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Tweeting links to Cochrane Schizophrenia Group reviews: a randomised controlled trial

Adams, Clive E.; Jayaram, M.; Bodart, A.Y.M.; Sampson, S.; Zhao, S.; Montgomery, Alan A.


Clive E. Adams

M. Jayaram

A.Y.M. Bodart

S. Sampson

S. Zhao

Director Nottingham Clinical Trials Unit


Objective: To assess the effects of using health social media on web activity.
Design: Individually randomised controlled parallel group superiority trial.
Setting: Twitter and Weibo.
Participants: 170 Cochrane Schizophrenia Group full reviews with an abstract and Plain Language Summary web page.
Interventions: Three randomly ordered slightly different 140 character or less messages, each containing a short URL to the freely accessible summary page sent on specific times on one single day. This was compared with no messaging.
Outcome: The primary outcome was web page visits at one week. Secondary outcomes were other metrics of web activity at one week.
Results: 85 reviews were randomised to the intervention and control arms each. Google Analytics allowed 100% follow up within one week of completion. Intervention and control reviews received a total of 1162 and 449 visits respectively (IRR 2.7, 95% CI 2.2 to 3.3). Fewer intervention reviews had single page only visits (16% vs 31%, OR 0.41, 0.19 to 0.88) and users spent more time viewing intervention reviews (geometric mean 76 vs 31 seconds, ratio 2.5, 1.3 to 4.6). Other secondary metrics of web activity all showed strong evidence in favour of the intervention.

Conclusion: Tweeting in this limited area of health care increases ‘product placement’ of evidence with the potential for that to influence care.

Trial Registration number: ISRCTN84658943.

Funding: This trial received no funding.

Strengths and limitations of this study
• This is the first randomised controlled trial that we are aware of evaluating the impact of Tweeting health-related web links on access to the target webpage and/or related webpages.
• This study quantifies the effects of Tweeting evidence and generates many questions for future research.
• We used free-to-use software with limited functionality – more sophisticated software may highlight more effects.
• We Tweeted links to large academic reviews focusing on one small area of health care to a relatively small ‘following’. Different techniques of Tweeting, other areas of health care, and a broad set of followers could result in more impact.


Adams, C. E., Jayaram, M., Bodart, A., Sampson, S., Zhao, S., & Montgomery, A. A. (2016). Tweeting links to Cochrane Schizophrenia Group reviews: a randomised controlled trial. BMJ Open, 6(3), Article e010509.

Journal Article Type Article
Acceptance Date Jan 26, 2016
Online Publication Date Mar 8, 2016
Publication Date Mar 31, 2016
Deposit Date Feb 8, 2016
Publicly Available Date Mar 8, 2016
Journal BMJ Open
Electronic ISSN 2044-6055
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 6
Issue 3
Article Number e010509
Keywords Twitter, schizophrenia, randomised controlled trial, social media
Public URL
Publisher URL


e010509.full.pdf (835 Kb)

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