Health and Science Twitter & Blog Top 50 and 100 Lists. How to Separate the Wheat from the Chaff.

24 04 2012

Recently a Top 100 scientists-Twitter list got viral on Twitter. It was published at accreditedonlinecolleges.com/blog.*

Most people just tweeted “Top 100 Scientists on Twitter”, others were excited to be on the list, a few mentioned the lack of scientist X or discipline Y  in the top 100.

Two scientist noticed something peculiar about the list: @seanmcarroll noticed two fake (!) accounts under “physics” (as later explained these were: @NIMAARKANIHAMED and @Prof_S_Hawking). And @nutsci (having read two posts of mine about spam top 50 or 100 lists [12]) recognized this Twitter list as spam:

It is surprising how easy it (still) is for such spammy Top 50 or 100 Lists to get viral, whereas they only have been published to generate more traffic to the website and/or to earn revenue through click-throughs.

It makes me wonder why well-educated people like scientists and doctors swallow the bait. Don’t they recognize the spam? Do they feel flattered to be on the list, or do they take offence when they (or another person who “deserves” it) aren’t chosen? Or perhaps they just find the list useful and want to share it, without taking a close look?

To help you to recognize and avoid such spammy lists, here are some tips to separate the wheat from the chaff:

  1. Check WHO made the list. Is it from an expert in the field, someone you trust? (and/or someone you like to follow?)
  2. If you don’t know the author in person, check the site which publishes the list (often a “blog”):
    1. Beware if there is no (or little info in the) ABOUT-section.
    2. Beware if the site mainly (only) has these kind of lists or short -very general-blogposts (like 10 ways to….) except when the author is somebody like Darren Rowse aka @ProBlogger [3].
    3. Beware if it is a very general site producing a diversity of very specialised lists (who can be expert in all fields?)
    4. Beware if the website has any of the following (not mutually exclusive) characteristics:
      1. Web addresses like accreditedonlinecolleges.com, onlinecolleges.com, onlinecollegesusa.org,  onlinedegrees.com (watch out com sites anyway)
      2. Websites with a Quick-degree, nursing degree, technician school etc finder
      3. Prominent links at the homepage to Kaplan University, University of Phoenix, Grand Canyon University etc
    5. Reputable sites less likely produce nonsense lists. See for instance this “Women in science blogging”-list published in the Guardian [4].
  3. When the site itself seems ok, check whether the names on the list seem trustworthy and worth a follow. Clearly, lists with fake accounts (other then lists with “top 50 fake accounts” ;)) aren’t worth the bother: apparently the creator didn’t make the effort to verify the accounts and/or hasn’t the capacity to understand the tweets/topic.
  4. Ideally the list should have added value. Meaning that it should be more than a summary of names and copy pasting of the bio or “about” section.
    For instance I have recently been put on a list of onlinecollegesusa.org [b], but the author had just copied the subtitle of my blog: …. a medical librarian and her blog explores the web 2.0 world as it relates to library science and beyond.
    However, sometimes, the added value may just be that the author is a highly recognized expert or opinion leader. For instance this Top Health & Medical Bloggers (& Their Twitter Names) List [5] by the well known health blogger Dean Giustini.
  5. In what way do these lists represent *top* Blogs or Twitter accounts? Are their blogs worth reading and/or their Twitter accounts worth following? A nobel price winner may be a top scientist, but may not necessarily be a good blogger and/or may not have interesting tweets. (personally I know various examples of uninteresting accounts of *celebrities* in health, science and politics)
  6. Beware if you are actively approached and kindly requested to spread the list to your audience. (for this is what they want).It goes like this (watch the impersonal tone):

    Your Blog is being featured!

    Hi There,

    I recently compiled a list of the best librarian blogs, and I wanted to let you know that you made the list! You can find your site linked here: [...]

    If you have any feedback please let me know, or if you think your audience would find any of this information useful, please feel free to share the link. We always appreciate a Facebook Like, a Google +1, a Stumble Upon or even a regular old link back, as we’re trying to increase our readership.

    Thanks again, and have a great day!

While some of the list may be worthwhile in itself, it is best NOT TO LINK TO DOUBTFUL LISTS, thus not  mention them on Twitter, not retweet the lists and not blog about it. For this is what they only want to achieve.

But what if you really find this list interesting?

Here are some tips to find alternatives to these spammy lists (often opposite to above-mentioned words of caution) 

  1. Find posts/lists produced by experts in the field and/or people you trust or like to follow. Their choice of blogs or twitter-accounts (albeit subjective and incomplete) will probably suit you the best. For isn’t this what it is all about?
  2. Especially useful are posts that give you more information about the people on the list. Like this top-10 librarian list by Phil Bradley [6] and the excellent “100+ women healthcare academics” compiled by @amcunningham and @trishgreenhalgh [7].
    Strikingly the reason to create the latter list was that a spammy list not recognized as such (“50 Medical School Professors You Should Be Following On Twitter”  [c])  seemed short on women….
  3. In case of Twitter-accounts:
    1. Check existing Twitter lists of people you find interesting to follow. You can follow the entire lists or just those people you find most interesting.
      Examples: I created a list with people from the EBM-cochrane people & sceptics [8]. Nutritional science grad student @Nutsci has a nutrition-health-science list [9]. The more followers, the more popular the list.
    2. Check interesting conversation partners of people you follow.
    3. Check accounts of people who are often retweeted in the field.
    4. Keep an eye on #FF (#FollowFriday) mentions, where people worth following are highlighted
    5. Check a topic on Listorious. For instance @hrana made a list of Twitter-doctors[10]. There are also scientists-lists (then again, check who made the list and who is on the list. Some health/nutrition lists are really bad if you’re interested in science and not junk)
    6. Worth mentioning are shared lists that are open for edit (so there are many contributors besides the curator). Lists [4] and [7] are examples of crowd sourced lists. Other examples are truly open-to-edit lists using public spreadsheets, like the Top Twitter Doctors[11], created by Dr Ves and  lists for science and bio(medical) journals [12], created by me.
  4. Finally, if you find the spam top 100 list truly helpful, and don’t know too many people in the field, just check out some of the names without linking to the list or spreading the word.

*For obvious reasons I will not hyperlink to these sites, but if you would like to check them, these are the links

[a] accreditedonlinecolleges.com/blog/2012/top-100-scientists-on-twitter

[b] onlinecollegesusa.org/librarian-resources-online

[c] thedegree360.onlinedegrees.com/50-must-follow-medical-school-professors-on-twitter

  1. Beware of Top 50 “Great Tools to Double Check your Doctor” or whatever Lists. (laikaspoetnik.wordpress.com)
  2. Vanity is the Quicksand of Reasoning: Beware of Top 100 and 50 lists! ((laikaspoetnik.wordpress.com)
  3. Google+ Tactics of the Blogging Pros (problogger.net)
  4. “Women in science blogging” by  ( http://www.guardian.co.uk/science)
  5. Top Health & Medical Bloggers (& Their Twitter Names) List (blog.openmedicine.ca)
  6. Top-10 librarian list by Phil Bradley (www.blogs.com/topten)
  7. 100+ women healthcare academics by Annemarie Cunningham/ Trisha Greenhalgh (wishfulthinkinginmedicaleducation.blogspot.com)
  8. Twitter-doctors by @hrana (listorious.com)
  9. EBM-cochrane people & sceptics (Twitter list by @laikas)
  10. Nutrition-health-science (Twitter list by @nutsci)
  11. Open for edit: Top Twitter Doctors arranged by specialty in alphabetical order (Google Spreadsheet by @drves)
  12. TWITTER BIOMEDICAL AND OTHER SCIENTIFIC JOURNALS & MAGAZINES (Google Spreadsheet by @laikas)






Grand Rounds: Evolving from Link-♥♥ to ♬♫-Links?

9 01 2012

Grand Rounds is “the weekly summary of the best healthcare writing online”. I’ve hosted this medical blog carnival twice and considered it a great honor to do so.

I have submitted a lot of posts to the Grand Rounds. Often I even wrote a special blog post to fit the theme if there was one. Almost all my submissions have been accepted. I really enjoyed the compilations. There was a lot of outstanding creativity and originality in how the links to the blogs were “aggregated” and highlighted.

Usually I only read those posts that seemed the most interesting to me (the summary thus works as a filter). But through the Grand Rounds I read posts that I would never have read and I learned about bloggers I never heard of.

Why am I talking in the past tense? The Grand Round is still there, isn’t it?!

Yes, it is still there (luckily), but the organizers are thinking of a “rejuvenation of  this old dinosaur”. As the previous host, Margaret Polaneczky explained

“… Grand Rounds has dropped a bit off all of our radars. Many, if not most of us have abandoned the old RSS feed to hang out on Twitter, where our online community has grown from a few dozen bloggers to feeds and followers in the hundreds and even thousands.”

One of the measures is that the Grand Rounds editions should be more concise and only include the “best posts”.

I too go for quality, and think one should carefully select contributors (and hosts), but is the 7-year-old dinosaur to be saved by chopping him in pieces? Should we only refer to 10 posts at the max and put the message in a tweet-format like Margaret did in an experiment?
I was glad that Margaret gave a good old fashioned long introduction in the Dinosaur’s style, for that was what I read, NOT the tweets. Sorry tweets are NOT a nice compilation. They are difficult to read.
It also isn’t a solution to tweet the individual links, because a lot of those individual tweets will be missed by most of the potential readers. It is not coherent either. The strength of the Grand Rounds is in the compilation, in the way the host makes the posts digestible. I would say: let the host present the posts in an attractive way and let the reader do the selection and digestion.

Also important: how many of us will write blog posts specially for the Grand Rounds if there is a chance of 2 in 3 that it will be rejected?

It is true that the Grand Rounds is less popular than a few years ago and it is harder to get hosts. But that may partly have to do with advertising. My first Grand Rounds got far more hits than the second one, mainly because we sent a notice to great blogs that linked to us, like Instapundit (853 hits alone) and there was an interview with the host announcing the Grand Rounds at MEDSCAPE. In this way the main intended audience (non-blogging lay people) were also reached. The second time my post was just found by a handful of people checking the edition plus this blog own readers.
(I have to admit that this last Grand Rounds Edition might have been better if it had been more concise, but at least one person (Pranab of Scepticemia) spend  2 hours in reading almost all the posts of the round-up. So it wasn’t for nothing)

If some busy clinicians can be persuaded to host The Grand Rounds using a shorter format, that is fine. And it is good to be more concise and leave out what isn’t of high quality. But why make it a rule to include just 10 or 12? Even more important, don’t change blog posts for tweets. For I don’t think, as Margaret passed on, that the concept of the individual blog has been sometimes “overshadowed by Twitter and Facebook, whose continual unending stream demands our constant attention, lest we miss something important that someone said or re-said…” Even I have given up to constantly follow all streams, and I suppose the same is true for most clinicians, nurses etc. Lets not replace posts by tweets but lets use Twitter and Facebook to promote the Grand Rounds and augment its radius.

The main reason for writing this post is that I disliked the description by Bryan Vartebedian (host of the next round) rather off-putting, perhaps even arrogant:

Grand Rounds is evolving as a more focused, curated publication.  Rather than a 4,000 word chain-o-links, Nick Genes, Val Jones and others felt that a focused collection of recommendations would be more manageable for both readers and hosts.  This is Grand Rounds for quality rather than link love.

Bryan loves the word link-love. Two posts back he wrote:

It isn’t contacts, followers, friends, subscriptions, readers, link love, mentions, or people’s attention.  It’s time.  With time I can have all of these things.  

“Link love” and “chain-o-links” undervalue what blog carnivals are about. Perhaps some bloggers just want to be linked to, but most want to be read, and that is the entire idea behind the blog carnival. I can’t imagine that the blog hosts aim to include as many links as possible. At the most it is love for particular posts not “link love” perse.

Changing the format to tweets (♬♫) will only increase the link/text ratio. Links will become more prominent.

I would rather go for the ♥♥-links*, because I  to blog and I  to read good stuff.

——–

* Note that ♥♥-links is not the same as link-♥

——–

Here is a short Twitter Discussion about the new approach. I fully agree with Ves Dimov viewpoint, especially the last tweet.





Friday Foolery # 47 WTF, the True Spirit of Christmas

30 12 2011

The true spirit of Christmas is in “loving” and to “do good for others”, ” thinking of” and “helping the less fortunate”.

However, many of today’s children,  weaned on luxury goods and gadgets, consider themselves as the “less fortunates” and thus are on the  “receiving” rather than the “giving” site. And are easily disappointed… and crossed if they don’t get the expected $$$ gift.

Am I exaggerating? I truly hope so.

But if you had searched Twitter for popular expensive gits “car”, “i-pad” or “i-phone” like comedy writer Jon Hendren (@fart) did, you had seen numerous dissatisfied tweets of extremely spoiled kids and adolescents:

https://twitter.com/#!/Tonimoretto/status/150701909479661569

https://twitter.com/#!/Bossybeegee/status/150985722730512384

http://twitter.com/LeemyLeem_/status/150978171200745472

https://twitter.com/#!/dizzydentgirl/status/150980418718543872

https://twitter.com/#!/guhrace_/status/151039463672397824

———–

The tweets have even been compiled in a song by Jonathan Mann, the “Song a Day Man“. After seeing the tweets it should be no surprise that it is called “WTF?! I wanted an iPhone!”

———–

It makes me kind a sad. It is quite an anti-Christmas attitude.

The kids in this video below have every right to be disappointed though. (via Mashable)

———–

Sources





Medical Black Humor, that is Neither Funny nor Appropriate.

19 09 2011

Last week, I happened to see this Facebook post of the The Medical Registrar where she offends a GP, Anne Marie Cunningham*, who wrote a critical post about black medical humor at her blog “Wishful Thinking in Medical Education”. I couldn’t resist placing a likewise “funny” comment in this hostile environment where everyone seemed to agree (till then) and try to beat each other in levels of wittiness (“most naive child like GP ever” – “literally the most boring blog I have ever read”,  “someone hasn’t met many midwives in that ivory tower there.”, ~ insulting for a trout etc.):

“Makes no comment, other than anyone who uses terms like “humourless old trout” for a GP who raises a relevant point at her blog is an arrogant jerk and an unempathetic bastard, until proven otherwise…  No, seriously, from a patient’s viewpoint terms like “labia ward” are indeed derogatory and should be avoided on open social media platforms.”

I was angered, because it is so easy to attack someone personally instead of discussing the issues raised.

Perhaps you first want to read the post of Anne Marie yourself (and please pay attention to the comments too).

Social media, black humour and professionals…

Anne Marie mainly discusses her feelings after she came across a discussion between several male doctors on Twitter using slang like ‘labia ward’ and ‘birthing sheds’ for birth wards, “cabbage patch” to refer to the intensive care and madwives for midwives (midwitches is another one). She discussed it with the doctors in question, but only one of them admitted he had perhaps misjudged sending the tweet. After consulting other professionals privately, she writes a post on her blog without revealing the identity of the doctors involved. She also puts it in a wider context by referring to  the medical literature on professionalism and black humour quoting Berk (and others):

“Simply put, derogatory and cynical humour as displayed by medical personnel are forms of verbal abuse, disrespect and the dehumanisation of their patients and themselves. Those individuals who are the most vulnerable and powerless in the clinical environment – students, patients and patients’ families – have become the targets of the abuse. Such humour is indefensible, whether the target is within hearing range or not; it cannot be justified as a socially acceptable release valve or as a coping mechanism for stress and exhaustion.”

The doctors involved do not make any effort to explain what motivated them. But two female anesthetic registrars frankly comment to the post of Anne Marie (one of them having created the term “labia ward”, thereby disproving that this term is misogynic per se). Both explain that using such slang terms isn’t about insulting anyone and that they are still professionals caring for patients:

 It is about coping, and still caring, without either going insane or crying at work (try to avoid that – wait until I’m at home). Because we can’t fall apart. We have to be able to come out of resus, where we’ve just been unable to save a baby from cotdeath, and cope with being shouted and sworn at be someone cross at being kept waiting to be seen about a cut finger. To our patients we must be cool, calm professionals. But to our friends, and colleagues, we will joke about things that others would recoil from in horror. Because it beats rocking backwards and forwards in the country.

[Just a detail, but “Labia ward” is a simple play on words to portray that not all women in the "Labor Ward" are involved in labor. However, this too is misnomer.  Labia have little to do with severe pre-eclampsia, intra-uterine death or a late termination of pregnancy]

To a certain extent medical slang is understandable, but it should stay behind the doors of the ward or at least not be said in a context that could offend colleagues and patients or their carers. And that is the entire issue. The discussion here was on Twitter, which is an open platform. Tweets are not private and can be read by other doctors, midwives, the NHS and patients. Or as e-Patient Dave expresses so eloquently:

I say, one is responsible for one’s public statements. Cussing to one’s buddies on a tram is not the same as cussing in a corner booth at the pub. If you want to use venting vocabulary in a circle, use email with CC’s, or a Google+ Circle.
One may claim – ONCE – ignorance, as in, “Oh, others could see that??” It must, I say, then be accompanied by an earnest “Oh crap!!” Beyond that, it’s as rude as cussing in a streetcorner crowd.

Furthermore, it seemed the tweet served no other goal as to be satirical, sardonic, sarcastic and subversive (words in the bio of the anesthetist concerned). And sarcasm isn’t limited to this one or two tweets. Just the other day he was insulting to a medical student saying among other things:“I haven’t got anything against you. I don’t even know you. I can’t decide whether it’s paranoia, or narcissism, you have”. 

We are not talking about restriction of “free speech” here. Doctors just have to think twice before they say something, anything on Twitter and Facebook, especially when they are presenting themselves as MD.  Not only because it can be offensive to colleagues and patients, but also because they have a role model function for younger doctors and medical students.

Isolated tweets of one or two doctors using slang is not the biggest problem, in my opinion. What I found far more worrying, was the arrogant and insulting comment at Facebook and the massive support it got from other doctors and medical students. Apparently there are many “I-like-to-exhibit-my-dark-humor-skills-and-don’t-give-a-shit-what-you think-doctors” at Facebook (and Twitter) and they have a large like-minded medical audience: the “medical registrar page alone has 19,000 (!) “fans”.

Sadly there is a total lack of reflection and reason in many of the comments. What to think of:

“wow, really. The quasi-academic language and touchy-feely social social science bullshit aside, this woman makes very few points, valid or otherwise. Much like these pages, if you’re offended, fuck off and don’t follow them on Twitter, and cabbage patch to refer to ITU is probably one of the kinder phrases I’ve heard…”

and

“Oh my god. Didnt realise there were so many easily offended, left winging, fun sponging, life sucking, anti- fun, humourless people out there. Get a grip people. Are you telling me you never laughed at the revue’s at your medical schools?”

and

“It may be my view and my view alone but the people who complain about such exchanges, on the whole, tend to be the most insincere, narcissistic and odious little fuckers around with almost NO genuine empathy for the patient and the sole desire to make themselves look like the good guy rather than to serve anyone else.”

It seems these doctors and their fans don’t seem to possess the communicative and emphatic skills one would hope them to have.

One might object that it is *just* Facebook or that “#twitter is supposed to be fun, people!” (dr Fiona) 

I wouldn’t agree for 3 reasons:

  • Doctors are not teenagers anymore and need to act as grown-ups (or better: as professionals)
  • There is no reason to believe that people who make it their habit to offend others online behave very differently IRL
  • Seeing Twitter as “just for fun” is an underestimation of the real power of Twitter

Note: *It is purely coincidental that the previous post also involved Anne Marie.





#FollowFriday #FF @DrJenGunter: EBM Sex Health Expert Wielding the Lasso of Truth

19 08 2011

If you’re on Twitter you probably seen the #FF or #FollowFriday phenomenon. FollowFriday is a way to recommend people on Twitter to others. For at least 2 reasons: to acknowledge your favorite tweople and to make it easier for your followers to find new interesting people.

However, some #FollowFriday tweet-series are more like a weekly spam. Almost 2 years ago I blogged about the misuse of FF-recommendations and I gave some suggestions to do #FollowFriday the right way: not by sheer mentioning many people in numerous  tweets, but by recommending one or a few people a time, and explaining why this person is so awesome to follow.

Twitter Lists are also useful tools for recommending people (see post). You could construct lists of your favorite Twitter people for others to follow. I have created a general FollowFridays list, where I list all the people I have recommended in a #FF-tweet and/or post.

In this post I would like to take up the tradition of highlighting the #FF favs at my blog. .

This FollowFriday I recommend:  

Jennifer Gunter

Jennifer Gunter (@DrJenGunter at Twitter), is a beautiful lady, but she shouldn’t be tackled without gloves, for she is a true defender of evidence-based medicine and wields the lasso of truth.

Her specialty is OB/GYN. She is a sex health expert. No surprise, many tweets are related to this topic, some very serious, some with a humorous undertone. And there can be just fun (re)tweets, like:

LOL -> “@BackpackingDad: New Word: Fungry. Full-hungry. “I just ate a ton of nachos, but hot damn am I fungry for those Buffalo wings!””

Dr Jen Gunter has a blog Dr. Jen Gunther (wielding the lasso of truth). 

Again we find the same spectrum of posts, mostly in the field of ob/gyn. You need not be an ob/gyn nor an EBM expert to enjoy them. Jen’s posts are written in plain language, suitable for anyone to understand (including patients).

Some titles:

In addition, There are also hilarious posts like “Cosmo’s sex position of the day proves they know nothing about good sex or women“,where she criticizes Cosmo for tweeting impossible sex positions (“If you’re over 40, I dare you to even GET into that position! “), which she thinks were created by one of the following:

A) a computer who has never had sex and is not programmed to understand how the female body bends.
B) a computer programmer who has never has sex and has no understanding of how the female body bends.
C) a Yogi master/Olympic athlete.

Sometimes the topic is blogging. Jen is a fierce proponent of medical blogging. She sees it as a way to “promote” yourself as a doctor, to learn from your readers and to “contribute credible content drowns out garbage medical information” (true) and as an ideal platform to deliver content to your patients and like-minded medical professionals. (great idea)

Read more at:

You can follow Jen at her Twitter-account (http://twitter.com/#!/DrJenGunter) and/or you can follow my lists. She is on:  ebm-cochrane-sceptics and the followfridays list.

Of course you can also take a subscription to her blog http://drjengunter.wordpress.com/

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The Second #TwitJC Twitter Journal Club

14 06 2011

In the previous post I wrote about  a new initiative on Twitter, the Twitter Journal Club (hashtag #TwitJC). Here, I shared some constructive criticism. The Twitter Journal Club is clearly an original and admirable initiative, that gained a lot of interest. But there is some room for improvement.

I raised two issues: 1. discussions with 100 people are not easy to follow on Twitter, and 2. walking through a checklist for critical appraisals is not the most interesting to do (particularly because it had already been done).

But as one of the organizers explained, the first session was just meant for promoting #twitjc. Instead of the expected 6 people, 100 tweople showed up.

In the second session, last Sunday evening, the organizers followed a different structure.

Thus, I thought it would only be fair, to share my experiences with the second session as well. This time I managed to follow it from start to finish.

Don’t worry. Discussing the journal club won’t be a regular item. I will leave the organization up to the organizers. The sessions might inspire me, though, to write a blog post on the topic now and then. But that may only work synergistic. (at least for me, because it forces me to rethink it all)

This time the discussion was about Rose’s Prevention Paradox (PDF), a 30 year old paper that is still relevant. The paper is more of an opinion piece, therefore the discussion focused on the implications of the Prevention Paradox theory. It was really helpful that Fi wrote an introduction to the paper, and a Points of Discussion beforehand. There were 5 questions (and many sub-questions).

I still found it very hard to follow it all at Twitter, as illustrated by the following tweet:

  • laikas I think I lost track. Which question are we? #twitjc Sun Jun 12 20:07:03
  • laikas @MsPhelps ik werd wel helemaal duizelig van al die tweets. Er zijn toch wel veel mensen die steeds een andere vraag stellen voor de 1e is beantwoord -9:47 PM Jun 12th, 2011 (about instant nausea when seeing tweets rolling by and people already posing a new question before the first one is answered)

I followed the tweets at http://tweetchat.com/room/twitjc. Imagine tweets rolling by and you try to pick up those tweets you want to respond to (either bc they are very relevant, or because you disagree). By the time you have finished your tweet, already 20 -possibly very interesting tweets- passed by, including the next question by the organizers (unfortunately they didn’t use the official @twitjournalclub account for this).

Well, I suppose I am not very good at this. Partly because I’m Dutch (thus it takes longer to compose my tweets), partly because I’m not a fast thinker. I’m better at thorough analyses, at my blog for instance.

But this is Twitter.  To speak with Johan Cruyff, a legendary soccer-player from Holland, “Every disadvantage has its advantage”.

Twitter may not favor organized discussions, but on the other hand it is very engaging, thought-provoking and easy accessible. Where else do you meet 100 experts/doctors willing  to exchange thoughts about an interesting medical topic?

The tweets below are in line with/reflect my opinion on this second Twitter Journal Club (RT means retweeting/repeating the tweet):

  • laikas RT @themattmak@fidouglas @silv24 Congratulations again on a great #twitjc. Definitely more controversial and debate generating than last week’s! -9:18 PM Jun 12th, 2011
  • laikas @silv24 well i think it went well (it is probably me, I’m 2 slow). This paper is broad, evokes much discussion & many examples can B given -9:45 PM Jun 12th, 2011
  • DrDLittle Less structure to #twitJC last night but much wider debate 7:41 AM Jun 13th, 2011
  • amitns @DrDLittle It’s obviously a very complex topic, more structure would have stifled the debate. A lot of food for thought.#twitJC -7:45 AM Jun 13th, 2011

Again, the Twitter Journal Club gained a lot of interest. Scientist and teachers consider to borrow the concept. Astronomers are already preparing their first meeting on Thursday… And Nature seems to be on top of it as well, as it will interview the organizers of the medical and the astronomy journal club for an interview.

Emergency Physician Tom Young with experience in critically appraisal just summarized it nicely: (still hot from the press):

The two meetings of the journal club so far have not focussed in on this particular system; the first used a standard appraisal tool for randomised controlled trials, the second was more laissez-faire in its approach. This particular journal club is finding its feet in a new setting (that of Twitter) and will find its strongest format through trial and error. indeed, to try to manage such a phenomenon might be likened to ‘herding cats’ that often used description of trying to manage doctors, and I think, we would all agree would be highly inadvisable. Indeed, one of its strengths is that participants, or followers, will take from it what they wish, and this will be something, rather than nothing, whatever paper is discussed, even if it is only contact with another Tweeter, with similar or divergent views. 

Indeed, what I gained from these two meetings is that I met various nice and interesting people (including the organizers, @fidouglas and @silv24). Furthermore, I enjoyed the discussions, and picked up some ideas and examples that I would otherwise wouldn’t know about. The last online meeting sparked my interest in the prevention paradox. Before the meeting, I only read the paper at a glance. After the session I decided to read it again, and in more detail. As a matter of fact I feel inspired to write a blog post about this theory. Originally I planned to write a summary here, but probably the post is getting too long. Thus I will await the summary by the organizers and see if I have time to discuss it as well.

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The #TwitJC Twitter Journal Club, a New Initiative on Twitter. Some Initial Thoughts.

10 06 2011

There is a new initiative on Twitter: The Twitter Journal Club. It is initiated by Fi Douglas (@fidouglas) a medical student at Cambridge,  and Natalie Silvey (@silv24)  a junior doctor in the West Midlands.

Fi and Natalie have set up a blog for this event: http://twitjc.wordpress.com/

A Twitter Journal Club operates in the same way as any other journal club, except that the forum is Twitter.

The organizers choose a paper, which they announce at their website (you can make suggestions here or via a tweet). Ideally, people should read the entire paper before the Twitter session. A short summary with key points (i.e. see here) is posted on the website.

The first topic was:  Early Goal-Directed Therapy in the Treatment of Severe Sepsis and Septic Shock [PDF]

It started last Sunday 8 pm (Dutch time) and took almost 2 hours to complete.

@twitjournalclub (the twitter account of the organizers) started with a short introduction. People introduced themselves as they entered the discussion. Each tweet in the discussion was tagged with #TwitJC (a so called hashtag), otherwise it won’t get picked up by people following the hashtag. (Tweetchat automatically provides the hashtag you type in).

Although it was the first session, many people (perhaps almost 100?!) joined the Journal Club, both actively and more passively. That is a terrific achievement. Afterwards it got a very positive Twitter “press”. If you know to engage people like @nothern_doctor, @doctorblogs, @amcunningham and @drgrumble and people like @bengoldacre, @cebmblog and @david_colquhoun find it a terrific concept, then you know that it is a great idea that meets a need. As such, enough reason to continue.

There were also not purely positive voices. @DrVes sees it as a great effort, but added that “we need to go beyond this 1950s model rather than adapt it to social media.” Apparently this tweet was not well received, but I think he made a very sensible statement.

We can (and should) asks ourselves if Twitter is the right medium for such an event.

@DrVes has experience with Twitter Journal Clubs. He participated in the first medical journal club on Twitter at the Allergy and Immunology program of Creighton University back in 2008 and presented a poster at an allergy meeting in 2009.

BUT, as far as I can tell, that Twitter Journal Club was both much more small-scale (7 fellows?) and different in design. It seems that Tweets summarized what was being said at a real journal club teaching session. Ves Dimov:

“The updates were followed in real time by the Allergy and Immunology fellows at the Louisiana State University (Shreveport) and some interested residents at Cleveland Clinic, along with the 309 subscribers of my Twitter account named AllergyNotes“.

So that is the same as tweeting during a conference or a lecture to inform others about the most interesting facts/statements. It is one-way-tweeting (overall there were just 24 updates with links).

I think the present  Twitter Journal Club was more like a medical Twitter chat (also the words of Ves).

Is chatting on Twitter effective?

Well that depends on what one wants to achieve.

Apparently for all people participating, it was fun to do and educative.

I joined too late to tell, thus I awaited the transcript. But boy, who wants to read 31 pages of “chaotic tweets”? Because that is what a Twitter chat is if many people join.  All tweets are ordered chronologically. Good for the archive, but if the intention is to make the transcribed chat available to people who couldn’t attend, it needs deleting, cutting, pasting and sorting. But that is a lot of work if done manually.

I tried it for part of the transcript. Compare the original transcript here with this Google Doc.

The “remix of tweets” also illustrates that people have their own “mini-chats”, and “off-topic” (but often very relevant) questions.

In addition, the audience is very mixed. Some people seem to have little experience with critical appraisal or concepts like “intention to treat” (ITT) and would perhaps benefit from supplementary information beforehand (i.e. documents at the TwitJC website). Others are experienced doctors with a lot of clinical expertise, who always put theoretical things in perspective. Very valuable, but often they are far ahead in the discussion.

The name of the event is Twitter  Journal Club. Journal Club is a somewhat ambiguous term. According to Wikipedia “A journal club is a group of individuals who meet regularly to critically evaluate recent articles in scientific literature”. It can deal with any piece which looks interesting to share, including hypotheses and preclinical papers about mechanisms of actions.

Thus, to me Journal club is not per definition EBM (Evidence Based Medicine).

Other initiatives are a critical appraisal of a study and a CAT,  a critical appraisal of a topic (sometimes wrongly called PICO, PICO is only part of it).

The structure of the present journal club was more that of a critical appraisal. It followed the normal checklist for an RCT: What is being studied? Is the paper valid (appropriately allocated, blinded etc ), what are the results (NNT etc) and are the results valid outside of the context of the paper?

Imo, official critical appraisal of the paper costs a lot of time and is not the most interesting. Looking at my edited transcript you see that half of the people are answering the question and they all say the same: “Clearly focused question” is answer to first question (but even in the edited transcript this takes 3 pages), “clear interventions (helpful flowcharts) is the answer to the second question.

Half of the people have their own questions. Very legitimate and good questions, but not in line with the questions of @twitjournalclub. Talking about the NNT and about whether the results are really revolutionary, is VERY relevant, but should be left till the end.

A twitter chat with appr. 100 people needs a tight structure.

However, I wonder whether this  approach of critical appraisal is the most interesting. Even more so, because this part didn’t evoke much discussion.

Plus it has already been done!!

I searched the TRIP database and with the title of the paper, to find critical appraisals or synopses of the paper. I found 3 synopses, 2 of which follow more or less the structure of this journal club here, here (and this older one). They answer all the questions about validity.

Wouldn’t it have better with this older key paper (2001) to just use the existing critical appraisals as background information and discuss the implications? Or discuss new supporting or contradictory findings?

The very limited search in TRIP (title of paper only) showed some new interesting papers on the topic (external validation, cost effectiveness, implementation, antibiotics) and I am sure there are many more.

A CAT may also be more interesting than a synopsis, because “other pieces of evidence” are also taken into consideration and one discusses a topic not one single paper. But perhaps this is too difficult to do, because one has to do a thorough search as well and has too much to discuss. Alternatively one could choose a recent systematic review, which summarizes the existing RCT’s.

Anyway, I think the journal club could improve by not following the entire checklist (boring! done!), but use this as a background. Furthermore I think there should be 3-5 questions that are very relevant to discuss. Like in the #HSCMEU discussions, people could pose those questions beforehand. In this way it is easier to adhere to the structure.

As to the medium Twitter for this journal club. I am not fond of  long Twitter chats, because it tends to be chaotic, there is a lot of reiteration, people tend to tweet not to “listen” and there is a constriction of 140 characters. Personally I would prefer a webinar, where people discuss the topic and you can pose questions via Twitter or otherwise.
Other alternatives wouldn’t work for me either. A Facebook journal club (described by of Neil Mehta) looks more static (commenting to a short summary of a paper), and Skyping is difficult with more than 10 people and not easy to transcribe.

But as said there is a lot of enthusiasm for this Twitter Journal Club. Even outside the medical world. This “convincing effort” inspired others to start a Astronomy Twitter Journal Club.

Perhaps a little modification of goals and structure could make it even more interesting. I will try to attend the next event, which is about Geoffrey Rose’s ‘Prevention Paradox’ paper, officially titled ”Strategy of prevention: lessons from cardiovascular disease”, available here.

Notes added:

[1] A summary of the first Twitter journal club is just posted. This is really valuable and takes away the disadvantages of reading an entire transcript (but one misses a lot of interesting aspects too)!

[2] This is the immediate response of one of the organizers at Twitter. I’m very pleased to notice that they will put more emphasis on implications of the Journal. That would take away much of my critic.

(Read tweets from bottom to top).

References

  1. Welcome (twitjc.wordpress.com)
  2. An important topic for the first Twitter Journal Club (twitjc.wordpress.com)
  3. Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M; Early Goal-Directed Therapy Collaborative Group. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001 Nov 8;345(19):1368-77. PubMed PMID: 11794169. (PDF).
  4. The First Journal Club on Twitter – Then and Now (casesblog.blogspot.com)
  5. Allergy and Immunologyclub on Twitter (allergynotes.blogspot.com)
  6. The Utility of a Real-time Microblogging Service for Journal Club in Allergy and Immunology. Dimov, V.; Randhawa, S.; Auron, M.; Casale, T. American College of Allergy, Asthma & Immunology (ACAAI) 2009 Annual Meeting. Ann Allergy Asthma Immunol., Vol 103:5, Suppl. 3, A126, Nov 2009.
  7. https://docs.google.com/document/pub?id=1qzk1WzjNO5fbWd0PAax6cIDdUGGg1sDn86FPT1li-sQ (short remix of the transcript)
  8. Model for a Journal Club using Google Reader and Facebook OR if the prophet does not go to the Mountain…. bring the journal club to FB! (blogedutech.blogspot.com)
  9. Astronomy Twitter Journal Club/ (sarahaskew.net)
  10. A summary of week one: Rivers et al (twitjc.wordpress.com)







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