YouTube Videos as a Source of Information on Colorectal Cancer: What Do Our Patients Learn?

Development of AI-generated medical responses using the ChatGPT for cancer patients

BACKGROUND AND OBJECTIVE

To develop a healthcare chatbot service (AI-guided bot) that conducts real-time conversations using large language models to provide accurate health information to patients.

METHODS

To provide accurate and specialized medical responses, we integrated several cancer practice guidelines. The size of the integrated meta-dataset was 1.17 million tokens. The integrated and classified metadata were extracted, transformed into text, segmented to specific character lengths, and vectorized using the embedding model. The AI-guide bot was implemented using Python 3.9. To enhance the scalability and incorporate the integrated dataset, we combined the AI-guide bot with OpenAI and the LangChain framework. To generate user-friendly conversations, a language model was developed based on Chat-Generative Pretrained Transformer (ChatGPT), an interactive conversational chatbot powered by GPT-3.5. The AI-guide bot was implemented using ChatGPT3.5 from Sep. 2023 to Jan. 2024.

RESULTS

The AI-guide bot allowed users to select their desired cancer type and language for conversational interactions. The AI-guided bot was designed to expand its capabilities to encompass multiple major cancer types. The performance of the AI-guide bot responses was 90.98 ± 4.02 (obtained by summing up the Likert scores).

CONCLUSIONS

The AI-guide bot can provide medical information quickly and accurately to patients with cancer who are concerned about their health.

Is YouTube Reliable to Teach Laparoscopic Gastric Bypass?

AIM

 The increasing prevalence of obesity has led to the popularity of bariatric surgery. Laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the most complex methods in bariatric surgery. The main steps of LRYGB were determined in the Delphi Consensus. This study investigated the instructiveness and reliability of YouTube videos about LRYGB based on the Delphi Consensus.

METHODS

In February 2024, three different searches were done in the search bar of the YouTube platform with the terms "laparoscopic gastric bypass" "laparoscopic Roux-en-Y gastric bypass" and "laparoscopic RYGB". The first 50 videos in each search were evaluated. Animations, lectures, advertisements, non-English videos, and non-surgical videos (pre-surgery, post-surgery vlog, etc.) were excluded from the study. Delphi consensus steps were used to determine the reliability of the videos. The quality of the videos was measured using the Global Quality Scale (GQS) and modified DISCERN test.

RESULTS

Forty-five videos were included in the evaluation. While 14 (31.1%) of these videos were classified as reliable, 31 (68.8%) were not found reliable. In reliable videos, video description, high definition (HD) resolution, GQS, and modified DISCERN were significantly higher (p-value 0.023, 0.004, 0.017, and 0.025 respectively).

CONCLUSION

The rate of unreliable videos was higher on the YouTube platform. We conclude that YouTube alone is insufficient to learn LRYGB.

Evaluation of the understandability, actionability and reliability of YouTube videos for brain, head, and neck cancer information

PURPOSE

Online videos accessed via YouTube are a popular method to provide health education. Videos need to be critically evaluated for educational qualities as the information could influence health outcomes. The present study aimed to evaluate the understandability, actionability and reliability of videos available on YouTube regarding brain, head, and neck cancer information.

METHODS

A scoping review was conducted with a specific search strategy and inclusion/exclusion criteria based on previous studies. For each video, video characteristics and user engagement activities were recorded. Videos were evaluated using the PEMAT-A/V and modified DISCERN criteria. Spearman's rank correlation, Kruskal-Wallis test and Mann-Whitney U test were used for analysis.

RESULTS

Out of 200 retrieved videos, 37 were included and analysed. The median length of the video was 3 min and 33 s. The majority of videos were published by health institutional and private channels (43.2%, n = 16). Health institutional channels received the highest actionability (Md = 37.5, p = 0.049), while private channels resulted in lower views/day (Md = 0.46, p = 0.001) and likes/day (Md = 0.01, p = 0.002). Animated and narrated videos acquired the highest understandability score (Md = 92.31, p < 0.001). Videos with professional transcripts reported higher actionability (Md = 62.5, p = 0.004), reliability (Md = 3.33, p = 0.028), views/day (Md = 29.31, p = 0.026), and likes/day (Md = 0.272, p = 0.023).

CONCLUSION

YouTube videos pertaining to brain and head and neck cancer have low understandability, low actionability and moderate reliability. It is beneficial to have a stronger representation of trustworthy and credible organisations for sharing essential health information via YouTube. Including animations and professional video transcripts may improve their overall quality and consumer engagement.

Cancer incidence and digital information seeking in Germany: a retrospective observational study

Awareness is vital for cancer prevention. US studies show a strong link between web searches and cancer incidence. In Europe, the relationship remains unclear. This study characterizes regional and temporal relationships between cancer incidence and web searches and investigates the content of searches related to breast, cervical, colorectal, lung, prostate, and testicular cancer, brain tumors, and melanoma in Germany (July 2018-December 2019). Aggregate data from Google Ads Keyword Planner and national cancer registry data were analyzed. Spearman's correlation coefficient (rS) examined associations between cancer incidence and web search, repeated measures correlation (rrm) assessed time trends and searches were qualitatively categorized. The frequency of malignancy-related web searches correlated with cancer incidence (rS = 0.88, P = 0.007), e.g., breast cancer had more queries than the lower-incidence cervical cancer. Seasonally, incidence and searches followed similar patterns, peaking in spring and fall, except for melanoma. Correlations between entity incidence and searches (0.037 ≤ rrm ≤ 0.208) varied regionally. Keywords mainly focused on diagnosis, symptoms, and general information, with variations between entities. In Germany, web searches correlated with regional and seasonal incidence, revealing differences between North/East and South/West. These insights may help improve prevention strategies by identifying regional needs and assessing impact of awareness campaigns.

Evaluation of the Quality and Comprehensiveness of YouTube Videos Discussing Pancreatic Cancer

Pancreatic cancer is one of the most lethal diseases worldwide and incidence continues to rise, resulting in increased deaths each year. In the modern era, patients often turn to online sources like YouTube for information regarding their disease, which may be subject to a high degree of bias and misinformation; previous analyses have demonstrated low quality of other cancer-related YouTube videos. Thus, we sought to determine if patients can rely on educational YouTube videos for accurate and comprehensive information about pancreatic cancer diagnosis and treatment. We designed a search query and inclusion/exclusion criteria based on published studies evaluating YouTube user tendencies, which were used to identify videos most likely watched by patients. Videos were evaluated based on two well-known criteria, the DISCERN and JAMA tools, as well as a tool published by Sahin et al. to evaluate the comprehensiveness of YouTube videos. Statistical analyses were performed using Chi-square analysis to compare categorical variables. We used linear regression to assess for correlations between quantitative variables. Kruskal-Wallis and independent samples t-test were used to compare means between groups. We assessed inter-rater reliability using Cronbach's alpha. After the initial search query, 39 videos were retrieved that met inclusion criteria. The comprehensiveness and quality of these materials was generally low to moderate, with only 7 videos being considered comprehensive. Pearson's R demonstrated strong correlations between video length and both comprehensiveness and quality. Higher-quality videos also tended to be newer. YouTube videos regarding pancreatic cancer are generally of low to moderate quality and lack comprehensiveness, which could affect patients' perceptions of their disease or understanding of treatment options. These videos, which have collectively been viewed over 6 million times, should be subject to some form of expert review before upload, and producers of this content should consider citing the sources used in the video.

Assessing the scientific quality and reliability of YouTube videos about chemotherapy

No studies have evaluated the interaction, quality, and reliability of chemotherapy-related videos published on YouTube. The aim was to evaluate the content of YouTube videos about chemotherapy using 5 different scoring tools. In this cross-sectional register-based study, popular videos on YouTube about the following keywords were examined; "chemotherapy," "what is chemotherapy," "types of chemotherapy," "chemotherapy side effects" and "chemotherapy treatments." Quality and reliability of video content were measured using the modified DISCERN (mDISCERN), the Journal of the American Medical Association (JAMA), the Global Quality Score (GQS), the Video Information Quality Index (VIQI), and Health on the Net code (HONcode) scores. A total of 108 videos were analyzed in the study. The median duration was 200 (30-2020) seconds and the median total number of views was 17500 (61-8615000). Among the video publishers, private hospitals were the most (n = 36, 33%). The most (n = 71, 66%) populer category of videos were patient education videos. Half (n = 55, 51%) of the narrators in the videos were only oncology professionals. Mean DISCERN, JAMA, GQS, VIQI, and HONcode scores were 2.73 ± 1.18, 1.97 ± 1.05, 2.94 ± 1.08, 14.03 ± 3.73, and 4.68 ± 2.46, respectively. A positive correlation was found between the 5 scoring points (P < .001 for all pairwise comparisons). There was a significant difference between video quality scores according to video categories and video publishers (P < .001 for both). Although most YouTube videos about chemotherapy were helpful to patients, content quality and reliability were moderate-low. Cancer patients looking for information on chemotherapy may find YouTube videos beneficial, but clinicians must be cautious to clear up any misunderstandings.

Assessment of Lung Cancer YouTube Videos for Patient Education

The internet is essential for obtaining information about lung cancer, which is the leading contributor to global cancer deaths. YouTube is a video-streaming platform that is popular among health consumers; however, the reliability of videos is variable, and few studies have evaluated their role in lung cancer education. This study uses a systematic approach to assess the characteristics, reliability and use of best practices of lung cancer YouTube videos for patient education. Using the search term "lung cancer," the first 50 YouTube videos were identified after applying exclusion criteria and removing duplicates. Two reviewers used a video assessment tool to evaluate 10 videos with minimal discrepancies. The remaining 40 videos were evaluated by one reviewer following a design based research approach. Under half the videos were published within 3 years. Mean video length was 6 min and 12 s. Video publishers were commonly from the USA (70%); were affiliated with a health care facility/ organization (30%), non-profit (26%) or commercial organization (30%); had a physician presenter (46%); were targeted towards patients (68%); and had subtitles (96%). Seventy four percent of videos supported optimal learning by including effective audio and visual channels. Lung cancer epidemiology, risk factors, and definitions (nature of the disease and classification) were among the most common topics covered. Prognostic and diagnostic information was covered less than expected. The reliability of the videos (measured by Modified DISCERN score) varied by presenter type; however, these results should be interpreted cautiously due to the absence of gold standard tools. This study encourages those producing health education videos to continue following best practices for video learning and provides strategies for healthcare providers and patients to support patient education.

The Quality of Coronary Artery Bypass Grafting Videos on YouTube

Objective  YouTube (YouTube LLC, San Bruno, California, United States), one of the most accessed sites on the internet, has become a widespread source of healthcare information for patients. Videos about coronary artery bypass grafts (CABG) have accrued tens of millions of views on the platform, yet their educational quality is unknown. This study investigates the educational landscape of videos regarding CABG procedures on YouTube. Methods YouTube was queried for "Coronary Artery Bypass Graft Surgery" and "Coronary Artery Bypass Graft Procedure". After applying exclusion criteria, 73 videos were assessed. Two independent reviewers rated the material with the Global Quality Scale (GQS) (5 = high quality, 0 = low quality) to judge educational value. A ratio of view count to days since upload was applied to assess video popularity. Source, modality, and date of upload were recorded for each video as well. Results An average GQS score of 2.94 was found, indicating poor educational quality of the 73 YouTube videos on CABG procedures. Videos uploaded by physicians (56/73; 76.7%) had a significantly higher average GQS score than those uploaded by non-physicians (p<0.001). When content was grouped by delivery method, physician-led presentations (24/73 or 32.9%) produced the highest average GQS score of 3.35; conversely, patient-friendly delivery methods (18/73 or 24.7%) yielded the lowest average GQS score of 2.36 (p<0.001). Neither the view ratio nor the days since upload significantly correlated with the educational quality of the video. Conclusion Although CABG videos are readily available on YouTube, they often contain considerable biases and misleading information. With online sources for healthcare education now commonplace, physicians must be aware of the vast quantities of low-quality videos patients often encounter when weighing different treatment options. Further analysis of CABG videos on YouTube may allow physicians to ameliorate this gap by producing videos that are not only high quality but highly viewed on the platform.

Assessing Arabic youtube videos on herbal cancer treatment: Absence of health information quality

This study assesses the quality of the health information in Arabic YouTube videos regarding herbal cancer treatment. It also provides an overview of how the quality of video content shapes user awareness by assessing the users' engagement indicators. A simple Python tool was developed using YouTube API V3 to automate the YouTube search based on the recommendation of Google Trends. After applying inclusion and exclusion criteria, 110 YouTube videos were selected, of which 95% were uploaded by non-experts and had a total of 8,633,569 views. The analyzed videos presented more than 40 different herbals as sources of cancer treatment; for example, Ephedra, garden cress, Green tea, Ginseng, Rosemary, and Thyme. 32.7% of the videos provided information about a single herb, 41% about mixing herbals, and 26.3% provided testimonials and success stories without pointing to specific herbs. The videos were assessed by two experts using two reliable tools, DISCERN and PEMAT, which were produced mainly for assessing health information quality. DISCERN has evaluated the reliability and quality of health information. PEMAT has assessed the understandability and actionability. The qualitative and quantitative analyses of the videos represent bias and poor health information quality, with a total score of 27 out of 80 for DISCERN and 31 out of 100 for the PEMAT. The results also showed weak users' awareness regarding the content of videos with no association between user engagement indicators (likes, dislikes, VPI, views, comments) and the dimensions of the two tools. The study concludes that it is evident that YouTube, in its current form, is an inadequate Arabic source for herbal cancer treatment information. To overcome this, this study proposed the GAP framework for social media that integrated Governance, Awareness, and Proficiency.

Assessment of the quality and reliability of the information on spasticity on youtube

BACKGROUND

Youtube has become an influential source of health. This study aimed to evaluate the reliability and quality of YouTube videos on spasticity.

METHODS

The keywords " spasticity, spasticity treatment, spasticity exercises" were used to search for videos. According to the search results, 180 videos were analyzed, videometric characteristics of the videos were recorded, and 2 groups were formed as health professionals and non-health professionals according to the video source. In addition, low, medium and high quality groups were formed using the global quality score (GQS). The reliability of the videos was evaluated using the modified DISCERN (mDISCERN) scale. Video popularity was assessed using the video power index (VPI).

RESULTS

After excluding videos that met the exclusion criteria, the remaining 68 videos were analyzed. The videos were uploaded by healthcare professionals (n = 47, 69.1%) and non-healthcare professionals (n = 21, 30.9%). The popularity (VPI), reliability (mDISCERN) and quality (GQS) of videos uploaded by healthcare professionals were significantly higher (p = 0.002, p = 0.001, p = 0.021, respectively). Most of the videos were of high quality according to GQS (n = 40, 58.8%). All of the high quality videos were of healthcare professionals. The number of sources from healthcare professionals was significantly higher in high quality videos than in both low (p = 0.001) and medium (p = 0.001) quality videos.

CONCLUSION

We can conclude that most of the YouTube videos on spasticity are reliable and of high quality. However, it should be kept in mind that patients may be exposed to low-quality and unreliable videos with misleading content.

Radionuclide Therapy Videos on YouTube as An Educational Material: Has the COVID-19 Pandemic Changed the Quality, Usefulness, and Interaction Features

Introduction

Current treatment approach aims to achieve greater efficacy with fewer side effects, by targeted cancer therapy as much as possible. Radionuclide therapy is a modality that uses cancer theranostics and is increasingly applied for various cancers as a targeted therapy. YouTube is a preferred tool for obtaining medical information from the internet. This study aims to determine the content quality, level of interaction and usefulness as education material of radionuclide therapy YouTube videos and to reveal the impact of the COVID-19 process on these parameters.

Materials and Methods

The keywords were searched on YouTube on August 25, 2018, and May 10, 2021. After removing duplicate and excluded videos, all remaining videos were scored and coded.

Results

Majority of the videos were useful educational material. Most of them were high quality. Popularity markers were unrelated to quality level. After COVID, the power index of videos with high JAMA scores increased. The COVID-19 pandemic did not have a negative effect on video features; the quality of the content increased even more after the pandemic.

Conclusion

Radionuclide therapy YouTube videos have high-quality content and provide useful education material. The popularity is independent of the content quality. During the pandemic, video quality and usefulness characteristics did not change, while the visibility is increased. We consider YouTube to be an appropriate educational material for patients and healthcare professionals to gain basic knowledge of radionuclide therapy. The Covıd-19 pandemic highlighted the power of radionuclide therapy YouTube videos as an educational material.

Evaluation of scientific reliability and quality of YouTube videos on cancer and nutrition

OBJECTIVES

YouTube is a video-sharing platform used by ∼2 billion people per month, and videos are watched in high numbers in the medical field. In this study, we aimed to evaluate the scientific reliability and the relationship between the quality and popularity of the most watched YouTube videos on cancer and nutrition.

METHODS

YouTube videos were evaluated independently by two oncologists. The video quality was evaluated according to the internationally valid medical video or document evaluation scores: DISCERN score, modified DISCERN score, Journal of the American Medical Association score, and Global Quality Scale score.

RESULTS

Forty-six (58%) of the videos were uploaded to the platform by physicians or dietitians. Although 29 videos (36%) recommended a uniform diet, 51 videos (64%) had food suggestions that could be added to the diet. The most recommended foods were cruciferous (n = 16 [20%]; broccoli and cauliflower) and berries (n = 12% [15%]; strawberries, blueberries, and raspberries). When the video quality was evaluated according to the DISCERN score, only 17 (21%) videos were evaluated as good or excellent. There was a strong negative correlation between the DISCERN score and the number of video views and likes (r = -0.426; P < 0.001 and r = -0.226; P = 0.017, respectively).

CONCLUSIONS

Videos about cancer and nutrition were highly watched, but the overall quality and reliability were low. Although the source of the information presented and its deficiencies and sometimes misleading statements were found, it was determined that the videos with less reliability were watched more. There is a need to produce quality content on YouTube or similar platforms.

Navigating Radiation Therapy During COVID-19 Using YouTube as a Source of Information

The COVID-19 pandemic brought considerable change to the practice of radiotherapy. In the meantime, patients are increasingly turning to online resources for health information, with YouTube being one of the biggest platforms. However, little is known about what information is being disseminated to cancer patients about radiotherapy in the context of COVID-19. Therefore, this study aims to characterize and assess YouTube videos on radiotherapy during COVID-19. A YouTube search using the terms "Radiation therapy COVID-19", "Radiation therapy coronavirus", "Radiotherapy COVID-19", and "Radiotherapy coronavirus" was completed using a clear-cache web browser. The top 50 videos were collected from each search. After applying pre-determined exclusion criteria, each video was assessed for general parameters, source, and content. Two raters were used to ensure interrater reliability. One hundred five unique videos resulted from the four searches. Ninety-eight per cent were published in the last year. The median video length was 6 min and 54 s, and the median number of views was 570. Most videos were from the USA (58%). The majority of videos were published by a commercial channel (31%), non-profit organization (28%), or healthcare facility (26%). Forty-two per cent of the videos covered a topic related to radiotherapy during the pandemic. Bias was identified in 6% of videos. YouTube information on radiotherapy during COVID-19 is non-specific and can be misleading. The results of this study highlight the need for healthcare providers to proactively address patient information needs and guide them to appropriate sources of information.

Quality of YouTube Videos Related to Colorectal Cancer Screening

Introduction YouTube, an unregulated video-sharing website, is the second most visited website on the internet. As more patients turn to the internet for information about colon cancer screening, it is important to understand what they are consuming online. Our goal was to evaluate YouTube videos about colon cancer screening to better understand the information patients are accessing. Methods We searched YouTube on October 28, 2020, using the following search terms sorted by relevance and view count: colonoscopy, colon cancer screening, virtual colonoscopy, colonoscopy alternatives, and cologuard. Videos longer than 10 minutes, not in English, and duplicates were excluded. Three evaluators graded each video using the DISCERN criteria. Numerical data were averaged into a composite score. Two-sided t-tests and one-way ANOVA tests were used to compare mean ratings between groups. Results Fifty videos were analyzed, with a total of 23,148,938 views, averaging 462,979 views per video. The average overall rating was 3.16/5. There was no difference between search methods, search terms, or presence of a physician. The average ratings for videos with gastroenterologists (3.08), other physicians (3.35), and non-physicians (3.09) were not significantly different. Videos without physicians had more views on average (1,148,677) compared to videos with gastroenterologists (157,846, p=0.013) or other physicians (35,730, p=0.013). Conclusion YouTube videos related to colon cancer screening were of good quality regardless of search terms, search methods, or presence of a physician. However, videos without physicians were viewed more frequently. Physicians should continue making videos that address deficits while increasing viewership.

Quality and accuracy of gastric cancer related videos in social media videos platforms

BACKGROUND

Gastric cancer is a major public health problem worldwide. Social media has affected public's daily lives in ways no one ever thought possible. Both TikoTok and its Chinese version Douyin are the most popular short video posting platform. This study aimed to evaluate the quality, accuracy, and completeness of videos for gastric cancer on TikTok and Douyin.

METHODS

The terms "gastric cancer" was searched on TikTok in both English and Japanese, and on Douyin in Chinese. The first 100 videos in three languages (website's default setting) were checked. QUality Evaluation Scoring Tool (QUEST) and DISCERN as the instrument for assessing the quality of the information in each video. Content was analysed under six categories (aetiology, anatomy, symptoms, preventions, treatments, and prognosis). The educational value and completeness were evaluated with a checklist developed by the researchers.

RESULTS

A total of 78 videos in English, 63 in Japanese, and 99 in Chinese were analyzed. The types of sources were as follows: 6.4% in English, 4.8% in Japanese, and 57.6% in Chinese for health professionals; 93.6% in English, 95.2% in Japanese, and 3.0% in Chinese for private users; none in English and Japanese, but 39.4% in Chinese for other sources. In all, 20.5% in English, 17.5% in Japanese, and 93.9% in Chinese of videos had useful information about gastric cancer. Among the useful videos, the videos published in Chinese had the highest QUEST(p < 0.05) and DISCERN scores(p < 0.05), followed by those published in Japanese. Among the educational videos, prognosis in English (37.5%), symptoms in Japanese (54.5%), and prevention in Chinese (47.3%) were the most frequently covered topic.

CONCLUSIONS

TikTok in English and Japanese might not fully meet the gastric cancer information needs of public, but Douyin in Chinese was the opposite.

Effectiveness of a rectal cancer education video on patient expectations

AIM

Discrepancy between patient expectations and outcomes can negatively affect patient satisfaction and quality of life. We aimed to assess patient expectations of bowel, urinary, and sexual function after rectal cancer treatments, and whether a preoperative education video changed expectations.

METHODS

A total of 45 patients were assessed between January 2018 and January 2021 in a tertiary care hospital in Vancouver, Canada. Patients included were rectal cancer patients who had neoadjuvant chemoradiation and were listed for low anterior resection but had not yet had surgery. Following surgical consultation but before surgery, a questionnaire assessing expectations of lifestyle after treatments was administered. Patients then watched an educational video and repeated the questionnaire to assess for changes in expectations.

RESULTS

Patient scores indicated expectation that control of bowel movements, urination, and sexual function would sometimes be problematic, but had a range from occasionally problematic to good function. Significant change after the video was seen in the expectation of needing medications for bowel control, and 44%-69% of individual patient answers changed from prevideo to post-video, depending on the question. The education video was scored as helpful or very helpful by 82% of patients.

CONCLUSIONS

Patients have varying expectations of problematic control of bowel, urinary, and sexual function following rectal cancer treatments. A pretreatment education video resulted in a trend toward changed expectations for functional outcomes in most patients. Further educational modalities for patients may provide more uniform expectations of function and increase patient satisfaction after rectal cancer treatments.

A Digital Cancer Ecosystem to Deliver Health and Psychosocial Education as Preventive Intervention

Health education and psychosocial interventions prevent emotional distress, and the latter has been shown to have an impact on survival. In turn, digital health education interventions may help promote equity by reaching a higher number of cancer patients, both because they avoid journeys to the hospital, by and having a better efficiency. A total of 234 women recently diagnosed with breast cancer in a comprehensive cancer center used the digital ecosystem ICOnnecta’t from March 2019 to March 2021. ICOnnecta’t consists of four care levels, provided to patients according to their level of distress. The second level of this intervention consists of an educational campus, which was analyzed to track users’ interests and their information-seeking behavior. Overall, 99 out of 234 women (42.3%) used the educational campus. There were no significant differences in sociodemographic and clinical variables between the campus users and non-users. Among users, the median number of resources utilized per user was four (interquartile range: 2−9). Emotional and medical resources were the contents most frequently viewed and the audiovisual format the most consulted (p < 0.01). Resources were used mainly within the first three months from enrolment. Users who were guided to visit the virtual campus were more active than spontaneous users. Offering an early holistic health educational platform inside a digital cancer ecosystem, with health professionals involved, can reach more patients, promoting equity in the access of cancer information and prevention, from the very beginning of the disease.

Netiquette for social media engagement for oncology professionals

Social media growth has revolutionized health care, facilitating user-friendly, rapid and global sharing of content. Within oncology, this allows for new frontiers in communication for cancer patients, caregivers and healthcare providers. As more physicians engage in online spaces, it is imperative that there are resources to assist in establishing a professional presence on social media. This article describes how to create a social media identity, best practices for engaging both in patient and caregiver spaces and professional communities, and how to address antagonistic and inappropriate behavior on social media with the goal of helping physicians develop an engaging, productive and enjoyable experience online.

Are YouTube Videos a Reliable Source for Obtaining Information About Colorectal Cancer Screening?

Objective: This study aimed to assess the content, quality, and reliability of YouTube videos on colorectal cancer screening. Colorectal cancer is the third most common cause of death worldwide.

Methods: A basic search was conducted on the YouTube^TM website on November 19, 2020, using the English keywords "colorectal cancer screening," without using any filter. The videos were categorized into five groups according to the source and then each video was evaluated by three physicians. The videos were compared in terms of the quality of the information, and their reliability and comprehensiveness, according to the sources.

Results: Of the 137 videos included in the study, 74 (54%) were categorized in the useful information group and 63 (46%) in the misleading information group. It was found that most (47.3%) of the videos in the useful information group were uploaded by academic-based sources. Conversely, most (46%) of the videos in the misleading information group were uploaded by for-profit companies, private hospitals, and medical advertisements. An analysis of the video features according to the upload source revealed that the total views (p=0.023), likes (p=0.004), and viewer engagement with the video (p=0.026) were higher in the public spotlight videos group.

Conclusionsː The quality of public spotlight videos with high viewing rates and audience interaction should be increased to inform the public. In addition, there is a need for videos containing comprehensive and accurate information to be uploaded to YouTube, which is an important source of information today, by universities, health organizations, and doctors who do not make a profit (financially) from the results.

Characteristics Assessment of Online YouTube Videos on Radiotherapy for Lung Cancer

Introduction

The internet has become a mainstay source of health information for cancer patients. Online patient education videos are common; however, there have been no studies examining the quality of publicly available videos on radiotherapy for lung cancer (one of the most common forms of cancer). To fill this knowledge gap, we aim to systematically map and objectively assess videos discussing radiotherapy for lung cancer on YouTube.

Methods

The terms “radiotherapy for lung cancer,” “radiation for lung cancer,” “radiation therapy for lung cancer,” and “radiation treatment for lung cancer” were searched on YouTube using a clear-cache browser. Results were sorted by relevance and the top 50 English-language results for each search were recorded. After removing duplicates, each video was assessed for length, Video Power Index (VPI, which is the product of a video’s average daily views and like and dislike ratio), source, content, comment moderation, and misinformation. Two raters were used to ensure consistency. Results were evaluated using descriptive and inferential statistics.

Results

A total of 88 unique videos resulted from the search. The median video length was 4 minutes and 5 seconds. The average VPI was 10.9 (95% CI: 1.5-20.4) and the median number of views was 954.5. All videos were published between July 8, 2009 and November 18, 2020. Of the videos, 44% were published within the past two years. A total of 61% of the videos were from the USA, 14% were from the UK, 6% from Australia, 5% each from Canada and India, and other countries make up the remaining 10%. Most of the videos were published by healthcare facilities (39%) and non-profit organizations (31%). Content-wise, 95% of videos contain information specific to lung cancer. A total of 46 videos (52%) were targeted toward patient education. Of which, 37 covered radiotherapy for lung cancer, 12 covered side effects for radiotherapy, and 11 covered both. The other 42 videos (48%) were designed for a professional audience. Stereotactic body radiation therapy (SBRT)/stereotactic ablative radiotherapy (SABR) was the most commonly described radiotherapy modality (42%), and the physician interview was the most common format, being used in 59% of videos. Out of the 38 videos with at least one comment, only two (5%) were moderated by the host channel. None of the videos featured misleading information.

Conclusions

This study comprehensively surveyed YouTube videos pertaining to radiotherapy for lung cancer to provide a high-level overview of the information that patients may find online. Although nearly half of the videos describe lung cancer radiotherapy for patients, only a small proportion comprehensively cover both radiotherapy and its side effects. The results of our study can help guide the development of patient education tools and encourage healthcare providers to recognize the limitations of online health information and proactively address patient questions regarding radiotherapy. Future research could examine videos on other lung cancer treatment options or radiotherapy for other cancers.

YouTube videos as a source of information concerning Behçet's disease: a reliability and quality analysis

In this study, we aimed to investigate the reliability and quality of YouTube videos concerning Behçet disease, for the first time in the literature. The most viewed 50 YouTube videos about Behçet disease were included. Study data used in the analysis included video length, image type, video content, uploaders, time since the date of upload, the number of total views, daily views, and the numbers of like, dislike and comments. The Video Power Index was used to determine popularity of the videos. Reliability and quality of the videos were evaluated using DISCERN and Global Quality Scale (GQS) instruments. The examined YouTube videos were divided into two groups as uploaded by professionals (physicians, health and hospital channels, institutions and societies) and non-professionals (patients, social organizations, others). Twenty-three (46%) videos were uploaded by professionals. The mean DISCERN score was found as 3.98 ± 0.77 in the videos uploaded by healthcare professionals and 2.83 ± 0.64 in those uploaded by non-professionals (p < 0.01). The mean GQS score was found as 4.09 ± 0.72 in the videos uploaded by healthcare professionals and 3.41 ± 0.69 in those uploaded by non-professionals (p < 0.01). 46% of the videos were of low-to-moderate reliability and 56% of low-to-moderate quality. Nearly half of the YouTube videos concerning Behçet disease were uploaded by non-physician sources with poor reliability and quality. Physicians should be encouraged to upload more professional videos to help and guide patients appropriately. YouTube videos should be subjected to an objective evaluation for content quality before they can be published.

Breast cancer screening literacy information on online platforms: A content analysis of YouTube videos

BACKGROUND

The YouTube platform has great potential of serving as a healthcare resource due to its easy accessibility, navigability and wide audience reach. Breast cancer screening is an important preventative measure that can reduce breast cancer mortality by 40%. Therefore, platforms being used as a healthcare resources, such as YouTube, can and should be used to advocate for essential preventative measures such as breast cancer screening.

METHODS

In this study, the usefulness of videos related to breast cancer and breast cancer screening were analyzed. Videos were first screened for inclusion and then were categorized into very useful, moderately useful, somewhat useful, and not useful categories according to a 10-point criteria scale developed by medical professionals based on existing breast cancer screening guidelines. Two reviewers independently assessed each video using the scale.

RESULTS

200 videos were identified in the preliminary analysis (100 for the search phrase 'breast cancer' and 100 for the search phrase 'breast cancer screening'). After exclusion of duplicates and non-relevant videos, 162 videos were included in the final analysis. We found the following distribution of videos: 4.3% very useful, 17.9% moderately useful, 39.5% somewhat useful, and 38.3% not useful videos. There was a significant association between each of the following and the video's level of usefulness: video length, the number of likes, and the uploading source. Longer videos were very useful, somewhat useful videos were the most liked, personally produced videos were the most not useful, and advertisements produced the highest ratio of very useful to not useful videos.

CONCLUSION

It is necessary to create more reliable and useful healthcare resources for the general population as well as to monitor health information on easily accessible social platforms such as YouTube.

The Quality, Reliability, and Popularity of YouTube Education Videos for Vestibular Rehabilitation: A Cross-sectional Study

HYPOTHESIS

Vestibular rehabilitation (VR) education videos on YouTube are poor-quality and unreliable.

BACKGROUND

YouTube has become a health information source. Recent studies have determined that videos on YouTube contain misleading and inappropriate information for different medical conditions. The aim of the present study was to assess the quality and reliability of VR education videos.

METHODS

A search was performed using the keywords vertigo, vertigo treatment, vertigo exercise, and vestibular rehabilitation, on YouTube. The first 50 videos for each keyword were analyzed. Videos were divided into four groups according to the video source: Group 1: universities/occupational organizations, Group 2: medical ad/profit-oriented companies, Group 3: independent users, and Group 4: others (news/media/state institution). The quality and reliability of videos were evaluated regarding the modified DISCERN criteria, the modified Journal of the American Medical Association (JAMA) benchmark criteria, and global quality scores (GQS).

RESULTS

Among the 200 videos analyzed, 103 were included. The main video source was medical ad/profit-oriented companies (60.2%). The mean modified DISCERN criteria score, the mean modified JAMA benchmark criteria score, and the mean GQS value of the videos were found as low (2.46 ± 1.37, 2.09 ± 1.23, and 2.67 ± 1.38, respectively). Videos uploaded by universities/occupational organizations (25.2%) had statistically significant higher modified DISCERN criteria scores, modified JAMA benchmark criteria scores, and GQS values compared with the other groups (p < 0.001).

CONCLUSION

Online information about VR education on YouTube was of poor quality and unreliable. Expert vestibular providers should be aware of these inappropriate sources and educate patients regarding the poor-quality of videos and also aim to provide more quality and reliable sources of information.

Is YouTube a high-quality source of information on cancer rehabilitation?

BACKGROUND

Searching for information on the Internet, especially YouTube^TM, is gaining popularity for cancer survivors. Based on the topic of online health information, the importance of studies using YouTube data for various cancer types and treatment methods has increased. This study aims to investigate the quality, reliability, and accuracy of YouTube videos on cancer rehabilitation (CR).

METHODS

YouTube search was performed on February 26th, 2021, with two keyword sets: "cancer rehabilitation" and "oncology rehabilitation." The modified DISCERN, the Journal of the American Medical Association (JAMA) scoring system, and the Global Quality Score (GQS) were used to evaluate the quality and reliability of the videos. The features of each video such as the number of likes, dislikes, and views, upload date, duration, like ratio, and the uploader profile were also collected.

RESULTS

Fifty-three of the first 200 videos shown in the search results met the criteria. Most of the videos were low quality. The most common uploader profile was academic institute/university hospital. The three most common subjects in the videos were CR definition, physical therapy and occupational therapy, and patient experiences. The mean modified DISCERN, JAMA, and GQS scores were 2.14, 2.03, and 2.78, respectively. Higher quality videos had longer duration, greater number of views, and better reliability scores.

CONCLUSION

The results showed that most of the rated videos were of low-quality and didn't provide sufficient information on the topic discussed. Higher-quality and more accurate YouTube videos are needed to increase awareness of CR.

IMPLICATIONS FOR CANCER SURVIVORS

For cancer survivors, CR-related YouTube video content often provides information of low reliability. In this context, it is necessary to focus on the production of video content that includes clinical guides, references, and are based on clinical-based practices.

Effectiveness of Colorectal Cancer Screening Promotion Using E-Media Decision Aids: A Systematic Review and Meta-Analysis

Colorectal cancer (CRC)-screening reduces mortality, yet remains underutilized. The use of electronic media (e-media) decision aids improves saliency and fosters informed decision-making. This systematic review aimed to determine the effectiveness of CRC-screening promotion, using e-media decision aids in primary healthcare (PHC) settings. Three databases (MEDLINE, Web of Science, and the Cochrane Library) were searched for eligible studies. Studies that evaluated e-media decision aids compared to usual care or other conditions were selected. Quality was assessed by using Cochrane tools. Their effectiveness was measured by CRC-screening completion rates, and meta-analysis was conducted to calculate the pooled estimates. Ten studies involving 9393 patients were included in this review. Follow-up durations spanned 3–24 months. The two types of decision-aid interventions used were videos and interactive multimedia programs, with durations of 6–15 min. Data from nine feasible studies with low or some risk of bias were synthesized for meta-analysis. A random-effects model revealed that CRC-screening promotion using e-media decision aids were almost twice as likely to have screening completion than their comparisons (OR 1.62, 95% CI: 1.03–2.62, p < 0.05). CRC-screening promotion through e-media has great potential for increasing screening participation in PHC settings. Thus, its development should be prioritized, and it should be integrated into existing programs.

Online Information for Colorectal Cancer Screening: A Content Analysis of YouTube Videos

Preventive care is a form of healthcare that aims to prevent diseases or detect diseases in an eary stage, especially for diseases like colorectal cancer. YouTube is a platform with great reach and opportunity to educate the public through preventive healthcare-related resources. However, understanding on current YouTube resources, specifically related to colorectal cancer screening, are inadequate in terms of informational quality. In this study, videos related to colorectal cancer and colorectal cancer screening were identified and analyzed by two reviewers. Very useful (4.5%), moderately useful (18.5%), somewhat useful (38.9%), and not useful (38.2%) videos were categorized based on a usefulness scale compiled by medical professionals. Less useful videos are paralleled with more views and public engagement in comparison with more useful videos which had been released by more credible sources. There is a significant association between video length and level of usefulness as well between video source and usefulness. This study illustrates the need for better educational healthcare resources and/or filtration on widely accessible platforms such as YouTube.

YouTube as a Source of Patient Information Regarding Placenta Accreta Spectrum

OBJECTIVE

 As the awareness of the accompanying morbidity of placenta accreta spectrum (PAS) has increased over recent decades. We sought to analyze the precision and reliability of the currently available content regarding PAS on YouTube.

STUDY DESIGN

 A YouTube search was performed on June 17, 2019 by using the search terms "placenta accreta," "PAS," and "invasive placentation." Search results were sorted by relevance, and up to 200 videos per search term were systematically evaluated by four independent reviewers. A quality assessment checklist relating to aspects of PAS was developed with a Likert's scale from 0 to 12 points to quantify video content. Videos were classified as poor educational quality (grade 0 to ≤4), moderate quality (grade >4-8), and high quality (grade >8-12).

RESULTS

 Of the 318 videos identified, 99 videos met inclusion criteria. The majority of videos (61.6%) were produced by a professional source, that is, appearing to be from a hospital, university, or educational service. Of the remaining videos, 16.2% were classified as personal, that is, posted from personal YouTube accounts and depicting a personal or family member experience, and 22.2% were classified as other. The majority of the "other" category consisted of news segments and short clips from talk shows. Overall, 60.6% of videos were of poor educational quality, 32.3% were of moderate quality, and 7.1% were deemed high quality. All seven of the high-quality videos were produced by a professional source and intended for an audience of medical professionals. There were neither high-quality videos intended for the general public nor the likely affected and relevant patient population.

CONCLUSION

 This study suggests that the currently available videos on YouTube regarding PAS are poor educational sources for patients seeking information, and demonstrates a need for high-quality content videos produced by medical professionals specifically focused on meeting the needs of patient population.

KEY POINTS

· Awareness of the accompanying morbidity of placenta accreta spectrum has increased over recent decades.. · YouTube videos are poor educational sources for patients seeking information regarding PAS.. · YouTube videos and all social media warrant improvements regarding patient's information..

COVID-19 pandemic: An analysis of popular YouTube videos as an alternative health information platform

Dispersal of COVID-19 related information from YouTube plays a vital role in containing the pandemic and diminishes associated anxiety in the population. This study investigated the characteristics of popular YouTube videos related to COVID-19 outbreak. YouTube videos were searched using the COVID-19 related specific keywords with the eligibility of at least 1 million views. The videos were classified as types of videos (News, TV Shows, Educational, and Documentary) and sentiment-based titled videos (Positive and Negative). Total viewership, length of videos, comments, likes, subscribers of the channel, and the number of days since upload was recorded as video and user engagement characteristics. A total of 93 videos were found eligible to include in the study. About 44.1% of videos were educational and 32.3% of videos were news updates related to COVID-19. Furthermore, 45.7% of videos had a positive sentiment-based title whereas 53.2% of videos had a negative sentiment-based title. Viewer's comment responses were classified into nine various categories; most frequent comments were sarcastic/humorous (21.5%) category. Results revealed the differences in audience behavior in response to different types of videos and sentiment-based titled videos. YouTube has a significant amount of informative COVID-19 videos and incorporating certain characteristics can increase YouTube video popularity.

YouTube as a source of information on breast cancer in the Arab world

BACKGROUND

The general population is increasingly using YouTube as a source of information on breast cancer, the most frequent cancer among women. Arabs are the most interested population in breast cancer on YouTube. The transmission of accurate information is important to reduce mortality rates. This cross-sectional study aims to evaluate breast cancer videos on YouTube in the Arab world.

METHODS

A YouTube search for "breast cancer" in Arabic was performed. The most viewed 60 videos included were evaluated for global quality (GQS score), reliability (modified DISCERN score), content (content score), and misleading claims. Recorded and calculated data included views, duration, videos power index, and viewers' interaction. Sources from legal persons (governments, universities, TV channels, physicians' groups), and blogs (online health channels, individuals) were categorized.

RESULTS

The median global quality (3/5), reliability (2/5), and content scores (4/11) were overall low. Misleading information was found in 42% of the videos. Although videos uploaded by legal persons were less popular (163,454 vs 327,488 views), they hosted more physicians (52% vs 15%), were less misleading (15% vs 64%), covered more content, and were of higher global quality and reliability than videos uploaded by blogs [p < 0.05]. While the topic of symptoms (55%) was discussed the most, genetic counseling (13%) and prevention (20%) were the least mentioned.

CONCLUSIONS

YouTube is poorly informational and inaccurate on breast cancer in the Arab World where it is highly used. Although videos uploaded by legal persons tend to be more adequate, they are of lower popularity. Governments and physicians are encouraged to upload more intelligibly informational videos, guide the population to reliable sources, and support regulations.

Making sense of "superbugs" on YouTube: A storytelling approach

Antimicrobial resistance is one of the greatest challenges facing the world. With the rapid growth of social media, YouTube has become an influential social media platform providing publics with expert health knowledge. This article explores how antimicrobial resistance is communicated on YouTube. Drawing on qualitative media analyses of the most viewed YouTube videos 2016-2020, we identify seven different genres and two main storytelling approaches, personalized and fictionalized storytelling, used to make sense of antimicrobial resistance and its complexities. The study contributes new knowledge about YouTube as a platform for health communication and the types of videos about antimicrobial resistance that gets most traffic. This is useful, not the least for public health experts working to improve communication strategies that target hard-to-reach media publics.

Suicide on YouTube:Factors engaging viewers to a selection of suicide-themed videos

Visual social media platforms can function as both facilitators and intervenors of concerning behaviors. This study focused on one of the health concerns worldwide, a leading cause of death related to mental health—suicide—in the context of a dominant visual social media platform, YouTube. This study employed content analysis method to identify the factors predicting viewer responses to suicide-themed content from the perspectives of who’s, what’s, and how’s of suicide-themed videos. The results of the hierarchical multiple regression showed that the characteristics of content provider and content expression were more significant predictors of viewer engagement than were the characteristics of the message. These findings have implications for not only platform service providers but also diverse groups of individuals who participate in online discussions on suicide. YouTube has the potential to function as a locus for open discussion, education, collective coping, and even the diagnosis of suicidal ideation.

Comparison of Online Learning Video Platforms Regarding Laparoscopic Adrenalectomy: YouTube and WebSurg

Background: The internet is a widely used source for receiving medical information. Nevertheless, the quality of data on online platforms is still questioned. Our aim was to compare the laparoscopic adrenalectomy videos published on the two online platforms, WebSurg^® (WS) and YouTube^® (YTb) regarding the quality of data, educational power, and accuracy of the sources. Materials and Methods: Most viewed popular visual content returned by YTb in reply to the keyword "laparoscopic adrenalectomy" were involved in the research protocol. The quality of the data, educational power, and the accuracy and reliability of the sources were assessed by applying new scoring systems. A novel scoring method estimated technical quality. The 10 most viewed videos in the WS were compared with 10 YTb videos with the highest technical scores. Results: Scoring systems measuring the quality of data and educational power of the mostly viewed WS visual content revealed higher scores than those of the most technically qualified 10 YTb videos (10 videos having the highest laparoscopic adrenalectomy scoring system scores [LASS-S]; P = .021; P = .003; P = .025, respectively). Also, there was no significant difference between the top 10 most viewed WS videos and 10 YTb videos having the highest LASS-S in terms of LASS-S (P = .34). Conclusions: Although WS videos were passed through a professional reviewing process, and were mostly provided by academicians, they remained below the expected quality. The presented research showed that attentively chosen YTb content on laparoscopic adrenalectomy is almost as accurate as WS content. Notwithstanding all its limitations, the informative power or potential of YTb should not be neglected.

What Are Patients Watching? A Quality and Content Evaluation of YouTube Videos About Gestational Diabetes. (Preprint)

BACKGROUND

People with gestational diabetes have enhanced learning requirements during pregnancy, and management of their disease often requires the translation of health information into new health behavior changes. Seeking information from the internet to augment learning from health professionals is becoming more common during pregnancy. YouTube is a popular free and accessible web-based resource, which may be particularly useful for individuals with low health literacy or other barriers to receiving high-quality health care; however, the quality and content of YouTube videos varies, and little is known about those covering gestational diabetes.

OBJECTIVE

We aimed to systematically evaluate the quality, content, and reliability of YouTube videos about gestational diabetes.

METHODS

A systematic search of YouTube videos was conducted over the course of 1 week in April 2020 using the following keywords: "gestational diabetes," "gestational diabetes management," "gestational diabetes treatment," and "pregnancy and diabetes." The search results were displayed by relevance, replicating a default YouTube search attempt. The first 60 results from each keyword were reviewed (n=240). Exclusion criteria were videos unrelated to gestational diabetes, videos not in English, and those for which the full video was not available at the time of review. For each unique video, a gestational diabetes content score was used to rate video comprehensiveness and accuracy, and the DISCERN instrument, a validated metric to assess consumer health information, was used to evaluate the reliability of information presented. Videos were further categorized by quality: videos with DISCERN scores lower than 3 (out of 5) or a content score less than 4 (out of 7) were categorized as low quality, and all others were designated high quality. We performed descriptive analysis and compared video characteristics by source and quality rating.

RESULTS

For 115 unique videos, the mean content score (out of 7) was 3.5 (SD 2.0) , and the mean DISCERN score (out of 5) was 2.7 (SD 0.7), representing low to moderate information comprehensiveness and reliability respectively. Video sources were categorized as personal vlog (12/115, 10.4%), web-based education (37/115, 32.2%), medical (52/115, 45.2%), business or company (13/115, 11.3%), and media clip (1/115, 0.9%). DISCERN and content scores trended higher among medical and web-based education videos. The majority of videos (n=88) were categorized as low quality, while 27 videos were categorized as high quality. Video duration was longer for high-quality videos (P<.001); high- and low-quality videos otherwise had similar views and viewer interaction numbers.

CONCLUSIONS

Although high-quality videos about gestational diabetes exist, reliability, accuracy, and comprehensiveness were low overall, and higher quality was not associated with increased viewer interaction. It is important to acknowledge the limitations of this platform and to assist patients in accessing high quality content and differentiating the quality of information sources.

Are DISCERN and JAMA Suitable Instruments for Assessing YouTube Videos on Thyroid Cancer? Methodological Concerns

The incidence of thyroid cancer continues to increase worldwide. The challenge facing the treatment of thyroid cancers is related to the fact that this disease exhibits a broad range of clinical behaviour from indolent tumour to very aggressive malignancies. Therefore, the public and patient education about thyroid cancer are becoming a crucial step in facing the challenge imposed by this cancer. Currently, social media channels such as YouTube, a video-sharing website on the Internet, play a significant role in public and patient education. Research on the part of YouTube in public education about cancer is on the rise, including a paper on thyroid cancer published recently in the Journal of Cancer Education. However, researchers conducting studies should use tools that are designed to assess videos, not written information or websites. DISCERN instrument and JAMA benchmark tools are not intended to evaluate videos such as those of YouTube. An ideal instrument for assessing YouTube should cover several parameters to identify educationally useful videos, including (i) scientific accuracy of video content, (ii) clarity of the massage given, (iii) authority (creator), (iv) pedagogy and educational basis and (v) technical design, including quality images and good visuals, production style, quality scripts, clear sounds and no noises in the background. While video images help in reinforcing the words and the message, both picture and sound quality are vital in creating a strong mental impression and engaging the audience. This commentary calls for the development of a standardised protocol that can help researchers to enhance their research publications and ensure that adequate and accurate data have been collected and analysed. Such a move will help us in establishing the right literature in this area and will help researchers conducting reviews and meta-analysis on YouTube videos.

Evaluating YouTube as a Source of Patient Information for Functional Endoscopic Sinus Surgery

OBJECTIVE

To evaluate the quality of information presented on YouTube regarding functional endoscopic sinus surgery (FESS) for patients.

METHODS

YouTube was searched using FESS-specific keywords under the setting of "relevance." The first 50 videos from each keyword were reviewed and analyzed by 2 independent physician reviewers. Videos not related to FESS and duplicates were excluded. Outcome measures included the modified DISCERN score (range 0-5), the Journal of the American Medical Association (JAMA) benchmark criteria (range: 0-4), a novel scoring checklist for FESS assessing usefulness (range: 0-16), and the Video Power Index (VPI). Intraclass correlation coefficient (ICC) was calculated.

RESULTS

Of the 200 videos identified, 95 videos were analyzed after exclusions. Videos had an average VPI of 40.8 and SD 133.2. Average scores from the 3 objective checklists among all videos were low: modified DISCERN: 1.91, SD: 1.15; JAMA benchmark: 1.91, SD: 0.76; and FESS score: 3.54, SD: 1.77. The ICC between the 2 independent reviewers was excellent for all 3 checklists. We noted significant positive Pearson correlation between all 3 checklist scores (P < .001). In between-group comparisons of mean scores, there was significantly higher DISCERN and JAMA scores for videos from university/professional organizations, as compared to videos from medical advertising/for-profit companies and independent users. There were no significant differences in FESS scores noted between the 3 groups.

CONCLUSION

There were overall low scores across the modified DISCERN, JAMA benchmark criteria, and FESS scoring checklists, reflecting the poor quality of YouTube videos as a source of patient information for FESS.

Xigua Video as a Source of Information on Breast Cancer: Content Analysis

Background

Seeking health information on the internet is a popular trend. Xigua Video, a short video platform in China, ranks among the most accessed websites in the country and hosts an increasing number of videos with medical information. However, the nature of these videos is frequently unscientific, misleading, or even harmful.

Objective

Little is known about Xigua Video as a source of information on breast cancer. Thus, the study aimed to investigate the contents, quality, and reliability of breast cancer–related content on Xigua Video.

Methods

On February 4, 2020, a Xigua Video search was performed using the keyword “breast cancer.” Videos were categorized by 2 doctors based on whether the video content provided useful or misleading information. Furthermore, the reliability and quality of the videos were assessed using the 5-point DISCERN tool and 5-point global quality score criteria.

Results

Out of the 170 videos selected for the study, 64 (37.6%) were classified as useful, whereas 106 (62.4%) provided misleading information. A total of 41.8% videos (71/170) were generated by individuals compared to 19.4% videos (33/170) contributed by health care professionals. The topics mainly covered etiology, anatomy, symptoms, preventions, treatments, and prognosis. The top topic was “treatments” (119/170, 70%). The reliability scores and global quality scores of the videos in the useful information group were high (P<.001). No differences were observed between the 2 groups in terms of video length, duration in months, and comments. The number of total views was higher for the misleading information group (819,478.5 vs 647,940) but did not reach a level of statistical significance (P=.112). The uploading sources of the videos were mainly health care professionals, health information websites, medical advertisements, and individuals. Statistical differences were found between the uploading source groups in terms of reliability scores and global quality scores (P<.001). In terms of total views, video length, duration, and comments, no statistical differences were indicated among the said groups. However, a statistical difference was noted between the useful and misleading information video groups with respect to the uploading sources (P<.001).

Conclusions

A large number of Xigua videos pertaining to breast cancer contain misleading information. There is a need for accurate health information to be provided on Xigua Video and other social media; health care professionals should address this challenge.

Usefulness of YouTube™ videos in training patients for blood glucose self-monitoring in current coronavirus disease-19 pandemic

Objectives:

During the coronavirus disease-19 pandemic, due to restricted health-care access, patients may not get hands-on training for self-monitoring of blood glucose (SMBG) from physicians. YouTube™ is a popular video-sharing web platform that can be used as a source of information for SMBG. This study aimed to assess the usefulness of YouTube™ videos on SMBG.

Material and Methods:

We searched the keywords “blood glucose self-monitoring,” “home blood glucose monitoring,” “blood glucose test,” and “blood sugar test” on YouTube™. The first 40 videos of each search were listed. After the two-stage screening, 49 videos were included for final data analysis. General characteristics and SMBG-specific characteristics (namely, strip handling, lancing device handling, measurement, and post- measurement action) were observed with pre-defined criteria having “yes” and “no” closed option. Data were tested statistically by the binomial test.

Results:

Average duration of 49 videos was 244.20 ± 72.61 s and those were online since 35.14 ± 20.52 months on YouTube™. Information about strip handling was mostly deficient, major being checking the expiry date (16.33% videos had the information). The handling of the lancing device was correct in the majority of the videos except for the disinfection of the tip of the lancing device (6.12% videos had the information). The measurement procedure was also correct in the majority of the videos except for the instruction to dry the hands (38.78% videos had the information) after washing. The post-measurement logbook entry was found in 48.98% videos.

Conclusion:

YouTube™ videos can be used as a potential source of information for patients’ education for SMBG. However, there are various levels of the incompleteness of the tutorials. Primary care physicians may suggest YouTube™ videos after exploring the videos and selecting the most appropriate one for their patients.

Characteristics of YouTube Videos in Spanish on How to Prevent COVID-19

OBJECTIVE

To analyze the characteristics of YouTube videos in Spanish on the basic measures to prevent coronavirus disease 2019 (COVID-19).

METHODS

On 18 March 2020, a search was conducted on YouTube using the terms "Prevencion Coronavirus" and "Prevencion COVID-19". We studied the associations between the type of authorship and the country of publication with other variables (such as the number of likes and basic measures to prevent COVID-19 according to the World Health Organization, among others) with univariate analysis and a multiple logistic regression model.

RESULTS

A total of 129 videos were evaluated; 37.2% were produced in Mexico (25.6%) and Spain (11.6%), and 56.6% were produced by mass media, including television and newspapers. The most frequently reported basic preventive measure was hand washing (71.3%), and the least frequent was not touching the eyes, nose, and mouth (24.0%). Hoaxes (such as eating garlic or citrus to prevent COVID-19) were detected in 15 videos (10.9%). In terms of authorship, papers produced by health professionals had a higher probability of reporting hand hygiene (OR (95% CI) = 4.20 (1.17-15.09)) and respiratory hygiene (OR (95% CI) = 3.05 (1.22-7.62)) as preventive measures.

CONCLUSION

Information from YouTube in Spanish on basic measures to prevent COVID-19 is usually not very complete and differs according to the type of authorship. Our findings make it possible to guide Spanish-speaking users on the characteristics of the videos to be viewed in order to obtain reliable information.

Comparison of New Era's Education Platforms, YouTube® and WebSurg®, in Sleeve Gastrectomy

INTRODUCTION

The Internet is a widely used resource for obtaining medical information. However, the quality of information on online platforms is still debated. Our goal in this quality-controlled WebSurg® and YouTube®-based study was to compare these two online video platforms in terms of the accuracy and quality of information about sleeve gastrectomy videos.

METHODS

Most viewed (popular) videos returned by YouTube® search engine in response to the keyword "sleeve gastrectomy" were included in the study. The educational accuracy and quality of the videos were evaluated according to known scoring systems. A novel scoring system measured technical quality. The ten most viewed (popular) videos in WebSurg® in response to the keyword "sleeve gastrectomy" were compared with ten YouTube® videos with the highest educational/technical scores.

RESULTS

Scoring systems measuring the educational accuracy and quality of WebSurg® videos were significantly higher than ten YouTube® videos which have the most top technical scores (p < 0.05), and no significant difference was found in the assessment of ten YouTube® videos that have the highest technical ratings compared with WebSurg® videos (p 0.481).

CONCLUSIONS

WebSurg® videos, which were passed through a reviewing process and were mostly prepared by academicians, remained below the expected quality. The main limitation of WebSurg® and YouTube® is the lack of information on preoperative and postoperative processes.

Analysis of the Most Viewed First 50 Videos on YouTube about Breast Cancer

Objective

Breast cancer is the most common cancer type among women worldwide. Today, health consumers search the Internet to gain health information about many diseases including breast cancer. YouTube™ is the second most commonly used website on the Internet. However, the quality and accuracy of health-related YouTube™ videos are controversial. The objective of this study was to investigate the quality and accuracy of breast cancer-related videos on YouTube™. Material and Methods. "Breast cancer" keyword was entered into YouTube™ search bar, and after excluding advertisement, duplicate, and non-English videos, the first most viewed 50 videos were analyzed. Videos' length, the number of views, comments, likes, and dislikes were recorded. DISCERN and JAMA scores and Video Power Index (VPI) values of the videos were calculated. All videos were evaluated by two independent radiologists experienced on breast cancer. The correlation between the two observers was also analyzed.

Results

Of all videos, 14% were uploaded by physicians, 26% by health channels, 20% by patients, 10% by news channels, 2% by herbalists, 2% by blog channels, and 2% by nonprofit activism channels. The mean DISCERN score was calculated as 26.70 ± 10.99 and the mean JAMA score as 2.23 ± 0.97. The mean VPI value, which was calculated to determine the popularity of the videos, was found as 94.10 ± 4.48. A strong statistically significant correlation was found between the two observers in terms of both DISCERN and JAMA scores. There was an excellent agreement between the two observers.

Conclusion

The overall quality of the viewed videos was found as poor. Healthcare professionals should be encouraged to upload breast cancer-related videos with accurate information to promote patients for screening and direct them appropriately.

YouTube: Searching for answers about breast cancer

INTRODUCTION

Breast cancer is the most common cancer in women, affecting approximately 1 in 8 women worldwide. Additionally, it is either the most or second-most lethal cancer depending on ethnicity. Many women and concerned family members turn to the internet for information regarding the signs, symptoms, diagnosis and treatment of this life-altering condition. We sought to objectively evaluate the quality of the information available on YouTube concerning breast cancer.

METHODS

We searched YouTube for videos relating to breast cancer. We included videos that were less than 20 minutes in length, were in the top 200 for most views and were available in English, either subtitled or narrated. Videos were independently and blindly scored using a standardized scoring form. Possible scores ranged from negative infinity to 25.5 with one point being deducted for each misleading statement or claim.

RESULTS

After exclusions, 133 videos in our sample were evaluated. Out of a possible 25.5 points, the true mean was 3.90 with a standard deviation of 1.38. There were only 30 videos (22.5%) that scored more than 7 points. 12 (9.0%) videos scored 0 points or fewer. 12 (9.0%) of the videos in our sample contained at least one misleading statement with 9 of those contained multiple misleading statements with some videos having up to 10 such statements.

CONCLUSION

While YouTube is an important source of information regarding breast cancer, few videos contain a significant amount of quality information and many of the videos contain false or misleading statements. In an area where patients are often scared and searching for answers, there is a significant need for more high-quality videos to educate patients and dispel myths and pseudoscience.

Levels of toothache-related interests of Google and YouTube users from developed and developing countries over time

Background

The preferences of Web users can be influenced by distinct factors of populations. Hence, hypothetically, source-based patterns of health-related Web searches might differ between individuals from developed and developing countries, due to their distinct educational, social, economic, political, cultural, and psychosocial backgrounds. In this context, this study aimed to determine the trends of toothache-related searches performed on Google Search and YouTube, regarding differences between developed and developing countries.

Methods

This retrospective longitudinal study analyzed computational metadata on toothache-related interests of Internet users. Google Trends was accessed to obtain the monthly variation of relative search volume (RSV) of the topic “Toothache-Disease” on Google (G) and YouTube (YT) through 2008–2017. Autocorrelation and partial autocorrelation plots, ARIMA models, Kruskal–Wallis, Dunn’s and T tests were performed for evaluating trends, 12-month forecasts and the differences of annual ratios of YT/G searches between developed and developing countries, respectively (P < 0.05).

Results

Uptrends of RSVs were observed in both country groups over time, although 12-month forecasts tended to plateau.The volumes of searches were higher in developed countries in comparison to developing ones; however, this difference was not observed regarding Google searches performed between 2016 and 2017. Independently of country groups, the ratios YT/G remained relatively constant throughout the period, indicating a greater interest in toothache-related information available on Google.

Conclusion

In conclusion, toothache-related searches from Google and YouTube increased during the last decade. The preferences of Web users seemed to be influenced by the differences between developed and developing countries, such as the availability and penetration of the Internet, and education levels.

Evaluation of the Reliability, Utility, and Quality of Information Used in Total Extraperitoneal Procedure for Inguinal Hernia Repair Videos Shared on WebSurg

Purpose The Internet is widely used by patients and physicians for obtaining medical information. WebSurg is a valuable information resource that can improve the learning experience of medical professionals if used appropriately. This study aimed to evaluate the quality and accuracy of videos on the total extraperitoneal procedure (TEP) for inguinal hernia repair. Methods We included 32 videos returned by the WebSurg search engine in response to the keyword "TEP." Video popularity was evaluated using the video power index (VPI). The videos' educational quality was measured using the DISCERN score, Journal of American Medical Association (JAMA) benchmark criteria, and Global Quality Score (GQS). Technical quality was measured using the TEP Scoring System (TepSS) by three surgeons who performed TEP routinely. Results All videos were obtained from medical doctors; 12.5% of the videos were uploaded from Belgium; 3.1%, China; 6.3%, Colombia; 6.3%, England; 59.4%, France; 9.4%, Germany; and 3.1%, Korea. No significant differences were noted in terms of the VPI, DISCERN scores, JAMA benchmark criteria, GQSs, and TepSS scores (p > 0.05). The mean VPI, DISCERN score, JAMA benchmark criteria, GQS, and TepSS score were 9454.53 ± 15085.57, 32.75 ± 6.99, 2.31 ± 0.47, 1±0, and 9.25 ± 2.36, respectively. No significant associations were noted between the VPI and DISCERN score, JAMA benchmark criteria, and GQS (p > 0.05). Similarly, there was no significant association between the VPI and TepSS scores (r = 0.100; p = 0.587). Conclusions The online information on TEP is of suboptimal quality. Although limited information is available on preoperative and postoperative processes, the educational potential of WebSurg cannot be ignored.

Reddit and Radiation Therapy: A Descriptive Analysis of Posts and Comments Over 7 Years by Patients and Health Care Professionals

Purpose

Reddit is a social media platform that allows health care professionals (HPs) to anonymously interact with patients. We analyzed content about radiation therapy (RT) on Reddit.

Methods and Materials

Reddit.com/r/cancer was queried with 20 search terms related to RT: IMRT, 3D-CRT, SBRT, EBRT, XRT, radiation, radiotherapy, RT, radio, rad, rads, gamma, gamma knife, gammaknife, cyber knife, cyberknife, cyber, brachytherapy, brachy, and cobalt. The search aimed to identify all posts discussing RT. A random sample of posts and their top 3 comments was selected to generate qualitative thematic codes per author consensus, which were used to characterize all posts and their top 3 voted comments. Posts were analyzed for time to first reply, mention of any specific RT modality, whether a self-identified HP responded, and time to first highly voted comment by an HP.

Results

Exactly 190 posts about RT by 178 users were shared from February 2011 to May 2018, and 468 replies by 295 users were also analyzed. Twenty-nine of these users (9.8%) were HPs; however, 48 of 181 top comments were contributed by HPs compared with 45 of 288 non–top comments by HPs (odds ratio, 1.95; 95% confidence interval [CI], 1.23-3.08; P < .004). The most common themes were treatment questions, chronology, and information; toxicities; and social support. The median time to first comment after posting was 64.0 minutes (95% CI, 53.0-82.0), and median time to first highly voted comment from an HP was 264.0 minutes (95% CI, 153.5-427.9; U = 4123.5; P < .0001 2-tailed). Fifty-three posts (27.9%) identified a specific RT modality, with proton therapy (7.4%), CyberKnife (5.3%), brachytherapy (4.2%), and whole brain radiation (4.2%) being the most common.

Conclusions

HPs did not reply often to RT posts and generally took longer to do so, but their replies were valued by users. Common themes included treatment questions, chronology, and treatment; toxicities; and social support. Proton therapy received notable attention.