Abstract
I am the first to admit to being a reluctant user of social media. I would be perfectly happy if my name were to return no hits in a Google search, and am in no hurry to be easily identified by any patient who might choose to hunt me down online. Many clinicians are similarly cautious, but I do wonder if we have been slow to recognise the potential educational benefits of the use of mobile technology and social media in a small medical specialty such as Obstetric Medicine. The use of Twitter and other social media fora are now ubiquitous, and for many clinicians and patients, indispensable.
Why is this issue particularly relevant to Obstetric Medicine? First, accurate information about medical problems or prescribing in pregnancy is particularly challenging to locate online. The advice found is often too generic to be helpful, and lacks relevance in the real-world setting where an individual patient with a complex problem depends on a particular medication or medications to remain well. Many of us will be able to recall a patient encounter where we have had to take time to counsel a woman against following potentially hazardous recommendations derived from a web search and period of browsing online.
Recently I was contacted by a patient whose child had developed a rare condition in the months following birth. She had found information from a single website linking this condition to a medication essential for her health that she had been taking throughout pregnancy. The incidence of the condition in offspring of mothers taking the medication was, in fact, identical to the background incidence determined from well-conducted population-based studies – reassuring data. However, because of the unbalanced and alarmist manner in which the information was presented, it is going to be challenging, if not impossible, to undo the damage that this one website has done. Should this woman become pregnant again she might opt to stop this crucial drug in this misguided belief she is protecting her unborn child, despite the fact that inadequate treatment of her medical condition is a grave risk to both her and the fetus. It is therefore essential for we us as Obstetric Physicians to maximise the availability of accurate resources in a publically accessible domain.
Secondly, there are potentially great benefits to low- and middle-income countries as social media overcomes physical borders, particularly when the information referenced is freely accessible. For this reason, open access to Obstetric Medicine via PubMed Central is particularly welcome.
Thirdly, engaging with social media fora such as Twitter can be a relatively passive process requiring minimal effort from the user. After the initial subscription or follow request, little effort is required, and the information is presented in a constant stream to which the user has continuous access, irrespective of location or time of day. There are risks with this approach, though. Setting up an educational Facebook group a few years ago, my intention was to keep an interested group up to date with relevant educational Obstetric Medicine events and articles. When other things got in the way and my input dwindled, the group was not of much use to the members any longer, as it had never become a forum for discussion with active contributors, but simply a means for people to be passive observers and receive information.
The same caveats apply to social media use as to other internet sites. The information provided is reliant on the contributor, and may well be influenced by the personal experience of that individual. Twitter may have an advantage over other social media fora in that the reliability of the source of the information provided may, to an extent, be judged. This is in stark contrast to internet fora where many individuals comment on the original post, but it is almost impossible to assess the reliability and qualifications of each person commenting. They may well be a leader in their field, but are just as likely to be an individual with limited or no medical qualifications, who has instead simply Googled the condition themselves, or who alternatively has personal experience and an agenda of their own.
What is our role in all this? Well, each of us has a small but important part to play in facilitating education and circulation of resources, and tweeting and retweeting are going to be increasingly important in the next few years. The articles in this issue of Obstetric Medicine are fascinating, and include analysis of important aspects of care of common conditions (gestational diabetes mellitus and how to diagnose impaired glucose tolerance after pregnancy) as well as that of uncommon diseases such as Pompe disease. Without mechanisms to circulate the valuable information obtained in these works more widely, they remain useful only to a small number of interested and motivated individuals. Judicious use of social media can aid dissemination and should ultimately facilitate education of a wider audience. I hope you will join me in maximising the potential of use of these social media resources. Why not tweet about your favourite article from this issue using @OBMedicine?