been a rise in social media applications and usage among individuals in the otolaryngology- head and neck surgery (OHNS) community. Hashtags (#), used to identify posts relating to similar topics, are utilized to search medical information, build a network, find providers, and discuss research. Previous OHNS literature in this arena includes a standard ontology, or list of hashtags, developed for the otology subspecialty. To date, the ontology of laryngology hashtags has not been created. The objective of this study is to propose a standardized ontology to use when discussing topics in laryngology on social media to maximize reach and effect.

METHODS

Using a combination of previously published techniques, along with laryngology specific adjustments, the authors developed a list of suggested hashtags. An initial list was systematically culled from laryngology Instagram accounts including academic programs, laryngology influencers (fellowship-trained laryngologists with publicly available professional accounts with greater than 500 followers), and professional societies/conferences. The list was abbreviated using current rate of use, specificity, and expert opinion. These were then categorized to include general terms, diseases and diagnoses, and treatment strategies RESULTS: Across all culled Instagram posts, there were 240 unique laryngology hashtags used and 1152 total hashtags were applied. The authors derived unique terms to be included in the ontology for laryngology by expert opinion of fellowship-trained laryngologists.

CONCLUSION

Laryngology is in the early stages of utilization of social media. Developing a specific ontology of hashtags to be used will optimize the reach and connections of term specific searches.

Elevating Twitter-Based Journal Club Discussions by Leveraging a Voice-Based Platform: #HemepathJC Meets Clubhouse

PURPOSE OF REVIEW

Social media-based scientific journal clubs provide an opportunity to promote published literature to a broader audience and allow robust multi-disciplinary and inter-professional discussion. Hematopathology Journal Club (#HemepathJC) on Twitter has successfully conducted monthly sessions since November 2019, covering topics related to lymphoma and leukemia.

RECENT FINDINGS

To enhance connectivity, multitasking, and productivity, we present our experience of leveraging the voice-based platform Clubhouse concurrent with Twitter. The Twitter and Clubhouse partnership for #hemepathJC holds the potential to increase dissemination of scientific knowledge and further promote journal club format discussion.

"We Have All This Knowledge to Give, So Use Us as a Resource": Partnering with Adolescent and Young Adult Cancer Survivors to Determine Consumer-Led Research Priorities

Purpose: Involvement of adolescent and young adult (AYAs) cancer survivors as consumers in research is increasingly encouraged, yet few studies have identified the feasibility and acceptability of methods used to involve them. We aimed to identify: (1) How feasible and acceptable is a consumer-driven, workshop-based research priority-setting approach? And (2) what research priorities do Australian AYA consumers endorse? Methods: AYA cancer survivors diagnosed 15-30 years old and currently younger than 35 years were invited to participate. The AYAs completed a pre-workshop survey to rank their top three priorities from the United Kingdom-based James Lind Alliance list, participated in a 90-minute focus group, and completed a post-workshop evaluation survey. We assessed the workshop feasibility by reviewing considerations, challenges, and enablers of success in the planning and conduct processes. Acceptability was assessed through participants' evaluation surveys and facilitators' informal reflections. The top three priorities were determined from pre-workshop surveys and focus group data. Results: Six survivors participated (M age = 24.2 years, M = 5 years post-treatment, 83% female). All reported that the workshop was an acceptable way to engage with researchers. Costs and recruitment challenges limited the workshop's feasibility. The AYAs' top priority was: What psychological support package improves psychological well-being, social functioning, and mental health during and after treatment? Discussion: The AYA survivors found our workshop to be an acceptable way to engage in research priority-setting. However, the feasibility of this approach depends on the resources available to researchers. Future research is needed to define the optimal method of engagement: What is most acceptable for AYAs and feasible for researchers?

Opportunities and pitfalls of social media research in rare genetic diseases: a systematic review

PURPOSE

Social media may be particularly valuable in research in rare genetic diseases because of the low numbers of patients and the rare disease community's robust online presence. The goal of this systematic review was to understand how social media is currently used in rare disease research and the characteristics of the participants in these studies.

METHODS

We conducted a systematic review of six databases to identify studies published in English between January 2004 and November 2020, of which 120 met inclusion criteria.

RESULTS

Most studies were observational (n = 114, 95.0%) and cross-sectional (n = 107, 89.2%), and more than half (n = 69, 57.5%) utilized only surveys. Only 101 rare diseases were included across all studies. Participant demographics, when reported, were predominantly female (70.1% ± 22.5%) and white (85.0% ± 11.0%) adult patients and caregivers.

CONCLUSION

Despite its potential benefits in rare disease research, the use of social media is still methodologically limited and the participants reached may not be representative of the rare disease population by gender, race, age, or rare disease type. As scholars explore using social media for rare disease research, careful attention should be paid to representativeness when studying this diverse patient community.

Twitter as a Tool to Spread Communication Regarding Genitourinary Cancers During the COVID-19 Pandemic

OBJECTIVES:

To better characterize the relay of information about prostate, kidney, and bladder cancer on Twitter in relation to the COVID-19 pandemic.

MATERIALS AND METHODS:

Tweets containing the joint hashtags “#COVID-19” and either “#bladder cancer”, “#kidney cancer”, or “#prostate cancer” were identified on the Twitter platform from January 1, 2020 to July 30, 2020. The Twitter handle responsible for each tweet was categorized as an Academic, Medical Education, Patient Advocacy Groups/Non-Profits, Pharmaceutical, or Other entity based on content domain. Descriptive statistics were used to summarize data on Twitter handle characteristics stratified by disease category (bladder, kidney, and prostate). Median/interquartile range and percentages were used to summarize continuous and categorical data, respectively. Number of tweets containing the relevant joint hashtags were tracked over time in relation to the cumulative United States case count of COVID-19.

RESULTS:

The content of 730 total tweets containing the joint hashtags “COVID-19” and either “#bladder cancer” (138 tweets), “#kidney cancer” (137 tweets), or “#prostate cancer” (455 tweets) from January 1, 2020 to July 31, 2020 were analyzed. We identified 326 unique Twitter handles across all disease states (62 bladder, 47 kidney, and 217 prostate-related). Academic Twitter handles accounted for the greatest number of tweets containing the joint hashtags (31%). Temporal tracking of tweets with regard to monthly U.S. COVID cases revealed that communication surged in March of 2020 and peaked in April for both bladder and kidney cancer, whereas related prostate cancer Twitter communication peaked in May of 2020.

CONCLUSIONS:

As COVID-19 case counts rose in the United States initially, so too did communication surrounding COVID-19 and genitourinary cancers on Twitter. Many of these conversations were driven by academically-associated Twitter accounts.

Next-Generation Scholarship: Rebranding Hematopathology Using Twitter: The MD Anderson Experience

Hematopathologists are witnessing very exciting times, as a new era of unsurpassed technological advances is unfolding exponentially, enhancing our understanding of diseases at the genomic and molecular levels. In the evolving field of precision medicine, our contributions as hematopathologists to medical practice are of paramount importance. Social media platforms such as Twitter have helped facilitate and enrich our professional  interactions and collaborations with others in our field and in other medical disciplines leading to a more holistic approach to patient care. These platforms also have created a novel means for instantaneous dissemination of new findings and recent publications, and are proving to be increasingly useful tools that can be harnessed to expand our knowledge and amplify our presence in the medical community. In this Editorial, we share our experience as hematopathologists with Twitter, and how we leveraged this platform to boost scholarly activities within and beyond our subspecialty, and as a powerful medium for worldwide dissemination of educational material and to promote our remote teaching activities during the COVID-19 pandemic.

The Democratization of Scientific Conferences: Twitter in the Era of COVID-19 and Beyond

Purpose of Review

The coronavirus disease 2019 (COVID-19) pandemic has had profound impacts upon scientific discourse in our field, most prominently through the abrupt transition of malignant hematology conferences to all-digital formats. These virtual components will likely be incorporated into future iterations of these conferences even as in-person attendance is reincorporated. In this review, we discuss ways in which usage of the social networking platform Twitter has expanded in the past year during virtual conferences as a method to facilitate—and, in some ways, democratize—information flow and professional networking.

Recent Findings

Emerging Twitter-based tools in malignant hematology include presenter-developed #tweetorials, conference-specific “poster walks,” and disease-specific online journal clubs. Twitter is also increasingly being used for networking across institutional and international lines, allowing for conversations to continue year-round as a first step toward multicenter collaborations as well as in-person #tweetups at subsequent meetings.

Summary

The ability of Twitter to enable uninterrupted information exchange has reinforced its central role in medical and scientific communication in a way that will certainly outlive the COVID-19 pandemic.

Look who's talking now: Cancer in primary care on Twitter. An observational study

Background

Twitter is a microblogging platform that helps share information. It is a dynamic tool that has been embraced by many user types including consumers and healthcare professionals (HCPs). Currently, there are no data on how cancer in primary care features on Twitter.

Aim

To explore the type of users and information shared about cancer in primary care on Twitter.

Design & setting

A descriptive exploratory study took place of publicly available Twitter data.

Method

Tweets were searched between July 2015 and June 2017 for ‘GP’, ‘general practice’, ‘primary care’, or ‘general practitioner’ in conjunction with ‘cancer’. A 20% random sample was coded for geographic location, user type, type of tweet, and theme. Tweet sentiment was analysed using R package sentimentr. Content that gained traction was compared by combining original tweets, retweets, favourites, and duration.

Results

There were a total of 3413 tweets from 1611 users in 44 countries. Consumers were the largest user group followed by health organisations, healthcare professionals, and the media. The most common theme across user types was diagnostic delay. Other themes that emerged included cancer screening, symptom awareness, and early diagnosis. Consumers published more negative tweets, particularly in relation to diagnostic delay. Health organisations focused on symptom awareness and screening. Over half of media tweets were stories that featured delayed diagnosis or screening.

Conclusion

A broad range of users engage with Twitter to share information about cancer in primary care. Content is different between user groups, but diagnostic delay and symptom awareness are common themes. Healthcare and professional organisations may need to consider approaches to counter negative messages about diagnostic delay.

Impact of Benign Hematology Didactic Lectures on In-service Exam in a Hematology-Oncology Fellowship Program: a Cross-sectional Longitudinal Study

It remains unclear on whether the traditional formal didactic lecture sessions improve knowledge acquisition with conflicting data in the literature. This study evaluates the impact of an additional benign hematology didactic curriculum on the American Society of Hematology In-Service Exam (ASHISE). During the first 5 years of the study (2012-2016), formal didactic lectures consisted of medical oncology and malignant hematology topics only. Formal benign hematology didactic lectures were added during the last 2 years of the study (2017-2018). All fellows are required to take the ASHISE annually. All fellows' ASHISE scores from 2012 to 2018 were collected. The mean total and Coagulation scale score were calculated by year of fellowship training. Pre-intervention (2012-2016) and post-intervention (2017-2018) scores were analyzed using a Student's t test. Over a 7-year period, 34 hematology-oncology fellows took the ASHISE. There was no statistical difference in the mean total and Coagulation scale score for the ASHISE in the pre-intervention and post-intervention group. The addition of a benign hematology curriculum did not improve fellows' performance on the ASHISE.

Research Synthesis and Thematic Analysis of Twitter Through Bibliometric Analysis

In literature, there is a shortage of comprehensive documents that can provide proper details about Twitter in research community. This study conducted a first descriptive bibliometric analysis to examine the most influential journals, institutions, and countries on Twitter. Similarly, bibliometric mapping analysis is carried out to explore different research themes in Twitter publications. VOSviewer was employed to process the 11,006 Twitter publications retrieved from the Web of Science (WoS) from 2009 to 2018. Obtained results suggest that USA and China received the highest number of publications on Twitter research, while the University of Illinois was the most productive institute. Furthermore, the five major themes have emerged in Twitter publications, and its remarkable role has been found in event detection, sentiment analysis, education, health, politics, and crisis as well as risk management. The authors believe that this study will open new doors for researchers to use online Twitter social networking communities in beauty salons, consulting companies, banks, and airlines.

An introduction and guide to becoming a social media savvy nephrologist

The use of social media has increased over the last several decades, with ∼72% of the US adult population indicating the use of social networking platforms. Expansion of social media use beyond personal reasons now includes professional uses. This growth is especially true in medicine—and specifically nephrology. An enhanced online presence has the potential to make positive contributions to professional development, education and collaborations, potentially opening doors to academic opportunities. With a growing number of online platforms, resources and conversations, it is natural for one to feel overwhelmed and ultimately avoid social media. We discuss the benefits of social media engagement for nephrologists and provide a practical guide on how they can harness social media professionally and effectively. With an understanding of the basics, existing resources and avoidance of potential pitfalls, physicians can learn to use social media and join the global nephrology community.

Tweeting the meeting: Quantitative and qualitative twitter activity during the 38th ESSO conference

INTRODUCTION

Social media is increasingly used to share information with the potential for fast and wide reach. Data on use during surgical oncology conferences is limited. We aimed to monitor twitter usage during a surgical oncology conference to audit impact of activity.

METHODS

A prospective, time-restricted, observational study of twitter activity using the #ESSO38 hashtag in the week before and during the 38th ESSO conference (10-12 October 2018; Budapest, Hungary). Data on individual tweets and retweets, including date and tweeter or retweeter were collected using NodeXL, FollowTheHashtag, Twitonomy and TAGS.

RESULTS

The study period (10-13 October) documented 328 tweets by 58 tweeters with 1167 retweets, with a soaring activity and mentions during the conference days, with a potential reach at over 7.5 million. The nodal network of tweets, the most active tweeters and retweeters are presented as well as the most frequently used hashtags. The top 3 hashtags used were #ESSO38, #SoMe4Surgery# and #EYSAC. A positive influence on the @ESSOweb twitter handle was noted, with the numbers of followers growing from 1.5 K to over 1.8 K representing a 20% growth in just over a week.

CONCLUSIONS

Activity on tweeter during the conference was considerable, with a potential for a wide reach beyond those attending the conference. A more structured approach to the use of twitter for future conferences may enhance experience, activity and reach.

Online and Social Media Resources for Patients with MDS

PURPOSE OF REVIEW

The number of online resources for patients with MDS is exponentially increasing; this is in large part due to the advent of social media which has introduced multiple avenues for information exchange and communication. Whether this information is targeted towards the patient population or not, the wealth of information online represents a new era of patient engagement in their health care. This review aims to highlight the different online resources being used in the field of MDS.

RECENT FINDINGS

Patients with MDS have access to the opinions of thought leaders in the field, advances in research and clinical trials, and the latest updates at national conferences and leading journals through social media. Social media is a powerful educational resource for patients with MDS when used conscientiously.

Using Twitter to recruit participants for health research: An example from a caregiving study

Twitter has the potential to optimize research conduct, but more research is needed around the nature of study-related tweets and strategies for optimizing reach. In the context of our caregiving study, we aimed to describe the nature and extent of study-related tweets, the extent to which they were shared by others, and their potential reach. To do so, we conducted a secondary analysis of our Twitter recruitment. We aggregated and categorized study-related tweets and analyzed the reach of the 10 most retweeted tweets. Results indicated that of 71 caregivers, 27 were recruited via Twitter. General recruitment tweets were most-shared by users. Tweet reach ranged from 5273 to 62,144 users. Twitter caregivers were demographically comparable to non-Twitter caregivers but had higher Internet proficiency and fewer children. Overall, using a personal Twitter account can expand the reach of study recruitment. Future research should compare different recruitment strategies and explore characteristics that may challenge the heterogeneity of Twitter samples.

Social Medicine: Twitter in Healthcare

Social media enables the public sharing of information. With the recent emphasis on transparency and the open sharing of information between doctors and patients, the intersection of social media and healthcare is of particular interest. Twitter is currently the most popular form of social media used for healthcare communication; here, we examine the use of Twitter in medicine and specifically explore in what capacity using Twitter to share information on treatments and research has the potential to improve care. The sharing of information on Twitter can create a communicative and collaborative atmosphere for patients, physicians, and researchers and even improve quality of care. However, risks involved with using Twitter for healthcare discourse include high rates of misinformation, difficulties in verifying the credibility of sources, overwhelmingly high volumes of information available on Twitter, concerns about professionalism, and the opportunity cost of using physician time. Ultimately, the use of Twitter in healthcare can allow patients, healthcare professionals, and researchers to be more informed, but specific guidelines for appropriate use are necessary.

Rare Cancers and Social Media: Analysis of Twitter Metrics in the First 2 Years of a Rare-Disease Community for Myeloproliferative Neoplasms on Social Media-#MPNSM

PURPOSE OF REVIEW

The use of social media has now become a standard means of communication for many individuals worldwide. The use of one specific form of social media, Twitter, has increased among healthcare providers, both as a means of information gathering and as a conduit for original content creation. Recently, major efforts by users have been put forward to help streamline the unprecedented amount of information that can be found on Twitter. These efforts have led to the creation of diseasespecific hashtag (#) medical communities and have greatly enhanced the ability to understand and better categorize the available data on Twitter. Specifically, for those involved in rare cancer fields, adhering to organically designed and consistently used hashtags has led to the rapid, reliable dissemination of information and the ability to efficiently discuss and debate topics of interest in the field. For the field of myeloproliferative neoplasms (MPNs), the creation of #MPNSM (myeloproliferative neoplasms on social media) in 2015 has facilitated interactions among healthcare stakeholders from all over the world in the MPN field.

RECENT FINDINGS

In order to better understand the trends and topics of interest to Twitter users of this novel medical community, we conducted the present analysis which focuses on Twitter analytics from the first two years of #MPNSM. In this analysis, we observed a sustained increase in the number of Twitter users, number of tweets, number of impressions, and number of retweets over time, demonstrating the feasibility of creating and maintaining a disease-specific hashtag for a rare cancer over time.