Not Going Viral: Social Media Fails to Boost Exposure to Circulation Articles in Study

Sad-face emoji for social media buffs: a randomized controlled trial looking at use of Twitter and Facebook to boost traffic to scientific articles in a cardiovascular journal has found no benefit to the strategy. 

The study marks the second time Circulation editors have studied social media as a means of increasing exposure to original articles published in the journal and has come up short.

“We set up a social media program at the journal Circulation several years ago,” lead author Caroline Fox, MD (Circulation Editorial Office, Boston, MA), told TCTMD in an email. “We were curious as to whether we could quantify return on investment and impact of the program.”

The current study appears in the Journal of the American Heart Association (JAHA).

Published in 2015, an initial study that randomized articles to customized posts on Facebook and Twitter or to no social media exposure found no difference in the number of page views for original research published in Circulation. To expand on this, Fox et al elected to take another crack at the issue—randomizing fewer original studies (74 and 78, respectively) to social media exposure or no such exposure but at a higher intensity—using a higher number of posts, including repeat posts, and using paid “boosting” tools specifically targeting people interested in cardiology.  For the second study, the number of Twitter followers and Facebook “likes” at the time of the “intervention” was also three times higher than in the original study.

The intent, explained Fox, was to “increase the ‘dosage’ of social media” in the hopes this might lead to a greater effect on journal article page views.

It didn’t. At 30 days, median number of page views was 500 in the social media arm and 450 in the control arm, “with no evidence of a treatment effect,” the authors write. They also found no significant interaction according to manuscript type, corresponding author, or trimester of publication date.

The role of social media in physician engagement and interaction, both professionally and with patients, is a topic of ongoing debate. The current study, Fox clarified, has “absolutely” no bearing on this discussion, showing only that social media in this context does not increase the number of downloads of a paper at 30 days. Whether and how social media affects other aspects of physician knowledge acquisition and sharing remain to be studied, the authors say.

The authors acknowledge that their Circulation study is at odds with findings from others, including a study by the Annals of Emergency Medicine that found a comprehensive social media campaign was associated with a 289% increase in traffic. They also point out that randomly selected articles may not perform as well on social media as articles that are specifically selected for promotion.

Of note, a handy tracker accompanying the JAHA article shows that at the time TCTMD’s story went online, the Fox et al paper had been tweeted 38 times. 



  • Fox CS, Gurary EB, Ryan J, et al. Randomized controlled trial of social media: Effect of increased intensity of the intervention. J Am Heart Assoc. 2016;5:e003088. 


  • Fox and four other coauthors report being editors at Circulation and receiving compensation for this work from the American Heart Association.  
  • Fox became an employee of Merck Research Labs as of December 14, 2015, and reports earning income and holding stock options. 

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Shelley Wood is the Editor-in-Chief of TCTMD and the Editorial Director at CRF. She did her undergraduate degree at McGill…

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