Novel Use of a Social-Media-Based Survey to Detect Regional Differences in Management of Monochorionic–Diamniotic Twins

Abstract

Objective This study aims to evaluate the utility of social media to distribute a patient survey on differences in management and outcomes of monochorionic–diamniotic (MCDA) pregnancies. Study Design A cross-sectional survey was posted to an English-language MCDA twins patient-centered support group within the social media site, Facebook from April 2, 2018 to June 26, 2018. Subjects were recruited through a technique called “snowballing,” whereby individuals shared the survey to assist with recruiting. Patient reported data were analyzed using Chi-square and Kruskal–Wallis's tests to explore characteristics associated with surveillance and outcomes as related to region and provider type. Results Over 3 months, the post “reached” 14,288 Facebook users, among which 5,653 (40%) clicked on the post. A total of 2,357 respondents with MCDA pregnancies completed the survey. Total 1,928 (82%) were from the United States (US) and 419 (18%) from other countries. Total 85% of patients had co-management with maternal–fetal medicine (MFM), more in the US compared with the rest of the world (87 vs. 74%, p < 0.01). MFM involvement led to increased adherence to biweekly ultrasounds (91 vs. 65%, p < 0.01), diagnosis of monochorionicity by 12 weeks (74 vs. 69%, p < 0.01) and better education about twin–twin transfusion syndrome (90 vs. 66%, p < 0.01). Pregnancies with MFM involvement had a higher take-home baby rate for both babies (92 vs. 89%, p < 0.01) or for at least one baby (98 vs. 93%, p < 0.01) compared with those without MFM involvement. Conclusion A survey distributed via social media can be effective in evaluating real-life management and outcomes of an uncommon obstetrical diagnosis. This survey elucidates wide international variation in adherence to guidelines, management, and outcomes.

Clinical characteristics and disease burden in prurigo nodularis

“…Previous larger epidemiological studies have found that PN is more prevalent in black than in white patients 17,40 . Our survey population was predominantly female, white and US residents, in line with other studies that also utilized social media platforms to deliver surveys 41–44 . The difference in the demographics seen in our study compared with the previous larger epidemiological studies is likely secondary to socioeconomic differences, as well as access to and engagement with the internet and online social media platforms.…”

“…The percentage of respondents who completed the survey after starting it (74%) was higher than that of previous studies that similarly utilized Facebook support groups 41,44 . Nonetheless, there is potential for response bias to affect the results.…”

Patient-Reported Monochorionic-Diamniotic Twin Pregnancy Management and Experiences During the COVID-19 Pandemic: A Mixed-Methods Cross-Sectional Survey

“…The lack of diversity among the respondents (eg, overwhelmingly well-educated, high income, married/in a partnership, and private insurance) results from the convenience sampling. While this composition of respondents is not unusual as this tends to be the mix of respondents to online, pregnancy-related surveys ( 16 – 18 ), we are likely not reaching and surveying those who would be most impacted by disparities in care for both MCDA pregnancies and COVID-19 ( 19 ). Although we are not reaching the most at-risk for disparities in care, it is critical to point out that, although a small percentage, we still see patients who are not receiving standard of care for ultrasounds and for whom COVID-19 is impacting pregnancy management.…”

Obstetrical Unit Response to the COVID-19 Pandemic: OUR Study

“…This was a nonprobability sampling technique where existing study participants "share" the survey to assist with recruitment. 15,16 Anyone with the survey could freely repost the link to their own profile page or share with members outside of the group. Survey details included instructions to designate a single representative to respond on behalf of each L&D unit.…”