{"id":7141,"date":"2017-02-22T04:39:18","date_gmt":"2017-02-22T03:39:18","guid":{"rendered":"https:\/\/blogs.bmj.com\/bjsm\/?p=7141"},"modified":"2017-02-22T17:56:19","modified_gmt":"2017-02-22T16:56:19","slug":"population-based-norms-personalised-medicine-health-fitness-sports-performance","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bjsm\/2017\/02\/22\/population-based-norms-personalised-medicine-health-fitness-sports-performance\/","title":{"rendered":"From population based norms to personalised medicine: Health, Fitness, Sports Performance"},"content":{"rendered":"

“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. – World Health Organisation 1948<\/span><\/p>\n

By Dr Nicky Keay<\/strong><\/p>\n

There has been\u00a0criticism<\/a>\u00a0of this definition, arguing that the word “complete” has opened the door to today’s\u00a0more medicalised\u00a0society. However, this trend\u00a0coincides with increased volume of “patients” seeking optimal health, together with\u00a0doctors who have a more extensive repertoire of medical interventions at their disposal.\u00a0In a time-pressed society there is less opportunity for either patient or doctor to explore longer term\u00a0adaptive measures<\/a>\u00a0and prevention strategies, which\u00a0facilitate taking responsibility for your health. Fortunately Sport and Exercise Medicine became a recognised medical specialty in the UK in 2006. This encompasses\u00a0population-based strategies for disease prevention outlined in\u00a0the global initiative founded in 2007 “Exercise is Medicine<\/a>“.<\/p>\n

What has this got to do with sports performance? There are subgroups within the population, such as\u00a0athletes already taking plenty of exercise. Elite athletes differ from\u00a0the general\u00a0population, due to superior adaptation processes to exercise, probably with\u00a0a genetic component. So are\u00a0the same “normal” population-based ranges of quantified medical parameters applicable?<\/p>\n

\"\"<\/p>\n

This is precisely the issue that arose when I was on the\u00a0international medical research team<\/a>\u00a0investigating the development of a dope test for\u00a0growth hormone (GH)<\/a>. Crucially, exercise is one of the major stimuli for growth hormone release from the anterior pituitary. So before we could even start investigating potential downstream markers of exogenous GH abuse, the “normal” range for elite athletes had to be established.<\/p>\n

Father and son compete in running race: How will their endocrine markers differ across age and fitness levels?<\/figcaption><\/figure>\n

In a similar way, are the “normal” ranges for other hormones applicable to athletes? In a fascinating lecture delivered by Dr Kristien Boelaert, Consultant Endocrinologist, it was explained that the distribution\u00a0for thyroid stimulating hormone (TSH) is affected by multiple factors, including illness, age and\u00a0exercise status. So “normal” for the general population is not necessarily normal for specific subgroups.<\/p>\n

The other issue, especially with the Endocrine system is that hormones act on a variety of tissues and so produce a variety of multi-system network effects with interactions and control feedback loops. Therefore symptoms of malfunction\/maladaptation and subclinical conditions can be non specific. From a doctor’s perspective this makes Endocrinology fascinating\u00a0detective work, but challenging when dealing with\u00a0subgroups in the population\u00a0who require a more intensive work-up and individualised approach.<\/p>\n

The vast majority of research studies involve exclusively male athletes, leaving female athletes under-represented (a\u00a0recent study on\u00a0heat adaptation in female athletes<\/a>\u00a0being a notable\u00a0exception). Some\u00a0areas of research<\/a>, including my own, have been directed more towards\u00a0female athletes<\/a>\u00a0in the case of female athlete triad, or Relative Energy Deficiency in sports (REDs). REDs is a more appropriate\u00a0term as it really sums up the important points: male and female can both be affected and therefore should both be studied. There are subgroups within the general population who may not fit the “normal” range: REDs is not necessarily a clinically defined eating disorder from lecture by Professor J. Sundgot-Borgen (IOC working group on female athlete triad and IOC working group on body composition, health and performance).<\/p>\n

No\u00a0medical\/physiological\/metabolic parameter can be considered in isolation: in the case of REDs, it is not menstrual disturbance and bone health that are affected in isolation. For example, there is currently great debate about whether a low carbohydrate\/high fat diet (ketogenic diet) can mobilise fat oxidation and potentially be a training strategy to enhance performance. Needless to say that a\u00a0recent study<\/a>\u00a0contained no\u00a0female athletes. Given that many female endurance athletes are already lean, potentially driving fat metabolism through diet manipulation may have an impact on Endocrine function, optimal health and hence sport performance. I understand\u00a0that a forthcoming study will include female athletes.<\/p>\n

So a continuum or distinct subgroups in the population? Clearly general medical principles apply to all, with a spectrum from optimal functioning, subclinical conditions\u00a0through to recognised disease state. We now have\u00a0evidence of distinct differences between subgroups in the population and even within these subgroups such as male and female athletes. We are moving into a world of personalised medicine, where recommendations for optimal health\u00a0are tailored for individuals within specific subgroups.<\/p>\n

*******************************<\/p>\n

Dr Nicky Keay<\/strong> BA, MA (Cantab), MB, BChir, MRCP, Clinical and research experience in Endocrinology applied to Sport and Exercise Medicine.<\/em><\/p>\n

Publications<\/a><\/h3>\n

“Subclinical hypothydroidism in athletes”. Lecture by Dr Kristeien Boelaert at BASEM Spring Conference 2014 on the Fatigued Athlete<\/p>\n

Awards<\/a><\/h3>\n

Relative Energy Deficiency in sport (REDs) Lecture by Professor Jorum Sundgot-Borgen, BAEM Spring Conference 2015 on the Female Athlete<\/p>\n

Low Carbohydrate, High Fat diet impairs exercise economy and negates the performance benefit from intensified training in elite race walkers<\/a><\/p>\n

References<\/h3>\n

How should we define health?<\/a><\/p>\n

Nobody is average but what to do about it? The challenge of individualized disease prevention based on genomics<\/a><\/p>\n

Exercise is Medicine<\/a><\/p>\n

Enhancing Sport Performance: part 1<\/a><\/p>\n

Effect of\u00a0adaptive responses to heat exposure on exercise performance<\/a><\/p>\n

<\/h3>\n

<\/p>\n","protected":false},"excerpt":{"rendered":"

“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. – World Health Organisation 1948 By Dr Nicky Keay There has been\u00a0criticism\u00a0of this definition, arguing that the word “complete” has opened the door to today’s\u00a0more medicalised\u00a0society. However, this trend\u00a0coincides with increased volume of “patients” seeking […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[3040,16017,2758],"class_list":["post-7141","post","type-post","status-publish","format-standard","hentry","category-uncategorized","tag-red-s","tag-subgroups","tag-youth"],"yoast_head":"\nFrom population based norms to personalised medicine: Health, Fitness, Sports Performance - BJSM blog - social media's leading SEM voice<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bjsm\/2017\/02\/22\/population-based-norms-personalised-medicine-health-fitness-sports-performance\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"From population based norms to personalised medicine: Health, Fitness, Sports Performance - BJSM blog - social media's leading SEM voice\" \/>\n<meta property=\"og:description\" content=\"“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. – World Health Organisation 1948 By Dr Nicky Keay There has been\u00a0criticism\u00a0of this definition, arguing that the word “complete” has opened the door to today’s\u00a0more medicalised\u00a0society. However, this trend\u00a0coincides with increased volume of “patients” seeking [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/bjsm\/2017\/02\/22\/population-based-norms-personalised-medicine-health-fitness-sports-performance\/\" \/>\n<meta property=\"og:site_name\" content=\"BJSM blog - social media's leading SEM voice\" \/>\n<meta property=\"article:published_time\" content=\"2017-02-22T03:39:18+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2017-02-22T16:56:19+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/blogs.bmj.com\/bjsm\/files\/2017\/02\/subgroups-graph.jpg\" \/>\n<meta name=\"author\" content=\"BMJ\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"BMJ\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/2017\\\/02\\\/22\\\/population-based-norms-personalised-medicine-health-fitness-sports-performance\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/2017\\\/02\\\/22\\\/population-based-norms-personalised-medicine-health-fitness-sports-performance\\\/\"},\"author\":{\"name\":\"BMJ\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\"},\"headline\":\"From population based norms to personalised medicine: Health, Fitness, Sports Performance\",\"datePublished\":\"2017-02-22T03:39:18+00:00\",\"dateModified\":\"2017-02-22T16:56:19+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/2017\\\/02\\\/22\\\/population-based-norms-personalised-medicine-health-fitness-sports-performance\\\/\"},\"wordCount\":855,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/2017\\\/02\\\/22\\\/population-based-norms-personalised-medicine-health-fitness-sports-performance\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/files\\\/2017\\\/02\\\/subgroups-graph.jpg\",\"keywords\":[\"RED-S\",\"subgroups\",\"Youth\"],\"articleSection\":[\"General\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/2017\\\/02\\\/22\\\/population-based-norms-personalised-medicine-health-fitness-sports-performance\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/2017\\\/02\\\/22\\\/population-based-norms-personalised-medicine-health-fitness-sports-performance\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/2017\\\/02\\\/22\\\/population-based-norms-personalised-medicine-health-fitness-sports-performance\\\/\",\"name\":\"From population based norms to personalised medicine: Health, Fitness, Sports Performance - BJSM blog - social media's leading SEM voice\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/2017\\\/02\\\/22\\\/population-based-norms-personalised-medicine-health-fitness-sports-performance\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/2017\\\/02\\\/22\\\/population-based-norms-personalised-medicine-health-fitness-sports-performance\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/files\\\/2017\\\/02\\\/subgroups-graph.jpg\",\"datePublished\":\"2017-02-22T03:39:18+00:00\",\"dateModified\":\"2017-02-22T16:56:19+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/2017\\\/02\\\/22\\\/population-based-norms-personalised-medicine-health-fitness-sports-performance\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/2017\\\/02\\\/22\\\/population-based-norms-personalised-medicine-health-fitness-sports-performance\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/2017\\\/02\\\/22\\\/population-based-norms-personalised-medicine-health-fitness-sports-performance\\\/#primaryimage\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/files\\\/2017\\\/02\\\/subgroups-graph.jpg\",\"contentUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/files\\\/2017\\\/02\\\/subgroups-graph.jpg\",\"width\":310,\"height\":213},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/2017\\\/02\\\/22\\\/population-based-norms-personalised-medicine-health-fitness-sports-performance\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"From population based norms to personalised medicine: Health, Fitness, Sports Performance\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/#website\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/\",\"name\":\"BJSM blog - social media's leading SEM voice\",\"description\":\"\",\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/#organization\",\"name\":\"BJSM blog - social media's leading SEM voice\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/files\\\/2017\\\/11\\\/blog-logo-bjsm.png\",\"contentUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/files\\\/2017\\\/11\\\/blog-logo-bjsm.png\",\"width\":222,\"height\":34,\"caption\":\"BJSM blog - social media's leading SEM voice\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/#\\\/schema\\\/logo\\\/image\\\/\"}},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\",\"name\":\"BMJ\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g\",\"caption\":\"BMJ\"},\"sameAs\":[\"https:\\\/\\\/blogs.bmj.com\\\/\"],\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/author\\\/admin\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"From population based norms to personalised medicine: Health, Fitness, Sports Performance - BJSM blog - social media's leading SEM voice","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/blogs.bmj.com\/bjsm\/2017\/02\/22\/population-based-norms-personalised-medicine-health-fitness-sports-performance\/","og_locale":"en_US","og_type":"article","og_title":"From population based norms to personalised medicine: Health, Fitness, Sports Performance - BJSM blog - social media's leading SEM voice","og_description":"“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. – World Health Organisation 1948 By Dr Nicky Keay There has been\u00a0criticism\u00a0of this definition, arguing that the word “complete” has opened the door to today’s\u00a0more medicalised\u00a0society. However, this trend\u00a0coincides with increased volume of “patients” seeking [...]Read More...","og_url":"https:\/\/blogs.bmj.com\/bjsm\/2017\/02\/22\/population-based-norms-personalised-medicine-health-fitness-sports-performance\/","og_site_name":"BJSM blog - social media's leading SEM voice","article_published_time":"2017-02-22T03:39:18+00:00","article_modified_time":"2017-02-22T16:56:19+00:00","og_image":[{"url":"https:\/\/blogs.bmj.com\/bjsm\/files\/2017\/02\/subgroups-graph.jpg","type":"","width":"","height":""}],"author":"BMJ","twitter_card":"summary_large_image","twitter_misc":{"Written by":"BMJ","Est. reading time":"4 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/blogs.bmj.com\/bjsm\/2017\/02\/22\/population-based-norms-personalised-medicine-health-fitness-sports-performance\/#article","isPartOf":{"@id":"https:\/\/blogs.bmj.com\/bjsm\/2017\/02\/22\/population-based-norms-personalised-medicine-health-fitness-sports-performance\/"},"author":{"name":"BMJ","@id":"https:\/\/blogs.bmj.com\/bjsm\/#\/schema\/person\/ba3da426ed20e8f1d933ca367d8216fe"},"headline":"From population based norms to personalised medicine: Health, Fitness, Sports Performance","datePublished":"2017-02-22T03:39:18+00:00","dateModified":"2017-02-22T16:56:19+00:00","mainEntityOfPage":{"@id":"https:\/\/blogs.bmj.com\/bjsm\/2017\/02\/22\/population-based-norms-personalised-medicine-health-fitness-sports-performance\/"},"wordCount":855,"commentCount":0,"publisher":{"@id":"https:\/\/blogs.bmj.com\/bjsm\/#organization"},"image":{"@id":"https:\/\/blogs.bmj.com\/bjsm\/2017\/02\/22\/population-based-norms-personalised-medicine-health-fitness-sports-performance\/#primaryimage"},"thumbnailUrl":"https:\/\/blogs.bmj.com\/bjsm\/files\/2017\/02\/subgroups-graph.jpg","keywords":["RED-S","subgroups","Youth"],"articleSection":["General"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/blogs.bmj.com\/bjsm\/2017\/02\/22\/population-based-norms-personalised-medicine-health-fitness-sports-performance\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/blogs.bmj.com\/bjsm\/2017\/02\/22\/population-based-norms-personalised-medicine-health-fitness-sports-performance\/","url":"https:\/\/blogs.bmj.com\/bjsm\/2017\/02\/22\/population-based-norms-personalised-medicine-health-fitness-sports-performance\/","name":"From population based norms to personalised medicine: Health, Fitness, Sports Performance - BJSM blog - social media's leading SEM voice","isPartOf":{"@id":"https:\/\/blogs.bmj.com\/bjsm\/#website"},"primaryImageOfPage":{"@id":"https:\/\/blogs.bmj.com\/bjsm\/2017\/02\/22\/population-based-norms-personalised-medicine-health-fitness-sports-performance\/#primaryimage"},"image":{"@id":"https:\/\/blogs.bmj.com\/bjsm\/2017\/02\/22\/population-based-norms-personalised-medicine-health-fitness-sports-performance\/#primaryimage"},"thumbnailUrl":"https:\/\/blogs.bmj.com\/bjsm\/files\/2017\/02\/subgroups-graph.jpg","datePublished":"2017-02-22T03:39:18+00:00","dateModified":"2017-02-22T16:56:19+00:00","breadcrumb":{"@id":"https:\/\/blogs.bmj.com\/bjsm\/2017\/02\/22\/population-based-norms-personalised-medicine-health-fitness-sports-performance\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/blogs.bmj.com\/bjsm\/2017\/02\/22\/population-based-norms-personalised-medicine-health-fitness-sports-performance\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/blogs.bmj.com\/bjsm\/2017\/02\/22\/population-based-norms-personalised-medicine-health-fitness-sports-performance\/#primaryimage","url":"https:\/\/blogs.bmj.com\/bjsm\/files\/2017\/02\/subgroups-graph.jpg","contentUrl":"https:\/\/blogs.bmj.com\/bjsm\/files\/2017\/02\/subgroups-graph.jpg","width":310,"height":213},{"@type":"BreadcrumbList","@id":"https:\/\/blogs.bmj.com\/bjsm\/2017\/02\/22\/population-based-norms-personalised-medicine-health-fitness-sports-performance\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/blogs.bmj.com\/bjsm\/"},{"@type":"ListItem","position":2,"name":"From population based norms to personalised medicine: Health, Fitness, Sports Performance"}]},{"@type":"WebSite","@id":"https:\/\/blogs.bmj.com\/bjsm\/#website","url":"https:\/\/blogs.bmj.com\/bjsm\/","name":"BJSM blog - social media's leading SEM voice","description":"","publisher":{"@id":"https:\/\/blogs.bmj.com\/bjsm\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/blogs.bmj.com\/bjsm\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/blogs.bmj.com\/bjsm\/#organization","name":"BJSM blog - social media's leading SEM voice","url":"https:\/\/blogs.bmj.com\/bjsm\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/blogs.bmj.com\/bjsm\/#\/schema\/logo\/image\/","url":"https:\/\/blogs.bmj.com\/bjsm\/files\/2017\/11\/blog-logo-bjsm.png","contentUrl":"https:\/\/blogs.bmj.com\/bjsm\/files\/2017\/11\/blog-logo-bjsm.png","width":222,"height":34,"caption":"BJSM blog - social media's leading SEM voice"},"image":{"@id":"https:\/\/blogs.bmj.com\/bjsm\/#\/schema\/logo\/image\/"}},{"@type":"Person","@id":"https:\/\/blogs.bmj.com\/bjsm\/#\/schema\/person\/ba3da426ed20e8f1d933ca367d8216fe","name":"BMJ","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/secure.gravatar.com\/avatar\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g","caption":"BMJ"},"sameAs":["https:\/\/blogs.bmj.com\/"],"url":"https:\/\/blogs.bmj.com\/bjsm\/author\/admin\/"}]}},"_links":{"self":[{"href":"https:\/\/blogs.bmj.com\/bjsm\/wp-json\/wp\/v2\/posts\/7141","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.bmj.com\/bjsm\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.bmj.com\/bjsm\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/bjsm\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/bjsm\/wp-json\/wp\/v2\/comments?post=7141"}],"version-history":[{"count":0,"href":"https:\/\/blogs.bmj.com\/bjsm\/wp-json\/wp\/v2\/posts\/7141\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.bmj.com\/bjsm\/wp-json\/wp\/v2\/media?parent=7141"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.bmj.com\/bjsm\/wp-json\/wp\/v2\/categories?post=7141"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.bmj.com\/bjsm\/wp-json\/wp\/v2\/tags?post=7141"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}