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1M to 91.1M, .05) despite the growth of users from 2700 in 2015 to 4100 in 2016 and ~6500 in 2017-2019. This change occurred despite no change in meeting attendance rates, regardless of specialty ( .05). The most influential organizations in hashtag use were the American College of Surgeons (ACS) and Association of Women Surgeons (AWS). Despite the significant reduction in views and online engagement activities in the past 2 years, the use of Twitter at the ACS CC has greatly increased the potential dissemination of informati