Healthcare is filled with observer effects.
Not the typical observer effects we presume to know – that by observing something we sway it – but the more abstract, quantum observer effects. Things like strangeness, in which things seem to be linked, but through bizarre, unexplainable relationships – something akin to the relationship between clinical research and social media.
Clinical research lives in the ivory towers of academic medicine, a world of sterile data rigorously analyzed and vetted for accuracy and repeatability. Social media lives in the messy world of our collective zeitgeist, changing and reacting to our ever fluctuating emotions.
At first blush, the two could not be farther apart. But in our pandemic crazed world, healthcare has become inextricably linked to all facets of life, which means clinical research and social media have been linked more than ever before.
This should come as no surprise to anyone who has been paying attention during the pandemic. But for most of us, it seems the two are only related superficially. Whenever misinformation appears on social media, clinical research studies or cited excerpts would be used to refute the misinformation or to counter it with additional information verified through other clinical studies.
In other words, the relationship is seen to be tangential at best, with social media serving as a mere platform to disseminate information from clinical studies. But like most things in the quantum world, the reality is more complex and bizarre.
Social media is far more than a conduit of healthcare information. It influences as much as it disseminates. The most glaring example of late comes from social media’s ability to affect the fluency of clinical information. Early in the pandemic, the clinical world went into overdrive, researching anything and everything related to COVID-19, from the benefits of masks to repurposing therapeutic drugs.
The rise in fluency came with a commensurate rise in pre-publications, clinical studies with data not yet verified through traditional peer reviewed sources. Yet despite the lack of verification, the studies went viral, spreading over social media.
In that moment, twitter became a clinical journal, publishing clinical studies with a rapidity never seen before. But rather than disregarding the data from such studies, we used them to enact policy and derive public opinion on all things pandemic.
This is why the public remains confused about masks. Numerous studies were released through social media early in the pandemic that had conflicting information about the benefits of masks. The information published on social media did more to influence public opinion than even the largest observational studies on mask wearing and COVID-19 transmission ever could.
For the public, the fluency of information trumps the accuracy of data.
But social media does more than influence public perception on the outcomes of clinical studies. It also influences clinical study designs. And this is where things get truly bizarre.
Much has been made about misinformation on the internet, particularly on high volume social media platforms like Facebook and Twitter. To gauge the effects of misinformation, studies were designed to examine how people use social media, a clear example in which social media determines clinical research.
But social media’s influence on clinical research is not just limited to analyzing patient behavior online. It is far more pervasive and influential in the everyday lives of physicians. The social media site QuantiaMD found that more than 90% of physicians use social media for personal activities and 65% use it for professional reasons. And even among the least active physicians, nearly 33% have reported participating in some social networks online.
Social media is fully ingrained into the lives of physicians, personally and professionally, a shift that took only a few years to materialize. But one that has dramatically altered basic communication for all things related to healthcare. And how physicians conceptualize healthcare online impacts how they look at patient care, including the clinical research of patient care.
Most clinical studies, even those robustly designed, have varying outcomes that serve as endpoints for clinical studies, which are chosen by physicians conducting the research. But what few realize is that these outcomes change routinely, even over the course of the studies themselves. And as our experience with healthcare changes, to be more technology driven and influenced by social media, the outcome endpoints for study designs will change as well.
This is inevitable, as we study what we experience. And when what we experience changes, so does what we study.
This is why a rise in misinformation on social media can lead to a rise in clinical studies that fact check misinformation – and a rise in poorly validated studies that contribute to the misinformation.
This is why the conversation around healthcare issues on social media influences clinical research, just as clinical research influences what is discussed on social media.
The medium is the message, no doubt. But the message also determines the medium, particularly when the message conveys healthcare information disseminated through rapid medium channels.
We are only now beginning to understand the bizarre symbiotic relationship between clinical research and social media. But from what we can already glean, the relationship is far more complex than cause and effect, reaction and counteraction.
It is a complex interdependence, in which complementary and reactionary forces emerge in near spontaneous unison, like a quantum particle collision, with medical information disseminating while changing in unforeseen, bizarre ways.
Soon, we just might have clinical studies that are peered reviewed by social media.
Per capita national health expenditures from 1960-2020
The data categorizes expenditures as national health expenditures, health consumption costs, personal health costs, administrative costs, and public health activities cost.
Source: Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group; U.S. Department of Commerce, Bureau of Economic Analysis; and U.S. Bureau of the Census.