title: Medical journals, impact and social media: an ecological study of the Twittersphere.
abstract: BACKGROUND
  Twitter is an increasingly popular means of research dissemination. I sought to examine the relation between scientific merit and mainstream popularity of general medical journals.
  
  
  METHODS
  I extracted impact factors and citations for 2014 for all general medical journals listed in the Thomson Reuters InCites Journal Citation Reports. I collected Twitter statistics (number of followers, number following, number of tweets) between July 25 and 27, 2015 from the Twitter profiles of journals that had Twitter accounts. I calculated the ratio of observed to expected Twitter followers according to citations via the Kardashian Index. I created the (Fifty Shades of) Grey Scale to calculate the analogous ratio according to impact factor.
  
  
  RESULTS
  Only 28% (43/153) of journals had Twitter profiles. The scientific and social media impact of journals were correlated: in adjusted models, Twitter followers increased by 0.78% (95% confidence interval [CI] 0.38%-1.18%) for every 1% increase in impact factor and by 0.62% (95% CI 0.34%-0.90%) for every 1% increase in citations. Kardashian Index scores above the 99% CI were obsverved in 16% (7/43) of journals, including 6 of the 7 highest ranked journals by impact factor, whereas 58% (25/43) had scores below this interval. For the Grey Scale, 12% (5/43) of journals had scores above and 35% (15/43) had scores below the 99% CI.
  
  
  CONCLUSIONS
  The size of a general medical journal's Twitter following is strongly linked to its impact factor and citations, suggesting that higher quality research received more mainstream attention. Many journals have not capitalized on this dissemination method, although others have used it to their advantage.
authors.affiliation: Telecommunications, Web & Internet Trust; and the Medical Research Council Unit for Lifelong Health & Ageing, University College London, London, UK tdcosco@cantab.net.
authors.forename: Theodore D
authors.initials: TD
authors.lastname: Cosco
mesh_terms: D006801:Humans; D033181:Information Dissemination; D055811:Journal Impact Factor; D010506:Periodicals as Topic; D061108:Social Media