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The challenge of Twitter in medical research

Recent years have seen an unprecedented surge in the use of social media. I still fondly recall how as a newly qualified doctor in 2001, I could afford to buy my first mobile phone. It lacked functionality beyond making phone calls and telling the time. It was also slightly too large for any reasonable sized pocket. Contrast this to today, when my mobile phone has become an essential part of my life, providing not only telephone communication, but also access to emails, medical reference applications, and soon I expect to be able to access my hospital’s electronic record via my phone as well.

One advantage to the clinician of the technological revolution is the rapid access to medical information. Every morning I spend ten minutes over coffee looking through the latest Twitter feeds from the major medical journals, to skim through what research might be emerging in fields other than my own niche (I still enjoy reading the paper editions of journals to cover my specialist area).

One morning, as I was browsing the conveniently short summaries from reputable sources such as the @NEJM or @TheLancet, I spotted a comment about an article I had already read in full, and it struck me that the 140 character-summary that I was provided with was very misleading. The original article was a trial of methotrexate in juvenile arthritis, and the study failed to meet the pre-specified primary endpoint. However, reading the full paper reveals some important nuance, and in reality the research provided strong evidence for a benefit of methotrexate.

The great challenge of Twitter is sharing something eye-catching and relevant. The eye-catching aspect might be achieved by an image (for example the pigeon displayed with this blog, which if anyone is curious can be found at the top of a car park in Frank’s Café in Peckham). However, the ‘relevance’ of a tweet is harder to understand. Sometimes journals simply tweet a statement that research has been published on a topic, but not alluding to what the conclusions might be – forcing the reader to go to the original article. However, oftentimes, the twitterer (is that a word?) will add their own judgement about what the research has shown. And if the twitterer uses the handle of a respected journal, who am I to dispute their opinion?

Cellphone by Free-Photos. CC0 public domain via Pixabay.

Of course, this opens a can of worms… as upon closer inspection it becomes apparent that Twitter authors are frequently anonymous, and the ‘editorial control’ of Twitter is equally opaque. Worse still, the twitterer may ‘retweet’ someone else’s opinion, leading to a sometimes amusing re-enactment of the childhood ‘whispering game’. Adding to this, the reality is that 140 characters are usually not sufficient to provide enough insight to form a judgement upon a piece of research, and it starts to make me doubt the value of Twitter in keeping up to date.

That said, I am aware that Twitter is starting to be viewed as a means of dissemination for research, and watch with excitement when articles I have been published get mentioned. If you haven’t heard of Altmetric, you might be interested to look it up; Altmetric is a relatively recent addition to the measures of academic dissemination that captures the reach of research outside of the medical literature (e.g. news channels, newspapers, Twitter, Facebook etc.). One catch is, you must always remember that the amount of attention research receives in the public domain does not distinguish between fame or infamy. Indeed, Altmetric reflects what the public talk about. A source on the inside of the academic publishing world recently advised me that if I wanted to maximise my Altmetric rankings, I would need to publish on Sex or Dinosaurs, or ideally, both.

As more of our profession move to using social media to review research output, we need to learn to both the strengths and weaknesses of the resource. Much in the same way that the public has been alerted to #alternativefacts and FAKENEWS by our world leaders over the last 12 months, the medical profession needs to equally pay attention to how we digest research through the likes of Twitter and Facebook. Good luck.

Featured image credit provided by Dr James Galloway. Used with permission.

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