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Examples of Types of Tweets from DDW

Twitter use as a platform for rapid dissemination of informative
content from DDW is increasing
Ryan D. Madanick
, Peter S. Fleming
, Renuka Kadali
Leybelis Padilla
, Rupali Prabhukhot
, Lee Sigmon
, Tejas Desai

Introduction and Study Aims
 The use of social media among physicians to disseminate
informative content is low but increasing.
 Twitter, a popular micro-blogging platform, has recently seen
increased use at medical conferences, including Digestive
Disease Week (DDW)
 Little is yet known about the content and educational value of
tweets from academic medical conferences.
Specific Aims:
1. Describe the type and informative (educational)
content of tweets composed during DDW 2011
and 2012
2. Compare the percentage of informative tweets
from DDW 2011 to 2012
Tweets using official DDW hashtags (#DDW11 & #DDW12) were downloaded from a
publicly available archive. Date ranges spanned 3 days before & after each meeting.
Authors of the tweets were de-identified
Tweets were analyzed for content & citation type using an established Twitter-specific
classification scheme.
Content type:
Informative: tweets that could educate the reader about scientific information
from the conference.
Uninformative: tweets that did not educate the reader; subclassified as (1)
advertisement, (2) status update, (3) query, (4) direct message, (5) opinion,
(6) other, or (7) unknown.
Citation type:
Internal: tweets re-amplifying a previously posted tweet from within the
conference, commonly referred to as a “retweet” (RT), modified tweet (MT)
or hat-tip (HT).
External: tweets containing shortened universal resource locators (URLs) to
third party websites.
Both: tweets containing both internal and external citations
Neither: tweets containing neither internal nor external citations
Five coders were trained to classify tweets using an open-source training set (10% of
tweets from Kidney Week 2011; #kidneywk11)
After training, the same five coders independently classified tweets listed randomly from
DDW2011 & 2012
University of North Carolina School of Medicine, Division of Gastroenterology and Hepatology;
East Carolina University School of Medicine;
University of North Carolina Hospitals
Center for
 On the training dataset (101 tweets from Kidney Week 2011), inter-
coder agreement for informative vs. uninformative content was near-
perfect (90%) based on Light’s kappa. Inter-coder agreement for
citation type was initially 74%, predominantly because of moderate
inter-coder agreement with one coder and each of the remaining
coders. After retraining this coder, inter-coder agreement for citation
type became near-perfect (88%).
 506 distinct Twitter users composed 3948 tweets with one of the
official hashtags during the time periods analyzed (range of
tweets/user, 1-238). There was a 38% increase in the number of
tweets and a 78% increase in the number of Twitter users in the
official DDW stream from 2011 to 2012. Only 47 Twitter users (9% of
the overall number of distinct Twitter users) composed tweets during
both years.
 The percentage of tweets with informative content increased
from 20% in 2011 to 33% in 2012 (p<0.001). The absolute number
of tweets with informative content increased by 129%, from 331
to 757, between 2011 and 2012.
 The number of tweets with at least an internal citation increased from
24% in 2011 to 27% in 2012 (p=0.02).
 Internal citations were found in 296 (27%) informative tweets and 732
(26%) uninformative tweets (p=0.30)
 Overall Twitter use at DDW, as determined by an
analysis of the stream of tweets containing official
DDW hashtags, increased between 2011 & 2012.
 Between 2011 and 2012, more Twitter users
composed tweets with the official DDW hashtag,
despite only a small percentage of common users
between the two years.
 Greater re-amplification of tweets from DDW
occurred in 2012 compared with 2011.
 With increasing use of Twitter from the conference
in 2012, a significantly greater proportion of the
DDW Twitter stream was composed of tweets
with educational value. However, uninformative
tweets still made up a bulk of the re-amplified
 The increasing use of Twitter at DDW may indicate
a greater use and/or acceptance of Twitter by
gastroenterologists to educate the public about GI
 This is the first study to indicate that Twitter use
at the same major annual medical meeting is not
only increasing from one year to the next, but
also is being used increasingly to disseminate
knowledge about the scientific content of the
Informative tweets:
PPI-clopidogrel interaction fact or fiction? Verdict based on evidence is no but
FDA advises use of non-omeprazole PPI #DDW11
In IBS, disturbed sleep contributes to GI symptoms & may serve as an important
target for intervention in optimizing symptom control #DDW12
Uninformative tweets:
Meet JAMA Editor David H. Mark, MD, MPH in booth 2734 at #DDW11 tomorrow
from 12:00-2:00 pm.
Don't miss one-on-one training using the latest haptic feedback technology at the
#DDW12 @ASGEendoscopy Learning Center in Exhibit Hall H
Tweets with Internal Citations (citation in red):
Retweet: RT @****: Surprised at how few GI docs are active on Twitter during the
largest annual GI conference #DDW11
Modified Tweet: MT @****: #DDW11 @DDWMeeting Sp876 Plevy
@UNC_Health_Care metronid/ornidizole have clin post-op recur (~8%) but endo
recur still ~50%
Tweets with External Citations (citation in blue):
More accurate detection of bilio-pancreatic cancer with #cellvizio final results of
#pCLE study announced @#DDW11 today
My blog from #DDW12: Comparison of Usual Medical Care for #IBS in Japan and
the U.S.:
Tweets with both Internal and External Citations:
RT @****: Pillcam colon vs colonoscopy in the evaluation of known inflammatory
bowel #DDW11
RT @****: My blog from #DDW12: Comparison of Usual Medical Care for #IBS in
Japan and the U.S.:
Tweets with neither Internal nor External Citations:
#DDW11 @DDWMeeting Sp876 Plevy metronidazole/ornidizole have low clin
post-op recur (~8%) but endo recur still ~50%
Observational study from MGH showing post menopausal females using
hormonal therapy at increased risk for UC not CD. #IBD #DDW12
Statistical Analysis:
Descriptive statistics were used to analyze the complete datasets of tweets
Cohen’s kappa statistic was calculated to assess inter-coder agreement on the
training set (poor: < 0.0; slight: 0-0.20; fair: 0.21-0.40; moderate: 0.41-0.60;
substantial: 0.61-0.80; near-perfect: 0.81-1.00). Light’s kappa was then calculated
by averaging the Cohen’s kappa statistics.
Chi square was used to calculate statistical significance between categorical
All statistical analyses were performed using Stata v11.2 (StataCorp LP, College
Station, TX)
DDW 2011
DDW 2012
Distinct Twitter users 506 199 354
Informative tweets 1088
Citation type
Internal 593
External 939
Both 435
Neither 1981
Table. Tweet analysis from DDW 2011 & 2012
• Desai T, Shariff A, Shariff A, et al. Tweeting the meeting: an in-depth analysis of Twitter
activity at Kidney Week 2011. PLoS ONE 2012;7(7): e40253.
• Chaudhry A, Glodé LM, Gillman M, Miller RS. Trends in Twitter use by physicians at the
American Society of Clinical Oncology Annual Meeting, 2010 and 2011. J Oncol Pract
• Ross C, Terras M, Warwick C, Welsh A. Enabled backchannel: conference Twitter use by
digital humanists. J Documentation 2011;67:214.
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