Tag: Declan Murphy

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#pass4prostate gears up for Rugby World Cup

August 17, 2015/by Declan Murphy

Here is a fun campaign which should appeal to anyone interested in rugby or prostate cancer for that matter. The 2015 Rugby World Cup kicks off in England and Wales next month and as part of their warm up schedule, Australia are playing USA Rugby in a friendly match at Soldier Field in Chicago on the 5th of September. As part of their sponsorship of this fixture, Astellas are supporting a social media campaign called #pass4prostate which will directly raise funds for prostate cancer research in both the USA and Australia.

As part of their support, Astellas will donate $5 to prostate cancer research and advocacy organizations for every qualifying #pass4prostate submission posted to Twitter, Facebook, or Instagram, up to a maximum contribution of $125,000 in the USA and a further $40,000 in Australia. At socialboost you will get the best review of the instagram traffic boosting tools. Therefore to make sure we maximize this commitment, we need to drive lots of traffic using the #pass4prostate hashtag! You can see examples of Australian and US rugby players supporting the campaign below by throwing around special blue rugby balls, but the campaign is encouraging people to make videos supporting the campaign and throwing anything blue around (in a rugby style of course!).

The campaign will run up to the match on 5^th September, and there be lots of activity at the 2^nd Prostate Cancer World Congress which takes place in sunny Far North Queensland, Australia, from 17-21^st August 2015. Follow #pcwc15 or #pass4prostate to get involved!

For full details, please visit the pass4prostate website.

Declan Murphy

Melbourne, Australia

@declangmurphy

The Social Media Revolution in Chinese Urology

June 23, 2015/5 Comments/by Wei Wang

It is well known that Twitter, Facebook and YouTube, the most popular social media platforms available in the West, are not easily accessible in China. It is also clear that urologists in the West have embraced these social media platforms (Twitter in particular), not just for personal interaction, but also for professional engagement, and journals such as BJUI have enthusiastically encouraged the use of social media for urologists through their use of Twitter, blogging, YouTube etc.

So what then of Chinese urology? Are we missing out on all this? Not at all! In fact, as a recent BMJ blog observed, China is among the most heavily connected populations on earth, and the smartphone revolution has seen this connectivity grow very rapidly in recent years, more than in many Western countries. The lack of access to Western websites has just meant that a host of home-grown websites have cropped up to allow the insatiable appetite for connectivity to be met. Therefore sites such as RenRen (like Facebook), Sina Weibo (like Twitter), and Youku (like YouTube). The BMJ have blogged about this and have highlighted the huge volume of activity on Chinese social media sites.

Figure from “Your quick guide to social media strategy in China”

At present, the most popular platform among Chinese urologists is WeChat. WeChat, (similar to WhatsApp), is connecting more than a half billion Chinese people now. Apart from free chat, video and voice call, group chat is perfect for professional online discussion. There are several major urological discussion groups. Each group has many hundreds of participants. It is estimated that more 3000 urologists (1/4) in China have been involved in one or more online discussion group. Earlier this month, Prof. Declan Murphy’s lecture slides were uploaded to our urology major discussion group after his presentation at the Asia Urology Prostate Cancer Forum in Shanghai.

More than 2000 Chinese urologists (1/6) watched his slides on smartphones that weekend and shared feedback using the app. Prof Murphy, one of the world’s foremost leaders in social media, even joined WeChat and engaged in dialogue with the discussion group.

At present, the top two most famous discussion groups are called scope art and Hippocrates group. A talented young urologist, Dr. QIan Zhang, set up scope art two years ago. More than 500 urologists from across the country were invited to join the group. New knowledge, case discussion and meeting information can be arranged in the group. Recently, the Top 10 WeChat urologists has been selected thorough WeChat vote platform system. More than 20,000 WeChat users voted for their favorite social medial stars. Several discussion groups were built based on the different specialties (stone disease, andrology etc.). Several leading uro-oncologists, urologists, pathologists, radiologists and related experts also built an MDT discussion group to discuss interesting uro-oncology cases to help select the best options for patients.

We are now also seeing these online discussions develop a physical presence. Recently, a WeChat integrated Hippocrates urological meeting was held in Jiaxing. When each speaker starts to talk, the slides were uploaded to the WeChat discussion group, allowing the entire membership of the discussion group to attach their comments and questions during the presentation. All the questions and comments are projected to the separate screen in the meeting hall. The speaker can discuss with all the members, wherever they are.

WeChat meeting in action in Jiaxing

As these examples demonstrate, social media significantly helps Chinese urologists communicate more effectively, especially in such a large country with a huge population. We are very keen to embrace these new communication platforms and to engage more with our colleagues in the West!

Dr. Wei Wang

Consultant Urologist, Beijing Tongren Hospital, Capital Medical University, China

WeChat ID: medtrip

The 3rd BJUI Social Media Awards – #AUA15 in New Orleans

May 27, 2015/by Declan Murphy

What a fun destination we had for the 3^rd Annual BJUI Awards! As you may know, we alternate the occasion of these awards between the annual congresses of the American Urological Association (AUA) and of the European Association of Urology (EAU). Our first awards ceremony took place at the AUA in San Diego in 2013, followed last year in Stockholm at the EAU. This year, we descended on New Orleans, Louisiana to join the 16,000 or so other delegates attending the AUA Annual Meeting and to enjoy all that the “Big Easy” had to offer. What a fun city; a true melting pot of food, music and culture all borne out of the eclectic French, American and African cultures on show. I think I met more key opinion leaders in the clubs on Frenchman Street than I did in some of the prostate cancer poster sessions!

You can read more about all that in our #AUA15 Conference Highlights blog, so on now to the Awards. The AUA Annual Meeting plays host to intense social media activity and it is fitting that the BJUI Social Media Awards gets to acknowledge the rapidly growing number of Uro-Twitterati in attendance. Over 100 of the most prominent tweeters turned up to the Ritz-Carlton to enjoy the hospitality of the BJUI and to hear who would be recognised in the 2015 BJUI Social Media Awards. Individuals and organisations were recognised across 16 categories including the top gong, The BJUI Social Media Award 2015, awarded to an individual, organization or innovation who has made an outstanding contribution to social media in urology in the preceding year. The 2013 Award was won by the outstanding Urology Match portal, followed in 2014 by Dr Stacy Loeb for her outstanding contributions. This year our Awards Committee consisted of members of the BJUI Editorial Board (Declan Murphy, Prokar Dasgupta, Matt Bultitude as well as BJUI Managing Editor Scott Millar whose team in London drive the content across our social platforms).

The full list of awardees, along with some examples of “best practice” in the urology social media sphere can be found on this Prezi. The winners are also listed here:

Most Read Blog@BJUI – “Are you ready to go to prison on a manslaughter charge?”. Accepted by Dr Ben Challacombe, on behalf of Prof Roger Kirby, London, UK
Most Commented Blog@BJUI – “Prof John Fitzpatrick – Life in the Fast Lane”. Accepted by Dr Ben Challacombe, on behalf of Prof Roger Kirby, London, UK
Best Blog Comment – Dr Brian Stork, Michigan, USA
Best BJUI Tube Video – Hospital volume and conditional 90 day post-cystectomy mortality. – accepted by Dr Angie Smith on behalf of Dr Matt Neilsen, North Carolina, USA.
Best Urology Conference for Social Media – SIU Annual Congress, Glasgow 2014. Accepted by Dr Sanjay Kulkarni on behalf of the SIU
Best Social Media Campaign – Dr Ben Davies, Pittsburgh, USA, for highlighting industry issues around BCG shortage
“Did You Really Tweet That” Award – Ben Davies, Pittsburgh, USA (three years running!)
Best Urology App – The Rotterdam Prostate Cancer Risk Calculator. Accepted by Dr Stacy Loeb on behalf of Dr Monique Roobol, ERSPC, Rotterdam, The Netherlands
Innovation Award 2015 – #eauguidelines. Accepted by EAU Guidelines panellists Dr Stacy Loeb and Dr Morgan Roupret, on behalf of Dr James N’Dow, Dr Maria Ribal, and the EAU Guidelines Committee.
#UroJC Award – David Canes, Boston, USA
Best Selfie – Morgan Rouprêt, Paris, France
Best Urology Facebook Site – European Association of Urology. Accepted by Dr Alex Kutikov, Digital Media Editor, European Urology
Best Urology Journal for Social Media – Nature Reviews Urology. Accepted by Editor-in-Chief, Annette Fenner
Best Urology Organisation – American Urological Association. Accepted by Taylor Titus, AUA Communications Office
The BJUI Social Media Award 2015 – International Urology Journal Club #urojc. Accepted by Dr Henry Woo, Sydney, Australia.

Most of the Award winners were present to collect their awards themselves, including the omnipresent Dr Henry Woo who received our top gong for his work on the very successful International Urology Journal Club #urojc. The #urojc now has over 3000 followers and its monthly, asynchronous 48hr global journal club has become a huge event. Many other specialties and #FOAMed resources have recognised #urojc and BJUI are delighted to publish a blog summarising each month’s discussions. Well done to Henry, Mike Leveridge and others in setting and maintaining this outstanding example of social media adding real value.

A special thanks to our outstanding BJUI team at BJUI in London, Scott Millar and Max Cobb, who manage our social media and website activity as well as the day-to-day running of our busy journal.

See you all in Munich for #EAU16 where we will present the 4^th BJUI Social Media Awards ceremony!

Declan Murphy

Associate Editor for Social Media at BJUI. Urologist in Melbourne, Australia

Follow Declan on Twitter @declangmurphy and BJUI @BJUIjournal

EAU 2015 Review Days 3 and 4

March 26, 2015/by Declan Murphy

Persistent rain throughout this year’s 30th EAU Annual Congress failed to dampen the spirits of over 12,000 delegates who have enjoyed another fantastic congress here in Madrid. The EAU Scientific Committee, led by Arnulf Stenzl, deserve tremendous credit for the work they have done to construct an extremely comprehensive and stimulating programme once again this year. I do recall my last EAU Congress in Madrid 12 years ago and there is no doubt but that the standard of this meeting has risen exponentially during this time. It is not just be Annual Congress of course which has developed in this time; the EAU has seen enormous growth in its global influence through the meteoric rise of European Urology, the activities of the European School of Urology (even beyond Europe), the pre-eminence of the EAU Guidelines, and the introduction of new initiatives such as UroSource. The Annual Congress is the nidus for much of this activity and it has become an unmissable event for many of us (even when based in Australia as I am!).

Rebecca Tregunna and Matthew Bultitude have already covered some of the highlights of the opening days of this year’s Congress in their BJUI blog . I will give you some further highlights and point you towards the excellent congress website which has archived a huge amount of material to allow you to catch up on sessions you may have missed.

Big highlights for me on day 3 and 4 include the following (please forgive my oncology focus):

PSMA PET scanning – there was considerable interest in the early data on PSMA PET scanning for recurrent prostate cancer at last year’s EAU Congress, and this year has seen some very positive data being presented from Munich and Heidelberg and further enthusiasm for this imaging modality. Tobias Maurer (Munich) presented a number of papers showing the high sensitivity in particular for PSMA PET in detecting recurrent prostate cancer at low levels of biochemical recurrence using either PET CT or PET MRI (poster 928).

Many other plenary speakers also highlighted the positive data surrounding PSMA PET and also the possible theragnostic potential of this in the future (poster 675 and Dr Haberkorn plenary lecture). However in the scientific souvenir session which closed the meeting, Dr Peter Albers burst the bubble somewhat by warning that we need much better data (tissue validation in particular), before we all rush towards PSMA. He has a point of course, although I have been extremely impressed with our initial experience using PSMA PET in Melbourne over the past six months and I do expect it to live up to the hype.

CHAARTED data looking good – Nine months after he made world-wide headlines when he presented the overall survival data of the CHAARTED study at ASCO, Dr Chris Sweeney crossed the Atlantic to again present this data to a packed eUro auditorium. This randomised study of 790 men with metastatic prostate cancer, has demonstrated that men who receive six cycles of docetaxel chemotherapy upfront at the time of starting androgen deprivation therapy, have a considerable survival benefit compared to those who receive ADT on its own (the current standard of care). This was especially so for men with high volume metastases who had a 17 month survival benefit (HR 0.61).

Although the French GETUG study has not shown the same benefit, Sweeney and others have proposed rational explanations for why this might be so. While the final paper has not yet been published (will be submitted this week), very many of us have already embraced the CHAARTED as the new standard of care for men presenting with high-volume metastatic prostate cancer. A proper landmark study.

Metastatic castrate-resistant prostate cancer (mCRPC) – still more questions than answers. What an amazing few years for this disease area! Five years ago, urology trainees only had a handful of “essential reading” papers in the world’s top journal, the NEJM, that we could cite to support evidence-based practice. It is now difficult to keep up with all the landmark trials in NEJM and other top journals reporting overall survival advantage for a variety of agents targeting mCRPC. Enzalutamide has already joined the ranks of these blockbuster drugs and this year’s EAU saw more data illustrating the powerful activity of enzalutamide in the pre-chemo mCRPC space. In the Breaking News session on the final day, Dr Bertrand Tombal presented the final analysis of the PREVAIL study which confirmed the overall survival advantage of patients receiving enza pre-chemo when compared with placebo. The HR of 0.77 was strongly significant (p=0.0002) and the therapy was well tolerated.

However as pointed out by discussant Dr Maria de Santis, we have still a way to go to figure out which patient will benefit from which therapy and when. The sequence and combination of therapies is still being worked out, and while the potential of predictive biomarkers such as AR7 is certainly exciting, we are still bereft of data and tools (and funding), to figure out the best pathways.

Robot vs open surgery – cystectomy is the new battleground. As Alberto Brignati pointed out in his outstanding souvenir session on localised prostate cancer, it appears that the old debate of robotic vs open prostatectomy is no longer of interest. Despite the lack of prospective randomised data, there appears to be little doubt that robotic prostatectomy is the standard of care in many regions. A large number of posters and plenaries demonstrated convincing data of excellent outcomes in robotic prostatectomy series, including data from a multicenter randomised study (REACTT, poster 622) led by Dr Stolzenberg which demonstrated improved potency outcomes for robotic prostatectomy (not the primary endpoint).

The same cannot yet be said of robotic cystectomy. Despite my own enthusiasm for and publications on robotic cystectomy, it is hard to get away from some of the cautionary language being expressed about the role of robotic cystectomy at the moment. An excellent plenary featuring giants in the field of bladder cancer (Dr’s Bochner, Wiklund, Studer, Palou), debated the issue in the main eUro auditorium and the following day’s newsletter summed it up nicely:

This provoked much discussion on Twitter with some prominent names chiming in from the US. Dr Khurshid Guru got involved to reassure us that the International Robotic Radical Cystectomy Consortium which he leads will provide the answer.

Well said @khurshidguru!

On a non-cancer note, it is clear that some of the most popular session and courses at EAU15 were focused on uro-lithiaisis. Stone surgeons are also very active on Twitter and although I did not attend any stone sessions, I was pleased to see that standardization of terminology is also important to the “pebble-ologists”:

Finally, #EAU15 was truly a social experience, not just in the wonderful bars and restaurants of Madrid, but also through Twitter and other social media channels, strongly supported by the excellent communications team at EAU. We recently published a paper in the BJUI documenting the growth of social media at major urology conferences and at EAU in particular. Between 2012 and 2014, the number of Twitter participants increased almost ten-fold, leading to an increase in the number of tweets from 347 to almost 6,000 At #EAU14, digital impressions reached 7.35 million with 5,903 tweets sent by 797 participants.

(From Wilkinson et al BJUI 2015)

As might be expected, #EAU15 has continued this trajectory with almost 8000 tweets sent by 1220 participants.

One of the only criticisms I have of EAU15 is that the scientific program is now so large that it is impossible to get to all the sessions I am interested in. There did seem to be a lot of prostate cancer running simultaneously but I am not sure how much the Scientific Committee can do to avoid such clashes. Thankfully, the EAU meeting website www.eaumadrid2015.org contains a huge amount of material including webcasts, interviews, posters etc which allows delegates and EAU members to catch up on some of the outstanding content.

Another big attraction of the EAU Annual Congress is of course that it takes place in Europe’s most wonderful cities. EAU16 heads to Munich – put the date in your diary 11-15 March 2016.

Declan Murphy, Urologist, Melbourne
Associate Editor – Social Media, BJUI
@declangmurphy

Click here for Declan Murphy’s disclosures

Racing ahead

March 3, 2015/1 Comment/by Declan Murphy

Since the new Editorial team assumed the reins here at the BJUI in January 2013, we have worked hard to embrace social media as the transformative communication technology it clearly is. While our priority is to only publish papers of the highest quality, we have also ensured that the reach and engagement of these papers are maximised using our social media platforms – Twitter, Facebook, YouTube, Instagram and Blogs@BJUI.

In this month’s BJUI, there are two intriguing papers that deal with this area but that deliver contrasting messages. The first from Nason et al. analyses the Twitter activity of all urology journals over a recent 6-month period. It is clear that the major journals have adopted Twitter as a preferred social media platform and it is gratifying to see how well the BJUI performs when assessed using the metrics in this paper. However, Fuoco and Leveridge report that most urologists in a Canadian survey believe that ‘social media integration into medical practice is impossible’ and attitudes towards the professional role of social media were ‘generally negative’.

Nevertheless, the power of social media in enhancing our personal and professional communication is undeniable and we at the BJUI expect more and more urologists to embrace social media in the coming years. We will continue to evolve our social media strategy to ensure the BJUI is a highly ‘social’ experience.

On another note, the BJUI is pleased to support an excellent conference taking place in Dublin in April in the memory of our previous Editor-in-Chief, Professor John Fitzpatrick, who passed away suddenly last year. The Inaugural John Fitzpatrick Irish Prostate Cancer Conference takes place from 23–24th April 2015 and has attracted an outstanding International Faculty of colleagues and friends who look forward to exploring the most challenging areas in prostate cancer in his memory. Details here https://www.globalteamwork.ie/prostate.html.

Declan G. Murphy – BJUI Associate Editor – Social Media

Department of Urology, University of Melbourne, Melbourne, VIC, Australia

Twitter @declangmurphy

Vasectomy causes aggressive prostate cancer – HELP!!!

July 14, 2014/7 Comments/by Declan Murphy

How many of you have already had a patient get in touch about this latest scare? As one expects nowadays, I first heard about this paper on Twitter within a few minutes of it being published, but it wasn’t long after that a recent patient of mine rang my rooms to challenge me about the reassurance I had given him only last week about the lack of increased risk of prostate cancer, which he had specifically asked me about. And of course since then, we have had headlines in the mass media all over the world alerting us to the results of this 24-year study that suggests that vasectomy confers an increased risk of not just prostate cancer, but high-grade prostate cancer in men undergoing vasectomy. Here are just some of the headlines:

So what are we to make of all this? The private vasectomy counselling has always been a challenging area due to the well documented possibilities of early and late failure, and also of the ever present issue of chronic scrotal pain. And while the area of prostate cancer risk has been raised previously, I must say I have always felt comfortable saying that on balance, the increased risk of developing significant prostate cancer following vasectomy proved to be minimal. “Don’t worry about it” was my typical blithe reassurance. Do I have cause to change my advice now?

Let’s look at this paper from Siddiqui et al. The data is taken from the well-known Health Professionals Follow-up Study (HPFUS), which originally enrolled almost 50,000 men aged between 40 and 75 back in 1986. Of these, about 12,000 (25%) underwent vasectomy and 6000 of these (12.2% of population) were subsequently diagnosed with prostate cancer over the 24-year follow-up period. Of these, 811 (1.6%) died of prostate cancer. The authors calculate that vasectomy was associated with a small overall increase in the risk of prostate cancer (RR = 1.10). However the headlines are coming from the higher relative risk of 1.22 among men subsequently diagnosed with high-grade prostate cancer (Gleason 8 to 10). Also, vasectomy appeared to confer a higher relative risk (1.19) of actually dying of prostate cancer or developing distant metastases compared to men who did not undergo vasectomy. It is these findings that vasectomy appears to confer not just an increased risk of prostate cancer, but an increased risk of developing aggressive or a lethal prostate cancer, which has provoked some concern.

This topic is not new and other studies have shown that this risk does not exist or at best, the risk is minimal and the quality of evidence not good enough to change practice. Does this current paper change all that? It will certainly change the nature of counselling for men considering vasectomy as there may well be a case to consider. As the population of men presenting for vasectomy are not a typical population who would be counselled about the early detection of prostate cancer, perhaps this other difficult counselling area also needs to be broached.

HELP!!!!

Declan Murphy is a urologist at Peter MacCallum Cancer Centre in Melbourne, Australia, and Associate Editor at BJUI. Twitter @declangmurphy

The Big Data challenge: amplify your content using video and maximise your impact

June 6, 2014/3 Comments/by Declan Murphy

It remains a great achievement for an author to have his or her work published in a peer-reviewed journal such as the BJUI. There is a tremendous sense of fulfilment when the e-mail from the Editor-in-Chief includes ‘accept’ in the subject heading. What may have been a long period from study design, through ethics approval, patient recruitment, intervention, data collection, statistical analysis, manuscript preparation, to final revisions, finally comes to an end – chapter closed, move on.

However, in this era of ‘Big Data’, we are now confronted with new challenges with respect to getting our content noticed. It is estimated that of all the data created in the history of mankind, from early cave drawings to medieval manuscripts and modern web 2.0 communication, >90% has been created in the past 2 years alone [1]. Two thousand years ago, 90% of the world’s content was thought to be archived in just one place, the Library of Alexandria in Egypt, and all of that content would easily fit on a flash drive today. With this massive amount of new data emerging, the current challenge is not just to get published, but also to get your work noticed. Are you always looking out for new methods of approaching potential customers? If the answer is yes, then you should definitely try out a geocoding service. Just imagine, you will have a large map in front of you, where the locations of all your customers are marked. You will know exactly where your customers live, and in which regions your products and services are most popular. Just think of what you can do with this knowledge. For starters, how about running some location based targeted marketing campaigns? These campaigns are sure to bring in lots of new customers, if you can fine-tune these properly. Geoparsing API by Geocodeapi.io can be done simply through address interpolation, which uses data from a street GIS where the street network is already inputted within the geographic coordinate space. Attributed in each street segment are address ranges, such as house numbers from one segment to another. Here is what geocoding does: (1) It takes an address, (2) matches it to a street and particular segment (e.g. a block), and (3) interpolates the address position. However, issues may arise in the geocoding process. What happens is that you have to distinguish between ambiguous addresses (say, “43 Hampton Drive” and “43E Hampton Drive”). It’s also a challenge when you geocode new addresses for a street that is not yet added to the GIS database. Using interpolation also entails a number of caveats, including the fact that it assumes that the parcels are evenly spaced along the length of the segment. This is quite unlikely in reality – it can be that a geocode address is off by a number of thousand feet. A more sophisticated geocoding application will match geocode information to the property level, using such tools as USPS address data, and cascade out to block, track or other levels depending on data matching accuracy.

This is where social media can help your content to rise above the morass and get into the mind of your target audience. At the BJUI, we have integrated social media into every aspect of the Journal [2], as it is clear that this is important for our readers [3]. The use of popular platforms, e.g. Twitter, YouTube, Facebook and Instagram, as well as our own blog site, allows us to greatly amplify the reach of our content, at lightning speed, and allows us to engage with our readers in a way that traditional print publishing never could.

In the video accompanying this editorial, we offer some practical advice to help our authors create high-quality video to augment their content. This advice includes:

Capture at the highest quality possible – digital video recorders outperform DVDs and are essential for laparoscopic and robotic work. For open surgery, a GoPro is our preferred capture device but an iPhone can also provide good footage.
Editing brings the video to life: video editing software is widely available and can transform your video from a dull procession into a vivid story. Add in additional footage (e.g. operating room footage to go with your laparoscopic video), still pictures, graphs, imaging etc, and add titles to help illustrate your key messages.
Output for social – your video-editing software will allow you to export your movie in a format optimised for YouTube (e.g. FLV file), or to upload directly to YouTube. Or just export it in a high-quality format and we will upload to YouTube for you.

We encourage the use of video to accompany any type of publication at BJUI, including web-only content such as blogs, and we require it for featured content such as the ‘Article of the Week’, ‘Article of the Month and Step by Step articles’. Videos in a surgical specialty like urology are often focused on procedural technique, but they do not have to be this limited and we encourage all other types of BJUI content to also be supplemented with video. Our BJUI Tube site and YouTube site contain good examples of how authors can describe their content with video by using figures and tables in an interview-style format. This latest video addresses issues around the capture and editing of videos to optimally complement your published work. These videos are then disseminated to a wider audience through our large social media network. All of our videos are ≈3 min in duration, as our analytics demonstrate that viewers ‘switch off’ when videos run for much longer.

We therefore encourage you to think social, think video, and help your content reach its maximum audience. We are here to help you!

Declan G. Murphy*^†‡, Wouter Everaerts^† and Stacy Loeb^§
*Peter MacCallum Cancer Centre, University of Melbourne, ^†The Royal Melbourne Hospital, ^‡Epworth Prostate Centre, Epworth Hospital, Melbourne, Australia, and ^§New York University, New York, USA

References

IBM. What is big data? 2013. Available at: https://www-01.ibm.com/software/data/bigdata/what-is-big-data.html. Accessed April 2014
Murphy DG, Basto M. Social media @BJUIjournal – what a start! BJU Int 2013; 111: 1007–1009
Loeb S, Bayne CE, Frey C et al. Use of social media in urology: data from the American Urological Association. BJU Int 2014; 113: 993–998

Reaching a consensus…robotic radical cystectomy

May 9, 2014/4 Comments/by Declan Murphy

What is your impression of a “consensus statement”? We have these periodically in urology and they do tend to get widely read. One wonders, how difficult could it be for a bunch of urologists to reach a consensus on something?? Especially if, at the end of the day, we are all agreeing to cut something out?! It’s not like radiation or doing nothing are on the cards for this particular topic! How difficult could it be?

Well, let me give you a peak into the workings of the robotic-assisted radical cystectomy (RARC) Consensus Conference which took place at the City of Hope Hospital in California last weekend, the findings to be known as “The Pasadena Consensus Statement on RARC”. This two-day conference took place in the beautiful foothills of the San Gabriel Mountains in Southern California, and was hosted by Dr. Tim Wilson, Chief of Urology at City of Hope. The event was co-ordinated by the eminent New England Research Institute, led by Dr. Ray Rosen, and funded by a generous philanthropist affiliated with the hospital. The format of the meeting was familiar, as there has already been a Pasadena Consensus Statement on robotic-assisted radical prostatectomy, which was published in European Urology in 2012 along with four systematic reviews, all of which have been highly-cited. The conference invited a group of leaders in radical cystectomy, open as well as robotic, to participate and the resulting faculty features some highly-published figures in muscle-invasive bladder cancer, including some of the pioneers of RARC. These include:

Tim Wilson, City of Hope, California
Bernie Bochner, Memorial Sloan-Kettering, New York
Peter Wiklund, Karolinska, Sweden
Khurshid Guru, Roswell Park, New York
Eila Skinner, Stanford University, California
Joan Palou, Fundacio-Puigvert, Barcelona
Jim Catto, Editor-in-Chief, European Urology, Sheffield
Giacomo Novara, Padua, Italy
Bertrand Yuh, City of Hope, California
Declan Murphy, Peter MacCallum Cancer Centre, Melbourne
Magnus Annerstedt, Stockholm, Sweden
Arnulf Stenzl, Tuebingen, Germany
Kevin Chan, City of Hope, California
Jim Peabody, Vattikuti Urology Institute, Detroit

Photo courtesy of Dr Jim Catto.

The goal was to review the current evidence for RARC (by way of systematic reviews and other detailed review), and to agree a “Best Practices” white paper. We had been split into working groups and had submitted slides overviewing our topics ahead of time. The two-day schedule then allowed presentation of these slides with (very) detailed critique and discussion. Systematic review maestro Giacomo Novara had worked with Bertrand Yuh to complete the systematic reviews prior to the conference and findings from these also informed much discussion. Bernie Bochner (the most knowledgeable person I have ever met on the topic of muscle-invasive bladder cancer!), kindly agreed to present the findings from the MSKCC randomised controlled trial which are key data in this area. This paper is about to be submitted so the Pasadena group will be able to include these findings in the final papers.

So was it a cosy chat in the Californian sunshine with much nodding of heads on key topics? Well, occasionally! The group were very sociable with very lively interaction, but there was certainly robust discussion on certain topics. Some of these leaked out on Twitter as one might expect with a few prominent uro-twitterati in the room (@jimcatto, @giacomonovara, @declangmurphy, @joanfundi, @AStenzl, @jamesopeabody), and with a lively response from social media enthusiasts from around the world getting involved in the #RARC conversation (@dytcmd, @@uretericbud, @daviesbj, @dmsomford, @matthayn, @kahmed198, @uroegg, @UROncdoc, @urogill, @urorao, @nickbrookMD, @joshmeeks, @wandering_gu, @urologymatch, @urology_verona, @chrisfilson, @mattbultitude, @clebacle, @chapinMD, @ggandaglia, @urogeek, and more) – every corner of the globe involved!

At certain times, the weight of data for open radical cystectomy was difficult to counter, and led to lively discussion between Bernie and Khurshid. For confidentiality reasons, we can’t reveal key findings until the final papers have been written and published, but Twitter does allow a sneak peak:

A general lament was the lack of high-quality data overall, as tweeted in this quote from Arnulf Stenzl:

However, some of the big publications from the pioneering centres, especially the data from the International Robotic Cystectomy Consortium (IRCC), and the RCT from Memorial have given us plenty to consider.

Having been involved in another large consensus statement recently (The Melbourne Consensus Statement on the Early Detection of Prostate Cancer), I can tell you that these statements feature very robust discussion before consensus is reached, and occasionally consensus is not reached leading to topics being omitted. The chosen faculty for such statements are highly-knowledgeable leaders in the field, but often have views which are highly discordant. The Chair has a great challenge to moderate so that the final statements are agreeable to all, and I am sure that the Pasadena Statement on RARC will prove of great interest to all working in this field.

[The Pasadena Consensus Statement Best Practices white paper will be published in European Urology in coming months, along with two systematic reviews and a Surgery in Motion technique paper]

Declan Murphy is a urologist at Peter MacCallum Cancer Centre in Melbourne, Australia, and Associate Editor at BJUI. Twitter @declangmurphy

Disclosure – Declan Murphy received support to cover travel and accommodation costs through the New England Research Institute. No industry support was received by any participants in this conference.

Engaging responsibly with social media: the BJUI Guidelines

April 30, 2014/1 Comment/by Declan Murphy

The final, peer-reviewed version of this paper has been accepted for publication in BJUI.
You can find it here. Please cite this article as doi: 10.1111/bju.12788

The social media revolution is well underway. Facebook, Twitter, YouTube, Instagram, Weibo, Blogger, LinkedIn, and many other social media platforms, have now penetrated deeply into our lives and have transformed the way in which we communicate and engage with society. The statistics are staggering. As of mid-2014, the total number of global users of the following platforms has exceeded billions of people from every nation in the world:
- Facebook – over 1.3 billion users
- Twitter – over 280 million active users
- YouTube – over 1 billion people view YouTube each month
- Instagram – over 200 million users
- LinkedIn – over 270 million users

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Social media has also become very popular among-st healthcare professionals both on a personal and professional basis. The reach and engagement which social media enables, along with the incredible speed with which information is disseminated, clearly creates opportunities for advances in healthcare communication. However, because healthcare professionals also have serious professional responsibilities which extend to their communication with others, there are dangers lurking in social media due to the inherent lack of privacy and control.

As a result, major professional bodies have now issued guidance for their members regarding their behaviour using social media. These include bodies representing medical students, general practitioners, physicians, oncologists, the wider medical community, as well as major regulatory bodies such as the Federation of State Medical Boards and the General Medical Council (GMC) in the UK, whose role is to licence medical practitioners. The guidance from the latter, part of the GMC’s Good Medical Practice policy, has significant implications as failure to comply with this guidance could impact a doctor’s licence to practice. All health care providers engaging in social media need to familiarize themselves with the relevant institutional, local, and national guidelines and policies.

There are many examples of healthcare providers who have faced disciplinary action following content posted on social media platforms. For example, posting photos of a drunk patient to Instagram and Facebook [1] is likely to result in serious disciplinary and legal action. In another case, a doctor in the USA was dismissed from her hospital and censured by the State Medical Board when she posted online details of a trauma patient [2]. Although her posting did not reveal the patient’s name, enough information was posted for others in the community to identify the patient. Furthermore, a review of physician violations of online professionalism and disciplinary action taken by State Medical Boards in the USA demonstrated that this case was not isolated [3]. Over 90% of State Medical Boards reported that at least one of several online professionalism violations had been reported to each of them. The most common violations were inappropriate patient communication online, often of a sexual nature. While the most frequent plaintiffs were patients and their families, it is noteworthy that complaints by other physicians were reported in half of State Medical Boards. Overall, serious disciplinary action including licence restriction, suspension or revocation occurred in over half of cases. There is clearly a need for healthcare professionals to be aware of their responsibility when communicating online.

So what of urology and social media? There is no doubt that many urologists have embraced social media with great enthusiasm, and urology has been one of the specialties leading the way [4-7]. The BJUI has been at the forefront of this enthusiasm as we have implemented a wide-ranging and evolving social media strategy including an active presence on the main social media platforms, a popular blog site, and a strategy to integrate our journal content across these platforms [8]. We now also recognise achievements in social media in urology through our annual Social Media Awards and by introducing a formal teaching course at the 2013 British Association of Urological Surgeons (BAUS) Annual Meeting, the first such course at a major urology meeting. While continuing to encourage the development of social media in urology as one of our key strategies, we also recognise that there are risks inherent in engaging in social media and that clinicians must be aware of these risks.

We therefore propose the following guidelines for healthcare professionals to ensure responsible engagement with social media. Much of this content is in alignment with advice issued by the other bodies listed above.

Always consider that your content will exist forever and be available to everyone. Although some social media platforms have privacy settings, these are not foolproof and one should never presume that a post on a social media platform will remain private. It should instead be assumed that all social media platforms lack privacy and that content will exist forever.
If you are posting as a doctor, you should identify yourself. The GMC guidance has specifically commented on anonymity. They advise that if you are identifying yourself as a doctor then you should also give your name, as a certain level of trust is given to advice from a doctor. People posting anonymously should be very careful in this regard as content could always be traced back to its origins, particularly if it became a matter for complaint.
State that your views are your own if your institutions are identifiable. It is commonplace for clinicians to identify their institutional affiliation in their social media profile. While not an excuse for unprofessional activity, it is good practice to state that your views are your own, particularly if you occupy leadership positions within that institution.
Your digital profile and behaviour online must align with the standards of your profession. Whatever standards are expected of the licencing body for your profession must be upheld in all communications online. You should also be aware that what you post, even in a perceived personal environment such as Facebook, is potentially accessible by your employers. As employers they will have a certain standard of behaviour that they expect. For example, use of inappropriate language or images of drunkenness could result in disciplinary action.
Avoid impropriety – always disclose potential conflicts of interest. The American Society of Clinical Oncology (ASCO) includes this important point in their guidance. Influencers in social media can hold powerful sway and clinicians have a responsibility to use this influence responsibly and manage any potential conflicts.
Maintain a professional boundary between you and your patient. It is not unusual for patients to be interested in their doctor’s social network. While most people do not restrict their Twitter and instagram followers for public profiles (and therefore all tweets must uphold professional standards), it is reasonable to politely decline a friend request on Facebook by stating that you keep your personal and professional social networks separate. The BMA guidance specifically advises against patients and doctors becoming friends on Facebook and advises that they politely refuse giving the reasons why.
Do not post content in anger and always be respectful. It is considered inappropriate to post personal or derogatory comments about patients OR colleagues in public. Defamation law could apply to any comment made in the public domain.
Protect patient privacy and confidentially at all times. There is an ethical and legal duty to protect patient confidentiality at all times, and this equally applies to online communication including social media. If posting a video or image, consent needs to be obtained for this even if the patient is not directly identifiable. Content within a post or image, including its date and location and your own identity, may indirectly identify a patient to others. The GMC guidance also states that you must not ‘discuss individual patients or their care with those patients or anyone else’. Thus posting about a case you have just seen could be in breach of these recommendations.
Alert colleagues if you feel they have posted content which may be deemed inappropriate for a doctor. Quite unintentionally, colleagues may post content which may be regarded as unprofessional for any of the reasons listed above. Although a digital shadow may always persist, deleting the online content before it becomes more widely disseminated may help mitigate the damage.
Always be truthful and strive for accuracy. All online content in social media should be considered permanent. It should also be considered that anyone in the world could potentially access this content. Therefore, truthfulness and accuracy are simple standards which should be upheld as much as possible.

Social media is a very exciting area of digital communication and is full of opportunities for clinicians to engage, to educate and to be educated. However, risks exist and an understanding of the boundaries of professional responsibility is required to avoid potential problems. Adherence to simple guidelines such as those proposed here may help clinicians achieve these aims.

Declan G Murphy^1-2, Stacy Loeb³, Marnique Y Basto¹, Benjamin Challacombe⁴, Quoc-Dien Trinh⁵, Mike Leveridge⁶, Todd Morgan⁷, Prokar Dasgupta⁴, Matthew Bultitude⁴

¹University of Melbourne, Peter MacCallum Cancer Centre, Melbourne, Australia, ²Epworth Prostate Centre, Epworth Healthcare Richmond, Melbourne, Australia, ³New York University, USA, ⁴Guy’s Hospital, King’s College London, UK, ⁵Division of Urologic Surgery and Center for Surgery and Public Health, Brigham and Women’s Hospital/Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA, ⁶Department of Urology, Queen’s University, Kingston, ON, Canada, ⁷Department of Urology, University of Michigan, Ann Arbor, MI, USA

References

ABC News. Chicago doctor allegedly posted photos of drunk patient on social media. Available at: https://jobs.aol.com/articles/2013/08/21/chicago-doctor-drunk-patient-photos-facebook/
Above the Law. ER doc forgets patient info is private, gets fired for facebook overshare. Available at: https://abovethelaw.com/2011/04/er-doc-forgets-patient-info-is-private-gets-fired-for-facebook-overshare/.
Greysen SR, Chretien KC, Kind T, Young A, Gross CP. Physician violations of online professionalism and disciplinary actions: a national survey of state medical boards. JAMA 2012; 307: 1141-1142.
Prabhu V, Lee T, Loeb S et al. Twitter Response to the United States Preventive Services Task Force Recommendations against Screening with Prostate Specific Antigen. BJU Int 2014; doi: 10.1111/bju.12748
Loeb S, Catto J, Kutikov A. Social media offers unprecedented opportunities for vibrant exchange of professional ideas across continents. Eur Urol 2014; doi: 10.1016/j.eururo.2014.02.048
Loeb S, Bayne CE, Frey C, et al. Use of social media in urology: data from the American Urological Association. BJU Int 2013; doi: 10.1111/bju.12586
Matta R, Doiron C, Leveridge MJ. The dramatic rise of social media in urology: trends in Twitter use at the American and Canadian Urological Association Annual Meetings in 2012 and 2013. J Urol 2014; doi: 10.1016/j.juro.2014.02.043
Murphy DG, Basto M. Social media @BJUIjournal – what a start! BJU Int 2013; 111: 1007-1009

The final, peer-reviewed version of this paper has now been accepted for publication in BJUI. You can find it here. Please cite this article as doi: 10.1111/bju.12788

The 2nd BJUI Social Media Awards – April 2014

April 22, 2014/1 Comment/by Declan Murphy

Following the inaugural BJUI Social Media Awards presented at the 2013 AUA Annual Meeting in San Diego, this year’s awards moved across the Atlantic to the EAU Annual Congress in Stockholm. Both of these conferences play host to intense social media activity and it is fitting that the BJUI Social Media Awards gets to acknowledge the Uro-Twitterati on both continents! Individuals and organisations were recognised across 16 categories including the top gong, The BJUI Social Media Award 2014, awarded to an individual or organization who has made an outstanding contribution to social media in urology in the preceding year. The 2013 Award was won by the all-conquering Urology Match portal which continues to innovate in social and digital media. There had been much anticipation and speculation ahead of time about who would win the top and bottom gongs, and whether or not the King of Twitter, Ben Davies @daviesbj, would be acknowledged

In keeping with the informality of the 2013 BJUI Social Media Awards (held in an Irish Bar in San Diego), this year’s ceremony was held in the Acoustic Bar of the Scandic Grand Central in beautiful Stockholm. Fifty of the World’s leading social media enthusiasts in urology gathered to meet up in person and to see who would be recognised. Yours truly once again played the role of MC wearing my hat of BJUI Social Media Editor, ably assisted by Matt Bultitude, BJUI Website Associate Editor, and Editor-in-Chief Prokar Dasgupta.

The full list of awardees, along with some examples of “best practice” in the urology social media-sphere can be found on this Prezi (https://prezi.com/iukizmhni9_w/bjui-social-media-awards-2014/). The winners are also listed here:

Most Read Blog@BJUI – The Melbourne Consensus Statement – accepted by Matt Cooperberg on behalf of the authors
Most Commented Blog@BJUI – Dr Rajiv Singal, Toronto, Canada
Best Blog Comment – Dr John Davis, Houston, USA
Best BJUI Tube Video – Blue Light cystoscopy RCT – accepted by Shamim Khan on behalf of colleagues at Guy’s Hospital
Best Urology Conference for Social Media – EAU Annual Congress, Stockholm 2014
Best Social Media Campaign – Stacy Loeb, for her birthday party campaign
“Did You Really Tweet That” Award – Ben Davies, Pittsburgh, USA
Best Urology App – jointly awarded to BJUI (Matt Bultitude) and European Urology (Cathy Pierce) for new iPad apps
Innovation Award 2014 – @UroQuiz – Nathan Lawrentschuk, Melbourne, Australia (accepted by Paul Anderson)
#UroJC Award – Vincent Misral, Paris, France
Best Selfie – Mike Leveridge, Toronto, Canada
Best Urology Facebook Site – American Urological Association (accepted by Matt Cooperberg)
Best Urology Journal for Social Media – European Urology (Jim Catto)
Best Urology Organisation – Urological Society of Australia & New Zealand (David Winkle)
The BJUI Social Media Award 2014 – Stacy Loeb, New York, USA

BJUI Editor Prokar Dasgupta presenting awards to Jim Catto, Matt Cooperberg and Stacy Loeb

Many of the Award winners were present to collect their awards themselves, including the omnipresent Stacy Loeb who was awarded our top gong to huge applause.

A special thanks to our outstanding BJUI team at BJUI in London, Scott Millar and Helena Kasprowicz, who manage our social media and website activity and who were present on the night.

For more pictures from the evening, please visit BJUI Associate Editor John Davis’ Flickr https://www.flickr.com/photos/jdhdavis/sets/72157643916525665/ page.

Declan Murphy is Associate Editor for Social Media at BJUI. He is a urologist in Melbourne, Australia

Follow Declan on Twitter @declangmurphy and BJUI @BJUIjournal