Social Media: Falsehoods

I was alarmed to read about falsehoods about health spreading through WhatsApp. It is a Facebook-owned application which has millions of users worldwide. It is impossible to get the actual numbers but suffice to say that it is prevalent in emerging economies.

The alarm went off with an excellent article from The Wired which has chronicled the rise in Yellow Fever epidemic in Brazil and the falsehoods surrounding the vaccination. I reproduce some essential bits here.

In recent weeks, rumours of fatal vaccine reactions, mercury preservatives, and government conspiracies have surfaced with alarming speed on the Facebook-owned encrypted messaging service, which is used by 120 million of Brazil’s roughly 200 million residents. The platform has long incubated and proliferated fake news, in Brazil in particular.

The phenomenon of fake news isn’t peculiar to Brazil, but these spread rapidly through the social networks.

“These videos are very sophisticated, with good editing, testimonials from experts, and personal experiences,” Sacramento says. It’s the same journalistic format people see on TV, so it bears the shape of truth. And when people share these videos or news stories within their social networks as personal messages, it changes the calculus of trust.

If you wish to have a scientific basis to why this happens, Science published a great resource.

We classified news as true or false using information from six independent fact-checking organisations that exhibited 95 to 98% agreement on the classifications. Falsehood diffused significantly farther, faster, deeper, and more broadly than the truth in all categories of information, and the effects were more pronounced for false political news than for false news about terrorism, natural disasters, science, urban legends, or financial information. We found that false news was more novel than true news, which suggests that people were more likely to share novel information.

This is an example of a rumour cascade:

The purpose of this post is that physicians should step up their game and have an active social media presence. A lot of sane voices will go a long way to dispel myths and fears about public health initiatives.

That is the reason why I set up Telegram channel to have physician vetted information and a one-stop solution for brain tumour affected patients. We owe people more!

Twitter for oncologists: Beyond 280 characters

I had my disdain for social media. It had been in the news for all wrong reasons. This post isn’t going to add to a growing and mounting evidence that social media is practically useless for politics because it amplifies our echo chambers and fuelling our confirmation biases. In the past few months, I have learned enough to hand hold a few tech-phobic colleagues and discover the positive side instead.

The hashtag: Twitter revolves around hash-tags. This is akin to a large room where people are discussing a topic; they come, and they leave the room. By having an open door policy, anyone can join in the conversation. It is like a large town-hall. Twitter usually lists trending hash-tags, but there are numerous third-party services which reveal global hashtags; not large enough to trend but essential nevertheless.

For example, #btsm is the hashtag for brain tumours social media. Often, patient advocates invite many thought leaders to debate and discuss on brain tumours. Anyone can use the hashtag to follow the process.

You guessed it right. The signal to noise ratio is very low, which makes it difficult to follow the conversation, meaningfully.

Username by @: They enduring symbol “@“ when prepended in front of a username, alerts the person (via notification) that he/she has been called out in the noisy room. You can either use the hashtag in the conversation (when the chats are being conducted) or individually if you wish to draw someone’s attention to their Twitter stream.

Twitter stream: Algorithms usually determine the endless “tweets” you see. Therefore, when you start out, with an empty slate, the number of tweets tend to be overwhelming as you start following various users. It happens because, Twitter, as a service, uses, the number of signals (your community engagement or number of re-tweets etc.) to determine what you are going to see there. The idea is to stay focused on what your goals are.

Direct Message: This works like an inbox system; you can restrict the users who can reach out to you.

It can quickly get overwhelming on this service. You will have to make several modifications to the way you are notified- via email, desktop or mobile clients. I prefer to get a notification only on a direct message from people who follow me. For everything else, it is switched off.

I prefer and recommend a desktop application (TweetBot for Mac). But you are forewarned. The developers do not bother to reply to your queries, and it lacks several customisation features. It gets the job done because I can filter out the advertisements on the web service. I also prefer to have a Tweetmarker service to go through the unread tweets. You can also turn off retweets from specific followers or mute them indefinitely.

Should you use Twitter or Facebook? In my opinion, both are bad. Even though the masses are there, but it represents too much of concentration of “power” in the hands of an algorithm. That’s why I prefer, the simple and straightforward Telegram. Groups work precisely that ways- you can quickly set up hashtags to organise the chats. Not many people follow this. Channels work exactly like a public broadcast. You can always set up links to discuss issues in the groups. As usual, there is a going to be a vast majority of people who will not speak up.

Closing thoughts: Twitter represents a dominant social media with numerous warts. I call it robust, only because of the sheer number of users, who have flocked to this medium. Most users are technology agnostic. People usually go by word of mouth recommendation or something which they have heard is “popular”.

It is time to take the leap of faith and contribute to the positive side of social media. As well as, try out something different and better! (Hint: Telegram)

How Twitter enriched me professionally as a radiation oncologist

I am a recent convert to Twitter but have flirted with it in its earlier days of inception when 140 characters were the norm. It wasn’t apparent as to why this service came into existence in the first place. Facebook started off with a similar pretence of “connecting dorm mates”, and it grew viral pretty fast from an invite-only platform to connect a majority of the online population.

I will not go in its politics or how toxic it has become. Its algorithms are an opaque science, and Facebook is a platform for social and psychological manipulation (despite public claims to the contrary). For this write-up, I’ll focus only on Twitter since I am engaging with it on a daily basis.

Twitter offers a place for discussion, sharing links, some media (pictures) and a medium to reach out to other users for marketing. Advertisers see some value in it (because Twitter offers granular options for targeting users). Beyond that, most scientists and doctors have discovered this as a platform to articulate their viewpoints. There’s life beyond academia as well, and most events affect us collectively. However, it blurs lines between personal and professional lives, often. This has prompted several professional organisations coming in with their “recommendations”, but social media is like any other platform which is public.

There is no inherent privacy if you get online. Period. Likewise, all this serves as a construct to showcase or to interact (like presenting a paper in conference or hanging out with colleagues post lunch). This also leads to a considerable scope for confusion because of the inherent limitation of characters. Like any written word, it cannot offer tone, tenor and contextual meanings which leaves things open to interpretation. However, Twitter provides only a limited scope of interaction via “re-tweet” or “like” which signals the intent. Beyond this engagement, it is a very limited platform.

With these caveats, Twitter offers a rich experience in professional interaction. I chanced on pathology colleagues, for example, who could reach out others in the world for a rapid “second opinion”. Pathological inferences usually require objective criteria, and it is not possible to be swayed by “wisdom of the crowd”. It makes it easier to nail the diagnosis for anything that’s obscure. Likewise, I interacted with a radiation oncologist, who advocated “shining the light in the basement”- exhorting fellow oncologists to embrace this medium. Another instance wherein I interacted with someone from the US to discuss the QA for a newer gamma knife machine. The follow-up comments were interesting, and I learned a lot in the process.

Similarly, it was fun to interact with professionals from down under! They are using social media in a very positive way (by dancing!) to target cancer and bring about an attitudinal change for radiation oncology (unstated and underused, like anywhere else in the world). I love their imaginative use of “targeting cancer” pin-ups with the backdrop of landmarks. Cats and dogs are also a part of it, for good measure! The idea is to get the word out to patients, who shouldn’t ever feel that they are alone. We are all a part of the team to take care of them.

These advocacy efforts on behalf of professionals are in addition to a lot of other patient advocates- one who has gone through the trauma of diagnosis and treatment and have lived to tell their stories.It is instructive for us to learn, as doctors, to understand and be empathic to their fears, concerns and how cancer diagnosis fundamentally changes their lives. A prominent patient advocate, for example, even suggested having “lego based models” to show what patients would be going through (radiation therapy mockups). A brilliant idea indeed!

Scientists have also joined in this chorus and have added their might to it. I follow their efforts to bring science to the public domain, how they navigate through government bureaucracy and how translational science can become the cornerstone of “cure”.

So yes, there are multiple positive attributes to being here on social media! For those who are starting out, a quick re-cap. You can follow specific “hashtags” like #btsm (brain tumour social media) or #radonc which are widely used around. Topical conversation happens around these hashtags. If you suffix the character “@“ before anyone’s username, it is like a “shout-out” to draw their attention. (Similar technique works in Telegram).

Join in here for the conversation and enjoy! Remember, you have only one life to make a difference!