- Email: [email protected]
Tu1109 Recent Shifts in Microblogging Behavior on Twitter at Digestive Disease Week
tweets associated with medical conferences lacked informative or educational content. With the rapid evolution of social media in recent years, particularly in healthcare fields, understanding the current behavioral characteristics of social media use during medical conferences may shed light on the trends of learning and disseminating knowledge by medical professionals and the public. Aim: To evaluate social media engagement characteristics during medical conferences using Twitter content from Digestive Diseases Week (DDW) meetings in 2011, 2012, 2014, and 2015. Methods: Tweets relevant to DDW 2014 and 2015 were identified using the hashtags "#DDW14" and "#DDW15" for the duration of the respective conferences. The total number of tweets (including both original content and "retweets" reposted by other users) and unique users, as well as user characteristics (individuals, professional societies/medical institutions, industry, or medical journals) were identified. Tweets were defined as informative if educational content from the conference was included. Chi-squared test was used to compare DDW 2014 to 2015 and to previously published data from DDW 2011 and 2012. Results: The number of total relevant tweets (7241 vs. 6017) and unique users (1332 vs. 1115) increased from DDW 2014 to 2015. Compared to 2014, DDW 2015 showed significant increases in proportion of tweets posted by societies/institutions (892 [14.8%] vs. 1106 [15.3%], p=0.47) and industry (866 [14.4%] vs. 1201 [16.6%], p<0.001). Conversely, a smaller proportion of tweets were posted in 2015 by individuals (66.76% vs. 68.56%, p<0.027) and journals (1.40% vs. 2.22%, p=0.002) compared to 2014. Overall, 2550 (42.3%) tweets were informative in 2014 of which 1332 (41.8%) contained original content, while 3425 (47.3%) of all tweets in 2015 were considered informative with 1381 (42.3%) containing original content. The proportion of informative tweets was significantly higher in 2014/2015 compared to published data from 2011/2012 (45.1% vs. 27.3%, p<0.001). The number of informative tweets that were re-tweeted also rose from 47.8% to 59.7% from 2014 to 2015 (p<0.001). Conclusion: Professional participation in social media during medical conferences significantly increased over the last few years, most notably among industry representatives. Furthermore, there continues to be a significant rise in informative tweets, mostly in the form of re-tweets, reflecting greater use of social media for medical information exchange.
Tu1110 Effect of Simulation-Based Medical Education on Improving Surgeons' Management of Short Bowel Syndrome Jovana Lubarda, Piyali Chatterjee Study objectives: Despite recent advances in short bowel syndrome (SBS) treatments, related guidelines have not been updated in nearly a decade, challenging clinicians to remain current in their management approaches. This study aimed to determine if online medical simulationbased education could improve clinical decision-making of surgeons managing SBS. Methods: -A CME activity was delivered online via MedSims, a virtual simulation-based learning platform that offers clinicians lifelike, point-of-care interactions through complete freedom of choice in clinical decision-making, along with mentoring feedback to improve the learner's knowledge gaps. -Surgeons were presented with two patient cases of SBS designed to address current barriers such as patient monitoring/assessment for optimization of nutritional adaptation, selection of appropriate pharmacologic therapy as part of intestinal rehabilitation, and strategies to help improve patient adherence with dietary/nutritional requirements. -Following virtual introduction of patients, physicians were asked to select from numerous available assessments, strategies for patient dietary adherence, and pharmacologic therapies. The clinical decisions made by the participants were analyzed using artificial intelligence technology. Clinical guidance (CG) was provided employing current evidence-based recommendations through a decision engine in the simulation. -Impact of the education was measured by comparing participant decisions pre- and post-CG using a 2-tailed paired t-test where P<0.05 was considered statistically significant. -The activity was hosted on Medscape Education from October 30th, 2014 and data were collected through to February 17th, 2015. Results: From pre- to post-CG in the simulation including patient case 1 and patient case 2, on average, surgeons (n=159) were more likely to make evidence-based clinical decisions related to: -Applying patient monitoring/assessment strategies to optimize nutritional adaptation in patients with SBS such as ordering colonoscopy (26% pre-CG to 40% post-CG, P<.05), ordering methylmalonic acid, serum (21% pre-CG to 35% post-CG, P<0.05), ordering upper gastrointestinal series (21% pre-CG to 35% post-CG, P<0.05), and in case 1 only, diagnosing small intestine bacterial overgrowth (4% pre-CG to 36% post-CG, P<.05). -Selecting appropriate pharmacologic therapy, such as teduglutide, as part of intestinal rehabilitation in SBS (1% pre-CG to 35% improvement post-CG, P<.05). Conclusions: Surgeons who participated in online medical simulation-based education significantly improved their clinical decision-making in SBS management, including ordering appropriate tests and selecting treatments to support intestinal rehabilitation. Further education is needed to reinforce these principles as well as optimize nutritional adaptation to improve patient outcomes.
Tu1108 Social Media Exposure is Independently Associated with Increased Citations of Publications in Gastroenterology Austin L. Chiang, Loren G. Rabinowitz, Javid Alakbarli, Walter W. Chan Background: Social media platforms such as Twitter have been increasingly adopted by medical journals to engage the public and medical professionals. However, studies showed that gastroenterology (GI) journals still rank below average among all medical specialties in social media engagement. The effect of social media exposure on citations of published research in GI also remains unclear. Aim: To evaluate the impact of social media exposure via Twitter by GI journals on citations of published articles. Methods: This was a retrospective cohort study assessing the citations of all full-length articles published in five major peerreviewed GI journals (Gastroenterology, Clincial Gastroenterology and Hepatology, Gastrointestinal Endoscopy, Pancreas, American Journal of Gastroenterology) in 2012. The number of citations in academic literature as of 11/15/2015 per Google Scholar was compared between articles tweeted by the official journal account and those that were not. Multivariate analysis using linear regression was performed to control for journal impact factor, time since publication, article type, frequency of re-posting by other users ("re-tweets"), and media addition to tweets. Comparisons of differences within covariates were performed using ANOVA. Results: 1671 GI articles were reviewed, with 482 having been tweeted by the official journal account. The order of included journals by average citations correlated with their Thomson Reuters impact factor ranks. Tweeting of an article ( b-coefficient=13.23,p=0.006) was independently associated with increased citations after controlling for potential confounders. Re-tweeting an article more than once, a possible proxy for strong public interest, also predicted more citations (b-coefficient=34.45, p = <0.0001). Significant overall association between article type and citations was noted on ANOVA (p<0.0001), with guidelines/technical reviews (90.23 ± 355.57), meta-analyses/systemic reviews (75.22 ± 124.85), and prospective studies (42.96 ± 54.26) having the most citations. Among tweeted articles, there was significant association between article type and number of re-tweets on ANOVA (p<0.0001), with guidelines/technical reviews (1.04, CI 0.22-1.87, p<0.05) and meta-analyses/ systemic reviews (1.04, CI 0.22-1.86, p<0.05) being re-tweeted significantly more than basic science articles on pair-wise comparisons. Media additions to tweets were not associated with number of citations or re-tweets. Conclusion: Exposure of GI journal publications on Twitter was independently associated with greater number of citations, after controlling for journal impact factor, type of article, and time since publication. Re-tweeting more than once also predicted increased citations. GI publications and researchers should consider wider adoption of social media to increase reach and measure uptake of published research.
Tu1111 The Shift in Crohn's Disease Management: Can Medical Education Help Clinicians Improve Knowledge? Jovana Lubarda, Keith Johnson, Stephen B. Hanauer, Gary R. Lichtenstein Study objectives: Management of Crohn's disease (CD) has evolved from treatment of clinical symptoms to the current practice of focusing on achieving mucosal remission. The evolution of this treatment paradigm has challenged clinicians to select treatments beyond symptoms as well to incorporate factors predictive of a more complicated course of disease into their treatment algorithm. This study assessed whether online continuing medical education (CME), a video of a discussion between two experts in CD, can impact clinicallyrelevant knowledge of gastroenterologists and primary care physicians (PCPs) managing CD. Methods: An online survey was used to assess the educational effect of the CME program focused on treatment goals in CD, by comparing the same participant's responses to 4 identical pre- and post-CME assessment questions. A paired 2-tailed t-test was used to assess whether the mean post-assessment score was different from the mean pre-assessment score. McNemar's chi-squared statistic was used to determine statistical significance and effect of education was calculated using Cramer's V which was used to determine the change in proportion of participants who answered questions correctly from pre- to post-assessment.
Tu1109 Recent Shifts in Microblogging Behavior on Twitter at Digestive Disease Week Austin L. Chiang, Javid Alakbarli, Walter W. Chan Background: Social media has been increasingly employed at medical conferences in recent years. Twitter is the prime social media platform that allows instant information dissemination and sentiments communication in 140-character "tweets." Previous data showed that most
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AGA Abstracts
Table 2. Factors influencing decision to pursue hepatology
Tu1110 Effect of Simulation-Based Medical Education on Improving Surgeons' Management of Short Bowel Syndrome Jovana Lubarda, Piyali Chatterjee Study objectives: Despite recent advances in short bowel syndrome (SBS) treatments, related guidelines have not been updated in nearly a decade, challenging clinicians to remain current in their management approaches. This study aimed to determine if online medical simulationbased education could improve clinical decision-making of surgeons managing SBS. Methods: -A CME activity was delivered online via MedSims, a virtual simulation-based learning platform that offers clinicians lifelike, point-of-care interactions through complete freedom of choice in clinical decision-making, along with mentoring feedback to improve the learner's knowledge gaps. -Surgeons were presented with two patient cases of SBS designed to address current barriers such as patient monitoring/assessment for optimization of nutritional adaptation, selection of appropriate pharmacologic therapy as part of intestinal rehabilitation, and strategies to help improve patient adherence with dietary/nutritional requirements. -Following virtual introduction of patients, physicians were asked to select from numerous available assessments, strategies for patient dietary adherence, and pharmacologic therapies. The clinical decisions made by the participants were analyzed using artificial intelligence technology. Clinical guidance (CG) was provided employing current evidence-based recommendations through a decision engine in the simulation. -Impact of the education was measured by comparing participant decisions pre- and post-CG using a 2-tailed paired t-test where P<0.05 was considered statistically significant. -The activity was hosted on Medscape Education from October 30th, 2014 and data were collected through to February 17th, 2015. Results: From pre- to post-CG in the simulation including patient case 1 and patient case 2, on average, surgeons (n=159) were more likely to make evidence-based clinical decisions related to: -Applying patient monitoring/assessment strategies to optimize nutritional adaptation in patients with SBS such as ordering colonoscopy (26% pre-CG to 40% post-CG, P<.05), ordering methylmalonic acid, serum (21% pre-CG to 35% post-CG, P<0.05), ordering upper gastrointestinal series (21% pre-CG to 35% post-CG, P<0.05), and in case 1 only, diagnosing small intestine bacterial overgrowth (4% pre-CG to 36% post-CG, P<.05). -Selecting appropriate pharmacologic therapy, such as teduglutide, as part of intestinal rehabilitation in SBS (1% pre-CG to 35% improvement post-CG, P<.05). Conclusions: Surgeons who participated in online medical simulation-based education significantly improved their clinical decision-making in SBS management, including ordering appropriate tests and selecting treatments to support intestinal rehabilitation. Further education is needed to reinforce these principles as well as optimize nutritional adaptation to improve patient outcomes.
Tu1108 Social Media Exposure is Independently Associated with Increased Citations of Publications in Gastroenterology Austin L. Chiang, Loren G. Rabinowitz, Javid Alakbarli, Walter W. Chan Background: Social media platforms such as Twitter have been increasingly adopted by medical journals to engage the public and medical professionals. However, studies showed that gastroenterology (GI) journals still rank below average among all medical specialties in social media engagement. The effect of social media exposure on citations of published research in GI also remains unclear. Aim: To evaluate the impact of social media exposure via Twitter by GI journals on citations of published articles. Methods: This was a retrospective cohort study assessing the citations of all full-length articles published in five major peerreviewed GI journals (Gastroenterology, Clincial Gastroenterology and Hepatology, Gastrointestinal Endoscopy, Pancreas, American Journal of Gastroenterology) in 2012. The number of citations in academic literature as of 11/15/2015 per Google Scholar was compared between articles tweeted by the official journal account and those that were not. Multivariate analysis using linear regression was performed to control for journal impact factor, time since publication, article type, frequency of re-posting by other users ("re-tweets"), and media addition to tweets. Comparisons of differences within covariates were performed using ANOVA. Results: 1671 GI articles were reviewed, with 482 having been tweeted by the official journal account. The order of included journals by average citations correlated with their Thomson Reuters impact factor ranks. Tweeting of an article ( b-coefficient=13.23,p=0.006) was independently associated with increased citations after controlling for potential confounders. Re-tweeting an article more than once, a possible proxy for strong public interest, also predicted more citations (b-coefficient=34.45, p = <0.0001). Significant overall association between article type and citations was noted on ANOVA (p<0.0001), with guidelines/technical reviews (90.23 ± 355.57), meta-analyses/systemic reviews (75.22 ± 124.85), and prospective studies (42.96 ± 54.26) having the most citations. Among tweeted articles, there was significant association between article type and number of re-tweets on ANOVA (p<0.0001), with guidelines/technical reviews (1.04, CI 0.22-1.87, p<0.05) and meta-analyses/ systemic reviews (1.04, CI 0.22-1.86, p<0.05) being re-tweeted significantly more than basic science articles on pair-wise comparisons. Media additions to tweets were not associated with number of citations or re-tweets. Conclusion: Exposure of GI journal publications on Twitter was independently associated with greater number of citations, after controlling for journal impact factor, type of article, and time since publication. Re-tweeting more than once also predicted increased citations. GI publications and researchers should consider wider adoption of social media to increase reach and measure uptake of published research.
Tu1111 The Shift in Crohn's Disease Management: Can Medical Education Help Clinicians Improve Knowledge? Jovana Lubarda, Keith Johnson, Stephen B. Hanauer, Gary R. Lichtenstein Study objectives: Management of Crohn's disease (CD) has evolved from treatment of clinical symptoms to the current practice of focusing on achieving mucosal remission. The evolution of this treatment paradigm has challenged clinicians to select treatments beyond symptoms as well to incorporate factors predictive of a more complicated course of disease into their treatment algorithm. This study assessed whether online continuing medical education (CME), a video of a discussion between two experts in CD, can impact clinicallyrelevant knowledge of gastroenterologists and primary care physicians (PCPs) managing CD. Methods: An online survey was used to assess the educational effect of the CME program focused on treatment goals in CD, by comparing the same participant's responses to 4 identical pre- and post-CME assessment questions. A paired 2-tailed t-test was used to assess whether the mean post-assessment score was different from the mean pre-assessment score. McNemar's chi-squared statistic was used to determine statistical significance and effect of education was calculated using Cramer's V which was used to determine the change in proportion of participants who answered questions correctly from pre- to post-assessment.
Tu1109 Recent Shifts in Microblogging Behavior on Twitter at Digestive Disease Week Austin L. Chiang, Javid Alakbarli, Walter W. Chan Background: Social media has been increasingly employed at medical conferences in recent years. Twitter is the prime social media platform that allows instant information dissemination and sentiments communication in 140-character "tweets." Previous data showed that most
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AGA Abstracts
Table 2. Factors influencing decision to pursue hepatology