Rise of the Tweetorial

One of the interesting developments in MedTwitter has been the chained tweet to demonstrate a point. I think the master of this is Professor Darrel Francis.

This one is nicely relevant to this week’s NephJC:

Renal denervation has now been shown to reduce BP by 4 to 7 mmHg against placebo procedure, in two recent trials.

What is your reaction?

— Prof Darrel Francis ☺ Mk CardioFellows Great Again (@ProfDFrancis) June 28, 2018

Another famous innovator of the Medical Tweetorial is Vinay Prasad. Vinay smartly collects the first tweet to his Tweetorials in a pinned tweet.

https://twitter.com/vinayprasadmd/status/1007337958846783488?s=21

Another master of the Tweetorial is Tony Breu. He, similarly, collected his Tweetorials in one place.

Here's a running list of #meded threads. Or, as @DrKerbel calls them, #Twearls

— Tony Breu (@tony_breu) June 16, 2018

This one has relevance to nephrology. Brilliant explanation.

1/
Why does normal saline (NS) contain 154 mEq of sodium per liter if a normal serum sodium is ~140 mEq/L?

This has bugged me for YEARS.

I’ll do my best to explain a potential reason below. As always, I’d love to hear from others, either confirming or refuting what follows…

— Tony Breu (@tony_breu) June 25, 2018

Speaking of relevance to nephrology, Swapnil has thrown his hat in the Tweetorial ring

Saturday morning diastolic BP thread as I wait & get tires changed to enjoy such moments 1/ pic.twitter.com/6nDfMvefSs

— Swapnil Hiremath @hswapnil@bsky.social (@hswapnil) November 25, 2017

Paul Sufka has joined the party focusing with a focus on rheumatology:

Going to play around with threaded tweets and make a tweetatorial (?) on positive ANAs in rheumatology. I'm sure I'll miss important points, but this is supported to be a discussion, so feel free to reply and fill what I've missed. 1/

— Paul Sufka, MD (@psufka) June 24, 2018

Here is Bryan Vartebedian’s take on this development. His problems with the rise of the tweetorial can be summed as:

• Poor indexing and search means these tweetorials will not be able to be found later.
• Using 280 character tweets to convey 500-word ideas is a mismatch between the medium and message. These ideas would be better conveyed in a blog post rather than chopped up into beads of text to be strung together.
• MedTwitter is a just a small sliver of the medical community and doing tweetorials traps the ideas in this small box.

In his conclusion, Vartabedian hedges a bit, but it is clear he believes in the blog:

I firmly believe that all of us should be poking at these applications to discover their most creative uses. But what any of us think is less relevant than what sticks with the public community of physicians. The market will bear this one out.

I love Sufka’s lessons on ANA. Prasay’s thread is a bold call to action that challenges the medical industrial publishing complex. It’s an important reminder that we are the publishers and no longer live in a permission-based system of launching ideas to the world.

We just need to remember that there’s a big medical world and a whole lot of eyeballs beyond our Twitter space. Let’s put our brilliance in the right place.