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Digital Opinion Leaders in Diabetes
The Worldwide HCP Social Media Study
Daniel Ghinn, Creation Healthcare @EngagementStrat
Special Event Edition with
Exclusive Pharma Insights
Diabetes in 2013-14
The global burden and threat of NCDs constitutes
a major public health challenge that undermines
social and economic development throughout
the world…
World Health Organization,
Global Action Plan for the Prevention & Control
of Noncommunicable Diseases 2013-2020
By the end of 2013, diabetes will have caused 5.1
million deaths and cost USD 548 billion in healthcare
spending. Without concerted action to prevent
diabetes, in less than 25 years’ time there will be 592
million people living with the disease. Most of those
cases would be preventable.
International Diabetes Federation,
IDF Diabetes Atlas, 6th Edition, 2013
Diabetes is a huge
and growing problem,
and the costs to society
are high and escalating.
Learning from Healthcare Professionals
A distilled view of public social media conversations
70M+ websites
Full Twitter ‘Firehose’ feed
All major social media
>100,000 verified
healthcare professional
(HCP) sources covering
websites & social media
8,189,534People connected to HCPs in the study
47,875HCPs connected to diabetes conversation
205,889HCP Tweets & posts about diabetes
19,068HCP authors in study
189,402HCP Tweets about diabetes
16,896HCPs Tweeting about diabetes
Big Data: impact of Healthcare Professionals
Most conversation is about Type 2 Diabetes
n=27,017
Type 1
29%
Type 2
64%
Gestationa
l
5%
Others
2%
Most HCP conversation about
diabetes does not refer explicitly
to a diabetes type, but implies Type 2.
>300 HCP Roles
Physician, 11,435
Dietitian, 10,951
Nutritionist, 10,099
Emergency Medicine
Physician, 9,079
Nurse Practitioner, 7,882
Endocrinologist, 7,714
Registered Nurse, 5,184
Pharmacist, 5,171
Family Medicine Physician,
4,322
Psychologist, 3,477
Naturopath, 3,254
Cardiologist, 3,087
Surgeon, 2,636
Preventive Medicine
Physician, 2,478
General Practitioner, 2,470
Top 15 HCP roles by share of voice
of >300 HCP roles in study
>200,000 posts; 19,000 HCPs in >125 countries
n=16,896
HCP networks within networks
n=16,896
Most influential endocrinologists – virtual network
Relationship mattersRelationship matters
A virtual professional network
connected by diabetes
Endocrinologists
discussing diabetes
online
HCP: Activism for patients
Partha Kar is also the most engaged HCP by peers in diabetes
Endocrinologist,
General
Physician,
Clinical Director,
UK
Activating
Multi-dimensional data
Place
Roles
Topics & issues
Time
Time & role: what the data tells us
Roles
Time
Global diabetes timeline
The story told by HCPs in social media
May
2013
Apr
2014
14-Nov-2013
World Diabetes
Day
3,000
2,000
1,000
All HCP conversation
Global diabetes timeline: Roles
Endocrinologists
May
2013
Apr
2014
14-Nov-2013
World Diabetes
Day
300
200
100
17-23 Jun 2013
Fall in diabetes-
related deaths
All HCP conversation
Endocrinologists
News: Fall in diabetes-related deaths
“Good news: the risk of dying early due to
diabetes has been greatly reduced! …
The treatment helps!”
17-23 June 2013
Physician,
Researcher
& Writer
Norway
Optimistic
News: Fall in diabetes-related deaths – sceptics?
17-23 June 2013
General
Practitioner
& Blogger
UK
Questioning
Sceptical
Global diabetes timeline: Roles
Endocrinologists
May
2013
Apr
2014
14-Nov-2013
World Diabetes
Day
300
200
100
17-23 Jun 2013
Fall in diabetes-
related deaths
8-14 Jul 2013
Roche halts trial
of diabetes drug
All HCP conversation
Endocrinologists
News: Roche halts trial of diabetes drug
8-14 July 2013
Endocrinologist
USA
Frustrated
News: Roche halts trial of diabetes drug – mixed reactions
8-14 July 2013
Family Med
Physician, Asst
Dean Med Ed
USA
Internist &
Medical Writer
USA
Indifferent
Concerned
Global diabetes timeline: Roles
Endocrinologists
May
2013
Apr
2014
14-Nov-2013
World Diabetes
Day
300
200
100
17-23 Jun 2013
Fall in diabetes-
related deaths
8-14 Jul 2013
Roche halts trial
of diabetes drug
All HCP conversation
Endocrinologists
May
2013
Apr
2014
24-30 Jun 2013
T1D Vaccine
trial results
Global diabetes timeline: Roles
Leadership roles
14-Nov-2013
World Diabetes
Day
120
80
40
17-23 Jun 2013
Fall in diabetes-
related deaths
8-14 Jul 2013
Roche halts trial
of diabetes drug
All HCP conversation
Endocrinologists
Leadership roles
May
2013
Apr
2014
24-30 Jun 2013
T1D Vaccine
trial results
Global diabetes timeline: Roles
Neurosurgeons
14-Nov-2013
World Diabetes
Day
17-23 Jun 2013
Fall in diabetes-
related deaths
30
20
10
19 Jul – 4 Aug 2013
Projection on US
diabetes by 2020
8-14 Jul 2013
Roche halts trial
of diabetes drug
All HCP conversation
Endocrinologists
Leadership roles
Neurosurgeons
May
2013
Apr
2014
24-30 Jun 2013
T1D Vaccine
trial results
Global diabetes timeline: Roles
Registered Nurses
14-Nov-2013
World Diabetes
Day
17-23 Jun 2013
Fall in diabetes-
related deaths
19 Jul – 4 Aug 2013
Projection on US
diabetes by 2020
8-14 Jul 2013
Roche halts trial
of diabetes drug
200
100
19-25 Aug 2013
Study finds
pumps > injections
All HCP conversation
Endocrinologists
Leadership roles
Neurosurgeons
Registered Nurses
May
2013
Apr
2014
24-30 Jun 2013
T1D Vaccine
trial results
Global diabetes timeline: Roles
Dieticians
14-Nov-2013
World Diabetes
Day
17-23 Jun 2013
Fall in diabetes-
related deaths
19 Jul – 4 Aug 2013
Projection on US
diabetes by 2020
8-14 Jul 2013
Roche halts trial
of diabetes drug
500
300
100
26 Aug – 2 Sep 2013
Study: Fruit juice vs
raw fruit
19-25 Aug 2013
Study finds
pumps > injections
Dieticians
All HCP conversation
Endocrinologists
Leadership roles
Neurosurgeons
Registered Nurses
Multi-dimensional data
Place
Roles
Topics & issues
Time
Time & topics: what the data tells us
Topics & issues
Time
Global diabetes timeline: Topics by patient age group
May
2013
Apr
2014
HCP conversation about all diabetes topics
300
200
100
Adults
Elderly
Pregnancy
Teens
Young
children
10-16 Jun 2013
Study: Taking walk reduces
risk of diabetes in elderly
9-25 Aug 2013
Phthalate increases risk of
diabetes in young children
13-19 Jan 2014
US Preventative Services
Task Force (USPSTF) backs
universal diabetes screening
for pregnant women
USPSTF backs universal diabetes testing for pregnant women
“Interesting that the US Preventive Services
Task force now recommends what has been
the standard of care for years.” Healthcare
Professional
CMO &
Pediatric
Surgeon,
USA
Gastroenterologist
USA
Dietician,
USA
13-19 January 2014
Supportive
Frustrated
Cynical
Interpreting
Diabetes testing for pregnant women - Japan
obstetrician
and
gynaecologist
Japan
“Doctor Song Mingyuan said that there
were some gynaecologists who didn’t do
their jobs properly, such as not conducting
examinations for gestational diabetes, and
it’s true. We recently got someone from a
place like this, which does so little pregnancy
examinations, it’s ridiculous. For blood
samples, all they do for early stage
examinations is check for infectious diseases
and do a red blood cell count, and then for
mid stage examinations, they just check for
casual blood glucose. And then they just go
home. Come on, seriously, stop it.”
13-19 January 2014
Frustrated
Multi-dimensional data
Place
Roles
Topics & issues
Time
Place & topics: what the data tells us
Place
Topics & issues
Geography matters
Diagnosis
Management & treatment
Monitoring & testing
Prevention & risk
Reversal
Canada
n=1,782
India
n=396
Japan
n=696
Spain
n=1,834
UK
n=4,070
USA
n=31,978
Venezuela
n=4,545
Australia
n=1,010
Key topics around prevention, diagnosis & management vary by country
Diabetes in multiple dimensions
HCPs bring their local
experience to the
global conversation
Many HCP roles
interact with unique
perspectives
Topics can answer
business & systems
questions
Time illustrates how
stories develop
INSIGHTS FOR PHARMA
HCPs who talk about diabetes and pharma brands
HCP mentions of pharmaceutical companies & products
May
2013
Apr
2014
HCP conversation about all diabetes topics
3-9 Jun 2013
GSK: FDA Panel Votes to Ease
Restrictions on Avandia
AstraZeneca BMS
Bayer Boehringer Ingelheim
Lilly GSK
J&J Merck
Novartis Novo Nordisk
Pfizer Roche
Sanofi Takeda
25 Nov 2013 - 1 Dec 2014
GSK: FDA Eases Restrictions
on Avandia
300
200
100
HCP roles discussing GSK products over time
May
2013
Apr
2014
3-9 Jun 2013
GSK: FDA Panel Votes to Ease
Restrictions on Avandia
25 Nov 2013 - 1 Dec 2014
GSK: FDA Eases Restrictions
on Avandia
300
200
100
Cardiologist
Pharmacist
Physician
Family Medicine Physician
Endocrinologist
Emergency Medicine Physician
GSK & products global picture – map of HCPs
GSK examples
Medical
Professional
USA
Internist
USA
Pharmacist
USA
Medical Doctor
USA
Assc. Prof
Medicine
USA
Sensational
Alarmed
Sharing
Shocked?
Balancing
Avandia FDA review – live updates via social media
Medic, Internal
Medicine
USA
Doctor, Author
UK
Acute Care
Nurse
Practitioner
USA
Doctor
Germany
Pharmacist
USA
Clinician
USA
Highlighting
Observing
Observing
Sensational
Sharing
Frustrated
Avandia – the feedback
Internist
Canada
Clinical
Pharmacist
USA
Family Doctor
USA
Nutritionist
USA
Warning
Encouraging
Warning
Warning
Reaction turns more positive
Chaiman, Dept
Psychiatry
USA
Physician
USA
Anaesthetist
Spain
Lipidology
Expert
USA
Pharmacist
USA
Supportive
Supportive
Hopeful
Empathetic
Encouraging
Changing attitudes in HCP conversation
May
2013
Apr
2014
3-9 Jun 2013
GSK: FDA Panel Votes to Ease
Restrictions on Avandia
25 Nov 2013 - 1 Dec 2014
GSK: FDA Eases Restrictions
on Avandia
300
200
100
Alarmed
Sensational
Sharing
Shocked?
Balancing
Highlighting
Observing
Observing
Sensational
Sharing
Frustrated
Warning
Encouraging
Warning
Warning
Supportive
Supportive
Hopeful
Empathetic
Encouraging
What next? Dive deeper:
Questions about this study?
daniel.ghinn@creationhealthcare.com
@EngagementStrat
www.creationhealthcare.com

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Doctors 2.0 & You Special - Diabetes Digital Opinion Leaders with Pharma Inisghts

  • 1. Digital Opinion Leaders in Diabetes The Worldwide HCP Social Media Study Daniel Ghinn, Creation Healthcare @EngagementStrat Special Event Edition with Exclusive Pharma Insights
  • 2. Diabetes in 2013-14 The global burden and threat of NCDs constitutes a major public health challenge that undermines social and economic development throughout the world… World Health Organization, Global Action Plan for the Prevention & Control of Noncommunicable Diseases 2013-2020 By the end of 2013, diabetes will have caused 5.1 million deaths and cost USD 548 billion in healthcare spending. Without concerted action to prevent diabetes, in less than 25 years’ time there will be 592 million people living with the disease. Most of those cases would be preventable. International Diabetes Federation, IDF Diabetes Atlas, 6th Edition, 2013 Diabetes is a huge and growing problem, and the costs to society are high and escalating.
  • 3. Learning from Healthcare Professionals A distilled view of public social media conversations 70M+ websites Full Twitter ‘Firehose’ feed All major social media >100,000 verified healthcare professional (HCP) sources covering websites & social media
  • 4. 8,189,534People connected to HCPs in the study 47,875HCPs connected to diabetes conversation 205,889HCP Tweets & posts about diabetes 19,068HCP authors in study 189,402HCP Tweets about diabetes 16,896HCPs Tweeting about diabetes Big Data: impact of Healthcare Professionals
  • 5. Most conversation is about Type 2 Diabetes n=27,017 Type 1 29% Type 2 64% Gestationa l 5% Others 2% Most HCP conversation about diabetes does not refer explicitly to a diabetes type, but implies Type 2.
  • 7. Physician, 11,435 Dietitian, 10,951 Nutritionist, 10,099 Emergency Medicine Physician, 9,079 Nurse Practitioner, 7,882 Endocrinologist, 7,714 Registered Nurse, 5,184 Pharmacist, 5,171 Family Medicine Physician, 4,322 Psychologist, 3,477 Naturopath, 3,254 Cardiologist, 3,087 Surgeon, 2,636 Preventive Medicine Physician, 2,478 General Practitioner, 2,470 Top 15 HCP roles by share of voice of >300 HCP roles in study
  • 8. >200,000 posts; 19,000 HCPs in >125 countries n=16,896
  • 9. HCP networks within networks n=16,896
  • 10. Most influential endocrinologists – virtual network
  • 11. Relationship mattersRelationship matters A virtual professional network connected by diabetes Endocrinologists discussing diabetes online
  • 12. HCP: Activism for patients Partha Kar is also the most engaged HCP by peers in diabetes Endocrinologist, General Physician, Clinical Director, UK Activating
  • 14. Time & role: what the data tells us Roles Time
  • 15. Global diabetes timeline The story told by HCPs in social media May 2013 Apr 2014 14-Nov-2013 World Diabetes Day 3,000 2,000 1,000 All HCP conversation
  • 16. Global diabetes timeline: Roles Endocrinologists May 2013 Apr 2014 14-Nov-2013 World Diabetes Day 300 200 100 17-23 Jun 2013 Fall in diabetes- related deaths All HCP conversation Endocrinologists
  • 17. News: Fall in diabetes-related deaths “Good news: the risk of dying early due to diabetes has been greatly reduced! … The treatment helps!” 17-23 June 2013 Physician, Researcher & Writer Norway Optimistic
  • 18. News: Fall in diabetes-related deaths – sceptics? 17-23 June 2013 General Practitioner & Blogger UK Questioning Sceptical
  • 19. Global diabetes timeline: Roles Endocrinologists May 2013 Apr 2014 14-Nov-2013 World Diabetes Day 300 200 100 17-23 Jun 2013 Fall in diabetes- related deaths 8-14 Jul 2013 Roche halts trial of diabetes drug All HCP conversation Endocrinologists
  • 20. News: Roche halts trial of diabetes drug 8-14 July 2013 Endocrinologist USA Frustrated
  • 21. News: Roche halts trial of diabetes drug – mixed reactions 8-14 July 2013 Family Med Physician, Asst Dean Med Ed USA Internist & Medical Writer USA Indifferent Concerned
  • 22. Global diabetes timeline: Roles Endocrinologists May 2013 Apr 2014 14-Nov-2013 World Diabetes Day 300 200 100 17-23 Jun 2013 Fall in diabetes- related deaths 8-14 Jul 2013 Roche halts trial of diabetes drug All HCP conversation Endocrinologists
  • 23. May 2013 Apr 2014 24-30 Jun 2013 T1D Vaccine trial results Global diabetes timeline: Roles Leadership roles 14-Nov-2013 World Diabetes Day 120 80 40 17-23 Jun 2013 Fall in diabetes- related deaths 8-14 Jul 2013 Roche halts trial of diabetes drug All HCP conversation Endocrinologists Leadership roles
  • 24. May 2013 Apr 2014 24-30 Jun 2013 T1D Vaccine trial results Global diabetes timeline: Roles Neurosurgeons 14-Nov-2013 World Diabetes Day 17-23 Jun 2013 Fall in diabetes- related deaths 30 20 10 19 Jul – 4 Aug 2013 Projection on US diabetes by 2020 8-14 Jul 2013 Roche halts trial of diabetes drug All HCP conversation Endocrinologists Leadership roles Neurosurgeons
  • 25. May 2013 Apr 2014 24-30 Jun 2013 T1D Vaccine trial results Global diabetes timeline: Roles Registered Nurses 14-Nov-2013 World Diabetes Day 17-23 Jun 2013 Fall in diabetes- related deaths 19 Jul – 4 Aug 2013 Projection on US diabetes by 2020 8-14 Jul 2013 Roche halts trial of diabetes drug 200 100 19-25 Aug 2013 Study finds pumps > injections All HCP conversation Endocrinologists Leadership roles Neurosurgeons Registered Nurses
  • 26. May 2013 Apr 2014 24-30 Jun 2013 T1D Vaccine trial results Global diabetes timeline: Roles Dieticians 14-Nov-2013 World Diabetes Day 17-23 Jun 2013 Fall in diabetes- related deaths 19 Jul – 4 Aug 2013 Projection on US diabetes by 2020 8-14 Jul 2013 Roche halts trial of diabetes drug 500 300 100 26 Aug – 2 Sep 2013 Study: Fruit juice vs raw fruit 19-25 Aug 2013 Study finds pumps > injections Dieticians All HCP conversation Endocrinologists Leadership roles Neurosurgeons Registered Nurses
  • 28. Time & topics: what the data tells us Topics & issues Time
  • 29. Global diabetes timeline: Topics by patient age group May 2013 Apr 2014 HCP conversation about all diabetes topics 300 200 100 Adults Elderly Pregnancy Teens Young children 10-16 Jun 2013 Study: Taking walk reduces risk of diabetes in elderly 9-25 Aug 2013 Phthalate increases risk of diabetes in young children 13-19 Jan 2014 US Preventative Services Task Force (USPSTF) backs universal diabetes screening for pregnant women
  • 30. USPSTF backs universal diabetes testing for pregnant women “Interesting that the US Preventive Services Task force now recommends what has been the standard of care for years.” Healthcare Professional CMO & Pediatric Surgeon, USA Gastroenterologist USA Dietician, USA 13-19 January 2014 Supportive Frustrated Cynical Interpreting
  • 31. Diabetes testing for pregnant women - Japan obstetrician and gynaecologist Japan “Doctor Song Mingyuan said that there were some gynaecologists who didn’t do their jobs properly, such as not conducting examinations for gestational diabetes, and it’s true. We recently got someone from a place like this, which does so little pregnancy examinations, it’s ridiculous. For blood samples, all they do for early stage examinations is check for infectious diseases and do a red blood cell count, and then for mid stage examinations, they just check for casual blood glucose. And then they just go home. Come on, seriously, stop it.” 13-19 January 2014 Frustrated
  • 33. Place & topics: what the data tells us Place Topics & issues
  • 34. Geography matters Diagnosis Management & treatment Monitoring & testing Prevention & risk Reversal Canada n=1,782 India n=396 Japan n=696 Spain n=1,834 UK n=4,070 USA n=31,978 Venezuela n=4,545 Australia n=1,010 Key topics around prevention, diagnosis & management vary by country
  • 35. Diabetes in multiple dimensions HCPs bring their local experience to the global conversation Many HCP roles interact with unique perspectives Topics can answer business & systems questions Time illustrates how stories develop
  • 37. HCPs who talk about diabetes and pharma brands
  • 38. HCP mentions of pharmaceutical companies & products May 2013 Apr 2014 HCP conversation about all diabetes topics 3-9 Jun 2013 GSK: FDA Panel Votes to Ease Restrictions on Avandia AstraZeneca BMS Bayer Boehringer Ingelheim Lilly GSK J&J Merck Novartis Novo Nordisk Pfizer Roche Sanofi Takeda 25 Nov 2013 - 1 Dec 2014 GSK: FDA Eases Restrictions on Avandia 300 200 100
  • 39. HCP roles discussing GSK products over time May 2013 Apr 2014 3-9 Jun 2013 GSK: FDA Panel Votes to Ease Restrictions on Avandia 25 Nov 2013 - 1 Dec 2014 GSK: FDA Eases Restrictions on Avandia 300 200 100 Cardiologist Pharmacist Physician Family Medicine Physician Endocrinologist Emergency Medicine Physician
  • 40. GSK & products global picture – map of HCPs
  • 41. GSK examples Medical Professional USA Internist USA Pharmacist USA Medical Doctor USA Assc. Prof Medicine USA Sensational Alarmed Sharing Shocked? Balancing
  • 42. Avandia FDA review – live updates via social media Medic, Internal Medicine USA Doctor, Author UK Acute Care Nurse Practitioner USA Doctor Germany Pharmacist USA Clinician USA Highlighting Observing Observing Sensational Sharing Frustrated
  • 43. Avandia – the feedback Internist Canada Clinical Pharmacist USA Family Doctor USA Nutritionist USA Warning Encouraging Warning Warning
  • 44. Reaction turns more positive Chaiman, Dept Psychiatry USA Physician USA Anaesthetist Spain Lipidology Expert USA Pharmacist USA Supportive Supportive Hopeful Empathetic Encouraging
  • 45. Changing attitudes in HCP conversation May 2013 Apr 2014 3-9 Jun 2013 GSK: FDA Panel Votes to Ease Restrictions on Avandia 25 Nov 2013 - 1 Dec 2014 GSK: FDA Eases Restrictions on Avandia 300 200 100 Alarmed Sensational Sharing Shocked? Balancing Highlighting Observing Observing Sensational Sharing Frustrated Warning Encouraging Warning Warning Supportive Supportive Hopeful Empathetic Encouraging
  • 46. What next? Dive deeper: Questions about this study? daniel.ghinn@creationhealthcare.com @EngagementStrat www.creationhealthcare.com

Notes de l'éditeur

  1. Our vision: how can the research we do into the digital behaviour of HCPs, with Creation Pinpoint, make a difference in the world of diabetes? References: http://www.who.int/nmh/en/ IDF
  2. Reach: Number of people connected to (and including) HCPs speaking about diabetes during the study: 8,189,534 Number of HCPs in extended community (1st-level): 47,875 Number of HCP contributors: 19,068 Number of non-Twitter posts: 16,487 Number of Tweets: 189,402 Total posts & Tweets analysed: 205,889
  3. The endocrinologists who are most-followed by other HCPs (most of whom are not shown here).
  4. Sources: http://vickisnotebook.blogspot.co.uk/2013/10/when-two-tribes-go-to-war.html
  5. Sources: https://twitter.com/WasimZahid/statuses/348013647194386433 http://www.bbc.co.uk/news/health-22995158#?utm_source=twitterfeed&utm_medium=twitter
  6. SOURCES: https://twitter.com/DocMartin68/statuses/347960099966447616
  7. Sources: http://www.nytimes.com/2013/07/11/business/roche-abandons-new-diabetes-drug.html?partner=rss&emc=rss&smid=tw-nytimes&_r=0 https://twitter.com/DrElena/statuses/354924642659614722
  8. Sources: https://twitter.com/PabloJooMD/statuses/354905497163415552 https://twitter.com/palmd/statuses/354933961589403650
  9. Sources: http://www.medpagetoday.com/Endocrinology/Diabetes/43787 http://www.medpagetoday.com/comments.cfm?tbid=43787 https://twitter.com/gastromom/statuses/423821948871663616 https://twitter.com/tomwhalen/statuses/423071262491955202 https://twitter.com/mburton0214/statuses/423135284268515328
  10. Sources: https://twitter.com/dokikoYAMAYOKO/status/422990657016184832   Profile: I am an obstetrician and gynaecologist. 1/3rd of my tweets are about medicine, 1/3 are about cats, and about 1/3rd are about home and my children. I am sorry that all my tweets are all so silly. My cats are a Brishow, a Russian, and a Bombay.   Kitakantou   From https://twitter.com/dokikoYAMAYOKO/status/422990657016184832       Dokiko ‏@dokikoYAMAYOKO Doctor Song Mingyuan said that there were some gynaecologists who didn’t do their jobs properly, such as not conducting examinations for gestational diabetes, and it’s true. We recently got someone from a place like this, which does so little pregnancy examinations, it’s ridiculous. For blood samples, all they do for early stage examinations is check for infectious diseases and do a red blood cell count, and then for mid stage examinations, they just check for casual blood glucose. And then they just go home. Come on, seriously, stop it.           Chunko ‏@junta0201 Jan 14 @dokikoYAMAYOKO There are some, there are. They don’t even check for infectious diseases in the early stage examinations and discretionary checks, and then for mid stage examinations they just check the red blood cell count. But, locally, they’re known as a friendly and popular maternity hospital ^_^;. Pregnant women think that just because an establishment puts up a sign they’re doing things properly, so I think it’s really sad for those going to that place.^_^;.         Dokiko ‏@dokikoYAMAYOKO Jan 14 @junta0201 Yeah, there are, aren’t there. I’m so tired of it. They’re cheap too, so the patients seem to like them. It’s seriously sad for the patients.
  11. In Japan, HCPs talk less about prevention & risk; more about diagnosis, monitoring & testing. In Venezuela, prevention is the big topic. In South America, prevention & risk is a bigger concern than in N America (by %). Why? Let’s take a look at one possible factor.
  12. 309 of 379 authors discussing GSK/Avandia – these have accurate location data Aqua in US: osteopath Red in UK: emergency med physician Green, oncologists