Nov 16, 2022

Public workspaceConflict of interest and funding in health communication on social media: a systematic review

DOI
dx.doi.org/10.17504/protocols.io.5jyl8jj4rg2w/v1
  • 1Faculty of Medicine, American University of Beirut, Beirut, Lebanon;
  • 2Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon;
  • 3LAU Gilbert and Rose-Marie Chaghoury School of Medicine, Lebanese American University, Byblos, Lebanon;
  • 4Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon;
  • 5Saab Medical Library, University Libraries, American University of Beirut, Beirut, Lebanon;
  • 6Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Canada;
  • 7Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
Vanessa Helou
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DOI: dx.doi.org/10.17504/protocols.io.5jyl8jj4rg2w/v1
Protocol Citation: Vanessa Helou, Fatima Mouzahem, Hussein A. Noureldine, Adham Makarem, Rayane Al Khoury, Dana Al Oweini, Razan Halak, Layal Hneiny, Joanne Khabsa, Elie A Akl 2022. Conflict of interest and funding in health communication on social media: a systematic review . protocols.io https://dx.doi.org/10.17504/protocols.io.5jyl8jj4rg2w/v1
License: This is an open access protocol distributed under the terms of the Creative Commons Attribution License,  which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Protocol status: Working
We use this protocol and it's working
Created: November 09, 2022
Last Modified: November 16, 2022
Protocol Integer ID: 72528
Keywords: funding, conflict of interests, social media, systematic review
Disclaimer
Ethics and dissemination
This review did not involve individuals’ private information or compromise their rights, and therefore does not require ethical approval. The results may be published in a peer-reviewed journal or disseminated at relevant conferences.

Conflict of interest
EAA and JK have conducted studies on the topics of conflicts of interest and funding.
Abstract
Objective: To synthesize the available evidence on the disclosure of conflicts of interests by individuals posting health messages on social media, and on the reporting of funding sources of studies cited in health messages on social media

Study design: systematic review

Data Sources: We developed a search strategy, using the help of a librarian, for MEDLINE, EMBASE and Google Scholar electronic databases from 2005 to present. The search combined various keywords and medical subject headings (MeSH) terms relevant to concepts of conflict of interest, funding, and social media. We did not restrict the search to specific languages. Teams of two reviewers will conduct the screening in duplicate and independently. We will also screen the reference lists of included studies as well as other relevant papers.

Data abstraction: The reviewers will abstract data from eligible studies in duplicate and independently. We will use a standardized and pilot-tested data abstraction form. We will abstract information on the general characteristics of included studies, characteristics of the social media examined, conflict of interest, and funding.

Quality assessment: A team of two reviewers will assess independently the risk of bias of included studies using the relevant part of the Mixed Methods Appraisal Tool.
Title: Conflict of interest and funding in health communication on social media: a systematic review
Title: Conflict of interest and funding in health communication on social media: a systematic review
Authors’ List:
Vanessa Helou
Fatima Mouzahem
Hussein Noureldine
Adham Makarem
Joanne Khabsa
Layal Hneiny
Rayane Al Khoury
Dana Al Oweini
Razan Hala
Elie A. Akl

Corresponding author: 
Elie A. Akl, MD, MPH, PhD
Department of Internal Medicine
American University of Beirut Medical Center
P.O. Box: 11-0236
Riad-El-Solh Beirut 1107 2020
Beirut – Lebanon
Phone: 00961 1 374374
ea32@aub.edu.lb


Keywords: conflict of interest, funding, social media, health, systematic review

Ethical approval: The study involves no human subjects and requires no ethical approval.
BACKGROUND
BACKGROUND
Social media has reshaped the dissemination of information and medical education. The patient-physician relationship has been transformed with the introduction of social media especially during the COVID-19 pandemic when quarantine and restrictions were applied. Many users rely on the internet to find answers to their medical questions. Health professionals can communicate and share their health-related opinions using posts, videos, or blogs.
Within recent years, the use of social media by physicians and health care professionals has increased significantly with some estimates reporting increases from 42% in 2010 to as high as 90% in 2011 [1]. While 90% of health care professionals use social media platforms for personal purposes, 65% use them for professional reasons such as promotion of health behaviors, discussions of health care policy, communicating with colleagues, and education of patients, peers, and students [2]. However, professionals may have conflicts of interest (COI) that may bias their shared health-related recommendations on their platforms [1].
STUDY OBJECTIVES
STUDY OBJECTIVES
The objective of this study is to synthesize the available evidence on the disclosure of conflicts of interests by individuals posting health messages on social media, and on the reporting of funding sources of studies cited in health messages on social media.
METHODS
METHODS
Design overview and definitions
We will conduct a systematic review to identify studies that addressed reporting of conflict of interest and funding in social media health communications. We will use the following definitions:
  • Conflict of interests: “a COI exists when a past, current, or expected interest creates a significant risk of inappropriately influencing an individual’s judgment, decision, or action when carrying out a specific duty” [3].
  • Declaration statement: any statement reporting a COI of a named individual, whether indicating the absence of COI or presence of a specific COI and describing it.
Eligibility criteria
We will include articles that meet the following eligibility criteria:
  • Topic: conflict of interest on social media or funding;
  • Type of social media: we will include all social media platforms that fit the Web 2.0 definition. This includes blogs, and social media applications such as Facebook, Instagram, Twitter, LinkedIn, and YouTube. We will exclude studies that involved traditional media channels (Web 1.0) such as newspapers, radio, TV, emails, and websites;
  • Field: health field, including clinical, health systems and policy, public health and biomedical sciences;
  • Study design: any primary study including surveys, research letters, and qualitative studies. We will exclude editorials, abstracts, letters to the editor, reviews and opinion pieces;
  • Date of publication: 2005 to current, with 2005 being the year of the rise of Web 2.0;
  • Language: any language.
Search strategy
We developed a search strategy, using the help of a librarian, for MEDLINE, EMBASE and Google Scholar electronic databases from 2005 to present. The search combined various keywords and medical subject headings (MeSH) terms relevant to concepts of conflict of interest, funding, and social media. We did not restrict the search to specific languages. We will also screen the reference lists of included studies as well as other relevant papers.
Article selection
Teams of two reviewers will assess in duplicate and independently the titles and abstracts of citations identified by the search for potential eligibility using Rayyan screening tool. We will retrieve the full texts of citations judged as potentially eligible by at least one reviewer. Reviewers subsequently will screen in duplicate and independently the full texts using Rayyan screening tool. They will resolve any disagreements by discussion or with the help of a third reviewer when consensus cannot be reached. We will use standardized and pilot-tested screening tools. We will record the reasons for exclusion and summarize the results of the selection process using the 2020 PRISMA flow diagram. The reviewers will conduct calibration exercises before the screening process.
Data abstraction
The reviewers will abstract data from eligible studies in duplicate and independently. We will use a standardized and pilot-tested data abstraction form. Disagreements will be resolved through discussion or with the help of a third reviewer (EAA). We will conduct a calibration exercise to enhance the validity of the process. Study authors will be contacted for any clarification.
We will abstract the following variables from each included study:
  1. General characteristics of the study:
  • Population (e.g., type of healthcare professionals: physicians, nurses, or other);
  • Year of conduct;
  • Study design;
  • Funding of the study;
  • COI of study authors
  • Country of study authors

2. Social media:
  • Type of social media (e.g., Facebook, twitter, Instagram, YouTube, LinkedIn …);
  • Number of posts, videos or blogs assessed;
  • Language of posts, videos or blogs
  • Country of the subjects of study
  • Topic focus of the study, if any.

3. Conflict of interest:
  • Type of conflict of interest
  • Subject of conflict of interest
  • Source of conflict of interest
  • Tools used to assess the presence of financial relationships
  • Prevalence of conflict of interest
  • Frequency of reporting of conflict of interest
  • Proportion of undisclosed conflict of interest
  • Unprofessional incidents involving conflict of interest

4. Funding:
  • Type of funding
  • Source of funding
  • Frequency of reporting of funding
Quality assessment
A team of two reviewers will assess independently the risk of bias of included studies using the Mixed Methods Appraisal Tool (MMAT). This tool is designed for the appraisal stage of systematic reviews that include qualitative, quantitative or mixed methods studies [4]. We expect most of the studies to be cross-sectional and these will be assessed using the quantitative part of the tool.
Data synthesis
Due to the nature of the data, we will report the results in narrative and tabular formats.

REFERENCES
REFERENCES
1. McCarthy CP, DeCamp M, McEvoy JW. Social Media and Physician Conflict of Interest. American Journal of Medicine. 2018;131(8):859-60.
2. TenBarge AM, Riggins JL. Responding to Unsolicited Medical Requests from Health Care Professionals on Pharmaceutical Industry-Owned Social Media Sites: Three Pilot Studies. Journal of medical Internet research. 2018;20(10):e285-e.
3. Akl EA, Hakoum M, Khamis A, Khabsa J, Vassar M, Guyatt G. A framework is proposed for defining, categorizing, and assessing conflicts of interest in health research. Journal of clinical epidemiology. 2022.
4. Hong QN, Fàbregues S, Bartlett G, Boardman F, Cargo M, Dagenais P, et al. The Mixed Methods Appraisal Tool (MMAT) Version 2018 for Information Professionals and Researchers. Education for information. 2018;34(4):285-91.