Harnessing the Hashtag: A Standard Approach to GI Dialogue on Social Media

Over the past several years, social media has changed how people communicate, allowing for rapid and broad transit of information so impactful as to cause political uprisings. Hashtags in social media are user-generated phrases preceded by the “#” symbol. Th ese hashtags serve as a built-in search function on social media platforms such as Twitter. Adoption of hashtags allows social media platforms to effi ciently aggregate dialogue within a specifi c subject domain, allowing users to contribute and view relevant content in one place. Although some hashtags have emerged as a label for certain events, other hashtags are deliberately created to collocate dialogue for specifi c subjects or conferences. Twitter is now a major hub for public discussion between patients, medical practitioners, professional organizations, and industry representatives. In one day alone, an estimated 500 million posts are made on Twitter. Social media in the general public has seen a marked increase in use across all age groups over the past decade, with many individuals using social media not only for personal use but also to access health-care knowledge. However, medical professionals and physicians in particular have been slow to adopt the medium, with nearly half of all gastroenterologists reporting never using any form of social media ( 1 ). In a survey of patients with infl ammatory bowel disease or chronic viral hepatitis, 84 and 73% of patients favored some form of interaction with health-care professionals on social media, respectively ( 2 ). Direct interaction with patients on social media understandably presents a set of privacy and accountability challenges, but indirect contact such as dissemination of medical information by professionals may serve to heighten awareness and augment medical understanding. Utilizing the hashtag as a method to better curate content online may allow lay audiences to better identify quality information. Members of the Urology ( 3 ), Radiology ( 4 ), and Oncology ( 5 ) specialties have devised “hashtag ontologies” that seek to unify all hashtags and organize discussion on specifi c medical topics. Th is approach allows patients and health-care professionals to discover relevant content easily, engage in ongoing dialogue, and develop research collaborations. Th us far, these hashtag ontologies have been hosted by Symplur.com, a social media analytic website and creators of the “healthcare hashtag project,” whose focus is tracking health-care hashtag activity on Twitter. Following the example of our Urology colleagues, we queried Twitter and Symplur to determine a relevant list of hashtags in use by the gastroenterology community. We then devised a list of standardized hashtags, organized by subspecialty. We requested review and endorsement of a consensus list of hashtags by key gastroenterology stakeholders, consisting of professional organizations and peer-reviewed journals. If broadly adopted, these hashtags may help drive dialogue among informed individuals and groups while fi ltering out “noise” posted by individuals not purposefully intending to join the scientifi c and clinical discussion. Ultimately, adopting a universal hashtag ontology will allow individuals to search for content or contribute to a conversation in a way that minimizes ineffi ciencies. Th e development of a hashtag ontology is not without its challenges. For example, it is diffi cult to select a comprehensive yet succinct list of hashtags for each condition. Because the social intent between patient and professional participants varies the adoption of existing hashtags in our ontology has the potential to create ‘noise’ if the hashtag is too commonplace while restricting conversation if too narrow. In addition, some hashtags such as #eosinophilicesophagitis are long and impact adoption given the 140-character limit for each Twitter post. However, replacing this hashtag with its associated acronym #EOE would introduce unrelated content that shares the letters of that acronym, therefore compromising the quality of search results. As previously noted by our Urology colleagues, another challenge in devising a list of hashtags is balancing the number of hashtags to cover the multitude of topics in gastroenterology. Given that most hashtags were organically generated and already in use, we queried Twitter to ensure that most hashtags included in the list were generally adopted by the community. An additional challenge was the presence of redundant hashtags for isolated conditions. Harnessing the Hashtag: A Standard Approach to GI Dialogue on Social Media