Section 1: Introduction: Why Twitter?

Mohamad Mohty:

Hi. Good morning. Good afternoon. Good evening, everybody. Wherever you are, welcome to this very special series of short Zoom conversations called VJSocial, designed to help the HemOnc professionals to leverage the power of social media channels in their professional lives. I’m Mohamad Mohty from the Sorbonne University in Saint-Antoine Hospital in Paris in France, and it is my great pleasure and honor to moderate this high-level educational activity with three esteemed colleagues, Dr. Sanam Loghavi from the US, Dr. Toby Eyre from the United Kingdom, and Dr. Amer Zeidan from the US.

Mohamad Mohty:

You probably know this is the second episode of this educational activity, and you may wish to catch up with the first session that was structured, organized, by Dr. Naveen Pemmaraju, Dr. Graham Collins, and Dr. Aaron Gerds. We tried to structure the discussion today, with my colleagues, around a few, I would say, keyword or chapters.

Mohamad Mohty:

A quick introduction about their experience in tweeting. How do they develop their content and engage at medical and scientific congresses? How to optimize engagement, and obviously, how to pick out the appropriate topic and what to do, but also what to avoid or what not to do?

Mohamad Mohty:

This is an educational activity. So, we do have Learning Objectives. And, I hope that once you have watched this broadcast, you will be able to learn and discuss about the different types of tweets and be able to identify the main components of engaging tweets, get an understanding on how much content one should be putting out versus liking, sharing retweeting, how to balance all of this. Learn about how you can engage on Twitter before, during, but also after a congress, between congresses, looking into publication, recognize how one can engage, authentically, whilst maintaining a very, very important professional attitude. And, of course, be aware of some of the topics that you may wish to avoid and stay away while on Twitter.

Mohamad Mohty:

So, with this background, I’d like to welcome my esteemed colleagues, and as it is the tradition, I would say ladies first. So, Sanam, if you allow me to call you by your first name, would you tell us a little bit about your Twitter journey? How and why did you go there? Share a little bit of anecdotes, experience, anything you’d like to share with us?

Sanam Loghavi:

Of course, yes. So, let me start by introducing myself. I’m Sanam Loghavi. I’m a hematopathologist and a molecular pathologist at MD Anderson in Houston, Texas. So, I’ve been active on Twitter, I believe, from sometime in 2019. I had an account before that, but I wasn’t really active much. I can tell you that I was very, very impressed by the power of Twitter, essentially because two people that were very active on Twitter helped us promote a conference on Twitter. And, they live tweeted during a local conference that we were holding at MD Anderson, and I just saw the power of it in front of my eyes. I saw that in a matter of a day, we had 3 million impressions for our conference. They created a hashtag for us, and we can go into that. And so, I became a believer from 2019.

Sanam Loghavi:

I think I’ve been very fortunate, just because of the essence of what my practice is, I’m a pathologist, and pathology is very conducive to social media because you can take beautiful pictures and put them on social media and people love pictures, right? Nobody has the attention span anymore to read a lot of text. People want to see pictures. So, I tend to use social media as an educational tool. Any interesting case that comes across my desk right now is going to get photographed and is going to be on Twitter. Because, I think it’s incredibly valuable to share those cases with people. We’re fortunate to be in positions to see a lot of cases and be able to share them.

Mohamad Mohty:

Wonderful. And, I can really certify that you usually share some very beautiful and lovely pictures. And, I really enjoy them. Toby, how is it on the other side of the Channel for me or the other side of the Atlantic for Sanam and Amer?

Toby Eyre:

Yeah. Thank you. So, I was peer pressured into Twitter by Graham Collins, actually, probably. He probably won’t thank me for saying this, though. A number of years ago.

Mohamad Mohty:

So, he was your guru.

Toby Eyre:

He was on Twitter a few years before I joined. I think he was on there since 2013, and I was slightly skeptical at the beginning, but I, like Sanam, really very quickly realized the potential of Twitter. I love the way you could engage with people who you either hadn’t met or had met at congress. But then, actually, enabled you to really engage with them throughout the calendar year. And actually, I found it really useful for networking, for contacting people, for just broadening out your network, really. I thought it’s hugely powerful and actually pretty unique in that regard.

Toby Eyre:

I really enjoy keeping up to date with new information on Twitter. I think, because there are lots of engaged professionals on there, actually, as soon as a drug is, for example, FDA approved, or there’s a new trial that’s just been published that’s highly impactful, perhaps, in your field, you’re there. Within 24 hours, you know about it. And, actually, what that does is it means you keep ahead of the game. You’re up with everything. That really helps, professionally, I find, certainly from a clinical aspect.

Toby Eyre:

Lots of very valuable aspects to Twitter in that regard. It’s also just a lot of fun, and you get to meet people through it and so forth, which is great.

Mohamad Mohty:

Wonderful. So, you became a believer very quickly. And, you’re enjoying it, definitely. So, Amer, of course you are an expert in MDS, but tell us about your expertise in Twitter and how did you get there.

Amer Zeidan:

Yeah. Thank you so much, Mohamad for having me. And, as you were saying, I never really think of myself as a digital media or social media or digital content expert. I actually joined Twitter quite late. I joined it to 2019. In 2019, actually, I started to hear more and, actually, when you submit to journals they start asking you about your Twitter handle and all of that, and it became apparent to me that somehow Twitter has become the science social media in contrast to other things like Facebook or Instagram, et cetera. So, this was when I signed up, initially. However, I did not use to log in much. And, my real engagement became actually after Corona hit, during that period.

Amer Zeidan:

I’m originally from Jordan. My entire family is there and this was a very difficult and isolating period, I think, for many of us, especially in different countries. And, my use of social media in general increased. After that I started engaging more on Twitter and looking more. So, I started to see more of the content that I thought was actually quite useful. I was able to connect with my colleagues who, many of them, I consider friends that I used to see regularly in meetings, but I could not anymore.

Amer Zeidan:

So. It was a good way to connect on what’s going on, aside from the scientific and medical aspects. And, I also started to connect with colleagues like Sanam, the first time we met was through Twitter. And so, it opened a lot of avenues that I wasn’t very aware of in the past. But, I think the good, overall, exceeds the bad in Twitter.

Mohamad Mohty:

Excellent. Thank you very much.

Section 2: Engaging on Twitter at conferences

Mohamad Mohty:

You mentioned the issue of topics. And that brings me to our next chapter in this discussion, which is about the content development. And for us in the medical community, and we may wish to focus this spot on engaging at medical and scientific congresses. And my questions, again, we’ll do this sort of roundtable debate I would say, would be about what are the different types of Tweets you currently do or could put out during meetings, congresses? How do you find or get most engagement? The main components of the perfect ideal Tweet, assuming it exists. I don’t know, you’re going to tell me. How do these components, this content help you to increase your engagement and is it going to be different from one congress to another? So maybe Sanam, you can start again, and we’ll do the same roundtable discussion.

Sanam Loghavi:

Sure, of course. So I think there’s two component to especially focusing on the meetings and congresses. One is being part of the audience. So you’re trying to follow the meeting and the highlights of the meeting. And I think the best way to do that is nowadays all the meetings have pre-registered hashtags, at least the large meetings that are associated with them. So essentially what you do is if you just search for that hashtag you get the most updated Tweets. And Twitter, they have very smart algorithms, they actually tailor what you see to things that you’ve engaged with and/or are interested in.

Sanam Loghavi:

So if I’m at ASH, I tend to see everything related to ASH on my Twitter. And so, being an audience, I think it’s very helpful to know the more you engage with that content, the more you’re going to see material from that content.

Sanam Loghavi:

I think in terms of a contributor or someone who Tweets, there’s a couple ways you can do this. You can either do live Tweeting when you’re at the sessions. You’re taking screenshots of people’s presentations. And usually, again, nowadays, most people actually consent to having their data on social media prior to the meeting, most presenters. And if they specifically don’t, they will tell you. And if someone’s presenting unpublished data, I think you need to be aware of that. And it’s just common courtesy that you don’t want to take pictures of anyone’s unpublished data, especially if it says unpublished data, and put it on Twitter, which is essentially just out in the public.

Sanam Loghavi:

But I think other than that, taking screenshots of presentations, again, from things that you think will be useful or beneficial for your audience and for your followers-

Mohamad Mohty:

Can I challenge you, Sanam, about this issue of unpublished data? I’m going to be the devil’s advocate here. Well, obviously it is written on the slide it is unpublished data, but it’s being presented publicly in front of a few hundred or thousands of people, even broadcasted. So why do you see this as an issue? I’m trying to be provocative.

Sanam Loghavi:

Of course, yes. I think it depends on the context. So if you’re at a meeting like ASH, I agree with you, that’s probably public data. But sometimes the meetings are not as large and not as public. Sometimes it’s only for a small invited group. You can still promote the content of that meeting on Twitter, but you want to be mindful of some of these intricacies.

Sanam Loghavi:

And then, the other one is essentially I find Twitter my kind of personal archive. I tend to Tweet things and tag them with hashtags, and then I can search for them later if I want to, and so can anybody else. So I think even if you’re not live Tweeting, if you find things interesting at meetings and you Tweet them and you tag them with the appropriate hashtags, you can later search for them and so can other people. And I think that’s a very useful way of summarizing the findings that your audience may be interested in.

Mohamad Mohty:

Toby, do you have the same experience or way of doing things?

Toby Eyre:

Yeah, I think Sanam’s brought up some really nice points. I think it’s quite an individual thing how you use Twitter at congresses. Some people like to engage with it constantly, in a way that you might… A bit like someone’s taking constant pictures at their child’s birthday. One of the risks is you can miss the event because you’re so obsessed with Tweeting. So I think there’s a bit of a balance to be struck.

Toby Eyre:

I quite like live Tweeting. I think there is a skill in it. I think you not only need to provide key data, but you need some sort of opinion to go with it. Certainly when you’re kind of in the clinical field. People don’t just necessarily want, “The response rate was X.” They want, “This means,” and your views, because that just automatically transforms something from an educational Tweet to something of potential interest. And I suppose changes the way people might view you as a Tweeter. So I think that’s one of the key things.

Toby Eyre:

But I honestly think when you’re at meetings, it can be really valuable to Tweet. Often people actually who aren’t at meetings rely on your information. I’ve had lots of people saying, “Oh, thanks.” A few weeks later, “Oh, thanks. I really followed your Tweets at ASH,” or whatever, which feels a bit surprising, that people are sort of relying on you when you’re at a meeting, but it does happen.

Toby Eyre:

I think it’s a bit of a personal thing really, actually, how you use Twitter at congresses. I kind of use it a moderate amount. I don’t want it to take over my meeting. But at the same time, it can be really useful and valuable to Tweet the key pieces of information at a meeting.

Sanam Loghavi:

I really like that. Let me just add something. I think Toby brings up a great point. Moderation is key. If you start putting out 100 Tweets per hour, people are going to mute you. So you don’t want to be muted. That’s also a key element to it as well.

Toby Eyre:

Yeah. You want your Tweets to be valuable but not excessive, right?

Sanam Loghavi:

Right.

Mohamad Mohty:

I think this is an important issue both of you are bringing and we’ll see Amer’s opinion about this, is to find the right balance. And I like this issue that if you are attending a meeting, well, you are supposed to follow. You are not a journalist exclusively focused on taking photos of the slides and sharing them. And we’ll talk about this, I think it’s part of how to optimize engagement and what to do and what not to do. Because obviously if you share the full presentation, actually, where is the added value? That’s in my opinion. Whereas if you share, just say, “Well, wow, the overall survival curve is amazing,” then probably it’s going to be a catchy message. That’s my understanding. Hopefully, I translated correctly what you said Toby.

Toby Eyre:

Yeah. I think you just need to be a bit selective and provide opinion as well as simply providing data because it enhances the engagement and gives you somewhat more credibility as a Tweeter if you’re actually providing some substance and some opinion. Because actually ultimately, people want a little bit of that. They want to understand sort of the views of what people think about the results, not simply the kind of raw data.

Mohamad Mohty:

Amer?

Amer Zeidan:

I think when you talk specifically about meetings, I agree with everything that was said. Two additional points.

Amer Zeidan:

One is, I think people go to meetings for different purposes. And I think in academia, as you advance in your career, one of the things that happen naturally is you actually spend less time in sessions and you are doing a lot of time basically in collaboration meetings or networking or other things. So many times you are actually missing a lot of the sessions that are part of the meeting. And I used to struggle with this. So after I go home, I start catching up on the major presentations that happened during the meeting outside of my main area.

Amer Zeidan:

Like for example, I would know everything about MDS, but I would not know what happened with CML or CLL or other things.

Amer Zeidan:

So I think Twitter, it became my go-to tool rather than the newspapers or the newsletters that they issue each morning. Now, you have something that that is live. People kind of put in the most important updates, but also they add the opinion component to it, beyond the presentation.

Amer Zeidan:

I think one area where I struggle with is sometimes people don’t share their opinions publicly, the same way they would share it in private. There could be other things that people are somewhat sensitive about, how the trial was designed, or how the data were presented, or things like that. So I think you still need to have that personal interaction regarding the data. But I do think it provides some important content.

Amer Zeidan:

And I have to say an additional bonus, whether in meetings or other settings, is sometimes you find data that somewhat aligns with something you are working on. And that has led to collaborations actually. I had several collaborations that actually started through Twitter. One of them is actually with Sanam… We Tweeted at one point about the difficulties that international medical graduates have when they come to the U.S. And that led to a paper that’s actually under review right now. So I think it definitely has led to productive work as well, aside from the Tweeting.

Section 3: Optimizing engagement on Twitter

Mohamad Mohty:

That brings me actually to our next topic. And we mentioned this in the introduction, because the power of Twitter that you can have in a meeting 500 people attending, but then your tweet can reach thousands of people. And this is about optimizing engagement. So optimizing engagement, I think there are rules. There are tricks. There are techniques, recipe. Is it about the hashtag you’re going to use in a given discussion? Is it about liking, sharing, retweeting, tagging someone? What are your personal, I would say, recommendations to our colleagues who are already there, or who would like to jump into this space. I personally call these personal guidelines my editorial policy. A journal has an editorial policy. And if you are sharing information, you should have a policy. So I have my policy on what to do, what not to do. But I would love to hear from you, Sanam, your view and how do you run, I would say. How do you optimize engagement and interactions on Twitter regarding your favorite topics, let’s say?

Sanam Loghavi:

Sure. So, I mean, I think it’s no secret that my favorite topic is #hemepath right? But I think… This is actually very complicated. In my opinion, and I think different people approach this differently, but I do believe that whether you like it or not, when you’re active in at least as a professional person on Twitter, you are creating a brand for yourself, right? So people judge you based on the content that you put out and it’s not necessarily in a bad way, but it’s just like being a pathologist consultant. You get judged based on your reports. Right? So I think your peers do judge you based on the content that you create and you put out on Twitter. I personally think there’s value to being authentic and not being just a person that puts out… I can just put out dry teaching material and I don’t think it will get as much engagement.

Sanam Loghavi:

So I try to have a little bit of a personal touch to it. I try to have a funny joke in there as well, but obviously one that’s professional. And then one of the things that I try aggressively to do is be very respectful of other people and just generally be kind right. If there’s something on Twitter that I see and I disagree with, if it’s in my area of expertise, I want to highlight it and I want to maybe contribute to knowledge, but I never want to be disrespectful of anybody else because I think we’re all professionals and we’re all trying to teach and learn. So I think those are important elements for me is first creating good content, that’s educational, again, maybe adding a little bit of a personal touch to it and being consistent, right. People tend to follow… I think the majority of the people that follow me are people that are interested in hematopathology. That’s the content that they want to see. Right? So I think it’s important to recognize your audience and know your audience as well.

Mohamad Mohty:

Well, I think I like this issue of personal touch. Let’s be in a meeting like ASH or EHA or whatever, EBMT, or any other meeting. Wouldn’t you be tempted by posting something between two sessions about the long queue during break to get a coffee.

Sanam Loghavi:

Of course I do. For instance, I had dinner with David Steensma at AACR and we had a bone marrow. I thought that would be a perfect topic to tweet about. I mean, I think it is good to once in a while put out something that’s purely for entertainment and people actually do enjoy that. And believe it or not, people actually tend to engage with that content more. They tend to like a picture of you more than they tend to like a picture of the bone marrow. But I think it’s important to… I try to do for every… I mean, not a number, but just to give you a sense, for every 10 purely educational tweets that I put out, maybe I’ll put out a picture that’s a… I like to cook and I cook Persian food, so I’ll put a picture of a Persian dish that I made. But again, that’s essentially just pure entertainment. So there is no educational value to that, but I think people enjoy it.

Mohamad Mohty:

Okay. So now I think that we’ll have to organize something around a Persian dinner or lunch, but.

Sanam Loghavi:

Let’s do it.

Mohamad Mohty:

It’s already on the cloud. Okay. Toby, how do you optimize engagement?

Toby Eyre:

Yeah, I mean, I really like all those points that were just made. I mean, I think absolutely there’s a tension between sort of how much personal stuff you put on Twitter versus professional. I think people want to see you as a human, rather than as a kind of Lymphoma machine or whatever your kind of interest is. I think when it comes to professional tweets, I tend to stay within my area of expertise because I think that’s helpful because if somebody does want to maybe engage with you about it or question you about it, you are at least within a realm where you kind of know what you are kind of broadly speaking, talking about. And I think that’s quite a valuable, important thing.

Toby Eyre:

Yeah. I occasionally like to put some personal things in there. People tend to like that more than they do some of my other tweets. Occasionally put a picture of my kids on Twitter, not very often, but they tend to get the most likes. But no, I’d really just kind of echo everything that was just said, getting that balance right about kind of the personal aspect of who you are, some of the things you might enjoy/like doing. Because people want to sort of engage with you on a personal level a little bit as well as all the kind of professional stuff as well. So yeah.

Mohamad Mohty:

Excellent. Well, Amer, thanks to your tweets, I managed to discover dozens of different types of breakfast from different countries across the globe. So because we mentioned the Persian food from Sanam. So what is your approach to optimizing engagement? Definitely breakfast looks like to be a highlight of your activities.

Amer Zeidan:

Yeah. So, and this is something I actually, I’ve given a lot of thought to because I think some people view Twitter as a completely kind of professional avenue where they only put things related to science. For me, I think and actually write that on the, what do you call it, the Twitter profile? I mean, I have two big hobbies, one of them is international cuisine and the second one is traveling. And actually during Corona, as I was saying, this is was the bulk of my engagement on Twitter during that period. I was missing traveling and trying international food a lot. So this is when I started kind of exploring that actually on Twitter. There is tons of kind of accounts that put some of the most amazing pictures and starting having ideas about where to travel and all of that.

Amer Zeidan:

So I certainly do a bit of that when I see a great picture. I think overall, I think it’s good to have some personal touch on your Twitter because again, I think, especially for people who don’t know you on a personal level. The other component I would add maybe particularly to me, probably also for Sanam is I actually started tweeting more in Arabic, which is my mother tongue, because actually I have a lot of people who follow me from Arab countries and Jordan and I’ve been able to connect actually on some social issues that are within Jordan that I think, I feel like sometimes I make a difference so I can deliver a message. So this has also become something that I do a little bit more in tweeting.

Mohamad Mohty:

Thank you for sharing this very specific aspect, which is about also tweeting in a different language with a special focus on a different target or different audience, which of course is definitely part of your policy.

Section 4: Using the ‘Like’ & ‘Retweet’ functions on Twitter

Mohamad Mohty:

I would like to ask all of you about your definition, or what would be your aim when you like a tweet of someone else or when you retweet something? Is it about to say, well, hi, this is my friend, and I always like whatever he or she would tweet? Or is it about because I really love the content? Do you retweet because you really share the idea, you believe in what is written in this article or in this opinion piece? Or you retweet actually just in a neutral manner to say, “Well, I believe this is an interesting information, I want to share it with my followers.”? What is your approach, Sanam, then Toby, and again, Amer?

Sanam Loghavi:

I’m a simple person. So when I like something, it’s actually because I genuinely like it. So that’s usually the reason that I like things. I think for retweeting, it’s a little bit different. There’s usually two scenarios in which I tend to retweet. One is when people, especially when trainees or your other colleagues, they specifically tag you on something it’s because they want you to retweet it. Right? So I try to retweet things that I get tagged on, to amplify if it’s a new paper that someone wrote. And it’s essentially everything that I try to retweet is either about pathology, heme, or heme pathology. And then there’s other tweets where you’re not directly tagged on, but you feel it’s either an important topic that you want amplified. Right? It’s a piece of new information about my area of practice or my area of expertise that I want other people to know about as well. And it’s, again, usually a new paper or a new finding and I tend to retweet those as well.

Mohamad Mohty:

Toby?

Toby Eyre:

Yeah, that’s very interesting. You’ve kind of asked us to analyze ourselves, which is a quite intriguing thing to do. I tend to do absolutely do that. So I will retweet if somebody’s mentioned me in a tweet. I will like things that I just like. But I’ll also like things as a way of demonstrating respect as well. So if somebody has published something highly impactful, or worked really hard on a project, I’ll like something because I respect that process as well, because everybody likes likes. Right? So I think that’s a good way of doing that.

Toby Eyre:

And I’ll also just finally, I’ll retweet something that I would’ve produced as a tweet myself if I’d got there sooner. So generally I will retweet somebody who’s written content about a particular new piece of work or whatever, and they’ve picked out the salient key points, and I’ve agreed with that, and I think it’s a useful tweet. Rather than sort of copying it two days later or whatever, I’ll generally retweet that because again, it’s a sign of respect, and a sign that you kind of agree with what’s been written a little bit. So those are my sort of main rules of thumb, I suppose.

Mohamad Mohty:

Okay. Thank you. Amer?

Amer Zeidan:

Yeah, I think I follow the same kind of, I guess, directions in retweeting. I think maybe two other points. One is I have certain teams that I tend to follow. One of them for example, is that I strongly believe that negative clinical trials in our field don’t get enough attention. And many times they get downgraded to journals with lower impact and all of that. So I think I see it as part of kind of social mission, I guess, is to publicize these, because I think there’s a lot of effort that goes into them, and a lot of information that you can learn from them. And along the same lines, investigator initiated trials, I also feel they don’t get enough attention. And especially for people outside the field. People within the field, they know the effort that goes into them, but people outside the field might not necessarily know the difference between a company trial versus an IIT. And so I think those aspects, I tend to kind of highlight, even if they are outside my area.

Amer Zeidan:

The second thing is in the disciplines outside of AML, MDS, where in all honesty, for example, I get most of my knowledge on Multiple Myeloma right now from Twitter. I don’t know much. I certainly don’t read Multiple Myeloma papers. So this is where I get a lot of the knowledge on it. And it’s actually, I’ve been always looking at how the discussions go there and I keep thinking how, for example, things are going to be for MDS, AML in the future, because there are many things to learn.

Mohamad Mohty:

Excellent, so that brings me to another question. And you mentioned this Sanam, this is about when to tag people. And how do you choose people that you tag in your tweet? So you mentioned, I think that if someone tags you, it means they want you to retweet it, to share it. I mean, what’s your view about tagging someone specifically in a tweet?

Sanam Loghavi:

Sure. So I mean, in my mind, there are multiple reasons to do that. One is that the author of the original tweet wants you to retweet them, or the people that get tagged. The other is if … So I personally try to be very, very selective in tagging people, just because I think if you get tagged on a lot of things, it can become annoying. Right? So I try to not do that. The only times I tag people on a tweet is if I’m tweeting about a paper. And so I tag the authors just as, as a mean of giving them credit, right. And if they choose to retweet it great, if they don’t want to retweet it, that’s perfectly fine too.

Sanam Loghavi:

But I think sometimes you will get tagged on things. People may want your opinion on a case. For us, it’s actually very common that someone will post a challenging case, pathology images of the case. And they’ll tag you and say, “What do you think this is?” And so sometimes people actually really want help with a case and they’ll tag you on it. And then other times it’s just to draw your attention so that you can see that right, if they think that this is something that might be of interest to you.

Mohamad Mohty:

Okay, wonderful. So Toby, if I tag you, what does that mean for you? Or if you tag me, what is your goal?

Toby Eyre:

Yeah. So when I get tagged or included within tweets, it generally is a clinical scenario about something. “So and so’s got a mediastinal mass. I don’t know how to manage it, @TobyEyre82 what shall I do?” I always find these things quite tricky to know actually how to engage with. You want to be helpful, but also Twitter isn’t a kind of MDT where you’ve got all the information you need to make clinical decisions. So I think there’s an element by which certainly as clinicians need to be a little bit cautious about how we go about that. But that’s often a way I’m tagged within tweets or within threads. I tend to do this a very similar thing about how I use, how I use tagging. It’s about giving people credit for their work. And so most often that’s co-authorship within a paper that’s been written, or a presentation they’ve given somewhere, or they’re involved in a teaching course or something. It could be multiple examples, but it’s generally about recognizing others. And that’s what I tend to do. And they’re the fairly basic principles I tend to stick with.

Mohamad Mohty:

I like this. And there is a keyword coming all the time, giving credit to the work of people. And this is very important. Amer what’s your tagging policy?

Amer Zeidan:

I certainly have been tagged. I guess generally people would tag me the same, like was said, to retweet their tweet, or many times actually to comment on a clinical case. And I have to say, I think there’s another layer of being cautious there, especially within the US in the kind of environment where you don’t want to be putting a medical opinion technically on a patient, certainly not in public, basically about a specific clinical case.

Amer Zeidan:

And I certainly think from a patient perspective, I see many doctors putting, “Oh, I had this case yesterday and this and that.” And I’m thinking if a patient kind of sees his case, although again, it doesn’t have the identifying information or anything, but I just wonder from a patient perspective, how do they think about that aspect. “Does my doctor know what he’s doing?” I just feel like sometimes you have to do it, not immediately when you are seeing someone. And you have to change the details of the case. You cannot put really the actual age or the actual gender. And so you have to give it more thought than kind of asking the whole word, what do I do with a certain case?

Mohamad Mohty:

Thank you very much.

Section 5: What is appropriate on Twitter?

Mohamad Mohty:

That brings me to the very important topic, which is about what to do and what not to do, what is appropriate to be done, this privacy and confidentiality issue, how to navigate through all of these, I would say, sensitive issues. Sanam, what is your to-do list, “I should do this. I should not do this?” Or, how do you navigate into these critical issues of privacy, confidentiality, avoiding disputes, endless Tweetings, replies, et cetera, et cetera.

Sanam Loghavi:

Sure.

Sanam Loghavi:

I think, to me, it’s actually pretty… A lot of it is just common sense. It’s pretty intuitive. Again, it goes back to the way… You have a brand, how do you want that brand to be perceived? I think for me, it’s important to be professional. I think I have a duty in that I represent my specialty in a way. I represent my profession. I represent my colleagues. So I try to be courteous. I’ve actually never had really negative experiences on Twitter. I try to be respectful of other people. And it’s usually reciprocal. Other people, even if they disagree with me, it’s usually in a respectful manner. If there’s something that is… My policy would tend to be that I just won’t engage with something that may be disrespectful. I don’t engage, and so it stops.

Sanam Loghavi:

I think the most important thing for us, especially because we post pictures a lot, as Amer was saying is, I try to be very mindful of not getting in trouble by identifying patient information or by revealing information that may identify the patients. One of the things that I don’t do… And again this is personal preference. I think people do it differently… I never trademark my pictures or slides. I think a lot of people do actually put their name on the pictures that they take. I don’t. I really don’t care if everybody takes the pictures, puts it in their presentation. They can do that, that’s fine for me. I mean, my mission is to educate. And so if you take it, put it in a presentation, that’s perfectly fine with me. And that’s essentially what I try to do. I try to make the post educational and try to stay out of trouble.

Mohamad Mohty:

Excellent. I like this because, of course, Twitter… And if we want to summarize some of the goals, at least for us in academia, it’s about disseminating knowledge and spreading, I would say, what we feel important to our colleagues, to patients, some advice, et cetera. And to advance in general the field.

Mohamad Mohty:

So Toby, what is your policy, let’s call it like this, on what to do and what to avoid? And were you ever stuck sometimes in a sensitive, I would say, issue and how did you avoid it or manage to get out of it?

Toby Eyre:

Yeah, great questions, aren’t they? I suppose, as I’ve mentioned before, I think you want to be in a position where you provide opinion because you provide something that’s interesting for people to hear and look at. And you have potentially a very, very large audience. When you look at some tweets that get retweeted a lot and so forth, you can reach many, many people. So you have to be sensitive to the type of people you reach and how they may view your work or your tweet, your opinion.

Toby Eyre:

And I suppose, three groups of individuals that I kind of broadly think about are your local and international colleagues. Patients, because there are many of those on Twitter. I know that I have lots of my own patients follow me on Twitter, which brings a interesting dynamic to making you think about how you tweet. And I think the other big group actually which just requires some careful thought is our industry colleagues are all on Twitter. And although often they’re not particularly vocal, they will watch a lot and will know exactly what’s going on. And so I suppose I think it’s useful to know that when you engage or provide opinion. And I agree a lot of what we should do is about crediting others. It’s about being respectful and acknowledging that these groups of people exist on Twitter.

Toby Eyre:

I suppose what do I kind of practically do and not do, I provide opinion. But I tend not to get involved in back and forths about why I provide that opinion, partly because it’s quite easy to get misconstrued. And you know what it’s like? We all occasionally have disagreements with our family because of a WhatsApp thread or something where there wasn’t really a disagreement in the first place. Amplify that on Twitter and show it to thousands of people, and that’s what can happen. So, I’m quite careful about how I go about engaging with back and forths. And I tend not to get engaged with that. I tend not to get too engaged with anything controversial, certainly not with patient related things. Again, not because I don’t want to help or whatever, but I just don’t think it’s an appropriate environment to do that.

Toby Eyre:

But I suppose the main thing I tend to avoid is a kind of back and forth about opinion, about a publication where there’s some controversy around endpoints, or toxicity, or whatever it might be, because I just don’t think it really enhances people’s general reputation when you have a big disagreement on Twitter and in front of many people.

Mohamad Mohty:

Thank you very much, Toby.

Mohamad Mohty:

Amer, are you aligned with Sanam’s and Toby’s opinion?

Amer Zeidan:

Yeah, I am I think for the most part. Although I have to say, again, I struggle with this issue, especially the last thing that Toby talked about. Because when I look at experts and colleagues on Twitter, I think there are people who generally do not comment on papers at all. And there are people who always praise papers that come out and don’t point out any obvious issues with those papers. So I think where you draw the line I think differs between different people. But at the end of the day, I think you always have to be very respectful. And I prefer for people to give their opinion rather than just kind of Retweet, or just be rosy about everything.

Toby Eyre:

Just to add to that point, one of the issues with Twitter is you get sort of more credit, more likes, more followers if you’re really quick with things. The problem with that is, of course, it doesn’t always result in a very considered thought process. So, the kind of clock starts the moment the JCO paper goes live. And then the person who tweets it first gets the most Retweets, and the most Likes, and all that kind of thing. But that’s not really conducive to critical thinking particularly. And so what I’ve tended to try and get into the habit with recently is just to give it a few days if there’s a controversial paper, and actually to do a little thread on some pros and cons of the paper. Because that way you’re not actually necessarily engaging in back and forth with people, but you’re maybe providing your own balance view after a few days.

Toby Eyre:

So I did that with a SHINE paper recently in the New England Journal and just did a kind of 12 thread thing because there were some pros and some cons of that data. And I thought that was something I might get into more, because it’s just a way of providing more detailed opinion. And many people do threads much better than me, but actually they could be really valuable when they’re done well.

Section 6: Conclusion: Wrap-up with top tips

Mohamad Mohty:

I think Amer and you, Toby, alluded to something which we are seeing more and more these days. There is a small group of colleagues, who are being extremely critical to any trial they can see coming there. So Sanam, what is your reaction when you start seeing this big aggressiveness against some trials, how do you handle this?

Sanam Loghavi:

Well, I’ll start with your second question, which is how do I handle it is I tend to not engage with those for the most part. And I have to tell you that I’m not a clinical trials expert. So for me it’s often actually not very easy. I don’t enroll patients in trials. I may be the pathologist for many of the trials, but I don’t actually deal with the hard part of conducting clinical trials, which is actually the consent, the enrollment. But again, I think it’s just like anything else in life. I think it’s always best to be respectful, right? It’s always best to be respectful of your colleagues. And I think if there are certain flaws to these clinical trials, I’m sure that the investigators are also aware of the flaws, but there’s, like you said, more often than not, there are reasons that the trials were conducted the way they were and there is no perfect clinical trial. So that’s my general take on it.

Mohamad Mohty:

No. Excellent. I like that. I can share with you my approach to this is whenever I have a serious question about something, before actually going to Twitter and Tweeting and commenting, I would simply send an email to my colleague. And most of the time actually, you get a reply and say, well we chose this control arm because that was designed in 2014 and in 2014, the FDA didn’t approve or this drug wasn’t approved by FDA. So we went to this, and we couldn’t change the control arm during the trial. Toby, how do you handle this issue?

Toby Eyre:

Yeah, I mean, I think it’s absolutely fascinating and there are opinions that are pretty polarized and actually seem to become more polarized on Twitter in the last kind of few months. It’s been interesting to watch. There are some points of relevance that are brought up. It’s just perhaps the manner in which that’s done is not necessarily to everybody’s taste, I suppose, as a community, we need to ask ourselves, well why is this phenomenon existing? What’s actually kind of going on here, which is kind of the interesting thing. And this is where we need to sort of understand the balance of kind of the pros and cons of kind of industry sponsored studies, particularly.

Mohamad Mohty:

Thank you very much. This is about those guys who find a problem to any solution. So what is your attitude to this Amer?

Sanam Loghavi:

It’s Einstein? I think.

Mohamad Mohty:

Okay, good. Thank you Sanam

Sanam Loghavi:

Avoid negative people because…

Mohamad Mohty:

Thank you Sanam for refreshing my Alzheimers.

Amer Zeidan:

Yeah. I mean, I think I view this from two points. I think the first point was more trying to understand the issues that are being brought up, especially if the trial, again, in a different context. So I think understanding the context is important, but I think the biggest challenge, or let me say the approach I took initially was along the lines of what Toby mentioned is to try to show from a clinical trialist, that clinical trials are the art of what is practical. Again, all of us can have the idea of what is the purest design for a clinical trial. But when you talk about trials happening in many different countries, with many different health systems, with hundreds or thousands of patients and a rapidly moving field, there are many different practical factors that you have to think about.

Amer Zeidan:

A lot of this discussion again, is happening in a fashion that many people don’t have the full context of what is being said. And the tone and what is being said sometimes is beyond the again, just pointing out deficiencies of the trials, but is going after … I think this is something that should not be thrown out lightly in a public media where many people could, again … they might need to go on a clinical trial. And if that’s their preconceived notion about how people are being enrolled, I think this could be damaging, especially with a bigger kind of echo and bigger number of people like seeing these type of discussions without having the right context and the right experience.

Mohamad Mohty:

Yeah. Wonderful. I can’t more agree. And I can assure you, at least, in my opinion, all our colleagues are really trying their best to help and to move forward our field. But obviously, as you nicely alluded to, life is not black and white, and it’s always, I think, in the gray zone and what’s true today may not be true tomorrow. And what’s valid in this place may not be valid in the other place. And there is always a big gap  between the ideal world and the world as it is. So guys, this has been a fascinating, exciting discussion. Thank you for taking part of it and dedicating some time. I have learned a lot from you. If I want to summarize this session and our discussion, my keyword is that Twitter and social media in general are here to stay, whether you like them or not. This is about sharing and disseminating knowledge.

Mohamad Mohty:

You may agree or disagree with the shared knowledge, but knowledge is knowledge. I heard a lot, the word, very important word of respect, respecting the people you are engaging with. I heard also about giving credit to those guys who are developing the content, and last but not least, definitely your advice guys apparently is to stay away from those aggressive, I would say, people and stay very professional. And again, because we all share at the end of the day, despite our different opinions, the same goal, which is, I think, in our field, at least, hematology, to improve the outcome of our patients. And this requires actually very good education and sharing of knowledge. So I hope you have enjoyed it. And I would like to thank VJHemOnc for putting this really lovely VJSocial Masterclass together. Thanks to all of you. And I hope you will join us for another exciting educational activity. For the time being, please stay safe and keep well, take care.

Toby Eyre

Toby Eyre, MBChB (Hons), DipMedEd, MRCP (UK), FRCPath (UK), MD, Oxford University Hospitals NHS Foundation Trust, Oxford, UK

Roche: Education Honorarium, Advisory Board Honorarium, Travel to scientific conferences
Gilead: Honorarium; Research support; Travel to scientific conferences
KITE: Education Honorarium, Advisory Board Honorarium,
Janssen: Honorarium
Abbvie: Honorarium; Travel to scientific conferences
AstraZeneca: Honorarium, Research funding, Travel to scientific conferences
Loxo Oncology: Advisory Board Honorarium, Trial steering committee
Beigene: Advisory Board Honorarium, Research funding
Incyte: Advisory Board Honorarium
Secura Bio: Advisory Board Honorarium

Amer Zeidan

Amer Zeidan, MBBS, Yale University and Yale Cancer Center, New Haven, CT

Celgene: Consultancy, Research funding, Honoraria, Clinical trial committees
BMS: Consultancy, Research funding, Honoraria, Clinical trial committees
Abbvie: Consultancy, Research funding, Honoraria, Clinical trial committees
Pfizer: Consultancy, Research funding, Honoraria, Travel support
Boehringer-Ingelheim: Consultancy, Research funding, Honoraria
Trovagene: Consultancy, Research funding, Honoraria
Cardiff Oncology: Consultancy, Research funding, Honoraria, Travel support
Incyte: Consultancy, Research funding, Honoraria
Takeda: Consultancy, Research funding, Honoraria
Novartis: Consultancy, Research funding, Honoraria, Clinical trial committees, Travel support
Aprea: Consultancy, Research funding, Honoraria
Amgen: Consultancy, Research funding, Honoraria
Otsuka: Consultancy, Research funding, Honoraria
Astex: Research funding
Medimmune: Research funding
AstraZeneca: Research funding
ADC Therapeutics: Research funding
Jazz: Consultancy, Honoraria
Agios: Consultancy, Honoraria
Acceleron: Consultancy, Honoraria
Astellas: Consultancy, Honoraria
Daiichi Sankyo: Consultancy, Honoraria
Cardinal Health: Consultancy, Honoraria
Taiho: Consultancy, Honoraria
Seattle Genetics: Consultancy, Honoraria
BeyondSpring: Consultancy, Honoraria
Gilead: Consultancy, Honoraria, Clinical trial committees
Kura: Consultancy, Honoraria, Clinical trial committees
Tyme: Consultancy, Honoraria
Janssen: Consultancy, Honoraria
Syndax: Consultancy, Honoraria
Geron: Consultancy, Honoraria, Clinical trial committees
Ionis: Consultancy, Honoraria
Epizyme: Consultancy, Honoraria