A Decade of Social Media Influence on Foot and Ankle Literature
Authors: Parrish James M. , Kaplan Jonathan R. , Aiyer Amiethab A. 
Published: November 2020

Category: Ankle; Ankle Arthritis; Arthroscopy; Basic Sciences/Biologics; Bunion; Diabetes; Hindfoot; Lesser Toes; Midfoot/Forefoot; Sports; Trauma; Other Introduction/Purpose: The topics, articles and discussions that arise within Foot and Ankle Orthopaedic literature are increasingly determined by their presence on social media outlets. The influence of social media mentions on Foot and Ankle Orthopaedic literature has not yet been investigated. The primary purpose of this study is to identify the social media outlets that were most associated with the Altmetric attention score (AAS). The secondary aim is to characterize the top 100 most highly cited articles within Foot and Ankle literature with the top 100 scoring Altmetric articles. Methods: We conducted a query of the Altmetric database for all journal titles containing the words ‘Foot’ and ‘Ankle.’ In accordance with other investigations, articles were only included after 2010, since this was beginning of academic social media participation. We assessed the frequency and percent of articles by journal, collecting variables including impact factor, AAS, along with average mentions within news, blogs, policy, patents, Twitter, peer review, Weibo, Facebook, Wikipedia, Google+, LinkedIn, Reddit, Pinterest, F1000, Q&A, online video, Syllabi, and traditional metrics such as number of Mendeley readers and citations (Table 1). We used a Spearman, semi-partial, and partial correlation test to detect the association between AAS and media outlet mentions, Mendeley readers or Dimensions citations. Finally, we ranked one article list with the 100 most popular articles on social media and one with the 100 most cited articles. Articles were examined for overlap, topic, article type, and level of evidence. Results: Our search returned 4,365 articles. Foot and Ankle International had the highest frequency of articles, though the Journal of Foot and Ankle Research had the highest AAS (Table 1). News and Twitter mentions had the greatest association with AAS. The top study designs for the AAS articles were prospective (n=35), retrospective (n=25), and systematic reviews (n=17), compared to the most highly cited articles which had retrospective (n=32), review (n=31), and observational studies (n=26) (p<0.001). When examining the top 100 highest AAS scoring articles with the 100 most cited, there was only one article in both groups. Compared to the most highly cited articles, the highest ranked AAS articles had a better average level of evidence (Cited: 3.4 vs. AAS: 2.9, p=0.001). Conclusion: Twitter and mentions within news are the most correlated with AAS. Although traditional metrics for article influence often reference an article’s citation count, attaining social media relevance is becoming more important than before. There is currently very little overlap among the most highly cited and the most mentioned articles on social media. Future research is needed to address whether citation counts or social media presence have more influence on actual clinical practice. [Table: see text]