Presentation Authors: Kevin Koo*, Tareq Aro, Brian Matlaga, Baltimore, MD
Introduction: The surgical management of urinary stone disease can be challenging due to complexity and multiple potential approaches. One advantage of urologists' increasing social media use is the opportunity for crowdsourcing these challenges. This study assesses urologists' use of Twitter to crowdsource dilemmas in surgical stone disease.
Methods: Twitter was queried with 22 stone-related keywords. All public tweets between September 1 and October 31, 2018, were reviewed to identify original posts and associated reply posts by urologists seeking clinical advice or feedback about surgical stone management. Crowdsourcing posts were reviewed to assess the nature and content of the requests. Content analysis was performed by 2 reviewers; differences were resolved by consensus.
Results: Urologists contributed a total of 299 posts to 29 crowdsourcing requests during the study period. On average each crowdsourcing request generated 12.8 replies from 9.6 unique users. Crowdsourcing requests were answered rapidly; the mean elapsed time from index post to final reply was 2.8 days. In 18 (62%) of the crowdsourcing requests, the index author responded directly to replying users or posted a follow-up question, indicating a bidirectional exchange of ideas. The majority of crowdsourcing threads engaged a multinational audience; index posts originated from 27 urologists in 12 countries, and all but one of the 29 requests (97%) had replies from users outside the origin country. Among crowdsourcing requests that received â‰¥1 reply, the mean number of Twitter followers of the index author was 795, but users with as few as 59 followers who initiated crowdsourcing requests also received numerous replies, suggesting that novice Twitter users may nonetheless be able to benefit. Of the 29 index requests, the most common reasons for crowdsourcing were to define an optimal surgical approach to the stone (11 requests, 38%) or ask for others' experiences regarding a challenging clinical scenario (10 requests, 34%). A novel use of crowdsourcing emerged from 2 quality improvement requests; the authors described their surgical complications and sought feedback about managing the problem and avoiding it in the future. Finally, protection of patient privacy may be a concern; among the 17 (59%) crowdsourcing requests that were about specific patients or cases, all included radiographic images or videos, but none stated whether the patient's permission had been obtained.
Conclusions: Twitter can facilitate crowdsourcing a range of general, patient-specific, and quality improvement challenges in surgical stone management. Urologists should consider privacy concerns when sharing imaging or patient data.