Representation and engagement of common pediatric urologic conditions on social media
Julie W. Cheng, MD, MAE, Nicolas Fernandez, MD, PhD, Margarett Shnorhavorian, MD, MPH, Paul Merguerian, MD, MS, Kathleen Kieran, MD, MME, MSc.
Seattle Children's Hospital, Seattle, WA, USA.
BACKGROUND: With the increasing use of social media, parents and caregivers report using social media platforms for health information. Social media content, however, has minimal regulations and “fake news” has only recently started to be monitored. Misinformation and disinformation in the form of articles in social media regarding genitourinary malignancies and posts regarding female pelvic medicine and reconstructive surgery have been reported. While internet content related to pediatric urology has been previously described, social media engagement has yet to be evaluated. The purpose of this study was to analyze how common conditions in pediatric urology are engaged in social media. We hypothesized that articles would have limited evidence to support their content and there would be greater social media engagement for articles citing less evidence.METHODS: A social media analysis tool identified articles that were engaged through Facebook, Reddit, Twitter, and Pinterest between July 2020 - July 2021. Engagement was defined as shares, tweets, upvotes, comments, likes, and reactions on respective platforms. The top 5 articles related to toilet training, circumcision, cryptorchidism, testicular torsion, and hypospadias were identified. Citations made by articles were classified by Oxford levels of evidence. The content of each article was also reviewed, compared against available supporting evidence through a PubMed search, and classified by levels of evidence. Statistical analysis was completed with descriptive statistics, comparison with the Mann-Whitney U test, and bivariate correlation.RESULTS: No articles cited level 1 evidence and 32% of articles cited no evidence (Table 1). In 15 (60%) articles, the content in the articles was supported by more evidence than cited by the article with a Pearson correlation coefficient of 0.53 (p=0.006). Of the 25 articles reviewed, 8 (32%) were affiliated with medical journals, hospitals, or academic institutions and 17 (68%) were on non-affiliated websites with advertisements. There was a higher level of engagement for articles that cited no evidence (p=0.0003), articles with no evidence to support content (p=0.012), and articles not affiliated with medical institutions (p=0.03).CONCLUSIONS: There was greater social media engagement for articles with no cited or supporting evidence and those not affiliated with medical journals, hospitals, or academic institutions. Parents and caregivers without a medical background may have difficulty identifying whether articles can be used as a reliable resource for health information. It is important to understand how information related to pediatric urologic conditions is engaged on social media so that misinformation and disinformation can be addressed in clinical, online, and regulatory settings.
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