Background: Social media has an increasing role within professional surgical practice, including the publishing and engagement of academic literature. This study aims to analyze the relationship between social media use and traditional and alternative metrics among academic surgical journals. Method: Journals were identified through the InCites Journal Citation Reports 2019, and their impact factor, h-index, and CiteScore were noted. Social media platforms were examined, and Twitter activity interrogated between 1 January to 31 December 2019. Healthcare Social Graph score and an aggregated Altmetric Attention Score were also calculated for each journal. Statistical analysis was carried out to look at the correlation between traditional metrics, Twitter activity, and altmetrics. Results: Journals with a higher impact factor were more likely to use a greater number of social media platforms (R 2 ¼ 0.648; P < .0001). Journals with dedicated Twitter profiles had a higher impact factor than journals without (median, 2.96 vs 1.88; Mann-Whitney U ¼ 390; P < .001); however, over a 1-year period (2018e2019) having a Twitter presence did not alter impact factor (Mann-Whitney U ¼ 744.5; P ¼ .885). Increased Twitter activity was positively correlated with impact factor. Longitudinal analysis over 6 years suggested cumulative tweets correlated with an increased impact factor (R 2 ¼ 0.324, P ¼ .004). Novel alternative measures including Healthcare Social Graph score (R 2 ¼ 0.472, P ¼ .005) and Altmetric Attention Score (R 2 ¼ 0.779, P ¼ .001) positively correlated with impact factor. Conclusion: Higher impact factor is associated with social media presence and activity, particularly on Twitter, with long-term activity being of particular importance. Modern alternative metrics correlate with impact factor. This relationship is complex, and future studies should look to understand this further.
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