A randomized controlled trial of social media promotion in neurosurgical publishing

The importance of social media has seen a dramatic increase in recent times, but much about its influence in academia is still unknown. To date, no comparative studies analysing the effect of social media promotion on citation counts have been undertaken in neurosurgical publishing. We randomized 177 articles published in Acta Neurochirurgica from May to September 2020. The 89 articles in the intervention group received a standardized social media promotion through one post on our official Twitter/X account, whereas the 88 articles in the control group did not receive any social media promotion. Citation counts, website visits and PDF downloads were tracked at one and two years post-promotion. We found no significant difference in number of citations at one year post-promotion (Intervention: 1.85 +/- 3.94 vs. Control: 2.67 +/- 6.65, p = 0.322) or at two years (5.35 +/- 7.39 vs. 7.09 +/- 12.1, p = 0.249). Similarly, no difference was detected in website visits at one (587.46 +/- 568.04 vs. 590.65 +/- 636.25, p = 0.972) or two years (865.79 +/- 855.80 vs. 896.31 +/- 981.97, p = 0.826) and PDF downloads at one (183.40 +/- 152.02 vs. 187.78 +/- 199.01, p = 0.870) or two years (255.99 +/- 218.97 vs. 260.97 +/- 258.44, p = 0.890). In a randomized study, a structured promotion of general neurosurgical articles on Twitter/X did not significantly impact citation count, website visits, or PDF downloads compared to no social media promotion. Combined with published evidence to date, the impact of social media on citation counts in academic publishing ultimately remains unclear.