Open access Viewpoint Open Heart: first published as 10.1136/openhrt-2019-001031 on 22 May 2019. Downloaded from View point on social media use in interventional cardiology Mirvat Alasnag, 1 Mamas Mamas,2 David Fischman,3 Salvatore Brugaletta,4 Jordan Safirstein,5 Pascal Meier,6,7 Vijay Kunadian,8 Lukasz Koltowski,9 Sheila Sahni,10 Chadi AlRaies,11 Michael Gibson12 To cite: Alasnag M, Mamas M, INTRODUCTION includes smaller chapters conducting their Fischman D, et al. View point on The dissemination of scientific develop- own regional or institutional workshops and social media use in meetings. With the advent of the World Wide interventional cardiology. Open ments has conventionally been through two Heart 2019;6:e001031. main platforms: medical journals and scien- Web, individual researchers have relied on doi:10.1136/ tific conferences. In 1665, the Royal Society the PubMed Medline search to navigate cate- openhrt-2019-001031 released the first medical journal, Philosoph- gorised published material. By 2000, other ical Transactions. In 1812, the New England online search engines, such as Google Scholar, Accepted 26 April 2019 Journal of Medicine published its first edition. further facilitated this process. Societies As a means to widely circulate advances in and journals have also collectively sought to medical science in the 19th and 20th centu- exploit the web to expand their outreach and ries, multiple medical journals focusing on membership globally. They established their medical subspecialties were subsequently own websites that detail the table of contents founded to share newly discovered data. and published articles, commentaries and The European Society of Cardiology was interviews. In addition, visually or techni- established around World War II. On 29 cally demanding specialties, such as cardiac January 1949, 14 National Societies estab- imaging and intervention, have used online lished the Board and laid down its by-laws. websites to allow for interactive case discus- The following year (1950), the First General sions, host videos of procedural techniques http://openheart.bmj.com/ Assembly, comprised of 200 people, met in and demonstrate complex cases including Paris for the World Congress of Cardiology three-dimensional images that would not be and discussed general cardiology topics. The possible using more traditional publication field of interventional cardiology was born platforms. These images, videos and publica- following Andreas Gruentzig’s first successful tion links are archived in the website allowing coronary angioplasty on 16 September 1977 for streamlined future searches by individual using a balloon dilatation catheter in which investigators. he treated a short lesion in the left anterior More recently, social media has become yet descending artery. Gruentzig presented the another avenue for the interactive sharing of on September 23, 2021 by guest. Protected copyright. results of his first four angioplasty cases at the data. Individuals, societies and journals have 1977 American Heart Association meeting. adopted Twitter, Facebook, Instagram, Snap- Between 1978 and 1980, he organised four chat, LinkedIn and Periscope to ‘publish’ and courses in Zurich, Switzerland, demon- promote new research, techniques, devices strating his new technique in humans. In as well as post links to upcoming issues and 1983, Professor Jean Marco organised the meetings and create quizzes. Unlike journals first course on angioplasty with live cases and conferences, these platforms remain 6 © Author(s) (or their from Toulouse. Over the next 35 years, this largely unregulated. There are no member- employer(s)) 2019. Re-use course evolved from a French to a European ship or submission requirements, fees, or permitted under CC BY-NC. No gathering and finally, now an international processes that check if users are licensed commercial re-use. See rights 1 and permissions. Published conference with more than 12 000 attendees. physicians. This has generated controversy by BMJ. As interventional cardiology became more over the credibility and influence of social 2 For numbered affiliations see widespread, due to refinements in stent plat- media in the educational process. The aim end of article. forms, pharmacotherapy and advances in of this document is to provide an overview of other technologies, particularly in the struc- the use of the various social media outlets. It Correspondence to tural arena, societies have sought options to provides a roadmap to guide the use of social Dr Mirvat Alasnag; mirvat@ jeddacath. com accommodate such growth. One such option media by clinicians as both an educational Alasnag M, et al. Open Heart 2019;6:e001031. doi:10.1136/openhrt-2019-001031 1 Open Heart Open Heart: first published as 10.1136/openhrt-2019-001031 on 22 May 2019. Downloaded from tool and a medium to discuss cases and to disseminate for chats with patients or groups. The deleted conversa- research. Finally, an outline on the protection of scien- tion serves to maintain the supposed confidentiality of tific propriety, patient data and patient–physician rights the conversation. is highlighted. CURRENT USES OF SOCIAL MEDIA IN INTERVENTIONAL TYPES OF SOCIAL MEDIA PLATFORMS CARDIOLOGY When referring to social media, it is important to recog- The interventional cardiology arena has exploited social nise that there are multiple outlets each with its unique media through several mechanisms. Below are the most features. common uses (online appendix 3): Twitter is a microblogging service founded in 2006. Posts 1. Demonstration and expansion of techniques through were initially restricted to 140 characters that doubled discussions and videos that highlight procedural steps to 280 characters in 2017. Service is available in most is the cornerstone of social media use by intervention- languages except Japanese, Korean and Chinese. Most al cardiologists. Examples include the #RadialFirst and users have posted cases, links to publications, promoted #ldtra (left distal transradial) hashtags which have been meetings or conducted journal clubs. This has also been successful in promoting safe access site procedures a medium for debate and critique of published trials. while at the same time referencing data to support a There are over 335 million active Twitter users. change in practice. Many procedural tips and tricks as Facebook is a social networking service launched in 2004. well as shared experiences are included. Other exam- It is available in multiple languages and has more than 2.2 ples are the #PercAx which demonstrates the safe use billion monthly active users. Unlike most other platforms, of the axillary artery as an alternative large bore access it has no limitation of characters or number of photos or videos posted. It allows for the option of live streaming. while #CTO101 accentuates new techniques and data Many use this medium exclusively for family and friends. with respect to revascularisation of chronic total occlu- Other individuals and societies have accessed Facebook sions. Trainees, in particular, have found social media to create events, share cases, live stream meetings and valuable as it enables them to ask experts in such pro- interviews, as well as network with other professionals in cedures directly and their educational experience is the field. no longer limited to their home institution. The hier- Instagram is primarily a photograph and video sharing archy is maintained, but the outreach has expanded to service. It was launched in October 2010 exclusively on all corners of the globe. iOS. By 2012, the Android and Windows applications 2. Social media has been used for the recruitment of re- were released. It is currently owned by Facebook and has search sites as well as for patient recruitment into ran- http://openheart.bmj.com/ over 800 million users. As of 2015, over 40 billion photos domised controlled trials (eg, HYBRID Trial (Percuta- have been uploaded. The service allows a photo to be neous coronary intervention in stable angina Trial)). edited, tagged and captioned. Most interventional cardi- It has also been used as a tracking tool for ongoing ologists who have used Instagram do so to share cases trials. One example is the ISCHEMIA trial, Interna- and angiograms or announce upcoming workshops and tional Study of Comparative Health Effectiveness with courses. Medical and Invasive Approaches, which has been the LinkedIn is a business service operating through a subject of heavy criticism on Twitter. In turn, expert website and mobile application. It was founded in 2002. perspectives were published to address the concerns 3 on September 23, 2021 by guest. Protected copyright. Most equate this platform with a public curriculum vitae raised and to clarify the ISCHEMIA trial design. that recruiters, meeting organisers, industry and institu- 3. Journal Clubs and TwitterChats are becoming more tions target to identify persons of interest. It is multilin- commonplace with robust discussions regarding re- gual and operates across all continents. It has 500 million cent publications focusing on study design, analysis members in 200 countries. Lately, it too has become a and impact on clinical practice. Recent discussions source for sharing cases and meeting details. of trials, such as ORBITA (Percutaneous coronary in- Periscope is a live video streaming application and is a tervention in stable angina), ISCHEMIA and FAME subsidiary of Twitter released in 2015. Although most (Fractional Flow Reserve versus Angiography