SAN DIEGO — Meeting attendees are pushing back against the enforcement of severe restrictions on social media posts that discuss the American Diabetes Association (ADA) 2017 Scientific Sessions taking place here this week. Since the meeting began on Friday, June 9, many of the attendees' Twitter posts, including photographs from sessions, have been met by a polite yet firm appeal from the ADA asking them to delete their tweet. "Thanks for joining us at #2017ADA! Photography isn't allowed during presentations — we'd appreciate it if you would delete this tweet," reads a typical Twitter response from the ADA's official handle, @AmDiabetesAssn. Twitter users immediately began expressing anger and frustration over the seemingly draconian attempts to limit social media conversations at the association's scientific sessions. Many say they see it as an unethical attempt to maintain a monopoly on data and educational effort. "Those in power are counting on you to NOT speak up & to comply. Stop deleting, Start tweeting, Don't be thanked for ur compliance," C Michael Gibson, MD, an interventional cardiologist at Beth Israel Deaconess Medical Center, Boston, Massachusetts, tweeted several times to his more than 300,000 Twitter followers. One prompted a long string of replies in agreement, as well as 150 likes and 90 retweets. Similar posts are also receiving brisk engagement. At times, the flood of negative reaction has dominated conversations about the conference on Twitter. The phrases "Freethetweet," "ludditeofthemonth," and "freedomoftweech" were just as often associated with the conference's official hashtag, #2017ADA, as phrases like "insulin," "mortality," and "changingdiabetes," according to the Twitter analytics site, keyhole.co. "The refusal of the American Diabetes Association to allow sharing of publicly presented content is out of step with the policy of other medical societies that have embraced social media to the benefit of both patients and healthcare providers alike," Dr Gibson told Medscape Medical News. "In the interest of speeding the transformation of diabetic care, patients and healthcare providers should call upon the ADA to reverse its policy to restrict the sharing of photos and slides from the meeting," he added. Tweeting From a Meeting "Not Considered Prior Publication," Says NEJM Even those not in attendance but still following the meeting on Twitter chimed in. Dr Kevin Campbell, a cardiologist and medical expert who makes frequent media appearances, posted more than a dozen tweets to his 137,000 followers, admonishing the ADA. In his view, the restrictions are an archaic form of censorship that only serves to stifle discussion and creativity. "All societies go out of their way to promote interaction and sharing on social," Dr Campbell told Medscape Medical News. "If we do not share data and information, we will only make slow advancements. Real-time interaction provided by SoMe [social media] allows us to make real progress much faster." Another highly prolific physician tweeter who blogs for theheart.org on Medscape, Dr John Mandrola, agrees. He said he finds the policy nonsense and largely unenforceable, a viewpoint he tweeted out several times to his nearly 20,000 followers. "This is the beginning of the end of the 'closed' or 'hierarchical' model of medicine," he told Medscape Medical News, adding that influential publications such as the New England Journal of Medicine (NEJM) encourage tweeting from medical conventions. In fact, NEJM guidelines state: "Online posting of an audio or video recording of an oral presentation at a medical meeting, with selected slides from the presentation, is not considered prior publication." More than a dozen people tweeted out a screen shot of the journal's policy. ADA Says "It's a Copyright Issue" But the ADA said it views the tweets as a copyright issue. "The association understands and appreciates the desire to publicly share photos of research slides and posters presented at Scientific Sessions, especially considering today's technology and the prevalence of instant communication via social media. "However, all research slides and posters are the legal property of each of the research authors and their study team, not the association," said Linda Cann, the association's senior vice president of professional services and education, in a written statement provided to Medscape Medical News. "Many presentations include unpublished data, and while researchers are eager to share it with their peers through their presentation at Scientific Sessions, they maintain legal ownership of their research work (intellectual property)." Ms Cann further asserted that the association is legally obligated to protect the legal rights of the study authors who submit their work for presentation. When registering, all attendees agree to the meeting policies and to follow all local and federal laws, including those related to the intellectual property rights of all parties, she pointed out. Reversing the policy could unwittingly dismantle the long-standing discourse and engagement of medical and scientific research meetings around the world and lead to a restriction of published medical research, she said. The majority of the feedback on Twitter does not agree with the ADA's point of view, however. And at times, the controversy has spilled out into the conference itself. While some presenters told participants it was fine to tweet about their poster or session, others said they couldn't. Many attendees took pictures and tweeted out their thoughts regardless. A growing number have defiantly ignored deletion requests. And some users expressed frustration that all the noise surrounding this was interfering with the legitimate purpose of most people trying to use social media at the meeting. For example, @RenzaS tweeted: "Impossible to follow the #2017ADA feed with all the discussion about photo ban." The association will be reevaluating the policy after the meeting is over, Ms Cann said. However, it seems too late to stem the digital ire surrounding this year's event. An official slide of the top 10 Twitter influencers at the conference, created by the ADA, was dominated by its most vocal critics, including Gibson and Campbell. And one tweeter, MZ Khalil, who was clearly miffed at the restrictions, summed it up by posting a picture of a large, empty conference room. "#2017ADA is this OK?" he asked. "Does this comply? Source