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These Days, Find Diabetes ‘Opinion Leaders’ on Twitter

Increasingly, social media platforms such as Twitter are giving knowledgeable but lesser-known experts on medical topics like diabetes a prominent voice.

“Key opinion leaders” in medical fields are those traditionally with the greatest academic expertise, high publication counts with first and last authorships, and large co-author networks.

An emerging crop of “digital opinion leaders,” less-established researchers, or even clinicians have garnered large followings on Twitter because they share valuable scientific content and engage in dialogue with others in their areas of expertise, especially now during the COVID-19 pandemic.

An estimated 29.1% of healthcare workers now use social media daily to exchange medical knowledge with their peers, noted Simon Leigh, PhD, head of digital innovation & insights at the healthcare consultancy VISFO Health, and colleagues.

Leigh and colleagues conducted the first-ever analysis to “explore the link between bibliometric and digital activity on a global medical scale,” studying nearly 3000 diabetes researchers who issued more than 100,000 tweets.

Publication count and first/last authorships were unrelated to tweet frequency or engagement, and the investigators with the most academic co-authors were less likely to tweet than were those with smaller networks. The findings were published online December 7 in Pharmaceutical Medicine.

“There are your heavy-hitting academics who are always going to be there…But your community clinicians who aren’t on national guidelines, who aren’t pioneering in new research but are dealing with patients day-to-day, these voices are just as important as the ones from the big-hitting [key opinion leaders] because they’re still being driven primarily by patient experiences. So I see Twitter as an opportunity,” Leigh told Medscape Medical News.

Key Opinion Leaders Aren’t Taking to Twitter

The investigators reviewed all diabetes-related research publications (n = 44,135) in PubMed from August 1, 2018 through August 1, 2020 and identified all authors whose names appeared at least once. Then they identified all global diabetes-related tweets, retweets, and comments on Twitter — a total of 20.6 million — for the same period. These included tweets using hashtags from major conferences such as the American Diabetes Association’s Scientific Sessions and the European Association for the Study of Diabetes annual meeting.

They then combined the two lists, yielding a total of 2686 unique global healthcare professionals who had published at least two diabetes-related publications and who altogether posted a total of 110,346 tweets.

Not surprisingly, diabetes researchers with more followers on Twitter were more likely to tweet about diabetes. But interestingly, those with a greater number of diabetes-related publications per month were no more likely to post diabetes content on Twitter than were those with fewer publications (P = .159). Moreover, those publishing seven or more papers per month — who may be considered “key opinion leaders” — were significantly less likely to publish content on Twitter than were those publishing fewer than one paper per month (P = .022).

First and last authorship on papers — considered indicators of academic responsibility and experience — had no relationship to the likelihood of tweeting diabetes-related content. However, the greater the number of co-authors the researcher had — a proxy for professional prominence — the less likely they were to post diabetes-related content on Twitter. For example, those with more than 200 total co-authors were 52% less likely to tweet about diabetes than were those with fewer than 50 co-authors (P = .001).

Researchers with a larger number of Twitter followers were more likely both to retweet others’ content and to have their own content retweeted by others.

But, notably, diabetes-related tweets from those highly published authors were significantly less likely to receive comments and replies on Twitter than were those with fewer publications. Those with 4-6 publications per month received 92% fewer comments and replies than did those with fewer than one scientific publication per month. Those with more publications were also far less likely to provide their own opinions on diabetes-related tweets from others compared to those with fewer publications.

However, there were certain topics — including insulin, pediatric diabetes, and type 1 diabetes — for which the researchers who frequently published were also tweeting about and engaging with more often. For example, each additional publication on type 1 diabetes was associated with an additional 1.25 type 1 diabetes-related tweets (P = .045).

But total publications, first/last authorship, publications per month, and the number of academic co-authors were all unrelated to Twitter engagement at conferences, “suggesting that high impact ‘key opinion leaders’ are no more likely to promote and respond to content at conferences than lesser known healthcare providers.”

“You Can Make a Name for Yourself”

While this research was primarily aimed at informing pharmaceutical companies on how best to interact with clinicians and patients via “medical science liaisons,” Leigh notes that there are several takeaways for clinicians. “You can make a name for yourself…more so in this space,” and “you can prune your following so you only have the people predominantly interacting with you whose opinions you care about.”

Leigh also noted that especially nowadays — with virtual medical meetings replacing in-person ones — digital platforms like Twitter provide a substitute for valuable lobby conversations. “It’s giving that opportunity for clinicians to interact in more of a community and learn from the experiences of other clinicians rather than saving it all for those big events or having all of the narrative driven by the [key opinion leaders] at the very top.”

Equity is the key, he believes. “Just because you don’t publish a lot doesn’t mean you aren’t a worthwhile clinician with something to say.”

Leigh is an employee of VISFO, a UK healthtech consultancy that works with multiple pharmaceutical companies.

Pharmaceut Med. Published online December 7, 2021. Full text   

Miriam E. Tucker is a freelance journalist based in the Washington, DC area. She is a regular contributor to Medscape, with other work appearing in the Washington Post, NPR’s Shots blog, and Diabetes Forecast magazine. She is on Twitter @MiriamETucker.

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