Twitter journal clubs: Sharing knowledge from a social distance

When I was an academic researcher, I attended many journal clubs — convening with my group in a conference room to discuss the methods and findings of a selected paper. These meetings are common in academic and medical education, allowing students to develop their presentation skills and helping everyone keep up with the flood of scientific literature.

In the era of social media, such in-person journal clubs are being replaced by Twitter journal clubs — now more than ever — and it’s led me to wonder, are 280 characters really enough?

I spoke with Roxana Daneshjou, MD, PhD, a dermatology resident at Stanford, to find out. She co-authored a recent editorial in JAMA that describes the advantages of using Twitter compared to the traditional format.

How do Twitter journal clubs work?

The journal club picks a paper to discuss, often using crowdsourcing to select something people are interested in. Everyone logs into Twitter at a specific time and has an online conversation with people from around the globe. Someone may facilitate and use pre-selected questions, but there’s also time for open discussion. You can string many tweets together, so you can basically write as much as you want.

Most journal clubs meet once a month for an hour, but the nice thing about Twitter is that the conversation is saved. So, if someone wants to comment the next day, the participants will see those responses whenever they log into Twitter. That’s important because participants are from different time zones. Having the conversation publicly recorded could be an issue for some people, but I think scientists and clinicians aren’t shy about asking questions and critiquing papers, even publicly.

Why did you start the first dermatology Twitter journal club?

I lurked in other journal clubs and participated in a dermatopathology one that was really interesting. But I wanted to have the same experience with medical dermatology, discussing disease management and new clinical discoveries.

I think Twitter journal clubs are particularly useful for small specialties like dermatology. They allow dermatologists to share knowledge across institutions. They also help promote the field of dermatology to a wider, cross-specialty audience, demonstrating the role that dermatologists can play for their patients. These interactions among specialists are easier with Twitter, compared to traditional journal clubs, because anyone can comment or ask a question about the topic, using the free Twitter website or app without advanced coordination.

Who participates?

We have over 1,700 people following our dermatology journal club, but we typically only have about 15 to 20 people actively participating in a meeting — with more people lurking. Our participants are a diverse group of residents, medical students, faculty and community physicians from across the country.

However, we’ve gotten a much larger group when we’ve done joint meetings with other specialties. For example, we did a joint journal club with nephrology — one of the largest Twitter journal clubs —  to discuss the role of dermatologists in helping manage immunosuppressed kidney transplant patients who are at higher risk of skin cancer. These cross-specialty Twitter interactions are great, because I’ve become friends with residents and faculty at other institutions and now feel comfortable sending them private messages if I have a question. For example, I met dermatologist Adewole Adamson, MD, MPP, through the journal club, and he provided me with a high level of mentorship to co-write the JAMA editorial.

How has the pandemic affected Twitter journal clubs?

Multiple Twitter journal clubs have discussed issues related to COVID-19 and their particular specialty. Our most recent dermatology journal club discussed how dermatologists were transitioning to virtual visits to help with social distancing and how resident training was continuing in dermatology with COVID-19. On April 6, infectious disease’s Twitter journal club will be discussing a paper entitled, “A Trial of Lopinavir-Ritonavir in Adults with Severe COVID-19.”

With social distancing, in-person journal clubs will be more difficult to have. Twitter is the perfect medium for having multiple conversations at once with many people. This is a really difficult time for many, and I hope Twitter journal clubs can help physicians and trainees continue to engage in academic conversations.

Image by Mohamed Mahmoud Hassan

This is a reposting of my Scope story, courtesy of Stanford School of Medicine.

Learning from health-related social media posts: A Q&A

Image by Max Pixel

About 6,000 tweets are sent every second and they aren’t all about celebrities. Posts about health or illness can be tremendously valuable to health care professionals, allowing them to track trends, spot epidemics and assess the quality of services provided by health facilities, to name just a few uses.

But how can the researchers make sense of this flood of data? To find out, I spoke with Sidhartha Sinha, MD, an assistant professor of medicine at Stanford, who analyzes social media posts to better understand patient and societal perceptions.

What sparked your interest in online data?

“While there are certainly downsides with working with unstructured data from sources such as social media and online patient forums, there are also tremendous advantages, including the scope of patients we can ‘reach.’

For example, in our work analyzing data from an online patient forum for patients with inflammatory bowel disease, we are able to access tens of thousands of posts from patients with IBD. These patients are describing a variety of issues around their experience with the disease — such as their therapy side effects (some of which have not been seen before and may offer early insights), psychosocial issues with chronic disease, and opinions regarding treatments and interventions. By analyzing this data, we are in effect  ‘listening’ to these patients’ experiences and hopefully gaining insights to better treat the disease.”

I understand you’ve also used online data to better understand public sentiment — could you describe that?

“One of the most important things health care providers do is try to prevent disease.  And one of the best means to do this is through disease screening.  However, millions of people do not get age-appropriate screening for diseases such as breast cancer or colon cancer.  My group’s initial work targeted understanding the perceptions around cancer screening tools.  Understanding how people feel about these screening interventions — particularly on the scale we’re able to examine using social media — allows us to not only identify barriers, but also further ascertain methods that work.”

How did you do that?

“Tens of thousands of tweets mentioning screening tests are created weekly. And while there are clear limitations to the quality of data and its generalizability, the sheer volume of data that we can access is much larger than most other means such as conventional surveys, which carry their own significant limitations. So we developed and validated a machine learning algorithm to classify sentiment (positive, negative, or neutral) around mentions of three common cancer screening tools: colonoscopy, mammography and PAP smears.

We found more negative sentiment expressed for colonoscopy and more positive sentiment for mammography. For example, the words ‘fear’ and ‘pain’ were commonly associated with negative sentiment. We also found that posts that were negative in sentiment spread more rapidly through social media than positive posts.”

How are these findings being used?

“Knowing the types of postings that reach more users, and some of the common issues expressed in them, could certainly influence how professional societies develop outreach interventions to improve engagement with preventive health efforts.

Based on our initial findings, we are developing additional algorithms to hopefully butter understand patient and societal perceptions of disease. We are also now engaged with professional societies such as the Crohn’s and Colitis Foundation to provide organizations with improved methods to understand patient needs and promote health.”

This is a reposting of my Scope blog story, courtesy of Stanford School of Medicine.

Can social media shed light on cardiovascular disease? Possibly, Stanford journal editors write

twitter-311922_1280
Illustration by Clker-Free-Vector-Images

Clearly social media is part of our every day lives, recording our personal communications in a way previously unimaginable.

Researchers are now analyzing this wealth of social media data to better understand what people think and say about their health. Recently, researchers at the University of Pennsylvania sifted through 10 billion English-language tweets to identify and study more than 550,000 US-based tweets related to cardiovascular disease, as reported in JAMA Cardiology.

The research team found that people who tweeted about five cardiovascular conditions — high blood pressure, heart attack, diabetes, heart failure and cardiac arrest — were more likely to be older and female compared to the general population of Twitter users. They also tweeted within minutes or hours in response to events, such as celebrity deaths or to mark World Diabetes Day. 

This study was discussed in the issue’s Editor’s Note by Stanford journal editors Mintu Turakhia, MD, an assistant professor of medicine, and Robert Harrington, MD, a professor and the chair of the Department of Medicine. In the editorial, they acknowledged that the Penn Twitter study was atypical research to include in JAMA Cardiology but noted that digital health is now a major priority for the journal. They explained:

“We accepted [the paper] because it highlights the potential for using these emerging data sources such as Twitter for cardiovascular research, in this case to evaluate public communication about cardiovascular medicine in a manner not previously possible on such a scale.”

Turakhia, the journal’s associate editor of digital health, elaborated in an email: “Twitter and other social media data allow us to examine daily interactions in a connected life in ways not possible before,” he said. “Previously, in order to gain insight on the public’s perception or interest in cardiovascular disease, we were limited to examine historical news and media archives or direct surveys.”

Although the editors believe that Twitter is a new and important research tool, they raised a few questions about future studies. They wrote in the editorial, “The use of Twitter and other social media platforms for cardiovascular research is in an early, proof-of-concept stage. Many important questions remain: Is there signal in the noise? Are these data or results… from the ‘Twitterverse’ generalizable to a broader population?” They also emphasized the need to establish analysis standards and overcome any ethical issues in linking the data with medical or clinical information. Turakhia added:

“Twitter users do not represent the broader population, but that’s not really its purpose. Twitter allows us to examine a highly connected subset of society and learn how cardiovascular disease might manifest in their connected world.”

Ultimately, researchers hope to use this new information to improve their patients’ health, but the research is in its infancy, he said, adding:

“We haven’t yet figured out how Twitter or social media can be definitely used to improve health and health care. The obvious avenues would be through social and community engagement. Although sharing of personal information is at the cornerstone of the success of social media, I’m not sure that society is ready to be as open with posting health information, as they are with selfies or pictures of kids. However social media could be used to gamify health care behavior by providing incentives, and that won’t need disclosure.”

This is a reposting of my Scope blog story, courtesy of Stanford School of Medicine.