The social media platform Twitter has had an invigorating impact on communication between urological healthcare professionals by enabling rapid and global information exchange.1, 2 Prime examples of Twitter use in Urology are online discussions at global conferences with more than 15,000 tweets at the #EAU16 and #AUA16 annual meetings. Indeed, urology’s engagement with social media has outpaced adoption from other specialties with Twitter traffic at meetings more than tripling the activity seen at all non-urological surgical conferences combined.3
Due to the large volume of Urologic Twitter traffic, we initiated the Urology Tag Ontology (UTO) project in summer 2015. The UTO is a global initiative supported by key urologic social media stakeholders that seeks to standardize content descriptor use in the urological community and to facilitate communication and collaboration between health care provider and patient communities.4 The UTO hashtag list comprises 45 disease-related hashtags as communication descriptors in 9 urological subspecialties.
After 1 year of the UTO project launch, we assessed UTO hashtag utilization by assessing Twitter traffic, users, and content on the UTO hashtags.5 Over the 1-year period, activity on the UTO hashtags included 334,642 tweets by 104,166 users with 1,397,107,305 impressions. Tweet activity varied between urological subspecialties with urological oncology topics leading the discussion. The #prostatecancer was the most utilized hashtag over the study period. Twitter users in Urology came from 224 countries and from all 6 inhabited continents. As such, these data suggest that the UTO hashtag list can be used as a reference standard to track Twitter activity in the field of Urology over time.
Hashtag creation and use is ultimately an organic process and can change rapidly given the spontaneity and immediacy of the Twitter platform. As the healthcare social media landscape evolves, we aim for the UTO to be a “living document” undergoing regular reassessments and updates. Accordingly, we assessed Twitter traffic for all UTO hashtags from 01 JUN 2015 until 01 JUN 2016 using the Symplur Signals analytics platform. Thus, we identified 6 hashtags (#NeuroUrol, #UroRecon, #MaleED, #UroEpi, #UroHPE, #UroHSR) with an activity of less than 1 tweet per week. In order to keep the UTO list manageable and relevant, we have removed, for now, these hashtags from the UTO list. We then queried key opinion leaders who regularly use social media for their opinions on deletions and additions to the list. A lively discussion among key opinion leaders during the 2017 UTO Update centered on the question of how to best handle duplicate hashtags, which are common for urologic oncology disease processes (e.g. #ProstateCancer and #PCSM which stands for “Prostate Cancer Social Media”). The final consensus was to keep duplicate hashtags, since these are well entrenched among Twitter users and have different audiences (longer hashtags tend to be patient-centered, while shorter ontology hashtags tend to be more physician-specific). Furthermore, KOLs suggested addition of 5 new hashtags (#Cystinuria, #Hypospadias, #lowT, #pedurojc, #prostatejc). As such, the 2017 Update of the UTO hashtag list contains 42 hashtags in 9 subspecialties (Table 1). Similarly to the initial rollout of the UTO list, we requested and received buy-in from 20 urology social media stakeholders for this 2017 UTO Update (Table 2).
We very much encourage the Urology Twitter community to utilize and promote the 2017 UTO list in order to better standardize Twitter communication descriptors. We strongly believe that having a standardized list of hashtags such as the UTO has the potential to improve online communication about urological care.
Table 1. Urology Tag Ontology List – 2017 Update
|#utuc||Upper Tract Urothelial Cancer|
|#FPMRS||Female Pelvic Medicine & Reconstructive Surgery|
|#UroBPH||Benign Prostatic Hyperplasia|
|Sexual Medicine and Infertility|
|#STD||Sexually Transmitted Disease|
|#pedurojc||Pediatric Urology Journal Club|
|#prostatejc||Prostate Cancer Journal Club|
|#urojc||International Urology Journal Club|
Table 2. Urologic Social Media Stakeholders Supporting the Urology Tag Ontology Project
|Organization||Hashtag or Twitter Handle|
|European Association of Urology||@UroWeb|
|American Urological Association||@AmerUrological|
|EAU Guidelines Committee||#EAUGuidelines|
|AUA Social Media Committee||NA|
|Society of Urologic Oncology/Young Urologic Oncology Committee||@SUO_YUO|
|Urological Society of Australia and New Zealand||@USANZurology|
|British Association of Urological Surgeons||@BAUSurology|
|Journal of Urology||@JUrology|
|Nature Reviews Urology||@NatRevUrol|
|Prostate Cancer and Prostatic Diseases||@PCAN_Journal|
|Journal of Sexual Medicine||@JSexMed|
|Bladder Cancer Journal||@BladderCaJrnl|
|Journal of Clinical Urology||@JCUrology|
|Canadian Journal of Urology||@CanJUrol|
|Current Opinion in Urology||@CO_Urology|
1. Loeb, S., Catto, J., Kutikov, A.: Social media offers unprecedented opportunities for vibrant exchange of professional ideas across continents. Eur Urol, 66: 118, 2014
2. Loeb, S.: Social media makes global urology meetings truly global. : The influence of Twitter. BJU Int, 115: 175, 2015
3. Chung, A., Woo, H.: Twitter in urology and other surgical specialties at global conferences. ANZ J Surg, 2015
4. Kutikov, A., Woo, H. H., Catto, J. W.: Urology Tag Ontology Project: Standardizing Social Media Communication Descriptors. Eur Urol, 2015
5. Borgmann H, K. M., Catto J, Weight C, Kutikov A: Quantification of Urology-Related Twitter Traffic Activity through a Standardized List of Social Media Communication Descriptors. Urology Practice (2016, in press).
Hendrik Borgmann(1) (@HendrikBorgmann), James Catto(2) (@JimCatto), Henry Woo(3) (@DrHWoo), Alexander Kutikov(4) (@uretericbud)
1. University Hospital Mainz, Dept. of Urology, Mainz, Germany
2. University of Sheffield, Academic Urology Unit, Sheffield, UK
3. University of Sydney, Dept. of Urology, Sydney, New South Wales, Australia
4. Fox Chase Cancer Center, Division of Urologic Oncology, Philadelphia, PA, United States
Corresponding author: Hendrik Borgmann MD
Department of Urology
University Hospital Mainz
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