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Social Media and Academic Oncology

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Digital communications are changing how we share health information. Are social media compatible with academic medicine and oncology?

This is a talk given at Brigham & Women's Hospital to the Harvard Radiation Oncology Program residents and staff on December 19 2014. It is intended as a survey rather than definitive presentation, highlighting the need for more research.

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Social Media and Academic Oncology

  1. 1. Social Media & Academic Oncology Challenges and Opportunities Matthew Katz, MD December 2014
  2. 2. 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
  3. 3. Overview  Social Media  Definition  Scope of Use  Risks & Benefits  Clinical Practice  Academic Medicine  Impact on Research  Ethical  Practical  Opportunities in Radiation Oncology
  4. 4. 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
  5. 5. Social Media  Global reach  Easy access  Little technical expertise needed to use  Immediate impact  Dynamic content Wikipedia, http://bit.ly/mZcwaH
  6. 6. Most active U.S. social websites
  7. 7.  Data analytics firms track us, including NPI numbers Creation Pinpoint, http://bit.ly/1hU6Kqd
  8. 8. 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
  9. 9. http://bit.ly/16cPIUH
  10. 10. Risks in Clinical Practice Patients/Caregivers  Misinformation  Loss of privacy  Psychologic amplification Professionals  Professional harm  Patient harm  Psychological harm
  11. 11. Benefits in Clinical Practice Patients/Caregivers  Support  Education  Collaboration  Advocacy Professionals  Coordinate Care  Collaboration  Networking  Education  Career Opportunity  Reputation Management
  12. 12. Social Media and Academic Medicine  Recruitment, Education & Training  Research  Collaboration  Crowdsourcing  Funding  Publication  Academic Promotion  Reputation
  13. 13. Recruitment
  14. 14. Who still buys textbooks?
  15. 15. Mentoring
  16. 16. Changing Dynamics of Mentorship  Geography less important  ? Mentor at another institution  ? Need to be in academics
  17. 17. What About Research? http://bit.ly/OPVFxV
  18. 18. Innovate Yourself
  19. 19. #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
  20. 20. Symplur.com, http://bit.ly/1cAmuR7
  21. 21. #lcsm Symplur.com
  22. 22. #gyncsm Symplur.com
  23. 23. 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
  24. 24. Collaboration  Hashtag project is one example  What about getting others to help you do your research?
  25. 25. • Released late September 2014 • 2 million slide high power fields analyzed by Thanksgiving Harness Amateurs with Games
  26. 26. 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
  27. 27. Funding National Cancer
  28. 28. National Institutes of
  29. 29. Funding Research Accessed 3/15/14 http://bit.ly/OPVUsB
  30. 30. 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
  31. 31. Thangasamy et al, Eur Urol 2014 , http://bit.ly/1io3Fx9
  32. 32. Publication
  33. 33. http://bit.ly/1HLbhKi Source: Nick Kim, lab-initio.com
  34. 34. 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
  35. 35. 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
  36. 36. Source: Nature, August 2014 go.nature.com/fjvxxt
  37. 37. Where you are the research subject?
  38. 38. 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
  39. 39. Reputation
  40. 40. Once it’s digital, it’s not yours
  41. 41. Therapists at Fruit Street Clinic
  42. 42. Monitor Your Reputation  Mainstream media  Key social networks  And….
  43. 43. 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
  44. 44. New York Medical College, http://bit.ly/1y8TlX9 Monitor Comments
  45. 45. Impact on Research
  46. 46. 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?
  47. 47. flowingdata.com
  48. 48.  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
  49. 49. http://nyti.ms/1m1AlR9
  50. 50. 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
  51. 51. 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
  52. 52. Open Access = More Citations? S Lawrence, Nature 2001  Easier to disseminate  One RCT: no increased citations* *Davis et al, BMJ 2008
  53. 53. Why Get Involved?
  54. 54. What is the alternative?
  55. 55. Radiation Oncology: Back to the Basement? M Katz, Mayo SMHN, http://mayocl.in/1tqewx2
  56. 56. Research and Create New Worlds
  57. 57. http://bit.ly/1w01D3D
  58. 58. http://bit.ly/1w01D3D
  59. 59. http://bit.ly/1w01D3D
  60. 60. Audience by communication method Bik HM, Goldstein MS. PLOS Biol 2013
  61. 61. Is Social Media Compatible? Value Social Media Medicine Science Academia Accountability + + + + Attribution + + + + Medical Ethics + + Engage Public + Expertise + + Hierarchy + + Integrity + + + + Persistence + + + + Privacy + Transparency +
  62. 62. Will it be valued?  Activity doesn’t guarantee  Quality  Rigor  Need metrics that matter to value social media activity for academic promotion
  63. 63. 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
  64. 64. 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
  65. 65. Questions? You’re invited to contact me:  Twitter: @subatomicdoc

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