• qualitative research
• patient perspective
• social work

In an era of rapidly expanding digital technologies and social media (SM), considerable transformations in the delivery of healthcare are taking place. SM channels such as Facebook and Twitter represent a generation of online platforms that foster user-generated content, social interaction and real-time collaboration.1 In this letter, we review the advantages and disadvantages of engaging with Twitter within the rheumatology field.

The ease of access to a wide range of SM platforms provides a dynamic medium for professional interaction. Twitter is gaining increasing attention by healthcare professionals as a platform for information sharing and professional networking, learning and communication. Twitter journal clubs (@RheumJC2 and @EULAR_JC3) are some examples of novel educational uses of Twitter.

Despite the many positive applications of Twitter, potential hazards cannot be underestimated. The restricted character count of a tweet (140 characters) represents an important limitation, posing a risk to the content and validity of the information shared.4 This limitation received high attention culminating in the recent doubling of the character count of tweets. Furthermore, the possibility to include links for further reading has overcome the limitations of not being able to present necessary assumptions under which the research findings hold.

The lack of knowledge on how to use SM professionally represents an unmet need.5 Scientific Journals have dedicated teams supporting and advising on the use of SM and facilitating a target-orientated and appropriate way of using these platforms. For example, Twitter is now used by publishers to disseminate their latest or ‘online first’ articles (see table 1). One potential bias with journals may be the selection of more provocative/attention-grabbing articles to be publicised, which would appeal to a much wider base over perhaps more methodological/scientific articles, which have a niche appeal but are still worthy of SM dissemination. Furthermore, there are concerns regarding potential information misuse.4 It is paramount that we take full responsibility to inform the society responsibly, minimising the risk of wrong and unreliable information being disseminated.

While the lack of control of what/how information is shared on Twitter is a limitation, the professional advantages of instant access to a wealth of information at a person’s fingertips are considerable. As an example, survey data suggest a significant role of SM in knowledge acquisition by young urologists6 highlighting the need to strive for educational content dissemination.

Although the majority of scientific accounts recognise as their target population physicians/experts in the field, one needs to remember that this information can also be easily accessed by patients and the wider community. This can be problematic due to ambiguous and misleading tweets. As with all SM, one needs to be mindful of anonymising identifiable patient data and restrict online discussions about patients.7 The distribution of articles’ lay summaries on SM is a way of informing patients of scientific work and allowing them to access a source they can understand and make use of (http://promotions.bmj.com/ardsummaries/).

We have previously demonstrated the ‘power’ of Twitter during key rheumatology conferences.5 Anecdotally, this kind of interaction enables a ‘virtual feel’ of the scientific content of a conference remotely. However, other needs remain; for example, to understand the influence of SM on citations.4 In this respect, where the impact of research is much broader than citation numbers, we advocate the use of additional and alternative metrics that capture impact on policy and wider stakeholders.8

To conclude, Twitter and other SM are clearly becoming increasingly used as a source of medical and scientific information. Despite potential caveats, these platforms will continue to provide novel ways for opinion sharing, learning and development. They are inevitably claiming a role in modern rheumatology practice and in healthcare in general.