Background

Social media have emerged as a platform for experience and knowledge sharing in the medical community. The online medical community is garnering increasing research attention; however, there is a lack of understanding of what factors influence the helpfulness and engagement of experience sharing in the community.

Methods

Clinical documents manifest physicians’ experience and knowledge. This study fills the knowledge gap by investigating what elements of clinical documents contribute to the helpfulness of sharing clinical documents online and what influence member engagement. Clinical documents follow certain architecture to specify their structure and semantics for exchange (e.g., HL7 C-CDA). Accordingly, the structural elements of clinical documents may influence document helpfulness for the online community. Member engagement is one of the indicators of community success. We collected 6514 clinical documents from a real-world online medical community, and normalized them with the structural elements of HL7 C-CDA. We performed regression analyses to identify the structural elements that have significant impacts on document helpfulness and member engagement.

Results

The results show that some structural elements of clinical documents such as assessment, chief complaints, medications, physical exams, procedures, results, and vital signs sections have positive effects whereas assessment and plan, general status, history and past illness of patients, instructions, problem and review of systems have negative effects on the helpfulness of clinical documents. The results also reveal that structural elements such as family history, history of past illness, medication, physical exam, review of systems, and vital signs positively; whereas assessment, assessment and plan, instruction, and result negatively; influence member engagement.

Conclusions

The findings provide guide on how to improve the effectiveness of sharing clinical experience online. The new and in-depth insights may contribute to the success of online medical communities and the quality of medical decisions.

中文翻译：

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是什么使临床文件有用和引人入胜？在线医疗社区中的经验共享的实证研究

背景

社交媒体已成为医学界中经验和知识共享的平台。在线医学界正在引起越来越多的研究关注。但是，对于哪些因素会影响社区中的经验分享的帮助和参与尚缺乏了解。

方法

临床文件体现了医师的经验和知识。这项研究通过调查临床文档的哪些元素有助于在线共享临床文档以及哪些因素影响成员的参与度来填补知识空白。临床文档遵循某些架构来指定其结构和语义以进行交换（例如HL7 C-CDA）。因此，临床文档的结构要素可能会影响文档对在线社区的帮助。成员的参与度是社区成功的指标之一。我们从一个现实世界的在线医学界收集了6514份临床文献，并使用HL7 C-CDA的结构元素对其进行了标准化。我们进行了回归分析，以确定对文档有用性和成员敬业度有重大影响的结构要素。

结果

结果表明，临床文件的某些结构要素，例如评估，主要投诉，药物，体检，程序，结果和生命体征部分，均具有积极作用，而评估和计划，总体状况，患者的病史和既往病史，说明，问题和系统审查对临床文档的有用性产生负面影响。结果还显示出积极的结构要素，例如家族病史，过去的病史，药物治疗，身体检查，系统检查和生命体征；而评估，评估和计划，指导和结果是负面的；影响成员的参与度。

结论

研究结果为如何提高在线共享临床经验的有效性提供了指导。新的深入见解可能有助于在线医疗社区的成功和医疗决策的质量。