Amol Akhade: The Rise of Visibility without Depth, and Popularity without Peer Review

Amol Akhade, Consultant Medical Oncologist at Suyog Cancer Clinics, shared a post on LinkedIn by Raffaele Giusti, Medical Director at Sant’Andrea Hospital, about a paper by Raffaele Giusti et al. published in JAMA Oncology:

“Thank you, Raffaele – this is a thoughtful and timely reflection. You’re absolutely right to highlight a growing tension in academic medicine: the rise of visibility without depth, and popularity without peer review. It’s true that social media can sometimes reward oversimplification, echo chambers, or algorithm-driven commentary that prioritizes virality over value. And we must remain vigilant about guarding scientific rigor from being diluted by performance metrics.

But there’s another side to this conversation – one that often goes unspoken in major journals and conferences. For many of us in low – and middle-income countries (LMICs), social media isn’t a vanity tool. It’s a necessity. It’s not a threat to evidence-based medicine – it’s the only accessible bridge to it.

In the U.S. or Europe, attending ASCO or ESMO often comes with:

• Visa-free or fast-track travel
• Institutional support for leave and funding
• Easy access to guideline panels, working groups, and paywalled journals

But for oncologists in India, Kenya, Peru, Brazil, or the Philippines, these are not privileges – they’re barriers. Getting a visa denied, lacking funds to attend global meetings, or being shut out by subscription paywalls is routine. Yet the clinical challenges we face are equally complex – and often more resource-constrained.

So when a young oncologist from Africa shares local innovations or a nuanced trial critique on X, it isn’t about ego. It’s about validity, trying to find voice. And when others retweet, engage, and learn from it – that’s global knowledge – sharing in action.

This is exactly the ethos of OncoWisdom – a growing, diverse network of oncologists across continents (including you, Raffaele) who come together not for attention, but for insight. We discuss trial data, contextualize applicability, and challenge assumptions – with mutual respect and scientific grounding.

That’s the power of social media.

And this benefits everyone:

• LMIC oncologists gain visibility and access
• Western oncologists gain diverse perspectives and partnerships
• The whole community becomes more inclusive, more reflective of real – world practice

Yes, metrics can be gamed. Yes, engagement can be superficial. But not all that trends is trivial, and not all that matters is hidden behind a paywall. With the right intent, social media can be a force multiplier for scientific equity, humility, and collaboration.

As President John F. Kennedy once declared, in 1963, standing in a divided Berlin:

‘All free men, wherever they may live, are citizens of Berlin. And therefore, as a free man, I take pride in the words – Ich bin ein Berliner.’

And today, in a divided world of oncology – between the visible and the invisible, the privileged and the peripheral – social media allows me to say

Auch Ich bin Onkologe – I am also an oncologist.”

Quoting Raffaele Giusti’s post, by Brian Shields, Founder of KOL Pulse:

“I appreciated the thoughtful reflections inspired by the recent article we published in JAMA Oncology (‘The Role of Social Media in Fueling Bias in Oncology’) and by Dr. Yakup Ergun’s incisive commentary. The central question remains: how do we preserve scientific integrity in a digital environment that rewards visibility over validity?

Ranking oncologists by social media metrics – tweet counts, impressions, likes – may appear benign, but it subtly redefines value in science. As highlighted in our piece, ’emphasizing superficial engagement metrics… often detracts from the principles of scientific rigor and evidence-based discourse.’

What is amplified is not always what is accurate.

The danger is not in the platform itself, nor in the individuals who use it in good faith – but in the design that favors attention over content. During major oncology congresses, only one-third of featured voices focus on research; selfies and sentiment dominate. Does this ecosystem truly support informed clinical debate?

And let us not forget the influence of financial conflicts: over 90% of prominent voices in some networks have significant industry ties. AI-driven dashboards and KOL heatmaps may ‘optimize visibility,’ but whom do they serve – patients, clinicians, or stakeholders with commercial interests?

We must ask: when a post trends under ASCO25, does it clarify data or dilute its meaning? Does it foster peer learning – or just spotlight those most fluent in the algorithms of engagement?

As we wrote in the article, ‘At the heart of scientific inquiry lies an unwavering pursuit of truth… navigating the uncertainties that drive progress.’ That pursuit is slowed, not accelerated, when influence is measured by retweets rather than reason.

The future of digital oncology communication lies not in rankings, but in shared responsibility: for context, for transparency, for evidence.”

Quoting Brian Shields’ post:

“Ranking Oncologists in Social Media.

What could go wrong?

Dr Yakup Ergun recently penned a letter in response to a publication by Dr. Raffaele Giusti (The Role of Social Media in Fueling Bias in Oncology)

In the letter, Dr. Ergun specifically pointed to platforms that offer weekly rankings of Oncologists, ‘While seemingly harmless, these informal rankings may incentivize superficial engagement over thoughtful analysis, fueling a race for visibility that risks distorting the norms of academic communication. The value of a scientific contribution must not be measured by its virality, but by its methodological rigor and clinical relevance’.

For folks like myself that curate KOL opinions in Oncology (KOL Pulse), the article and the letter from Dr. Ergun are important pieces of feedback from the Oncology social media community. There’s a few questions we need to ask ourselves when we post to a Hashtag such as ASCO25, etc.

1. Are we just adding noise?

This is an important question for any company or firm that chooses to post to these Physician led conference hashtags. It is well known that the Oncology Hashtags have a plethora of key opinion leader insights and resources. Does your tweet help clinicians find these data, or are your tweets hijacking the hashtag for marketing purposes?

2. Does your Twitter strategy incentivize Vanity Metrics?

This is another point in Dr. Ergun’s letter. ‘Rankings may incentive superficial engagement’. Are you just ranking KOLs based on popularity? Are you ranking KOLs based purely on Tweet Volume? Metrics such as impressions are impacted by the X algorithm of virality, not necessarily the scientific rigor of the tweets. Are your rankings hurting the discussion? Do popularity metrics lead to hype in the tweets?

3. ‘Distorting the norms of Academic Communication’:

This is another key quote from Dr. Ergun’s discussion. What are the norms of Academic Communication? Does a KOL want to be on the Times Square Billboard? Do they want to be in a Top 10 listing every week? Or do digital opinion leaders simply want to share their analysis of data with their colleagues and learn from one another? Are your rankings discouraging some KOLs from posting on the platform?

Quote from Dr. Raffaele Giusti’s article: ‘At the heart of scientific inquiry lies an unwavering pursuit of truth, a deliberate process of disentangling fact from misconception while navigating the uncertainties that drive progress’.

When non-physicians or marketing organization tweet to a hashtag like ASCO25 they are interrupting this ‘scientific inquiry’. Does your tweet (or social media campaign) add to the scientific inquiry, or does it harm this delicate process of peer collaboration?

Excerpt from Dr. Ergun’s letter is in the image below.”

Title: The Role of Social Media in Fueling Bias in Oncology

Authors: Raffaele Giusti, Gennaro Daniele, Fotios Loupakis

You can read the Full Article in JAMA Oncology.

More posts featuring Amol Akhade.