Our position on X

The considerations

X has been a contentious channel since the takeover of Elon Musk in October 2022. The platform has seen an increase in the prevalence of bots and misinformation. In addition, there has been a drop in the performance of posts and some features (such as paid advertising and analytics) have become available only for ‘premium’ users.  

Organizations have responded to these changes in different ways, with some choosing to remain on the platform and others withdrawing. There are many reasons for organizations to stay on, or leave, X. Some of these are summarized below.

Reasons to remain on X:

  • To combat the misinformation with high-quality evidence
  • Reach and use, although declining, are still significant  
  • Ability to share real‑time information during crises or emergencies
  • Ongoing use of the platform by UK politicians, government bodies, journalists, and traditional media outlets
  • Visibility of conversations that may not take place on other platforms

Reasons to withdraw from X:

  • Ethical considerations  related to platform governance and content moderation
  • Loss of analytics, limiting the ability to measure impact and effectiveness
  • Declining reach and use  
  • Limited relevance for Cochrane, which rarely requires real‑time communications in crisis scenarios
  • Reduced relevance for academic audiences, many of whom have migrated to other platforms

In March 2025, Cochrane paused proceedings on X to re-evaluate our use of the platform.

The central team’s current position

Current guidance from X recommends posting approximately five times per day in order to meet best‑practice standards. Maintaining this level of activity would require a disproportionate level of staff time and resource.

We want to balance the resources we put into our social media channels and ensure we have enough capacity to manage and grow our other channels too. Given that we get a better return on investment on other channels, and the resources X would require to be an effective channel, the central team does not currently plan to resume activity on X.

What this means for groups

Cochrane Groups may continue to use the social media platforms they consider most effective for reaching their intended audiences, provided they have the capacity to manage those channels appropriately. There is no requirement for Groups to use or avoid any specific platform.  

Groups considering opening a new social media account should refer to existing Cochrane guidance before doing so. 

Updated April 2026