Social media has transformed medicine allowing physicians to connect with their colleagues, share medical knowledge, and promote academic publications [1]. Physicians can also connect with patients, disseminating pertinent medical knowledge [2]. Because of the accessibility of social media and the large number of users posting information, it is important to identify reliable individuals for patients and physicians to follow.

This study identifies the top medical journals, organizations, and physician influencers in ob/gyn and related subspecialties on Twitter. We compared rank with journal impact factor and physician h-index. The purpose of this study is to identify reliable and active ob/gyn influencers. This study will allow physicians and patients to identify key individuals to follow in ob/gyn and have confidence they are reading reliable information.

We modeled our methods on a previous study by Riccio et. al [3], utilizing the Right Relevance API (rightrelevance.com, San Francisco, CA, United States) to collect Twitter influencer scores on June 28, 2022. Right Relevance API assesses Twitter users' followers/followings and engagement (views, likes, retweets) to provide a numerical rank of influence. It uses graph partitioning to determine influence scores for topic searches [4]. We searched "obgyn" and abstracted the top 10 medical journals, top 10 organizations, and top 100 physician influencers.

The following specialties were included: female pelvic medicine and reconstructive surgery, gynecology oncology, maternal–fetal medicine, reproductive endocrinology, complex family planning, minimally invasive gynecologic surgery, pediatric & adolescent gynecology, and urogynecology. These specialties were included based on their recognition by the American Board of Obstetrics & Gynecology.

After identifying the top 10 medical journals, we obtained their Journal Impact Factor as reported by the journal. After identifying the top 100 physician influencers, we obtained their academic h-index scores from Google Scholar and SCOPUS. Google scholar was searched first and if the physician did not have a Google Scholar page, we searched SCOPUS after. Practice location was found as reported by the physician on Twitter or by their board certification. Board certification was confirmed for United States based physicians using certificationmatters.org [5]. Two independent reviewers abstracted the table data (LJD & DVV). All data entries were then checked by the first author (SG), who ensured accuracy and resolved any discrepancies. Descriptive statistics were performed and reported. The coefficient of determination (r2) was calculated between (1) journal impact factor and twitter influence rank and (2) physician h-index and twitter influence rank.

The top 10 ob/gyn medical journals are shown in Table 1. The average impact factor of the top 10 ob/gyn medical journals was 5.0, with a median of 5.5. The coefficient of determination (r2) between impact factor and twitter influence rank was 0.0379 (Fig. 1). The top 10 ob/gyn medical organizations are shown in Table 2.

Table 1 Top 10 ob/gyn medical journals
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Fig. 1
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Correlation between Twitter influence rank and journal impact factor

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Table 2 Top 10 ob/gyn organizations
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Of the top 100 physician influencers, 47% are general ob/gyn physicians, followed by the subspecialties: 11% specialize in maternal–fetal medicine, 9% minimally invasive gynecologic surgery, 6% reproductive endocrinology and infertility, 3% gynecologic oncology, 3% female pelvic medicine and reconstructive surgery, 3% urogynecology, 2% pediatric and adolescent gynecology, 1% family planning and 1% reproductive genetics (Table 3). Of the top 100 physicians, 14% were in non-ob/gyn specialties, including family medicine, pediatrics, emergency medicine, psychiatry, hematology and oncology, internal medicine, and pulmonology/critical care (Fig. 2).

Table 3 Top 100 ob/gyn physician influencers
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Fig. 2
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Specialties of the Top 100 Twitter Influencers in ob/gyn

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The majority of physician influencers worked in the U.S. (91%), and specifically, California (15%), followed by New York and Texas (11%) (Fig. 3). The average h-index of the top 100 physician influencers was 13.6, with a median of 8.5. The coefficient of determination (r2) between h-index and twitter influence rank was 0.0092. All U.S. physicians were board certified (Fig. 4).

Fig. 3
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Locations of the Top 100 Twitter Influencers in Ob/Gyn

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Fig. 4
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Correlation between Twitter influence rank and h-index

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This study found that of the top ob/gyn medical journals, 80% were ob/gyn or women's health focused, while 20% were education focused. We found a positive correlation between journal Twitter influence rank and journal impact factor. This can be due to higher ranked journals tweeting more frequently about newly accepted articles to increase journal readership.

The majority of influencers were general ob/gyn physicians. The top ob/gyn subspecialties included 9 different specialties, and 7 non-ob/gyn specialties. The majority of influencers were from the United States, and specifically California, New York, and Texas. There was an inverse correlation with Twitter influence rank and influencer academic h-index, where people ranked lower in Twitter influence actually had a higher h-index. This may indicate that Twitter influence rank is not a valid predictor of academic productivity as measured by h-index. This may change with time as more physicians continue to turn to Twitter to promote their academic papers, and as newer generations of physicians who grew up with social media rely more heavily on it. Additionally, h-index alone, does not encompass all forms of academic productivity, including teaching positions (e.g., assistant, associate, and professor of medicine), leadership roles (e.g., clerkship directors, research chairs, deans of medical schools), and advocacy.

Physicians use social media for a variety of reasons, including advancing medical research, advancing clinical practice, communicating with other physicians, and providing health information for patients [6]. Health misinformation spread on Twitter can lead to delays or prevention of necessary care, or even threaten patient lives [7].

The importance of providing patients with reliable information is highlighted by the influx of abortion-related information following the Supreme Court decision in Dobbs v. Jackson Women's Health Organization. Widespread confusion surrounding new anti-abortion laws resulted in the dispersal of misinformation regarding how herbs or toxins could be used to perform abortions at home [8]. Physicians expressed concerns that online misinformation may cause patients seeking an abortion to try unsafe methods[7]. Patients need to be able to identify legitimate leaders in ob/gyn to receive reliable information on safe abortion practices.

Twitter has become increasingly popular in the medical community to facilitate connections, communication, and academic promotion. During unprecedented times such as the COVID-19 pandemic, and the post-Dobbs legal climate, more people turn to Twitter for information. Knowing legitimate influencers in ob/gyn permits Twitter users to follow reliable accounts. With the increasing reliance on Twitter by both physicians and patients, medical professionals should embrace Twitter, abide by ethical guidelines, and only promote reliable information.