Hand holding a Social Media 3d SphereThe Social Media Index (SM-i) started with a pilot on BoringEM. The rationale for the experiment was that the health care professionals creating Free Open-Access Medical Education (FOAM) resources had no way to measure their impact in the way that scholars (h-index) and journals (Impact Factor) do. This made it difficult for them to quantify the impact of their work and for the consumers of FOAM to distinguish between reputable and unproven websites. While I am aware of the many imperfections of the index as it now stands, I believe the pilot demonstrated that there is enough value in the concept to justify further exploration.

The most recent update to the SM-i marks its move from BoringEM to ALiEM and expansion to 60 websites (up from 45 in August and 25 in June). I felt the move was necessary because ALiEM’s mission is more consistent with and appropriate for the SM-i’s purpose than BoringEM. I plan to continue its expansion with every iteration and will focus on adding websites that post open-access emergency medicine (pediatric and adult) and critical care content. Updates will occur every 2-3 months.

SM-i Details

The SM-i is a comparative index derived from easily obtainable measures including: Google PageRank, Alexa Rank, Twitter Followers (of the most prominent regular contributor), Facebook Likes (site-specific) and Google+ Followers (site-specific). The formula used for the derivation of the index is on the SM-i Page.

The most prominent criticism that I have heard of the index is that “just because something is popular, does not mean it is good – and this is measuring popularity.”

The Update

View the ALiEM SM-i page

The Top of the Chart

The top of the chart is still dominated by “The Big 3” (LITFLEMCrit and ALiEM). The SM-i gain by ALiEM (#3) appears fairly dramatic, but it is almost entirely due to the correction of their Alexa rank (their previous rank was lost when they changed domain names). ALiEM passing EMCrit (#2) on this indicator is what caused EMCrit’s 28 point drop. Interestingly, the PageRank crown was taken by two established websites (The NNT (#10) and BestBETs (#11)) that were indexed for the first time.

Exciting new sites

There were some huge debuts! Specifically, REBEL EM (#21) and Don’t Forget the Bubbles (#25) came out with a bang jumping into the top half of the SM-i. REBEL EM has done an impressive job of engaging users across Facebook, Twitter and Google+ in a very short period of time. Don’t Forget the Bubbles is must be getting themselves traffic with good search engine optimization (SEO) – their Alexa ranking reached the top 4 only a couple months after launch. Both of these sites were held back by the slow-poke of the online world, PageRank. Neither of them have been ranked yet so they received the undeserved score of zero. Had the Index been calculated using only the 4 faster indicators REBEL EM would have moved to #15 and Don’t Forget the Bubbles to #17.  Expect to see them there or higher next edition.

Overall downward trend

The problem with adding additional sites every iteration of the SM-i is that sites already on the index often see their rankings drop. Fortunately, that will become less apparent as more sites are added. Eventually I hope any drops in ranking result from other sites raising the bar and not simply because more were added.

Moving Forward

I look forward to seeing greater discussion about the SM-i, its usefulness (or lack of usefulness) and how it can be improved.

Brent Thoma, MD MA
ALiEM Associate Editor
Emergency Medicine Research Director at the University of Saskatchewan
Editor/Author at CanadiEM.org
Brent Thoma, MD MA