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SAN DIEGO -- The "publish or perish" adage may have a modern corollary for thoracic surgeons: "Tweet yourself to fame in your field."

The most engaged users on Twitter in thoracic surgery also happen to have the biggest research profiles, at least judging by their citation indexes, a study found.

"The more engaged you are on Twitter, the higher your chances are for your research to be quoted by other scientists, and the more influential you are in thoracic surgery," said Wael Hanna, MD, of McMaster University in Hamilton, Ontario, whose group presented the findings at the annual meeting of the Society of Thoracic Surgeons here.

Hanna said they launched their Twitter analysis after noticing that some researchers are world-famous thanks to Twitter and Instagram, even though their posts lack scientific gravitas. "Is this guy famous because he's on social media, or is he famous because of his science? We decided to study how promoting your work on Twitter affects your citation index."

The researchers found h-indexes -- numbers that reflect how a researcher's level of productivity and how often he or she is cited -- for 722 (19.3%) of 3,741 surgeons in the U.S. and Canada. They focused on the 95% of those who had h-indexes calculated by ResearchGate.

The researchers determined who among those surgeons had Twitter accounts and analyzed how well those surgeons engage with others on the service. Specifically, they focused on the amount of time spent on Twitter, the number and frequency of tweets they posted, the number of followers they have, the number of people they follow, and the number of posts they "liked."

The 188 surgeons who were on Twitter had nonsignificantly higher average h-indexes than the 534 surgeons who weren't on it (15.02 vs 13.86, P=0.38). The Twitter users who had more followers (P=0.029), followed more people (P=0.048), and tweeted more often (P=0.046) had higher citation indexes.

The study couldn't pinpoint which came first: Mastering the art of tweeting or getting cited all over the place. "It could be that the reason you're engaged on Twitter is because you're a brilliant researcher, and you're highly quoted, and you talk about it on Twitter, and you engage in these conversations," Hanna said.

His theory was more general. "People who are more active on Twitter promote their work," he said. "And other scientists quote it because they're [now] aware of their work."

Thoracic surgeon Mara Antonoff, MD, an active Twitter user who reviewed the study findings for 名媛直播, said in an interview that they built upon previous studies linking Twitter activity about research articles to citations.

"It is not surprising to see similar findings at the author level," said Antonoff, of the Thoracic & Cardiovascular Surgery Department at the University of Texas MD Anderson Cancer Center in Houston.

She questioned if there's a simple chicken-and-egg relationship between tweeting and getting cited. Surgeons who are active on Twitter may be more active in research, too, because they want to "generate and disseminate novel information that may change our field," she said.

So should thoracic surgeons tweet? "Absolutely," she said. "Twitter is an outstanding vehicle for disseminating impactful research, engaging in scholarly discourse, and even forming collaborations for future studies."