key: cord-0724796-hpoixb6j
authors: Munoz-Acuna, Ronny; Leibowitz, Akiva; Hayes, Margaret; Bose, Somnath
title: Analysis of top influencers in critical care medicine “twitterverse” in the COVID-19 era: a descriptive study
date: 2021-07-20
journal: Crit Care
DOI: 10.1186/s13054-021-03691-6
sha: 4a9999b4d0761f3167bc61e86d49d94918a01f04
doc_id: 724796
cord_uid: hpoixb6j

nan

Twitter, a microblogging platform, has become increasingly popular within the medical community as it facilitates prompt dissemination of information among users within and across specialties [1] [2] [3] . With a worldwide subscriber base of over 190 million, Twitter's reach is broad and its impact substantial. Since the onset of the COVID-19 pandemic, the quantity of medical information shared through the platform has grown exponentially. Unfortunately, the veracity of the content disseminated is frequently unclear. Besides, the brevity of the information limits the ability to convey and interpret complex ideas, promoting valid and invalid ad hominem arguments as substantial forces in propagating ideas. Furthermore, misinformation spread through social media can lead to harm [4] . Therefore, it is essential to identify the main actors in the field since the top influencers are not necessarily experts in this area.

We aimed to characterize the demographics, academic credentials and research productivity of the top 250 critical care medicine influencers on Twitter as identified by proprietary software, Cronycle (London, UK) which uses a proprietary algorithm to calculate an influencer score based on engagement (which includes features such as retweets, likes and views) to determine the "influence" of a Twitter account within a topic of discussion [5] . This was performed on March 30, 2021, taking into consideration the following time period March 30, 2020-March 30, 2021, which coincided with the first wave of the ongoing pandemic. A network graph was created using NodeXL (Social Media Research Foundation, CA, USA) utilizing the last 1000 tweets of each account and establishing a visual relationship between the different accounts as shown in Fig. 1 [6] . To retrieve each influencer's information, we looked at Twitter pages, Doximity accounts, LinkedIn profiles and institutional webpages. The h-index was obtained using the Scopus Preview Website.

Among the top 50 influencers, only 28% (n = 14) had formal training in Critical Care Medicine (CCM). 84% (n = 42) of the top influencers were male. Emergency medicine was the most common specialty (n = 35, 70%), followed by anesthesia (n = 4, 8%), pulmonary critical care medicine (n = 2, 4%), internal medicine (n = 2, 4%), surgery (n = 1, 2%), pediatrics (n = 1, 2%). Most influencers (n = 31, 62%) held academic titles. Our descriptive study demonstrates that the CCM "twitterverse" is dominated by male US-based academic physicians mostly without fellowship training in CCM and modest scholarly productivity evidenced by publication, citations and h-indices (Table 1) . Emergency medicine was the most predominant specialty represented among the top influencers. Limitations of using a proprietary software notwithstanding, our results indicate that the reach of influencers remains significant and is not correlated with academic productivity. Our limited sample does not allow us to draw overarching conclusions and should be considered exploratory; it is essential to consider that the veracity of the disseminated information may not necessarily correlate with the academic credentials or productivity and that the associations noted are highlighted solely for descriptive purposes. Further investigation in this area should focus on development of mechanisms categorizing tweets by their scientific content and validity. 

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