Cancer communication in the social media age: Could Twitter help clinical trial accrual?

194 Background: Twitter, a social networking site, is transforming communication. Effective use of Twitter might be one way to communicate with the public about cancer clinical trials and increase awareness and perhaps enrollment. We conducted a content analysis of tweets about lung cancer, describing dialogues specific to lung cancer clinical trials and seeing where embedded-links in tweets about therapeutic trials are leading the public. Methods: We used the Twitter search engine to identify a cohort of 26,059 tweets with the keyword “lung cancer” from January 5 - 21, 2015. Tweets were captured and prepared using Nvivo qualitative data analysis software. Duplicate and non-English tweets were excluded. Of the remaining 15,346 unique tweets, 1,516 (10%) were randomly selected for detailed content analysis (kappa = 0.71). Tweets related to clinical trials underwent further analysis to categorize the trial type and embedded-links. University of Pennsylvania IRB exempted this study from review. Results: Most, 83% (1,260/1,516) of tweets in our sample contained lung cancer-specific content and 17% (256/1,516) were categorized as miscellaneous (e.g., extraneous content, non-sequiturs). Table 1 shows the distribution of content categories of lung cancer related tweets by frequency. Most of the tweets focused on support or prevention. Among the lung cancer related tweets, 18% (221/1,260) related to clinical trials. Of clinical trial tweets, 83% (183/221) concerned therapeutic trials, 13% (28/221) non-therapeutic, and 4% (10/221) basic research. Among the therapeutic clinical trial tweets, 79% (144/183) concerned immunotherapy and 86% (158/183) had embedded-links directing users to news articles. Only 1 tweet linked to a patient recruitment website. Conclusions: A significant proportion of lung cancer tweets are about clinical trials, but virtually none direct patients to enrollment sites. Twitter is a new communication medium for the cancer community, and further research is needed to test its potential to promote clinical trial accrual. [Table: see text]