JMIR Publications

ABSTRACT

Background:

In recent years social media have emerged as an important space for commercial marketing of health tests which can be used for the screening and diagnosis of otherwise asymptomatic healthy people. However, little is known about how health tests are promoted on social media and whether the information provided is accurate, balanced and there is transparency around conflicts of interest.

Objective:

This study aims to understand and quantify how social media is being used to promote health tests with potential for overdiagnosis and/or overuse, to asymptomatic healthy people. Specifically, the study will explore whether the information being promoted is evidence-based, how the benefits and harms of the tests are discussed, what narratives are used, and examine transparency around potential conflicts of interest in promotion of the tests.

Methods:

Content analysis of social media posts on the Anti-Mullerian Hormone (AMH) test, whole-body MRI scan, multi-cancer detection (MCED) test, testosterone test and gut microbe test from influential international social media accounts on Instagram and TikTok will be conducted. The five tests have been identified as having the following criteria: 1) there are evidence-based concerns about overdiagnosis and/or overuse, 2) there is evidence and/or concerns that the results of tests do not lead to improved health outcomes for asymptomatic healthy people and may cause harm or waste, and 3) the tests are being promoted on social media to asymptomatic healthy people. English language text-only posts, images, infographics, articles, recorded videos including reels and audio-only posts will be included. Posts from influencers and/or pages with <1,000 followers, stories, live videos and non-English posts will be excluded. Using keywords related to the test, the top posts will be searched and screened until there are 100 eligible posts from each platform for each test (1000 posts total). Data from the caption, video and on-screen text will be summarised and/or extracted into an Excel spreadsheet and included in the analysis. The analysis will take a deductive approach using a pre-specified framework. Quantitative data will be analysed in SPSS.

Results:

Data on Instagram and TikTok has been searched and screened. Analysis has not yet commenced. The findings will be disseminated via publication/s in peer-review international medical journals and will also be presented at national and international conferences in late 2024 and 2025.

Conclusions:

This study will contribute to the limited evidence base on how social media may be driving overdiagnosis and causing overuse of healthcare services. Understanding this is essential to develop strategies to mitigate potential harm and plan solutions, thus protecting members of the public from being marketed low-value tests, becoming patients unnecessarily and taking resources away from the health system.