Social Media &
Academic Oncology
Challenges and Opportunities
Matthew Katz, MD
December 2014

Conflict of Interest
 Partner, Radiation Oncology Associates PA
 Medical Director of Radiation Medicine, Lowell
General Hospital
 External advisor, Mayo Clinic Center for Social
Media
 Founder, nonprofit blog Radiation Nation

Overview
 Social Media
 Definition
 Scope of Use
 Risks & Benefits
 Clinical Practice
 Academic Medicine
 Impact on Research
 Ethical
 Practical
 Opportunities in Radiation Oncology

Definition
“Social media are web-based tools for
interaction that, in addition to conversation,
allow users to share content such as photos,
videos, and links to resources”
-- Meredith Gould, The Social Media Gospel

Social Media
 Global reach
 Easy access
 Little technical expertise needed to use
 Immediate impact
 Dynamic content
Wikipedia, http://bit.ly/mZcwaH

Most active U.S. social websites

 Data analytics firms track us, including NPI numbers
Creation Pinpoint, http://bit.ly/1hU6Kqd

Rapid Adoption in U.S.
In the US:
35% have searched for
a medical condition
online
80% start with a
search engine
Pew Internet Pew Internet http://bit.ly/1moDRZ4
http://bit.ly/1gXxHv7
N = 1,445, Sept. 2013
42% of adults are using social networks
N=3,014, Sept. 2012

http://bit.ly/16cPIUH

Risks in Clinical Practice
Patients/Caregivers
 Misinformation
 Loss of privacy
 Psychologic
amplification
Professionals
 Professional harm
 Patient harm
 Psychological harm

Benefits in Clinical Practice
Patients/Caregivers
 Support
 Education
 Collaboration
 Advocacy
Professionals
 Coordinate Care
 Collaboration
 Networking
 Education
 Career Opportunity
 Reputation Management

Social Media and Academic Medicine
 Recruitment, Education & Training
 Research
 Collaboration
 Crowdsourcing
 Funding
 Publication
 Academic Promotion
 Reputation

Recruitment

Who still buys textbooks?

Mentoring

Changing Dynamics of Mentorship
 Geography less
important
 ? Mentor at another
institution
 ? Need to be in
academics

What About Research?
http://bit.ly/OPVFxV

Innovate Yourself

#bcsm – Breast Cancer & Social Media
 Weekly Twitter chats start July 4, 2011
 Organized by two advocates, breast surgeon
 Focus on advocacy, survivorship, support,
metastatic breast cancer, new research

Symplur.com, http://bit.ly/1cAmuR7

#lcsm
Symplur.com

#gyncsm
Symplur.com

Communities with Chats
Group When Tweets
2013
2014* Δ
#ayacsm Every 3rd
Thursday, 4 PM EST 199 19588 9700%
#bcsm Monday, 9 PM EST 84391 80356 -5%
#btsm 1st
Sunday, 10 PM EST 49077 50431 3%
#gyncsm 2nd
Wednesday, 9 PM EST 4374 15649 258%
#lcsm Every other Thursday, 8 PM EST 32339 70142 117%
#mmsm 3390 9208 172%
#pancsm Every 1st
Thursday, 9 PM EST 257 3052 1087%
Symplur.com
* Tweets through Nov 27 2014

Collaboration
 Hashtag project is one example
 What about getting others to help you do
your research?

• Released late September 2014
• 2 million slide high power fields analyzed by Thanksgiving
Harness Amateurs with Games

Improving Clinical Trials
Potential Use Example Journal PMID
Recruitment,
Lower costs
Smoking Cessation
Facebook recruiting
JMIR 25348050
Adherence Smoking Cessation JNCI 24395994
Investigator Training
Informed Consent
Clinical Trial Design Protocol draft wikis
Let public design/vote

Funding
National Cancer

National Institutes of

Funding Research
Accessed 3/15/14
http://bit.ly/OPVUsB

Academic Disadavantage = Overhead
 Accounts for $10B of NCI budget
 69% for Harvard as of 2013
 What if NIH favors proposals with little or no
overhead?
Boston Globe, 3/18/2014
http://bit.ly/11Da86G

Thangasamy et al, Eur Urol 2014 , http://bit.ly/1io3Fx9

Publication

http://bit.ly/1HLbhKi
Source: Nick Kim, lab-initio.com

Social Networking for Academics
Users Article Uploads/Day
14 M 15,000
3 M
5 M 71,000
Source: The Lancet, Nov 2014
http://bit.ly/1ykZeOA
1300 share negative results, raw data
every day

Motivations for Public Data Sharing
Reason for Sharing %
Standard practice 57%
Increase visibility and impact 55%
Public benefit 50%
Journal requirement 42%
Transparency, re-use 37%
Personal trust in requester 30%
Discoverability, accessibility 25%
Funder requirement 23%
Institutional requirement 18%
Freedom from information request 13%
Preservation 13%
N = 2250
3% response rate
Source: Wiley, March 2014.
http://bit.ly/1rz4UQf

Source: Nature, August 2014
go.nature.com/fjvxxt

Where you are the research subject?

Sorrell v. IMS Health
 Vermont created legislation to prevent
doctor prescription data mining by
pharmacies selling data to drug marketers
 Supreme Court recently ruled 6-3 in favor of
IMS Health because VT “burdens the speech
of pharmaceuticals and data miners”
 Focus on harm to commercial free speech
Sorrell v. IMS Health, 10-779

Reputation

Once it’s digital, it’s not yours

Therapists at Fruit Street Clinic

Monitor Your Reputation
 Mainstream media
 Key social networks
 And….

PubMed 2.0 – Comment on Abstracts
Disease Trial Journal + Year PMID
Anal Canal RTOG 87-04 JCO 1996 8823332
Bladder BC 2001 NEJM 2012 22512481
Breast NSABP B-06 NEJM 1985 3883167
Cervix GOG NEJM 1999 10202165
Esophagus RTOG 85-01 NEJM 1992 1584260
Glioblastoma EORTC-NCIC NEJM 2005 15758009
Larynx VA Larynx NEJM 1991 2034244
Lung CALGB 8433 NEJM 1990 2169587
Lung RTOG 0236 JAMA 2010 20233825
Prostate EORTC NEJM 1997 9233866
Prostate EORTC 22911 Lancet 2012 23084481

New York Medical College, http://bit.ly/1y8TlX9
Monitor Comments

Impact on Research

Ethics in Flux
 Newer research models may conflict directly
with Belmont Report
 HIPAA an issue as well
 Do we need to adapt current ethical
frameworks?
 How should these technologies be used?

flowingdata.com

 Saliva  SNPs for detecting
risk of disease
 $99
 No genetic counseling
 Shut down by FDA 11/2013
Direct to Consumer (DTC) Research
FDA, http://1.usa.gov/1nVOyUt

http://nyti.ms/1m1AlR9

Research in an Apomediated World
 Subjects play more active role
 How do you regulate “when it is not clear who the
researcher is and who the subject is”
 What role for IRBs if done online only?
 How can you separate trial recruitment from
solicitation?
D O’Connor, J Law Med Ethics 2013

Social Media and Citations
G Eysenbach, J Med Int Res 2011
 Correlation only?
 One RCT: no
increased citations*
 Altmetrics used for
Impact Factor
*Fox CS et al, Circulation 2014

Open Access = More Citations?
S Lawrence, Nature 2001
 Easier to disseminate
 One RCT: no increased
citations*
*Davis et al, BMJ 2008

Why Get Involved?

What is the alternative?

Radiation Oncology: Back to the Basement?
M Katz, Mayo SMHN, http://mayocl.in/1tqewx2

Research and Create New Worlds

http://bit.ly/1w01D3D

http://bit.ly/1w01D3D

http://bit.ly/1w01D3D

Audience by communication method
Bik HM, Goldstein MS. PLOS Biol 2013

Is Social Media Compatible?
Value Social
Media
Medicine Science Academia
Accountability + + + +
Attribution + + + +
Medical Ethics + +
Engage Public +
Expertise + +
Hierarchy + +
Integrity + + + +
Persistence + + + +
Privacy +
Transparency +

Will it be valued?
 Activity doesn’t guarantee
 Quality
 Rigor
 Need metrics that matter to value social
media activity for academic promotion

Summary
 Social media are powerful communications tools
 Rapid adoption despite poorly defined risks & benefits
 More connected = more reward and risk
 Increasing attention in major journals
 Academic oncology needs to help us research best use in
cancer care

Thank You
Jay Harris
Anthony D’Amico and Anthony Zietman
Tracy Balboni and Akila Viswanathan
Lee Aase, Meredith Gould, Patricia Anderson
Twitter mentors and collaborators

Questions?
You’re invited to contact me:
 Twitter: @subatomicdoc