title: Are Health-Related Tweets Evidence Based? Review and Analysis of Health-Related Tweets on Twitter.
abstract: BACKGROUND
  Health care professionals are utilizing Twitter to communicate, develop disease surveillance systems, and mine health-related information. The immediate users of this health information is the general public, including patients. This necessitates the validation of health-related tweets by health care professionals to ensure they are evidence based and to avoid the use of noncredible information as a basis for critical decisions.
  
  
  OBJECTIVE
  The aim of this study was to evaluate health-related tweets on Twitter for validity (evidence based) and to create awareness in the community regarding the importance of evidence-based health-related tweets.
  
  
  METHODS
  All tweets containing health-related information in the Arabic language posted April 1-5, 2015, were mined from Twitter. The tweets were classified based on popularity, activity, interaction, and frequency to obtain 25 Twitter accounts (8 physician accounts, 10 nonofficial health institute accounts, 4 dietitian accounts, and 3 government institute accounts) and 625 tweets. These tweets were evaluated by 3 American Board-certified medical consultants and a score was generated (true/false) and interobserver agreement was calculated.
  
  
  RESULTS
  A total of 625 health-related Arabic-language tweets were identified from 8 physician accounts, 10 nonofficial health institute accounts, 4 dietician accounts, and 3 government institute accounts. The reviewers labeled 320 (51.2%) tweets as false and 305 (48.8%) tweets as true. Comparative analysis of tweets by account type showed 60 of 75 (80%) tweets by government institutes, 124 of 201 (61.7%) tweets by physicians, and 42 of 101 (41.6%) tweets by dieticians were true. The interobserver agreement was moderate (range 0.78-0.22). More than half of the health-related tweets (169/248, 68.1%) from nonofficial health institutes and dietician accounts (59/101, 58.4%) were false. Tweets by the physicians were more likely to be rated "true" compared to other groups (P<.001).
  
  
  CONCLUSIONS
  Approximately half of the medical tweets from professional accounts on Twitter were found to be false based on expert review. Furthermore, most of the evidence-based health-related tweets are posted by government institutes and physicians.
authors.affiliation: Al-Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia. alnemerk@hotmail.com.
authors.forename: Khalid A
authors.identifier: http://orcid.org/0000-0002-3848-5766
authors.initials: KA
authors.lastname: Alnemer
authors.forename: Waleed M
authors.identifier: http://orcid.org/0000-0003-3743-9140
authors.initials: WM
authors.lastname: Alhuzaim
authors.forename: Ahmed A
authors.identifier: http://orcid.org/0000-0003-3318-5734
authors.initials: AA
authors.lastname: Alnemer
authors.forename: Bader B
authors.identifier: http://orcid.org/0000-0002-7530-4127
authors.initials: BB
authors.lastname: Alharbi
authors.forename: Abdulrahman S
authors.identifier: http://orcid.org/0000-0002-4617-6699
authors.initials: AS
authors.lastname: Bawazir
authors.forename: Omar R
authors.identifier: http://orcid.org/0000-0003-1796-4503
authors.initials: OR
authors.lastname: Barayyan
authors.forename: Faisal K
authors.identifier: http://orcid.org/0000-0002-3048-3168
authors.initials: FK
authors.lastname: Balaraj
mesh_terms: D055317:Evidence-Based Practice / Q000379:methods*; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D061108:Social Media / Q000706:statistics & numerical data*
keywords: daily medical information; diseases; doctor accounts; health; health accounts; medical accounts; nutrition accounts