Introduction: The surgical management of nephrolithiasis can be challenging due to multiple appropriate and feasible approaches. One advantage of urologists’ increasing social media use is the opportunity for crowdsourcing or aggregating feedback from remote participants. This study assesses the purposes and extent of online crowdsourcing by urologists for surgical stone disease. Methods: Twitter was queried with 22 stone-related keywords during a 60-day study period. All public posts were reviewed to identify crowdsourcing requests by urologists seeking clinical advice or feedback about surgical stone management. Content analysis of the crowdsourcing posts was performed by two reviewers to assess the purposes of and responses to the requests. Results: A total of 399 posts linked to 29 crowdsourcing requests were analyzed. Crowdsourcing requests were answered rapidly; the median time from initial post to final reply by participants was 2 days. In the majority of requests, the author of the initial request posted a follow-up question or clarification, underscoring a bidirectional exchange of ideas. Most crowdsourcing engaged an international audience; requests originated from 27 urologists in 12 countries, and all but one of the 29 requests (97%) received replies from users outside the origin country. Four purposes for crowdsourcing were observed: patient-specific surgical planning (206 posts, 52%); colleagues’ experiences with a device or technique (86 posts, 22%); general advice about stone-related concerns (57 posts, 14%); and solutions to complications or quality improvement challenges (50 posts, 12%). Finally, protection of patient privacy appeared to be a concern; among the 17 (59%) crowdsourcing requests that were about individual patients or cases, all included patient-specific images or radiography, but none noted whether patient permission had been obtained. Conclusions: Social media crowdsourcing facilitates a range of general, patient-specific, and quality improvement challenges in surgical stone management. Participants should consider privacy concerns when publicly sharing imaging or patient data.

Journal of endourology. 2019 Oct 03 [Epub ahead of print]

Kevin Koo, Tareq Aro, Brian R Matlaga

Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland.