Decoding Twitter: Understanding the History, Instruments, and Techniques for Success

Utilizing sentiment analysis of X data to document the evolution of colorectal surgical innovations: The case of transanal total mesorectal excision

AIM

The evolution of the utility of medical social media and its global reach has led to a much greater speed of dissemination of medical innovation, such as transanal total mesorectal excision (TaTME). The acceptability and discussions surrounding such innovations can be followed online. Here, we sought to determine if online discussions over time could match known models of innovation evolution using the example of TaTME since its initial description in 2010.

METHODS

Data on using the X hashtag #TaTME were analysed using the social media analytics tool Brandwatch. Trends in mentions, impressions and reach were highlighted over 13 years (1 May 2010 to 31 July 2023). Each mention's sentiment and emotional connotations were analysed using Brandwatch's natural language processing approach.

RESULTS

We identified 18 525 mentions of #TaTME by healthcare professionals, reaching over 30.6 million X users. A Gartner's hype-cycle-like pattern was identified for mention volume and emotional connotation over time. The majority of mentions had a neutral (84%; n = 15 341) or positive connotation (15%, n = 2675). A peak of negatively connotated mentions was identified surrounding the temporary suspension of TaTME in 2019.

CONCLUSION

This study presents a novel method of monitoring online discussions surrounding new surgical innovations by healthcare professionals based on sentiment analysis of public social media data. Mention volume and emotional connotation were the most accurate parameters closely resembling Gartner's hype cycle.

Twitter (X) in Medicine: Friend or Foe to the Field of Interventional Cardiology?

Twitter, which recently changed its name to "X," is a popular social media platform that is used widely across the world due to its easy accessibility through the internet. Due to more public familiarity, we referred to this social media platform as "Twitter (X)" in this article. Users can create posts, also called as "tweets" with a limitation of 280 characters and can add images, videos, and weblinks. While there are several social media platforms used by health care professionals, eg, Facebook, Instagram, Snapchat, TikTok, LinkedIn, and Periscope, Twitter (X) is an extremely popular platform among physicians, especially cardiologists. Due to its persistent growth and ever-expanding outreach, Twitter (X) is facilitating dissemination of scientific information including complex medical knowledge leading the way in collaborations, and in organizing and networking of various health care professionals, patients, and caregivers with shared medical interests. While there are several advantages of Twitter (X) as an important tool in our contemporary medical armamentarium, there are also some drawbacks. False information can be distributed effortlessly and can entrench unscientific beliefs as there is no peer-review process. Occasionally, discourteous discussions between health care professionals can be misinterpreted by users with limited medical knowledge. Other disadvantages include Health Insurance Portability and Accountability Act violations and hacking of accounts. Therefore, it is imperative for health care professionals interested to use this valuable tool to be familiar with and cautious about its potential risks and limitations.

Seeing Is Believing: The Effect of Graphical Abstracts on Citations and Social Media Exposure in Gastroenterology & Hepatology Journals

BACKGROUND

Graphical abstracts (GAs) have recently been included as an essential element in various journals, including those in the field of Gastroenterology & Hepatology. However, there has been no study on the effect of GAs on the impact factor (IF) of journals, and the citation index or social media exposure of individual articles.

METHODS

We investigated the presence of GAs, total citations and social media exposure of full-length original articles in the top ten journals of gastroenterology and hepatology for three years (2019-2021). Citations and social media exposure were evaluated with the Web of Science citation index, Altmetric Attention score, Dimension recorded citation count, and PlumX index.

RESULTS

A total of 4,205 articles from ten journals were evaluated for three years. First, journals that have adopted GAs demonstrated significantly higher IF increases for the past three years than those of journals without GAs. The longer GAs have been utilized in a journal, the higher IFs the journal had. Secondly, individual articles with GAs had significantly higher Web of Science citation counts (median 14 vs. 12), more social media exposure (median 23 vs. 5) and more Altmetric.com tweet counts (median 15 vs. 7) than those of articles without GAs. In multiple regression analysis, the inclusion of GAs was particularly effective in increasing the number of Web of Science citations (β = 14.1, SE = 1.9, P < 0.001) and social media exposure (β = 13.3, SE = 6.1, P = 0.030) after adjusting for journal IFs and topics.

CONCLUSION

GAs are effective in increasing IFs of journals in the field of gastroenterology and hepatology, as well as increasing citations and social media exposure of individual articles.

Can Social Media Profiles Be a Reliable Source of Information on Nutrition and Dietetics?

Background: Social media are growing worldwide platforms for unlimited exchange of various content. Owing to their accessibility and short form, they can be utilized as usable, wide-range communication and information tools for companies, scientific communities, patient advocacy organizations, and special interest groups. This study aimed to investigate whether Instagram^® profiles can be reliable sources of information and knowledge about nutrition and dietetics. Materials and Methods: Random identification of nutrition-related posts was performed using a built-in website search engine. Posts were searched by five popular hashtags: #nutrition, #nutritionist, #instadiet, #diet, and #dietitian, 250 newest posts of each. Advertisement posts were discarded. Each eligible post was then categorized (dietetics, fitness, motivation, other) and assessed with regard to the quality of nutrition information provided (five levels from none to good quality), popularity (number of followers, likes, and comments), and engagement measures (like, comment, and engagement ratio). Results: A total of 1189 posts were reviewed. The overall quality of the content regarding nutritional knowledge was extremely low (93.9% of all posts), also when divided into categories. Among all posts, 63.8% were categorized as “nutrition and dietetics”, while “fitness”, “motivation”, and “other” categories comprised 8.2%, 4.8%, and 23.2% of the posts, respectively. Posts recognized as dietetics were the most liked (mean n = 116 likes per post) and of the highest quality. However, those motivational raised the greatest degree of engagement (32.7%). Posts with cooking recipes were the most commented. Conclusions: Random post search cannot provide viewers with valuable nutrition information. A dedicated search for high-quality professional profiles is preferred to obtain quality information.

Surgeons Underestimate the Importance of Surgical Topics for Non-Surgeons: Results of a National Survey

OBJECTIVE

To determine if surgeons and non-surgeons agree on the importance of surgical topics covered in the surgical clerkship to the daily practice of non-surgeons.

DESIGN

An IRB-approved anonymous survey ranking the relative importance of 35 topics drawn from surgical clerkship curricula asking physicians to rank the relative importance of each topic, using a five-point Likert scale, to the daily practice of non-surgeons.

SETTING

Online anonymous survey.

PARTICIPANTS

Convenience sample of practicing physicians and trainees. The survey was offered to physicians in all specialties via social media and professional connections, responders identified their practice specialty.

RESULTS

295 physicians completed the survey. Two hundred thirty-one (85%) were from non-surgical specialties: emergency medicine (EM, n = 100); primary care (PC, n = 71 - included internal medicine, family medicine, and pediatrics); a variety of others (n = 60).  Surgeons and non-surgeons agreed on the relative importance of the acute abdomen, breast disease, inguinal hernias, inflammatory bowel disease, morbid obesity, sinusitis, thyroid and parathyroid disease, and wound care; surgeons believed colorectal cancer and diverticulitis to be more important. Surgeons rated all other topics as less important to non-surgeons than non-surgeons. EM rated most acute problems more important that PC; both groups ranked most topics higher importance to the practice of a non-surgeon than surgeons (p < 0.05).

CONCLUSIONS

Surgeons consistently underestimate the importance non-surgeons place on surgical topics in their practice.  These results reinforce the perceived importance of a wide exposure to surgery in the surgical clerkship to all medical students - but topics could be focused differently depending on acute or non-acute non-surgical care career plans.

Social Media in Surgery

Social media has become a permeating form of communication with billions of daily users. Twitter in particular has become a tool for the surgical community to engage with other providers, as well as patients, through active online discussions, sharing of research, and highlighting opportunities for community outreach. Twitter can help with personal branding, mentorship, and international collaboration on multiple types of academic endeavors. Likewise, institutional and residency programs can harness the power of social media to develop an online presence and aid in resident recruitment.

#Crohn's: Historical Cohort of Twitter Activity

Background

Analysis of the Twitter activity on #Crohn's, identifying individuals with interest in Crohn's disease on Twitter.

Methods

A historic cohort study was conducted about Twitter activity evaluation of #Crohn's analyzed over a period of 9 years. For the Twitter analysis, a health-care social media analytics tool, Symplur Signals, was adopted.

Results

From 2011 until 2019, 627,000 tweets of #Crohn's were detected, with 276,380 retweets by 109,937 users; of these users, 32.4% were patient advocates and 12.6% were doctors. There was a pattern of annual peak activity of the #Crohn's, mainly in May and December, and less activity, usually in July. Of all tweets, 52.5% were categorized as positive and 47.5% as negative.

Conclusions

Social media, especially Twitter, represents an important information tool, but it is still underutilized by gastroenterologists. This study suggests a significant interference of international awareness campaigns about inflammatory bowel disease in the activity of #Crohn's on Twitter, denoting an increase in debating this topic on the platform. Discussions on the subject by health professionals are still below expectations regarding the importance of the theme.

Hashtag Global Surgery: The Role of Social Media in Advancing the Field of Global Surgery

INTRODUCTION

Surgery is increasingly recognized as an indispensable part of healthcare, but lack of awareness about its cost-effectiveness and cross-cutting impact remain. Social media has become an important resource for healthcare professionals in a variety of settings due to its instant global reach in a non-discriminatory and low-threshold manner. In 2010, #globalsurgery was first used on Twitter to spread awareness, foster international collaborations, and raise voices of advocates around the world. Here, we examine the role of social media in the field of global surgery.

METHODS

The use of #globalsurgery on Twitter was analyzed through Tweetreach from July 31 to December 31, 2018. Additional analysis of hashtags in Spanish, Japanese, Malay, and Portuguese was done to determine the number of tweets, retweets, impressions, and users using #globalsurgery or translated hashtags. Sentiment analysis was performed to determine the affective state of tweets.

RESULTS

A total of 4,519 tweets and 15,861 retweets were posted by 4,449 different contributors. Tweets totalled 58,733,406 potential direct impressions and 46,560,293 potential amplified impressions, with potential reach of 11,272,014. English was the major language (99.47%), followed by Spanish (0.49%) and Japanese (0.04%). Portuguese and Malay hashtags were not used during the study period.

CONCLUSION

#globalsurgery provides an innovative way to overcome barriers and strengthen collaboration among advocates, and more effectively raise awareness about global surgery.

Social Media in Surgical Training: Opportunities and Risks

BACKGROUND

Surgeon engagement with social media is growing rapidly. Innovative applications in diverse fields of health care are increasingly available.

OBJECTIVE

The aim of this review is to explore the current and future applications of social media in surgical training. In addition, risks and barriers of social media engagement are analyzed, and recommendations for professional social media use amongst trainers and trainees are suggested.

METHODS

The published, peer-reviewed literature on social media in medicine, surgery and surgical training was reviewed. MESH terms including "social media", "education", "surgical training" and "web applications" were used.

RESULTS

Different social media surgical applications are already widely available but limited in use in the trainee's curriculum. E-learning modalities, podcasts, live surgery platforms and microblogs are used for teaching purposes. Social media enables global research collaboratives and can play a role in patient recruitment for clinical trials. The growing importance of networking is emphasized by the increased use of LinkedIn, Facebook, Sermo and other networking platforms. Risks of social media use, such as lack of peer review and the lack of source confirmation, must be considered. Governing surgeon's and trainee's associations should consider adopting and sharing their guidelines for standards of social media use.

CONCLUSIONS

Surgical training is changing rapidly and as such, social media presents tremendous opportunities for teaching, training, research and networking. Awareness must be raised on the risks of social media use.

The academic tweet: Twitter as a tool to advance academic surgery

Social media, Twitter in particular, has emerged as an essential tool for surgeons. In the realm of academic surgery, it enables surgeons to advance the core values of academic surgery, as outlined by the Association for Academic Surgery: inclusion, leadership, innovation, scholarship, and mentorship. This article details the ways in which surgeons are using Twitter to embody these values and how the Twitter account for the Association of Academic Surgeons accomplishes its goal of inspiring and developing young academic surgeons.

What Does the Future Hold for Scientific Journals? Visual Abstracts and Other Tools for Communicating Research

Journals fill several important roles within academic medicine, including building knowledge, validating quality of methods, and communicating research. This section provides an overview of these roles and highlights innovative approaches journals have taken to enhance dissemination of research. As journals move away from print formats and embrace web-based content, design-centered thinking will allow for engagement of a larger audience. Examples of recent efforts in this realm are provided, as well as simplified strategies for developing visual abstracts to improve dissemination via social media. Finally, we hone in on principles of learning and education which have driven these advances in multimedia-based communication in scientific research.

Breaking International Barriers: #ColorectalSurgery Is #GlobalSurgery

Colorectal surgeons have lagged behind other professionals in the use of social media. Currently, Twitter is the most widely utilized social platform for professional purposes among them. Connection and contagion are the two key actions that, together with immediate feedback and quantifiable impact, favor the use of Twitter over other social networks. In early 2016, a group of colorectal surgeons launched the #colorectalsurgery hashtag and, in less than 1 year, the ecosystem has incorporated over 2,600 users that generated over 24,000 tweets and 100 million impressions. "Live-Tweeting" surgical conferences by attendees including institutional or society accounts have greatly contributed to the success of the initiative. However, there are some barriers to a more wide adoption of social media, such as misrepresentation of non-peer-reviewed data, challenges to intellectual property protection, or even damage to the professional image. Active engagement with the #colorectalsurgery community may result in benefits for the global surgery community through information sharing, social interactions, personal branding, and research.

#colorectalsurgery

BACKGROUND

The use of social media platforms among healthcare professionals is increasing. A Twitter social media campaign promoting the hashtag #colorectalsurgery was launched with the aim of providing a specialty-specific forum to collate discussions and science relevant to an engaged, global community of coloproctologists. This article reviews initial experiences of the early adoption, engagement and utilization of this pilot initiative.

METHODS

The hashtag #colorectalsurgery was promoted via the online microblogging service Twitter across a 180-day interval. Data on all tweets containing the #colorectalsurgery hashtag were analysed using online analytical tools. Data included total number of tweets, number of views, and user engagement since registration and launch of the campaign. Content of tweet and user demographic analysis was undertaken.

RESULTS

The number of tweets using #colorectalsurgery grew rapidly following the launch on 24 April 2016; #colorectalsurgery was used in 15 708 tweets, which resulted in 65 398 696 impressions and involved 1863 individual Twitter accounts. Increased volumes of #colorectalsurgery tweets were noted in association with the timing of three major international colorectal surgical conferences, and geographical trends were noted. Some 88·4 per cent of all posts were by male users. The top 25 users by volume of #colorectalsurgery tweets had considerable influence and posted 8023 tweets (51·1 per cent).

CONCLUSION

Online global communities formed via healthcare-related hashtags, such as #colorectalsurgery, unify social media posts, scientists, surgeons and authors who have an interest in coloproctology. Furthermore, they facilitate greater connectivity among geographically separate users.

History of Social Media in Surgery

In many ways, the history of surgeons on Twitter echoes the initial resistance and ultimate mass adoption of laparoscopic surgery that led to the field of minimally invasive surgery. At its inception, social media was similarly met with skepticism and concerns of threats to professionalism. Despite these concerns, numerous surgeons and other physicians pioneered the use of social media to establish a virtual medical community and share scientific knowledge regarding a variety of topics including medical conferences, journal publications, and more. After these initial successes, surgeons' views have evolved, leading to mass adoption of social media and participation on Twitter as a means of professional networking and dissemination of science. This article chronicles that history.

The iLappSurgery taTME app: a modern adjunct to the teaching of surgical techniques

Application-based technology has emerged as a method of modern information communication, and this has been applied towards surgical training and education. It allows surgeons the ability to obtain portable and instant access to information that is otherwise difficult to deliver. The iLappSurgery Foundation has recently launched the transanal total mesorectal excision educational application (taTME app) which provides a useful adjunct, especially for surgeons interested in mastery of the taTME technique and its principles. The article provides a detailed review of the application, which has achieved a large user-base since its debut in June, 2016.