Twitter Promotion Boosts Visibility, Citation for CV Research

Megan Brooks

May 26, 2022

Promoting cardiovascular medicine articles on Twitter increases online visibility and citation rates, a new randomized study indicates.

A study by the European Society of Cardiology (ESC) found that actively tweeting cardiovascular articles in the @ESC_journals handle was associated with a 12% increase in the citation rate at a median follow-up of 2.7 years.

The results confirm the "gut feeling" of the medical community that is actively involved on Twitter, Ricardo Ladeiras-Lopes, MD, PhD, Gaia Hospital Centre Cardiovascular R&D Unit, Faculty of Medicine, University of Porto, Portugal, told theheart.org | Medscape Cardiology.

The results "add to the growing importance of social media and especially Twitter for medical education and scientific dissemination," he said.

The study was published online in the European Heart Journal.

Engagement, Discussion

The association between dissemination of scientific articles on Twitter and online visibility remains "controversial," and, until now, the impact on citation rates had not been rigorously addressed for cardiovascular medicine journals in studies that involved randomization, Ladeiras-Lopes explained.

In the ESC Journals Study, 695 articles published in ESC medical journals between March 2018 and May 2019 were randomly allocated (1:1) for promotion on Twitter or to a control arm with no active tweeting from ESC channels. One article was excluded in the final analysis, owing to retraction.

For all articles combined, the median number of citations was 14 (IQR: 7 to 27), and the median Altmetric score (a weighted count of all the "attention" research output has received) was 15 (IQR: 4 to 31).

For research articles that were promoted on Twitter, the median number of citations was 15 (IQR: 8 to 27), the median Altmetric score was 24 (IQR: 13 to 41), and the median number of tweeting users was 41 (IQR: 24 to 63).

For articles in the control group, for which there was no active tweeting, the median number of citations was 14 (IQR: 7 to 27), the median Altmetric score was 5 (IQR: 1 to 18), and the median number of tweeting users was 6 (IQR: 1 to 20).

Articles promoted on Twitter were tweeted after a median of 29 days (IQR: 17 to 53 days) upon online publishing.

After a median follow-up of 994 days, promotion of articles on Twitter was associated with a higher citation rate of 1.12 (95% CI: 1.08 – 1.15), independently of the type of article. Altmetric score and number of users tweeting were positive predictors of the number of citations.

Key upsides of promoting CV articles online include "wide dissemination, engagement and opportunity for peer discussion (otherwise possible only during medical meetings), continuing medical education, live update of latest evidence published," Ladeiras-Lopes told theheart.org | Medscape Cardiology.

He said weaknesses of Twitter promotion of research articles include the potential for confusing discussions about results or attacks directed at an author rather than at a particular finding.

"All major cardiovascular journals have their own Twitter handle and are actively tweeting their papers, with generating very interesting online discussions and a unique learning opportunity for the cardiovascular healthcare community," Ladeiras-Lopes said.

Valuable Pathway

Offering perspective, Eldrin F. Lewis, MD, MPH, chair, American Heart Association (AHA) Scientific Publishing Committee, said all the AHA's scientific journals "actively engage" with the cardiology and broader community on Twitter.

The findings from the ESC study on Twitter's impact on article visibility are "not surprising and align with our experience," said Lewis, professor of medicine and chief of cardiovascular medicine, Stanford University, California.

"Articles with Twitter posts from the journals' social media accounts regularly receive twice the level of engagement compared to posts on other social media platforms (Facebook or Instagram) and are a significant driver of traffic to articles," he added.

Lewis said thousands of users rely on access to the AHA journals via open access and subscription platforms individually and through their institutions.

"Social media is a valuable pathway to connect readers with scientific discoveries, and it complements traditional ways of sharing and accessing research," Lewis said.

The study had no specific funding. Ladeiras-Lopes and Lewis have disclosed no relevant financial relationships.

Eur Heart J. Published online April 7, 2022. Abstract

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