Tag Archives for evidence-based medicine

Social media and evidence-based practice: A primer on Twitter

January 25, 2011

As I keep telling you, we’re busy developing content for a workshop on “Using social media for evidence-based practice” at the upcoming Cochrane Canada Symposium. Our three content areas of focus will be blogs, wikis and Twitter. As we develop a “manual” to hand out to participants, I put together a one- 0r two-pager on Twitter. Just the basics. Take a read, and let me know if it’s clear or if there’s anything, as a beginner, you’d wished you’d known. What do you need to know to get started on Twitter?

Twitter: a primer

Definition: Twitter is a “microblogging” (“tiny” blog) service that allows networks of users to send short updates to each other in less than 140 characters. Initially used to share personal information, Twitter is now a platform for global information dissemination, social networking and real-time communication.

Background: Twitter was launched in 2007 as a tool where personal updates were shared by cell phones but has expanded in popularity due to its simple, accessible way to connect with others. It is estimated that Twitter has 190 million users, generating 65 million tweets a day and handling over 24 billion search queries per month [2]. Today, Twitter allows for updates to be sent using SMS but has expanded to include software for the Web as well as smartphones (e.g. iPhone, Android, Blackberry).

Key characteristics of Twitter:

Platform for sharing short updates called “tweets” of less than 140 characters
Tweets often include links (URLs) or “mentions” of other Twitter users
Personalized profiles include updates from people you choose to “follow”
By including a topic keyword preceded by a ‘#’, users can find and track only those tweets related to a specific topic (e.g. #ehealth) or event (e.g. #ccsymp11)
All tweets are public by default (i.e. other users can choose to follow you) but may be made private if desired

Uses of Twitter:

Sharing links and opinions about online content (e.g. blog posts, literature) [3].
Short conversations with other users and sharing of personal/professional opinions and expertise. (“Don’t underestimate this platform” [4])
Collecting a broad view of current news and important events in real-time [5].

Challenges:

Detailed conversations/debate are difficult to carry out effectively in 140 characters [6].
Tweets are meant for consumption by the public; some may be uncomfortable with the “broadcast” nature of the tool [6].
Spam and fake accounts are common. Requires proactive maintenance of your followers

Recommended Twitter Users:

@cochranecollab: The Cochrane Collaboration: Working together to provide the best evidence for health care
@DrVes: Assistant Professor at University of Chicago, Allergist/Immunologist, Internist. Former Cleveland Clinic Assistant Professor and NEJM Advisory Panel Member.
@Berci: Medical doctor, founder of Webicina.com, health 2.0 consultant, blogger; Second Life resident, Wikipedia administrator doing PhD in genetics
@laikas: Medical Librarian, scientist, mom, wife and human

Recommended hashtags:

#ccsymp11: Cochrane Canada Symposium, 2011
#hcsm: “Health care and social media”
#hcsmca: Health care and social media in Canada
Other hashtags to explore: #ehealth, #healthlit, #pharma

References:

http://blog.twitter.com/2010/10/world-of-tweets.html
http://searchengineland.com/twitter-search-queries-up-33-24-billion-searches-per-month-45840
Mandavilli A. Peer review: Trial by Twitter. Nature. 2011 Jan 20;469(7330):286-7. doi:10.1038/469286a
http://www.slideshare.net/mavergames/web-20-and-the-cochrane-collaboration-a-case-study?type=presentation
Chew C, Eysenbach G. Pandemics in the age of Twitter: content analysis of Tweets during the 2009 H1N1 outbreak. PLoS One. 2010 Nov 29;5(11):e14118. doi:10.1371/journal.pone.0014118
Cunningham AM. What I have learnt about Twitter [blog post]. 2011 Jan 23. Available from: http://wishfulthinkinginmedicaleducation.blogspot.com/2011/01/what-i-have-learnt-about-twitter.html
Hawn C. Take Two Aspirin And Tweet Me In The Morning: How Twitter, Facebook, And Other Social Media Are Reshaping Health Care. Health Aff. 2009 Mar;28(2):361-368. [link to abstract]

Social media and evidence-based practice: What good are blogs anyway?

January 18, 2011

In preparation for my (and Dean Giustini and Francisco Grajales’s) workshop at the Cochrane Canada Symposium entitled “Using Social Media to Promote Evidence-Based Practice“, we have been pouring over literature, past presentations and other resources to figure out the best way to deliver a current and relevant workshop to the Cochrane community.

We met last night to discuss the various planning ideas that we had gathered so far for the workshop, and ended up having a great discussion on the biomedical blogosphere in general, and what, if any, roles the reflective learning and collaboration that blogs are so good at fostering play in the promotion and improvement of best evidence.

It’s true that in some fields, the amount of bloggers seriously taking a critical look at reviewing and synthesizing research literature may be thin (not every article gets the same treatment as the IBS/placebo study in PLoS One). No blogger can hope or aspire to replace the work that systematic reviews do in assembling, reviewing and appraising the state of the biomedical literature on a given research question. But they can promote discourse, even if it does not always bear directly on the improvement of a clinical treatment for a certain condition.

As we know, no evidence from a single source is complete. Certainly not from a celebrity blogger, but also not even necessarily from a world-renowned journal. One of the purposes that blogs serve is to equalize the publishing field, allow a commentary on certain (or any) topics and foster an overall engagement with evidence and practice that is simply not possible on another medium. Letters to the Editor may be the closest analogue but there are only so many published in any given issue, and, perhaps worse, they often face the same access restrictions that the full-text articles do. (Also, and this is an honest question: without a paper issue to flip through, do people read those anymore?)

I know we touched on more during our meeting, but I thought I would jot down these notes for now, leave them up to marinate for a month or so and see if my own or other reactions have changed at all between now and February. As we continue planning and I work this week on a one-pager about Twitter and EBM, there will likely be more ideas floating around.

Laika’s MedLibLog. The Web 2.0-EBM Medicine split. [1] Introduction into a short series. April 1, 2009.
Palepu A, Kahn N. Keeping up with the evidence. [PDF]. Canadian Society of Internal Medicine Annual meeting. October 27-30, 2010.
Sciencebasedmedicine.org [great evidence-based blog]
Workshop planning wiki page.

Using social media to promote evidence-based practice at the Cochrane Canada Symposium

December 10, 2010

Good news yesterday that our workshop abstract for the Cochrane Canada Symposium was accepted! This year’s symposium theme is Early Exposure to Cochrane: Accessible, Credible, Practical. Our topic (see below) is one that will hopefully spark some interest and some great discussion and practice at the symposium. Leading up to February, we’ll obviously be interested in gathering some sources and opinions on how others use social media for evidence-based practice, so please get in touch with your thoughts if your have ideas or suggestions!

“Using Social Media to Promote Evidence-Based Practice: A Primer on Blogs, Wikis & Twitter”

Dean Giustini, Francisco Jose Grajales, Daniel Hooker

When / Where: Fairmont Pacific Rim, Vancouver, BC. February 16-17, 2011.

Background
This workshop provides an overview of three popular social media technologies, blogs, wikis and microblogging (e.g., Twitter, Yammer). The authors will show where to locate medical blogs and wikis on the social web and the type of information that can be found there to support evidence-based practice. Through a mix of didactic lecture, hands-on practice, and group discussion, this workshop provides an entry point for social media beginners.

Learning objectives
At the end of this workshop, participants will:

Understand blog, wiki and microblogging tools and how they are used in medicine
Have some basic knowledge of how to select one of the social tools examined to support evidence-based practice and medical education
Identify major blogging and wiki platforms to create accounts, new content and social networks
Be able to assess issues of privacy on various social media platforms
Contextualize workshop information for personal use in practice, research and continuing education

Presenters
Dean Giustini, UBC Biomedical Branch Librarian, Adjunct Faculty, SLAIS
Francisco Grajales, Trainee, Western Regional Training Centre for Health Services Research
Daniel Hooker, Researcher, eHealth Strategy Office, Faculty of Medicine

Format
A practical session that combines lecture, live demonstrations and practical exercises.
Equipment required
Participants can bring their laptops and mobiles. Internet access will be provided.
Level of knowledge required
Some awareness of social media and basic knowledge of the web.

Books you might like, Vol. 2: The Decision Tree by Thomas Goetz

July 01, 2010

The Decision Tree by Thomas Goetz is an excellent call-to-arms for personalized medicine and taking control of the options that you, as a patient, now have in our new era of healthcare. Goetz has an extraordinary ability (honed at Wired Magazine) to parse complicated scientific topics into clear and efficient prose.

He touches on many personal stories, some that have been heard before in medical non-fiction (like an Ashkenazi Jew being tested for BRCA1, the genetic mutation that often leads to breast cancer. An almost identical story is related, somewhat ironically, in one of Dr. Jerome Groopman’s early books, but more on him in a minute). Other stories are newer, and focus on some other possibilities of not only genetic testing but also of self-tracking and patient communities, and this is where the book really shines.

Goetz illuminates many of the technologies that are allowing modern patients track and control their health, such as Nike+, 23 and Me, PatientsLikeMe and many others. He also sheds new light on Weight Watchers and explains, by way of what we know now from other self-tracking programs (and other failed diet regimes), why the Weight Watchers model of “points” and group meetings has been so successful for so many.

The one thing that doesn’t quite stack up is the title of the book itself. It is my hunch that using the “decision tree” metaphor to explain the unique choices that we will all have to face as patients is an attempt to legitimize patient activism by translating it into a scientific and statistical model often used in evidence-based medicine (for an example of using decision trees in evidence-based clinical care, see here).

Integrating patient activism into the paradigms of modern medicine is difficult and requires the eloquence and dedication that Goetz provides in this book. Too often patients still meet the locked doors of the ivory tower. But Goetz does a good enough job explaining the different choices each of his examples faces, that the “decision trees” themselves do not add much to the book; if anything, they consistently struck me as over-simplified pictures of a situation just described in detail. It is vital to know and to learn the ins and the outs of your medical situation in order to assist your doctor in your treatment plan. But whether you jot notes in a book or mock-up your choices in SketchUp seems inconsequential.

It is also important that patients not forget the lynchpins of their care in the face of all these wonderful (but often distracting and sometimes frightening) technological tools: their doctors. I recently came across an excellent encapsulation of this book by @Doctor_V as compared to Dr. Jerome Groopman’s “How Doctors Think.” In it, he sets up the two books as opposite one another; the latter arguing for a golden-age of wisdom handed down by Harvard-trained “Masters of the Universe,” while the former seems to push self-tracking and patient activism so hard that there is hardly for a doctor in your care whatsoever. As a librarian, I’ll now be hard pressed to recommend either one without the other.

Wiley's Essential Evidence Plus hits the mobile web

June 11, 2010

As of May 26, Wiley-Blackwell has added mobile web access to their evidence-based summary tool, Essential Evidence Plus. The press release tells it like it is:

Global scientific, technical, medical and scholarly (STMS) publisher Wiley-Blackwell today announced the that its evidence-based clinical decision support product, Essential Evidence Plus (EE+), is now accessible from mobile devices. Physicians on the move can now easily find answers to challenging point-of-care questions from their iPhoneTM, IPod Touch®, AndroidTM, Blackberry® or other Smartphones.

The web display works nicely, with sections of each evidence summary cordoned off into separate pages. The “Bottom Line” section of most pages provides grades for the strength of the evidence, something that not all point-of-care tools offer.

Access to the mobile version is free for all current subscribers, but institutional members and those accessing EE+ through their library’s proxy server will have to sign up for a (free) individual account to get onto the mobile version.

One of the advantages of these large publisher-driven EBM tools is that the content is all web-based to begin with and it seems, then, to be a trend that they will develop alternate interfaces for the Web to be accessed by a mobile browser, rather than compartmentalizing their content to be an iPhone- or Android-only app. In the case of EE+, the interface and user experience doesn’t seem to suffer, and physicians can use any web-enabled phone to access the content.