Tag: Twitter

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A beer a day keeps stones away

June 10, 2013/5 Comments/by Helen Nicholson

This month the Twitter-based International Urology Journal Club #urojc made a bold move away from cancer to discuss kidney stones. The paper entitled ‘Soda and other beverages and the Risk of Kidney Stones’ by Ferraro et al. was published online on 15^th March 2013. Open access to the article was generously provided by the Clinical Journal of the American Society of Nephrology. The lead author, Pietro Manuel Ferraro, was kind enough to actively participate within the Twitter discussion.

This particular study looked at a total of 194 095 participants amalgamated from the Harvard-based Health Professionals Follow-Up Study and The Nurses Health Studies I and II. These individuals all filled in biennial questionnaires regarding their diet, general health and kidney stone pain for a median follow up period of 8 years. It is interesting that the event rate was relatively low with only 4462 cases identified, however it is important to note that the study looked only for new stone formers and persons who had previously had a kidney stone were excluded from the trial. At the outset this begs the question as to whether these results are in any way applicable to the recurrent stone former population.

So what did they find? The referent is the consumption of less than one drink per month, so with respect to daily consumption of one or more sugar sweetened colas there was a 23% increased risk in the incidence of renal calculi. Other beverages to show a statistically significant increased risk of stones included:

Sweetened non-cola soft drinks	33% increased risk
Artificially sweetened non-cola soft drinks	17% increased risk (p=0.05)
Punch (sugar sweetened fruit drink)	18% increased risk

And what decreases your risk?

% risk reduction

Coffee	26%
Decaffeinated coffee	16%
Tea	11%
Red Wine	31%
White Wine	33%
Beer	41%
Orange Juice	12%

Missing my poison of choice, diet cola? While there was a trend towards a decreased risk, this was not found to be statistically significant. But not an increased risk….so I may just keep drinking it for the time being. I am not alone.

There were certainly more than one of the so called Urological ‘Twitterati’ who seemed delighted that the study findings justified their habits:

There are undoubtedly limitations with any cohort questionnaire analysis. The authors have acknowledged that while they tried to control and adjust for variables including age, BMI, diabetes, race, BP and dietary intake, there are variables that simply cannot be accounted for on the basis of a simple questionnaire. Fructose, for example, is purported to be a potential contributor to the increased risk of stones by increasing calcium, oxalate and uric acid excretion. There are many other dietary sources of fructose, including fruits, cereals and processed foods and sauces that are not accounted for and are potential confounders. Along the same lines, coffee is a relatively broad category of beverage. When one compares an espresso with a teaspoon of sugar to a Starbucks Frappuccino the difference in sucrose, and thus fructose, content is extraordinary. The caffeine content of these beverages, while purported to decrease the risk of stones through diuresis, is variable and thus also a potential confounder.

Manuel Ferraro importantly acknowledged that the study observed ‘associations, not causal effects’. Harder evidence such as 24 hour urines, stone analysis and imaging data would be useful to draw more significant conclusions as to causality.

The population studied was also somewhat limited. As mentioned by Jason Lee, Henry Woo and Matt Bultitude the study included male health professionals and female nurses, who were generally white, an older population with a relatively low BMI and potentially prone to dehydration. There was also limited control of comorbidities.

As suggested by Christopher Bayne, the only evidence as yet in randomized controlled trials is that water consumption as reflective of hydration status and urinary volume is the only substance known to reduce the risk of stone formation.

An astute observation by one of my fellow Australian trainees Janice Cheng noted the relatively dehydrated status of the study subjects.

This won the best Tweet prize, kindly donated by European Urology @EUplatinum.

Increased water intake has been reviewed on the Cochrane Database in 2012, however the consensus drawn was that there is currently insufficient evidence that increased water intake specifically, as opposed to other fluids, prevents the formation of urinary calculi.

So what conclusions should we draw? A patient with his first presentation kidney stone actually asked me yesterday whether he could keep drinking his favourite drink….beer. I simply replied that there was no current evidence that this would increase his risk of stones, however that moderation was key. We must remember that many of these calorific drinks have significant impact on comorbidities outside of the world of kidney stones. #a(lotof)wateradaykeepstheurologistaway

The overall participation in #urojc continues at a solid rate, with 39 participants and 178 total tweets over the 48 hour period. The next #urojc will be on the first Sunday or Monday of July (depending on your time zone).

Dr Helen Nicholson is an Australian Urology Trainee, currently based at The Sydney Adventist Hospital, NSW. Tweeted initially under duress, now a voluntary convert @DrHLN

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You are Not Connected to the Internet: Seeking Stable WiFi at the Modern Conference

June 4, 2013/4 Comments/by Mike Leveridge

Urologists the world over have at last settled back into their rhythms after congregating en masse in San Diego, California for the American Urological Association Annual Meeting. While I hadn’t expected to escape balmy Ontario for crisp breezes in Southern California, the setting was an excellent one.

This year’s AUA meeting had all the hallmarks of years past – heaving throngs of AUA-branded-faux-leather-bagged urologists speed-walking between sessions in the enormous SD Convention Centre, bleary-eyed sufferers burning away their respective fogs with espresso in the cavernous Exhibit Hall, and plenary sessions packed to the gills to hear the latest and greatest. One pernicious tradition was unfortunately manifest again, however, in the form of unreliable wireless internet access in the conference hall and ancillary venues.

Modern conferences and conference centres (where (ironically) the latest technologies and scientific advances are presented) seem to have barricaded themselves from the digital world the modern conference-goer inhabits. This may at first seem inconsequential, as the sequestration and forced attention might keep the focus on the presented data. In truth, an entire communication meta-layer, that of the conversations, opinions and dissemination created by social media activity, are needlessly compromised.

As has been stated repeatedly in social media circles, this year’s annual meeting was a bonanza of twitter activity at the #aua13 hashtag, with over 4000 tweets sent from 468 users during the meeting proper. The recent European Association of Urology meeting in Milan was similarly well subscribed, with almost 1800 tweets from 251 users.

It seems universal at urology (and doubtless other disciplines’) meetings that some of the earliest twitter activity centers around the pain of spotty or absent wifi. To wit:

– from #uro12 (AUA Atlanta):

– from #eau13 (EAU Milan):

– from #aua13 (AUA San Diego):

These are but a few of the dozens of agonized tweets based on weak, spotty or absent wifi, and for each there is doubtless a dozen, fifty, a hundred more people in the same building steaming with the same frustrations. International delegates, loathe to “roam” outside their home data plans, are perhaps the most handicapped. One imagines the conference centre tech team testing their seemingly robust signal in an empty room, devoid of the hundreds or thousands of devices queuing for bandwidth space once the meeting is in full swing. And let’s not forgive the conference-adjacent hotels that host dozens of ancillary meetings, such as the well-attended Society of Urologic Oncology meeting, each year in advance of the AUA proper. Typically there is a total absence of available wifi in these conference halls. In 2013, the mind boggles at this omission (on the part of organizers as well as the hotels).

Certainly the modern conference centre and the modern meeting must see beyond their own walls, and address the modern realities of communication. The reach of social media, and indeed the basic need of busy attendees to connect with their practices, lives and colleagues make this all the more imperative. Relative to all the other logistic feats that underpin a conference, building in extra bandwidth (with redundancy to avoid catastrophe) should be a simple infrastructure and expenditure issue, well within the means of the centre to predict and to deploy.

A brief set of expectations for the modern conference centre’s wireless internet:

Conference wifi must be available to all who wish to access it, when and where they wish to do so. Hotels are not exempt if they host parts of the meeting. Wifi is no longer a perk or a luxury.
Login should be simple and able to be performed in the native settings of the users’ devices, rather than the agonizing experience of web- or browser-based login.
Requiring repeated logins when re-entering rooms or buildings is excruciating and anathema to the speed of communication and discussion that define social media. One formal login per device per meeting.
The ubiquity of mobile devices may require a building retrofit or construction of stations to facilitate the ability of delegates to charge these devices.

Until these conditions are met, associations, conferences and conference centres will be forced by their own inertia to stifle the full potential of the meetings they host. Here’s hoping that the volume of our discontent is heard by organizers, and suitable guarantees are established and met as conditions of hosting our meetings.

Mike Leveridge is an Assistant Professor in the Departments of Urology and Oncology at Queen’s University, Kingston, ON, Canada. @_theurologist_

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Social media @BJUIjournal – what a start!

May 24, 2013/2 Comments/by Declan Murphy

When Prokar Dasgupta assumed the role of new Editor-in-Chief of the BJUI in January 2013, he outlined his vision and some of the major changes that the Journal would make as it transitioned to a new editorial team. After 10 years of progress under John Fitzpatrick, it was clear that we are now working in a much-changed publishing landscape, one which will change even more in the next few years. In particular, the way in which medical professionals receive information and interact with colleagues, patients, journals and other professional groups is unrecognisable from what it was just 2 or 3 years ago.

Social media is the driver of much of this change. It has transformed the way in which the current generation of trainees interact—Facebook, Twitter, YouTube, LinkedIn, Urban Spoon, Expedia, Trip Advisor, Instagram – all of these platforms are key conduits for how Generation Z experiences life. This generation will find the idea of a printed journal arriving in the post every month to be anathema. In a world with an ever-increasing amount of content being produced, and much competition for our limited attention span, Gen Z live their lives through mobile platforms capable of delivering the precise content they want, immediately to their devices. Not just that, this content, whether that be breaking news via Twitter, friend status updates on Facebook, job opportunities via LinkedIn, is delivered through vibrant media that allows them to engage and respond by liking, sharing, favourite-ing, re-tweeting and commenting, even as the content reaches them. All of this activity is done through convenient and increasingly pervasive mobile platforms while on the train to work, while queuing for a coffee, between cases in theatre, during a lecture, first thing in the morning, last thing at night. Gen Z will not seek out this type of content – it will seek them out and be delivered straight to their timeline/twitter-feed.

The BJUI is the first surgical journal to introduce an Associate Editor for Social Media. The aim is to devise and implement a strategy to ensure that the BJUI evolves in this new world; to ensure that the next generation of trainees find us a meaningful organisation to engage with and be informed, educated and entertained by. Our fellow Associate Editor, Matt Bultitude (Web) plays an important role here as do our publishers, our Executive team and Editor-in-Chief.

Our social media platforms

So what have we done? If you are on Twitter or Facebook you will have noticed that BJUI has come to life on these key social media platforms.

Between January and April 2013, our followers on Twitter have grown from by one third to over 1300, and continue to grow at over 100 followers per month. Through Twitter alone, we have generated huge traffic back to our website with over 3500 link clicks from the hundreds of interactions we have had during this period.

Advanced social media metrics allow us to measure all of this activity against other organisations active in urology. For example our Klout score has increased from 46 to 55 with a corresponding increase in our Peerindex rating. We are leading the field across all of the key domains we have targeted to date and continue to make progress as we introduce further changes at www.bjui.org in 2013.

Our Facebook site is now highly engaging and is constantly updated with news and content from our website.

We have recorded over 133 000 page impressions by 23 000 Facebook visitors in the first 3 months of 2013, a huge rise from previously, and all of this traffic gets directed back to content at www.bjui.org, whether that be a Journal article, blog, picture quiz or our new ‘Poll of the Week’.

Our YouTube site is updated with videos from authors and other multimedia content to complement citable articles published in the Journal. You will see a lot more content added here in coming months.

Blogs@BJUI

But perhaps the most talked-about area we have introduced is Blogs@BJUI. And although we are the first mainstream urology journal to introduce a blog site, other journals have done so with great success. In September, we visited the social media team at the BMJ to get some tips on how they had developed their social media strategy into the very successful multi-platform spectacular, which they now oversee. Juliet Dobson, Blogs Editor and Assistant Web Editor at the BMJ offered some excellent advice to help us get up and running and their former Editor, Richard Smith, remains one of the bloggers we most admire. BMJ Blogs is well worth a visit for aspiring bloggers to read some of the best.

We launched our new web journal on the 2 January 2013 to coincide with the new Editor taking the helm, and also published our first blog that day. From then until April 2013, Blogs@BJUI has featured the following:

51 blogs contributed by 25 authors on three continents
193 comments from all over the world, including opinion from some household names in academic urology
16 editorial blogs from our specialty Associate Editors
4 blogs from major urology conferences
Multidisciplinary contributions from both authors and comment-leavers

The topics have included everything from urology humour, through the European Working Time Directive, reality TV and an eminent urologist describing his recent personal experience of robotic radical prostatectomy. Our contributors have included many of the key opinion leaders in social media in urology, many of whom are rising stars or already established in academic urology. Also established urology opinion-leaders who are rather new to social media but enjoying the challenge! Other contributors are young trainees who have proved themselves to be talented bloggers already. Blogs@BJUI has been highly successful at driving traffic to the Article of the Week as improving quality remains our main objective.

Also of note is the impact that social media has made at urology conferences in the past few months. As part of a planned strategy, the BJUI social media team has been very active posting updates on Twitter, Facebook and YouTube from major urology conferences, thereby increasing the reach of these meetings to a much larger audience and also allowing those following on social media to engage pro-actively with the conference. This has been a very successful strategy; social media metrics confirm that the BJUI team has been leading the social media revolution at this year’s Annual European Association of Urology (EAU) Congress:

We had set a target that by the end of the first quarter we would have 1000 readers per month visiting Blogs@BJUI. By the end of the February, we had already had over 9000 visits to our blog site! Each reader spent over 3.5 min reading the web journal and many of them left comments or pushed out links using Twitter or Facebook. We have had many comments posted by readers from every corner of the world and have enjoyed some very humorous posts. For us, social media is all about engagement. We want to use these platforms to allow readers to passively engage with us by liking, sharing, tweeting content that they enjoy whether that is a full paper in the BJUI, a blog post, YouTube video, weekly poll or Picture Quiz of the Week. And for those who want to engage more actively, we strongly encourage you to join the conversation and add a comment.

So we have had a great start to our social media push at the BJUI. And there will be a lot more to come in the coming months. For those of you who are new to social media, we encourage you to dip your toes in by reading a blog or two and adding a comment. Before you know it you will have downloaded the Twitter app to your smartphone and you’ll be off and running! For the Twitterati, we thank you for all your enthusiasm in helping us get social media up and running at the BJUI and we look forward to your blogs, mentions, re-tweets and podcasts over the coming months. Social media is all about engagement – join the conversation @BJUIjournal.

Declan G. Murphy and Marnique Basto

Division of Cancer Surgery, University of Melbourne, Peter MacCallum Cancer Centre, Melbourne, Australia

Declan Murphy is Associate Editor for Social Media at the BJUI.
Follow him on Twitter @declangmurphy

The new AUA PSA Testing Guidelines leave me scratching my head

May 9, 2013/25 Comments/by Tony Costello

The fact that Otis Brawley describes the new PSA testing guidelines of the American Urological Association (AUA) as “wonderful”, should immediately raise a red flag at AUA headquarters. Dr Brawley, Chief Medical Officer of the American Cancer Society, and the most vocal anti-prostate cancer screening voice in the USA over the past decade, has enthusiastically welcomed the new document and “commended” the AUA for bringing its policy closer to that of his Society. The Guidelines have also been compared to those of the United States Preventative Services Task Force (USPSTF) which completely opposes PSA testing in any situation – a position which the AUA called “inappropriate and irresponsible” just a few months ago. Oh dear – where has it all gone wrong? ?

For those who haven’t yet seen the document, here are the five statements issued by the Guideline committee at the Annual Meeting of the AUA in San Diego this week along with some of my thoughts in italics:

The Panel recommends against PSA screening in men under age 40 years. This appears reasonable.
The Panel does not recommend routine screening in men between ages 40 to 54 years at average risk. I have some problems with this (as do many others). In addition to this statement, the AUA highlights its view that the likelihood of causing harm is high and that any benefit is marginal. It appears to have completely dismissed evidence (and its own previous view), that a baseline PSA in men in this age group is highly predictive of future prostate cancer, metastasis and death. In my view, there is considerable value in having a baseline PSA in this age group and I am disappointed that the AUA has not recognised the evidence to support this.
For men ages 55 to 69 years the Panel recognizes that the decision to undergo PSA screening involves weighing the benefits of preventing prostate cancer mortality in 1 man for every 1,000 men screened over a decade against the known potential harms associated with screening and treatment. For this reason, the Panel strongly recommends shared decision-making for men age 55 to 69 years that are considering PSA screening, and proceeding based on a man’s values and preferences. I agree with the emphasis here on shared decision-making, although the concept can be somewhat nebulous and difficult to achieve in real-life. However, I think that this statement somewhat over-emphasises the harms associated with PSA testing in this group. Rather than portray the reduction in prostate cancer mortality as being very minor (1 in 1000), men should know that when compared with a man who chooses not to have PSA testing in this age group, those who do have regular PSA testing have a 44% reduction in prostate-cancer mortality over a 14 year period. Furthermore, the numbers needed to screen (293) and number needed to treat (12) to save one life stack up very well when compared with other screening modalities such as mammography (Hugosson et al). Why has the AUA instead chosen to over-emphasise the harms? This is disappointing.
To reduce the harms of screening, a routine screening interval of two years or more may be preferred over annual screening in those men who have participated in shared decision-making and decided on screening. As compared to annual screening, it is expected that screening intervals of two years preserve the majority of the benefits and reduce over-diagnosis and false positives. This appears reasonable.
The Panel does not recommend routine PSA screening in men over age 70 years or any man with less than a 10 to 15 year life expectancy. Yes, but this strong advice not to offer PSA testing in men greater than 70 belies the fact that many men in this age group have a long life expectancy (eg in Australia a male who reaches 70 has a 15 year life expectancy (www.abs.gov.au), and an early diagnosis of prostate cancer may prevent their untimely death from this disease. Clearly, not all men in their 70’s are the same but following this advice to the letter could deny many men the option of avoiding death from prostate cancer in later life.

Therefore, it appears that the only circumstances under which the AUA currently recommend a PSA test be performed is for men between the age of 55 and 69 following a weekend seminar so they can be adequately informed (or thoroughly confused).

These statements have led to headlines such as these in the mass media today:

Urology Group Stops Recommending Routine PSA Test (USA Today)
Looser Guidelines Issued on Prostate Cancer Screening (New York Times)
Urologists No Longer Support Routine Prostate Cancer Screening (Minn Post)
Most men don’t need PSA test (Arizona Star)
AUA No Longer Recommend Routine PSA Testing For Prostate Cancer (Huff Post)

I think it is reasonable to say that this AUA document adds more confusion than clarity to the debate around prostate cancer testing. It has certainly provoked some anger among prominent members of the AUA who voiced their displeasure to the Committee during the plenary and also through social media. Dr Catalona was first to the microphone asking why AUA members were not more widely consulted prior to publication and in particular, challenging the guidance around men aged 40-54 (reported on Twitter):

Dr Stacy Loeb also voiced her concerns at various sessions during the day:

Much progress has been made in the last few decades with a 30% reduction in prostate cancer-specific mortality since the introduction of PSA testing. And while we accept that this has led to a large amount of over-treatment of less aggressive disease, it is clear that (at least outside the USA), active surveillance is being enthusiastically embraced for appropriate patients. Any return towards the pre-PSA era would likely lead to a reversal in these mortality gains and we would again see many more men presenting to our rooms with incurable disease.

As Dr Smith editorialized in the Journal of Urology following the publication of the ERSPC and PLCO trials in 2009, “Treatment or non-treatment decisions can be made once a cancer is found, but not knowing about it in the first place surely burns bridges”. It is clear that many urologists consider these new AUA PSA Guidelines to be in danger of burning these bridges. However, rather than burn bridges, it is likely that urologists and others will ignore these guidelines and continue to counsel men in a more balanced fashion about the pros and cons of PSA testing. The AUA will then need to consider whether ignored guidelines are failed guidelines.

Prof Tony Costello is a Director and Professor of Urology at the Royal Melbourne Hospital, Melbourne, Australia.

Twitter: @proftcostello

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Twitterboards: EAU 2013

March 18, 2013/by admin Z.9

Declan Murphy explains Twitterboards; one of the key social media features in use at EAU 2013 Congress. Follow BJUI on Twitter.

Social media @BJUIjournal: what a start!

March 11, 2013/5 Comments/by Declan Murphy

When Prokar Dasgupta assumed the role of new Editor-in-Chief of the BJUI in January 2013, he outlined his vision and some of the major changes that the Journal would make as it transitioned to a new editorial team. After ten years of progress under Professor John Fitzpatrick, it was clear that we are now working in a much-changed publishing landscape, one that will change even more in the next few years. In particular, the way in which medical professionals receive information and interact with colleagues, patients, journals and other professional groups is unrecognizable from what it was just two or three years ago.

Social media is the driver of much of this change. It has transformed the way in which the current generation of trainees interact – Facebook, Twitter, YouTube, LinkedIn, Urban Spoon, Expedia, Trip Advisor, Instagram – all of these platforms are key conduits for how Generation Z experiences life. This generation will find the idea of a printed journal arriving in the post every month to be anathema. In a world with an ever-increasing amount of content being produced, and much competition for our limited attention span, Gen Z live their lives through mobile platforms capable of delivering the precise content they want, immediately to their devices. Not just that, this content, whether that be breaking news via Twitter, friend status updates on Facebook, job opportunities via LinkedIn, is delivered through vibrant media that allows them to engage and respond by liking, sharing, favourite-ing, re-tweeting and commenting even as the content reaches them. All of this activity is done through convenient and increasingly pervasive mobile platforms while on the train to work, while queuing for a coffee, between cases in theatre, during a lecture, first thing in the morning, last thing at night. Gen Z will not seek out this type of content – it will seek them out and be delivered straight to their timeline/twitter-feed.

My role as Associate Editor (Social Media) at BJUI, has been to devise and implement a strategy to ensure that the BJUI evolves in this new world – to ensure that the next generation of trainees find us a meaningful organization to engage with and be informed, educated and entertained by. My fellow Associate Editors, Dr Matt Bultitude (Website), Dr Ben Challacombe (Innovation) and Dr Quoc-Dien Trinh (Health Services Research), play important roles here as do our publishers, our Executive team and Editor-in-Chief at BJUI.

So what have we done? If you are on Twitter or Facebook you will have noticed that BJUI has come to life on these key social media platforms.

Since 1^st January, our followers on Twitter have grown by over 20% to 1151 and we have generated huge traffic back to our website with over 2000 link clicks from the 500 interactions we have had during this period.

Advanced metrics allow us to measure all of this activity against other organisations active in urology. For example our Klout score has increased from 46 to 53 with a corresponding increase in our Peerindex rating. We are leading the field across all of the key domains we have targeted to date and continue to make progress as we introduce further changes at bjui.org in 2013.

Our Facebook site is now highly engaging and is constantly updated with news and content from our website.

We have recorded over 73,000 page impressions by 11,000 Facebook visitors in the first two months of 2013, a huge rise from previously, and all of this traffic gets directed back to content at bjui.org, whether that be a Journal article, blog, picture quiz or our new “poll of the week”.

Our YouTube site is updated with videos from authors and other multimedia content to complement citable articles published in the Journal. You will see a lot more content added here in coming months.

But perhaps the most talked-about area we have introduced is Blogs@BJUI. And although we are the first mainstream urology journal to introduce a blog site, other journals have done so with great success. In September, Matt Bultitude and I visited the social media team at the BMJ to get some tips on how they had developed their social media strategy into the very successful multi-platform spectacular that they now oversee. Juliet Dobson, Blogs Editor and Assistant Web Editor at the BMJ offered some excellent advice to help us get up and running and their former Editor, Richard Smith, remains one of the bloggers I most admire. BMJ Blogs is well worth a visit for aspiring bloggers to read some of the best.

We launched our new website on the 2^nd January 2013 to coincide with the new Editor taking the helm, and also published our first blog that day. From then until the 28^th February 2013, Blogs@BJUI has featured the following:

35 blogs contributed by 25 authors on three continents
133 comments from all over the world
8 editorial blogs from our specialty Associate Editors
Multidisciplinary contributions from both authors and comment-leavers

The topics have included everything from urology humour, through the European Working Time Directive, reality TV and an eminent urologist describing his recent personal experience of robotic radical prostatectomy. Our contributors have included many of the key opinion leaders in social media in urology, many of whom are rising stars or already established in academic urology. Also established urology opinion-leaders who are rather new to social media but enjoying the challenge! Other contributors are young trainees who have proved themselves to be talented bloggers already. I am quite pleased that the most-read blogs in January and February were written by two young trainees of mine in Melbourne. But I am sure the self-appointed King of Twitter, Ben Davies, and other established stars of urology social media will be vying for such coveted titles as the months go by.

I had set a target that by the end of the first quarter we would have 1000 readers per month visiting Blogs@BJUI. By the end of the February, we had already had over 9000 visits to our blog site! Each reader spent over 3.5 minutes per blog and many of them left comments or pushed out links to our blogs using Twitter or Facebook. We have had many comments posted by readers from every corner of the world and have enjoyed some very humorous posts. For us, social media is all about engagement. We want to use these platforms to allow readers to passively engage with us by liking, sharing, tweeting content that they enjoy whether that is a full paper in the BJUI, a blog post, YouTube video, weekly poll or Picture Quiz of the Week. And for those who want to engage more actively, we strongly encourage you to join the conversation and add a comment to any of our blogs.

So we have had a great start to our social media push at the BJUI. And there will be a lot more to come in the coming months – watch for our activity during the upcoming conference season and look forward to the results of the inaugural BJUI Social Media Awards to be announced at the American Urological Association Annual Meeting. For those of you who are new to social media, I encourage you to dip your toes in by reading a blog or two and adding a comment. Before you know it you will have downloaded the Twitter app to your smartphone and you’ll be off and running! For the Twitterati, I thank you for all your enthusiasm in helping us get social media up and running at the BJUI and I look forward to your blogs, mentions, re-tweets and podcasts over the coming months. Social media is all about engagement – join the conversation @BJUIjournal.

Declan Murphy is a uro-oncologist in Melbourne and is Associate Editor of Social Media at the BJUI. Follow him on Twitter @declangmurphy

Twitter Chat Tools for International Urology Journal Club

February 18, 2013/11 Comments/by Brian Stork

Twitter is a great social channel for professionals to exchange ideas. I regularly use Twitter to connect with urologists, health care professionals, patients and thought leaders around the world. I also use Twitter to share my blog posts.

Participating in Twitter Chats

One of the many other ways I find value on the platform is by participating in Twitter Chats. Twitter chats are a great way to get people with a common interest into a community. A Twitter Chat can be a one-time event; however, most take place on a regular basis – weekly or monthly – and are organized around a designated hashtag.

Weekly healthcare chats that I regularly enjoy include: #hcsmanz (Healthcare and Social Media in Australia and New Zealand) and #hcsm (Healthcare Communications and Social Media) both on Sundays, #hcldr (Healthcare Leader) on Tuesdays, and #HITsm (Health IT Social Media) on Fridays.

My favorite Twitter chat, however, is the monthly #UROJC chat, International Urology Journal Club on Twitter. #UROJC takes place on the first Sunday of every month, starting at 3 pm Eastern time, and continues over a 48-hour period, rather than one hour. During this time, I can review and discuss current research in urology and engage with academic and community urologists around the world. The origins of #UROJC have previously been described by Dr. Henry Woo, @DrHWoo, in a BJUI blog post.

Twitter Chat Tools to Know

When you participate in #UROJC, or any other Twitter Chat, there are a few tools and tips that can be used to enhance your experience.

1. Tweetchat

A great application for Twitter Chats and conferences is Tweetchat.com. You can tweet directly from Tweetchat, and your tweets will automatically be appended with the hashtag. All participants using the hashtag can be viewed in a real-time stream.

How to use Tweetchat:

Go to Tweetchat.com.
Log in with your Twitter account.
Add the hashtag for the chat, i.e., #UROJC, in the “room” text box.
Now you will see all the people participating in the chat displayed in the stream in real time.
You can tweet directly from the platform through the tweet box provided. Tweetchat.com will automatically add the hashtag, and you are visible in the stream. You can click on buttons next to a tweet to reply or retweet another user.
You can also click to follow colleagues in the chat via Tweetchat. This is a great way to expand your network.

2. Twitterfall

Twitterfall is similar to Tweetchat, but has some customizable features. For example, you can edit out retweets, and control the speed of the Twitter stream. Twitterfall also has a place to create lists of people you want to engage with.

To get started on Twitterfall:

Go to Twitterfall.com.
Log in with your Twitter account to tweet directly from the platform.
Enter the hashtag #UROJC into the “search” text box.
View the discussion and participants in the stream.
Set your selections for a variety of other options including creating a list of participants.

3. Symplur

You can get a transcript of the tweets from each monthly #UROJC chat courtesy of Symplur. This is valuable if you want to review a chat or if you happened to miss a chat altogether.

In addition to chats, Symplur’s Healthcare Hashtag project is a rich resource for discovering and mining healthcare conversations on Twitter around specialties, disease states, patient communities, and healthcare conferences.

It is also interesting, at the end of a chat, to view Symplur’s analytics that show the participants who have the most mentions, tweets and impressions. Symplur can also a great place to identify new people to follow.

4. World Clock:

Because #UROJC is a global discussion over a two-day period, it can be confusing to keep track of starting times across multiple time zones. A great tool to find the time in your part of the world is the World Clock time zone converter.

I hope that you find these Twitter Chat tools and tips helpful, and I look forward to seeing you in the stream of our next monthly #UROJC. You can keep updated on what is up and coming on #UROJC by following the official Twitter account for the chat at @iurojc. You can always connect with me on Twitter @storkbrian.

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No Heat in the Desert

January 22, 2013/by Ben Davies

I am blogging again my friends. Blogging is freedom in the 21^st Century; the modern equivalent of standing on a soapbox in Speakers’ Corner in London. Still, only old people write formal blogs now, young people microblog. They use Twitter, Reddit, Tumblr, or Instagram. Blogging is no more modern than an open radical prostatectomy is sexy; actually its old-fashioned and beneath me. Still, I like it. And more importantly, it gives me an easy outpost to write about urology in an informal manner. So off we go – I am going to give blogging its sexy back.

For the past 20 years, my department at the University of Pittsburgh has sponsored and developed a course to aid board-eligible urologists tackle the oral urology boards (or part 2). We locate the course in Scottsdale, Arizona in Maricopa County. Maricopa county was recently in the news for having a controversial sheriff cited by the Department of Justice for “engaging in a pattern or practice of unconstitutional policing” and had “a chronic culture of disregard for basic legal and constitutional obligations.” I use this to scare the candidates into submission. If they misbehave I simply release them into the streets and lock the hotel door. Good luck out there!

I have been the supreme leader – or king as my followers call me – of the course for the past 3 years. The onus is on me to develop, curate, prod, shape, and refine the protocols for the exam. Naturally, I do a great job. This year we had an active hashtag following the course #GUMOCK13.

The urotwitterati were in heavy attendance from Dr. Loeb (@LoebStacy) gracing us with her fashionista presence, and the braintrust of Drs. Morgan and Kutikov (@wandering_gu and @uretericbud) were also there. Even my colleague Dr. Averch (@tdave) made a good twitter presence (a breakthrough). The break dancing and karaoke crooner Prof. Cooperberg (@cooperberg_ucsf) also had a defining presence.

The highlight for me was the profound talk from our guest motivational speaker Wayne Sotile. Just calling yourself a motivational speaker makes me yearn for a shotgun. As a non-believer I was thoroughly entertained and – more importantly – actually learned a great deal about the work/family balance. Some highlights with (tongue-in-cheek) twitter reactions as hyperlinks:

It is not the absolute hours you work that impacts your family life it’s the mood you bring home with you. Tweets here….
We work in a high-demand and low-control environment – that is the ultimate stressful situation. Tweets here…here
Levels of intimacy plummet until the 10 year mark in your marriage then they increase markedly. Tweets….here

The course ended with overall good reviews. The candidates appeared well-prepared, fine young doctors and I was impressed. Still – with a fail rate hovering at 11% the stress levels are high for these physicians. It did not help that the hotel seemed unable to provide the comfort we all desire after working all day and drinking all night – a hot shower. Over 50% of the attending participants had to contend with a cold or tepid shower because of a failed water pump that the hotel scampered to fix. I didn’t mind the dishevelled hippie hair look and – luckily – it appeared to keep the Sheriff’s department at bay.

Benjamin Davies is Assistant Professor of Urology at the University of Pittsburgh; Program Director, Urologic Oncology Fellowship and Chief, Division of Urology Shadyside Hospital. His views are his own. @daviesbj

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The self-proclaimed King of the Urology twitter world

January 9, 2013/3 Comments/by Ben Davies

Howard Stern proclaimed himself the King of all Media; I have proclaimed myself the King of the Urology twitter world. There is no basis for my claim. I certainly do not have the most followers nor do I have regal heritage. If you repeat things often enough they simply become true on the web – so I’m happy to be the king

What is true is that I was the first academic urologist to take to the twitterverse in a persistent, snarky, timely, and – at times- academic manner. I coached the uro-twitterati including Declan (@declangmurphy), Quoc (@qdtrinh), Alex (@uretericbud), Coops (@cooperberg_ucsf), Tony F (@urooncmd) , Mike L (@_TheUrologist_), and Henry Woo ( @DrHWoo). And I am proud of them.

Many of my most compelling tweets have been published in real news outlets (like on NPR and the Washington Post blog) and even a real article grew from it in Nature Urology. The biotech twitterverse (see Adam Feuerstein) has there hooks in me as well and I have had several consulting jobs as a result.

Like any father I have problems with my kids. They dont listen to my sage advice and they should. To tweet is not to be boring. It is not to be glib and tidy (Hi mom!). That is why we have Facebook. You have several style options for your tweets in the twitterverse and here are a few:

Academic tweets: Boring. These people add pithy tag lines to an interesting article (good example is @drMEisenberg). I have no problem with this approach. It makes for a safe environment and there is no question you have to be safe with your remarks (which I occasionally am not). It is a purely an informational tweet.

Snarky and academic: This is the province of Matt Cooperberg and I. I am vastly more funny. He is what I would describe as almost funny. The strategy is simple – find an article in urology or medicine in general and add a funny comment. They become strangely profound if done right. Good examples are here ….. or here

Mash-up Tweets: This is hard and rare. It is basically the ability to makes a tweet about a timely topic (could be breaking news) and tie it to something else that is urologic or some other breaking news. Sounds hard? It is. This is an advanced twitter move. My best tweets (judged by RTs) were mashups. Remember my best tweets are actually not available after some time since twitter archives your tweets for a limited time. Here is one ok example

Academic Modified Tweets and/or Snarky Academic Modified tweets: Modified tweets are taking a tweet and changing it to either to it make shorter or to completely change it to make a funny and/or compelling point. I’m better at funny. This is hard. These are by far my favorite form of tweets. Good one here

Odd ball tweet: I also love just saying something funny totally out of context. Remember do not be boring. This has been championed by @robdelany who is champion tweeter and raunchy comedian. Not everyone likes him but his a great odd ball tweeter. Here is my attempt. It is ok.
There is a lot to teach my people. Follow good tweeters. Do not tell us about your heartburn, gas, or inlaws (unless its a mashup!). Do not talk to your friends about something silly. Do not add silly hashtags to seem funny. They are never funny. Never. Repeat that over and over until you stop doing it. I will blog frequently about urologic twitter topics now that I am the Senior Consultant and Highly Paid Advisor for Social Media for BJUI. This of course is false but if you keep repeating it…

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International Urology Journal Club on Twitter

January 3, 2013/9 Comments/by Henry Woo

International Urology Journal Club on Twitter: The Beginnings of a New Application of Social Media in Urology CME

The International Urology Journal Club on Twitter almost came about by accident, although the formation of such was an inevitability. Over the course of 2012, a number of research papers have been the subjects of discussion amongst urologists on Twitter.

The standout paper as example for discussion in 2012 was the PIVOT study. This generated comments that were difficult to follow unless you were following all of the many participants. Although one could find the majority of the tweets in chronological order by doing a search under the tab “Discover”, it was still dependent upon whether the term PIVOT was used in the tweet or not – it was quite often the case that a comment was made without the term PIVOT being used and these would be missed by a search for PIVOT. In essence, a form of journal club was already happening although there was no organized manner by which all comments could be filed or arranged to provide context. When limited to 140 characters, a tweet can easily lose context if it cannot be connected to other tweets it may refer to or be in reply to. The use of a hashtag provides a filing system for related tweets and had all participants in the PIVOT study discussion used the hashtag #PIVOT, a search under that term would have enabled easy following and review of the discussion pertaining to that topic. The use of a hashtag does require general agreement by contributors that this will be the agreed filing (this is what I call it even though it is not a universal way of describing it) system for the tweets. It also meant that inclusion of long twitter handle names such as @cooperberg_ucsf would not eat into the precious 140 character limit to which we wish to make comment – as we are a tolerant, respectful and good humoured community, we of course continue to tolerate this blight on our character count. (I have incidentally shortened my Twitter name from @DrHenryWoo to @DrHWoo as a donation of 4 precious characters to those who wish to engage me on Twitter).

So how did the International Urology Journal Club on Twitter come about? It all started with Canadian urologist Michael Leveridge sending a few live tweets from his local journal club and nominally used the hastag #quroljc, which stood for Queens Urology Journal Club. A number of urology colleagues around the world, including myself, were intrigued by this.

Following an exchange of tweets, we came to realization that we were effectively engaging in a Twitter urology journal club. We soon realized that in order to do this effectively, we needed a hashtag to which we could all tweet our journal club responses and the hastag #urojc was born.

According to the exchange of tweets above, we can credit Michael Leveridge for coining the hashtag #urojc. On Twitter, it does not take long for the message to spread.

To administer Journal Club, an administrative account @iurojc and specific blog account was established. You will note that the administrative account is @iurojc and not @urojc since the latter had already been taken by another urologist. The #urojc blog carries information about the journal club as well as the tweet logs from the discussions.

In short, a recently published manuscript is selected for each month’s discussion. Such manuscripts are usually those that have been published online ahead of print in order to offer the most cutting edge research discussion. Discussions occur on the first Sunday or Monday of each month depending on which time zone you are in. Tweet discussion is carried out in an asynchronous manner over the course of 48 hours. Since commencing in November 2012, there has been a truly global engagement and with the amplification effect of Social Media, we have seen in excess of 50,000 impressions (a Twitter metric of reach). A novel approach to this format of journal club is the invitation and participation of the lead author and/or corresponding author associated with the paper for discussion – there is no question that this significantly enhances the value of the discussion.

Prior to the commencement of the first #urojc discussion, it was suggested that there should be a prize for the best tweet. This has now been instituted and a #urojc Hall of Fame is now in the making. With the Best Tweet prize for November 2012 being awarded to Ben Davies, it has only fueled his belief that he is indeed the urological King of Twitter. He is, however, the inaugural prize winner and at the top of the list of the #urojc Twitter Hall of Fame. The winner of the December Best Tweet Prize was another Ben, namely Ben Jackson. We thank Urology Match and Nature Reviews in Urology for donating the prizes for November and December respectively. Whilst there were suggestions of a Ben conspiracy, we cannot promise that the January Best Tweet Prize, which has been donated by the Urological Society of Australia and New Zealand (USANZ) will be awarded to a non-Ben participant.

It is our belief that the #urojc is the first truly international clinical journal club discussion taking place on Twitter in an organized manner. Whilst there are local real time Twitter journal club chats and similar discussions in non-clinical areas of health care, this is again a demonstration of how urologists lead the way with the embracement of technology to advance health care. For now, the discussions are on a monthly basis with a focus on uro-oncology. As interest grows, the plan is to expand to twice monthly with the mid-month discussion being on topics such as endourology or voiding dysfunction or female urology or any other area of interest. Do follow @iurojc and put forward your suggestions for papers to discuss. Again remember that the Twitter user name is slightly different to the hashtag, which is #urojc.

We look forward to having you join us for the next #urojc.

Henry Woo is an Associate Professor of Surgery at the Sydney Adventist Hospital Clinical School of the University of Sydney in Australia. He has been appointed as the inaugural BJUI CME Editor. He is currently the coordinator of the International Urology Journal Club on Twitter. Follow him on Twitter @DrHWoo

January #urojc paper will be on PHI by @LoebStacy jurology.com/article/S0022-… ncbi.nlm.nih.gov/pubmed/23206426

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