Dissemination of Misinformative and Biased Information about Prostate Cancer on YouTube

Advancing Patient Education in Idiopathic Intracranial Hypertension: The Promise of Large Language Models

Background and Objectives

We evaluated the performance of 3 large language models (LLMs) in generating patient education materials (PEMs) and enhancing the readability of prewritten PEMs on idiopathic intracranial hypertension (IIH).

Methods

This cross-sectional comparative study compared 3 LLMs, ChatGPT-3.5, ChatGPT-4, and Google Bard, for their ability to generate PEMs on IIH using 3 prompts. Prompt A (control prompt): "Can you write a patient-targeted health information handout on idiopathic intracranial hypertension that is easily understandable by the average American?", Prompt B (modifier statement + control prompt): "Given patient education materials are recommended to be written at a 6th-grade reading level, using the SMOG readability formula, can you write a patient-targeted health information handout on idiopathic intracranial hypertension that is easily understandable by the average American?", and Prompt C: "Given patient education materials are recommended to be written at a 6th-grade reading level, using the SMOG readability formula, can you rewrite the following text to a 6th-grade reading level: [insert text]." We compared generated and rewritten PEMs, along with the first 20 googled eligible PEMs on IIH, on readability (Simple Measure of Gobbledygook [SMOG] and Flesch-Kincaid Grade Level [FKGL]), quality (DISCERN and Patient Education Materials Assessment tool [PEMAT]), and accuracy (Likert misinformation scale).

Results

Generated PEMs were of high quality, understandability, and accuracy (median DISCERN score ≥4, PEMAT understandability ≥70%, Likert misinformation scale = 1). Only ChatGPT-4 was able to generate PEMs at the specified 6th-grade reading level (SMOG: 5.5 ± 0.6, FKGL: 5.6 ± 0.7). Original published PEMs were rewritten to below a 6th-grade reading level with Prompt C, without a decrease in quality, understandability, or accuracy only by ChatGPT-4 (SMOG: 5.6 ± 0.6, FKGL: 5.7 ± 0.8, p < 0.001, DISCERN ≥4, Likert misinformation = 1).

Discussion

In conclusion, LLMs, particularly ChatGPT-4, can produce high-quality, readable PEMs on IIH. They can also serve as supplementary tools to improve the readability of prewritten PEMs while maintaining quality and accuracy.

Prioritising Key Concepts for informed health choices in cancer: An evidence-based online educational programme

Objective

The overabundance of health misinformation has undermined people's capacity to make evidence-based, informed choices about their health. Using the Informed Health Choices (IHC) Key Concepts (KCs), we are developing a two-stage education programme, Informed Health Choices-Cancer (IHC-C), to provide those impacted by cancer with the knowledge and skills necessary to think critically about the reliability of health information and claims and make well-informed choices. Stage 1 seeks to prioritise the most relevant Key Concepts.

Methods

A project group and a patient and carer participation group completed a two-round prioritisation process. The process involved disseminating pre-reading materials, training sessions, and a structured judgement form to evaluate concepts for inclusion. Data from each round were analysed to reach a consensus on the concepts to include.

Results

Fourteen participants were recruited and completed the first-round prioritisation. Fifteen participants undertook the second-round prioritisation. Nine Key Concepts were selected for the programme across five training sessions and two consensus meetings.

Conclusion

The prioritised concepts identified represent the most pertinent aspects of cancer-related information for those impacted by the disease. By incorporating these concepts into educational materials and communication strategies, healthcare providers and organisations can potentially help cancer patients, survivors, and their loved ones to recognise and combat cancer-related misinformation more effectively.

Innovation

This study introduces a participatory prioritisation process, which integrates the expertise of healthcare professionals with the insights of patients and carers, thereby enhancing the programme's relevance and applicability.

Trust of social media content and risk of making misinformed decisions: Survey of people affected by cancer and their caregivers

Background

This study explores social media (SM) usage and trust in information among cancer patients and their caregivers. We compare socio-demographic characteristics to identify groups more likely to rely on social media for treatment decisions and those less inclined to validate social media information with their provider.

Methods

A national survey of people diagnosed with cancer and those who were caregivers to people diagnosed with cancer was conducted via online survey in November-December 2021. Socio-demographic factors associated with respondents' use of SM and comfort disclosing SM use were assessed using logistic regression.

Findings

Out of 262 respondents, 65% were likely to use SM to make decisions about lifestyle changes, cancer screening, vaccination, cancer treatment, medical testing, or choosing a provider. SM users were younger (ORadj = 0.11, p < 0.01), identified as Black (ORadj = 10.19, p < 0.01), and had less education (ORadj = 0.86, p = 0.02). Those with less education reported not being comfortable discussing SM with their providers (ORadj = 1.25, padj = 0.01).

Discussion

Results contribute new understanding of the digital divide, highlighting the need for not only improving access to digital information but also the need for a supportive environment that provides patients with dependable methods to verify the authenticity of the information they encounter.

TikTok misinformation and user engagement in female pelvic floor conditions

IMPORTANCE

Social media platforms are increasingly utilized to distribute medical information. Our study emphasizes the need for accuracy in pelvic health education on social media and the involvement of female pelvic floor (FPF) specialists in content creation.

AIMS

In this cross-sectional study, we assessed the FPF TikTok videos with the highest engagement for quality of information and misinformation and investigated the relationship between misinformation and user engagement.

METHODS

We collected all TikTok videos on the US app with hashtags related to FPF conditions, including 76 on pelvic organ prolapse, 323 on urinary tract infection, 84 on overactive bladder, and 972 on incontinence. The top 20 videos for each FPF condition were selected based on highest engagement, and 74 videos total met inclusion criteria. TikTok videos were scored with the validated DISCERN instrument for quality of consumer health information and a 5-point Likert scale for misinformation. The correlation between misinformation and user engagement was assessed.

RESULTS

Our analysis revealed positive correlations among higher average misinformation scores and shares (r = 0.37, p < 0.001), likes (r = 0.23, p = 0.004), and overall engagement (r = 0.25, p = 0.002) in FPF TikTok videos as a group, likely driven by the #UTI category. Most TikTok videos (96%) had poor quality of information (DISCERN score < 3), and 18% of TikTok videos contained misinformation.

CONCLUSION

The poor quality and prevalence of misinformation in FPF-related TikTok videos with the highest engagement raise concerns about the propagation of nonevidence-based health information.

Potential Reinforcement of Health Misconceptions in YouTube Videos: Example of Elbow Enthesopathy (Tennis Elbow)

BACKGROUND AND OBJECTIVES

We evaluated the prevalence of potential reinforcement of common unhealthy misinterpretations of bodily sensations in social media (YouTube videos) addressing elbow enthesopathy (eECRB, enthesopathy of the extensor carpi radialis brevis, tennis elbow).

METHODS

We recorded video metric data on 139 unique YouTube videos when searching "lateral epicondylitis" and "tennis elbow." We designed a rubric to assess the level of potential reinforcement of unhelpful thinking in videos about eECRB. Informational quality was scored with an adapted version of the DISCERN instrument. We then assessed the factors associated with these scores.

RESULTS

Sixty-five percent (91 of 139) of videos contained information reinforcing at least one common misconception regarding eECRB. Potential reinforcement of misconceptions was associated with longer video duration, higher likes per day, and higher likes per view. No factors were associated with information quality scores.

CONCLUSIONS

These findings of a high prevalence of potential reinforcement of misconceptions in YouTube videos, in combination with the known associations of misconceptions with greater discomfort and incapability, point to the potential of such videos to harm health. Producers of patient facing health material can add avoidance of reinforcement of unhelpful thinking along with readability, accuracy, and relevance as a guiding principle.

A Comparison of ChatGPT and Human Questionnaire Evaluations of the Urological Cancer Videos Most Watched on YouTube

AIM

To examine the reliability of ChatGPT in evaluating the quality of medical content of the most watched videos related to urological cancers on YouTube.

MATERIAL AND METHODS

In March 2024 a playlist was created of the first 20 videos watched on YouTube for each type of urological cancer. The video texts were evaluated by ChatGPT and by a urology specialist using the DISCERN-5 and Global Quality Scale (GQS) questionnaires. The results obtained were compared using the Kruskal-Wallis test.

RESULTS

For the prostate, bladder, renal, and testicular cancer videos, the median (IQR) DISCERN-5 scores given by the human evaluator and ChatGPT were (Human: 4 [1], 3 [0], 3 [2], 3 [1], P = .11; ChatGPT: 3 [1.75], 3 [1], 3 [2], 3 [0], P = .4, respectively) and the GQS scores were (Human: 4 [1.75], 3 [0.75], 3.5 [2], 3.5 [1], P = .12; ChatGPT: 4 [1], 3 [0.75], 3 [1], 3.5 [1], P = .1, respectively), with no significant difference determined between the scores. The repeatability of the ChatGPT responses was determined to be similar at 25 % for prostate cancer, 30 % for bladder cancer, 30 % for renal cancer, and 35 % for testicular cancer (P = .92). No statistically significant difference was determined between the median (IQR) DISCERN-5 and GQS scores given by humans and ChatGPT for the content of videos about prostate, bladder, renal, and testicular cancer (P > .05).

CONCLUSION

Although ChatGPT is successful in evaluating the medical quality of video texts, the results should be evaluated with caution as the repeatability of the results is low.

Quality of Information About Kidney Stones from Artificial Intelligence Chatbots

Introduction: Kidney stones are common and morbid conditions in the general population with a rising incidence globally. Previous studies show substantial limitations of online sources of information regarding prevention and treatment. The objective of this study was to examine the quality of information on kidney stones from artificial intelligence (AI) chatbots. Methods: The most common online searches about kidney stones from Google Trends and headers from the National Institute of Diabetes and Digestive and Kidney Diseases website were used as inputs to four AI chatbots (ChatGPT version 3.5, Perplexity, Chat Sonic, and Bing AI). Validated instruments were used to assess the quality (DISCERN instrument from 1 low to 5 high), understandability, and actionability (PEMAT, from 0% to 100%) of the chatbot outputs. In addition, we examined the reading level of the information and whether there was misinformation compared with guidelines (5 point Likert scale). Results: AI chatbots generally provided high-quality consumer health information (median DISCERN 4 out of 5) and did not include misinformation (median 1 out of 5). The median understandability was moderate (median 69.6%), and actionability was moderate to poor (median 40%). Responses were presented at an advanced reading level (11th grade; median Flesch-Kincaid score 11.3). Conclusions: AI chatbots provide generally accurate information on kidney stones and lack misinformation; however, it is not easily actionable and is presented above the recommended reading level for consumer health information.

Large language models: a new frontier in paediatric cataract patient education

BACKGROUND/AIMS

This was a cross-sectional comparative study. We evaluated the ability of three large language models (LLMs) (ChatGPT-3.5, ChatGPT-4, and Google Bard) to generate novel patient education materials (PEMs) and improve the readability of existing PEMs on paediatric cataract.

METHODS

We compared LLMs' responses to three prompts. Prompt A requested they write a handout on paediatric cataract that was 'easily understandable by an average American.' Prompt B modified prompt A and requested the handout be written at a 'sixth-grade reading level, using the Simple Measure of Gobbledygook (SMOG) readability formula.' Prompt C rewrote existing PEMs on paediatric cataract 'to a sixth-grade reading level using the SMOG readability formula'. Responses were compared on their quality (DISCERN; 1 (low quality) to 5 (high quality)), understandability and actionability (Patient Education Materials Assessment Tool (≥70%: understandable, ≥70%: actionable)), accuracy (Likert misinformation; 1 (no misinformation) to 5 (high misinformation) and readability (SMOG, Flesch-Kincaid Grade Level (FKGL); grade level <7: highly readable).

RESULTS

All LLM-generated responses were of high-quality (median DISCERN ≥4), understandability (≥70%), and accuracy (Likert=1). All LLM-generated responses were not actionable (<70%). ChatGPT-3.5 and ChatGPT-4 prompt B responses were more readable than prompt A responses (p<0.001). ChatGPT-4 generated more readable responses (lower SMOG and FKGL scores; 5.59±0.5 and 4.31±0.7, respectively) than the other two LLMs (p<0.001) and consistently rewrote them to or below the specified sixth-grade reading level (SMOG: 5.14±0.3).

CONCLUSION

LLMs, particularly ChatGPT-4, proved valuable in generating high-quality, readable, accurate PEMs and in improving the readability of existing materials on paediatric cataract.

Evaluation of YouTube videos as a source of information on facial paralysis exercises

BACKGROUND

YouTube has emerged as an important source for obtaining information regarding health issues.

OBJECTIVE

The study aimed to assess the reliability and quality of facial paralysis exercise videos that are accessible on the YouTube platform.

METHODS

The investigation was carried out on Youtube, utilizing the keyword "facial paralysis exercises". We listed the first 100 videos based on relevancy. The quality and reliability of the videos were assessed using DISCERN, the Journal of the American Medical Association (JAMA) Benchmark Criteria, the Global Quality Scale (GQS), and the Video Power Index (VPI).

RESULTS

Out of 100 studies, we excluded 52 and included the remaining 48. The scores we obtained for the videos were as follows: DISCERN Quality (2.92±0.91), DISCERN Total (39.16±6.75), JAMA (2.09±0.55), and GQS (3.00±0.89). Our study also revealed that videos uploaded by healthcare professionals had significantly higher DISCERN total, JAMA and VPI scores compared to those uploaded by non-healthcare professionals (p = 0.018, 0.001 and 0.023, respectively). Additionally, we observed a positive and statistically significant correlation between the DISCERN quality score, total score, JAMA, and video features.

CONCLUSION

The facial paralysis exercise videos were determined to be of medium to low quality. Higher-quality videos need to be produced.

Cancer misinformation on social media

Social media is widely used globally by patients, families of patients, health professionals, scientists, and other stakeholders who seek and share information related to cancer. Despite many benefits of social media for cancer care and research, there is also a substantial risk of exposure to misinformation, or inaccurate information about cancer. Types of misinformation vary from inaccurate information about cancer risk factors or unproven treatment options to conspiracy theories and public relations articles or advertisements appearing as reliable medical content. Many characteristics of social media networks-such as their extensive use and the relative ease it allows to share information quickly-facilitate the spread of misinformation. Research shows that inaccurate and misleading health-related posts on social media often get more views and engagement (e.g., likes, shares) from users compared with accurate information. Exposure to misinformation can have downstream implications for health-related attitudes and behaviors. However, combatting misinformation is a complex process that requires engagement from media platforms, scientific and health experts, governmental organizations, and the general public. Cancer experts, for example, should actively combat misinformation in real time and should disseminate evidence-based content on social media. Health professionals should give information prescriptions to patients and families and support health literacy. Patients and families should vet the quality of cancer information before acting upon it (e.g., by using publicly available checklists) and seek recommended resources from health care providers and trusted organizations. Future multidisciplinary research is needed to identify optimal ways of building resilience and combating misinformation across social media.

Using Large Language Models to Generate Educational Materials on Childhood Glaucoma

PURPOSE

To evaluate the quality, readability, and accuracy of large language model (LLM)-generated patient education materials (PEMs) on childhood glaucoma, and their ability to improve existing the readability of online information.

DESIGN

Cross-sectional comparative study.

METHODS

We evaluated responses of ChatGPT-3.5, ChatGPT-4, and Bard to 3 separate prompts requesting that they write PEMs on "childhood glaucoma." Prompt A required PEMs be "easily understandable by the average American." Prompt B required that PEMs be written "at a 6th-grade level using Simple Measure of Gobbledygook (SMOG) readability formula." We then compared responses' quality (DISCERN questionnaire, Patient Education Materials Assessment Tool [PEMAT]), readability (SMOG, Flesch-Kincaid Grade Level [FKGL]), and accuracy (Likert Misinformation scale). To assess the improvement of readability for existing online information, Prompt C requested that LLM rewrite 20 resources from a Google search of keyword "childhood glaucoma" to the American Medical Association-recommended "6th-grade level." Rewrites were compared on key metrics such as readability, complex words (≥3 syllables), and sentence count.

RESULTS

All 3 LLMs generated PEMs that were of high quality, understandability, and accuracy (DISCERN ≥4, ≥70% PEMAT understandability, Misinformation score = 1). Prompt B responses were more readable than Prompt A responses for all 3 LLM (P ≤ .001). ChatGPT-4 generated the most readable PEMs compared to ChatGPT-3.5 and Bard (P ≤ .001). Although Prompt C responses showed consistent reduction of mean SMOG and FKGL scores, only ChatGPT-4 achieved the specified 6th-grade reading level (4.8 ± 0.8 and 3.7 ± 1.9, respectively).

CONCLUSIONS

LLMs can serve as strong supplemental tools in generating high-quality, accurate, and novel PEMs, and improving the readability of existing PEMs on childhood glaucoma.

YouTube Video Clips on Breastfeeding Education and Promotion for Arabic-Speaking Populations: A Social Media Content Analysis

Background/Objective: Although the benefits of breastfeeding are well-documented and widely recognized, reports indicate that optimal breastfeeding rates are low in Arabic-speaking countries. This is a significant concern given the health benefits associated with breastfeeding for both infants and mothers. Previous research has shown that education interventions can increase breastfeeding knowledge, attitudes, and practices in Arabic-speaking populations. The social media platform YouTube holds significant potential for distributing customized health education for diverse audiences; specifically, this platform has the potential to empower mothers and normalize long-term breastfeeding. The aim of this study was to evaluate the quality of YouTube videos on breastfeeding available in the Arabic language. Methods: We used standard procedures to search YouTube for Arabic breastfeeding videos posted on YouTube in December 2023. Videos were evaluated using the three scales of the DISCERN quality evaluation instrument (reliability, information quality, video quality) and total score. Comparative statistics were generated. Results: In total, 165 videos met the inclusion criteria, with 29.7% in the Education category; 43.6% were in Egyptian Arabic dialect. Almost all (91.75%) of the educational videos had a "medium" quality assessment. Educational videos and those using health professionals had higher quality assessments than those in other categories or done with other speakers. Conclusion: The results of this review suggest that most content on the topic of breastfeeding was of only medium reliability and informational quality. New mothers seeking breastfeeding information or support may be in need of specific problem-solving information at a time when they are living with the often-difficulty reality of caring for a newborn or very young infant. There is a clear need for accurate, culturally congruent information to effectively support breastfeeding in Arabic-speaking countries. Future efforts should focus on improving the quality of online health education content, with implications for public health strategies and policy development.

Communication in oncology between healthcare providers, patients, the scientific community, and the media: recommendations from the Italian Association of Medical Oncology (AIOM)

AIM

To identify barriers between health and communication in oncology in order to promote the best possible practice. The areas of communication to be focused on are communication directly with the patient, communication within the scientific community, and communication with the media.

MATERIAL AND METHODS

A working group including eminent experts from the national mass media, healthcare system, and patients' advocacy has been established on behalf of the Italian Association of Medical Oncology (AIOM), with the aim of developing suitable recommendations for the best communication in oncology. A literature search has been conducted selecting primary studies related to the best practices applied to communication in oncology. Subsequent to having identified the most representative statements, through a consensus conference using the RAND/University of California Los Angeles modified Delphi method, the panel evaluated the relevance of each statement to support useful strategies to develop effective communication between oncologist physicians and patients, communication within the scientific community, and communication with media outlets, including social media.

RESULTS

A total of 292 statements have been extracted from 100 articles. Following an evaluation of relevance, it was found that among the 142 statements achieving the highest scores, 30 of these have been considered of particular interest by the panel.

CONCLUSIONS

This consensus and the arising document represent an attempt to strengthen the strategic alliance between key figures in communication, identifying high-impact recommendations for the management of communication in oncology with respect to patients, the wider scientific community, and the media.

Assessment and Acquisition of Knowledge Regarding Urinary Tract Infection Among Adult Women in the United States

OBJECTIVE

To assess baseline UTI knowledge, interest in health resources, and platform preferences for information acquisition and dissemination.

MATERIALS AND METHODS

Adult women who had a UTI in the past 12 months were recruited from Researchmatch.org to participate in a web-based quantitative study. Women with recurrent UTI (rUTI) were compared to women with a history of UTI (without rUTI).

RESULTS

Six hundred and eighty-seven women were included in the study of which 27.4% (N = 188) had rUTI. Regarding knowledge, significantly more women without rUTI believe UTIs are caused by lack of cleanliness and that most women suffer from UTIs. Significantly more women with rUTI believe that UTIs are inherited and that getting older is associated with getting more UTIs. Regarding barriers to health information, significantly more women without rUTI feel that information is too complex and language barriers exist. More than 90% of subjects utilize their healthcare provider (HCP) for health information and most prefer office-based HCPs for health information. More than 50% of women with rUTI would like to receive UTI health updates.

CONCLUSION

Misinformation exists regarding causes, management, and prevention of UTIs. This study identified perceived barriers as well as preferred educational platforms with the hope that this will drive improvements in UTI-related health education.

A Social Media Content Analysis of Dental Health Information Involving the Use of Miswak (Salvadora persica) Chewing Stick on YouTube™

Background The widespread availability of Internet access and the rising popularity of social media platforms have facilitated the dissemination of health-related information, including dental health practices. However, assessing the quality and effectiveness of such information remains a challenge, particularly concerning traditional practices such as Miswak (Salvadora persica) usage. This study aims to assess the description, use, and effectiveness of the Miswak (Salvadora persica) chewing stick posted as video clips on YouTube™ and provide considerations for future interventions. Methodology YouTube videos were searched using the terms "Miswak," "Siwak," "Salvadora persica," and "Chewing stick." Each video's descriptive features, i.e., title, links, country of origin, upload date, running time, views, comments, likes, and dislikes, were recorded. Content quality was assessed using the DISCERN tool, which rates the reliability, dependability, and trustworthiness of online sources across 16 items. Scores were aggregated for analysis. The statistical analysis examined video features and associations between the speaker, video type, source, and quality, with significance set at a p-value <0.05 using SPSS Statistics Version 20 (IBM Corp., Armonk, NY, USA). Results A total of 45 videos were included in the study, with the majority (62%) created by the "other professionals" category. Almost three-quarters (73.3%) of the videos were educational. The quality of the video clips was correlated with the speaker source and category of "other," revealing that high-quality information was considered such when the source was other than a dentist. Further, we found that a video's source did not elicit differences in the opinion of the video's quality. Conclusions This social media analysis provides considerations and implications for future research on the potential use of YouTube as a platform for Miswak educational interventions.

Pitfalls of social media for aesthetic eye surgery patients: assessing YouTube's aesthetic canthoplasty content

PURPOSE

YouTube, a popular source for diverse information, hosts a wealth of content on aesthetic canthoplasty. Yet, concerns linger about the accuracy and reliability of these videos, with potential for inaccuracies, biases, or misleading information. This study aims to evaluate the quality and reliability of YouTube content on this sought-after facial enhancement procedure.

METHODS

The study employs four distinct scoring tools: the Global Quality Score (GQS), the Medical Quality Video Evaluation Tool (MQ-VET), the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V), and the Video Power Index (VPI).

RESULTS

Analysis of a total of 173 YouTube videos relevant to aesthetic canthoplasty revealed scores that were primarily indicative of poor quality and reliability.(Mean score ± SD, PEMAT A/V: 30.75 ± 28.8, MQ-VET: 28.57 ± 12.6, GQS: 1.7 ± 1) Notably, these videos were predominantly uploaded by healthcare professionals (82.1%), and they focused more on advertisements (46.2%) than on scientific or educational information. Their elevated viewership and engagement metrics (likes, comments, and shares) attest to their significant popularity and influence. (Mean VPI score: 176.6 ± 635.8).

CONCLUSION

YouTube's influence on aesthetic eyelid surgery is undeniable, shaping patient choices and expectations. However, unrealistic beauty ideals, heightened body dissatisfaction, and social comparisons lurk within its content, potentially harming psychological well-being and surgical decisions. Prioritizing qualified medical guidance and critical evaluation of online information are crucial for patients. Authors and platforms must act responsibly: authors by producing high-quality content, platforms by tackling misinformation.

Qualitative Study on Internet Use and Care Impact for Black Men With Prostate Cancer

Black men have a greater risk of prostate cancer as well as worse quality of life and more decisional regret after prostate cancer treatment compared to non-Hispanic White men. Furthermore, patients with prostate cancer who primarily obtain information on the internet have significantly more decisional regret compared to other information sources. Our objective was to explore the perspectives of Black patients on the use and impact of the internet for their prostate cancer care. In 2022-2023, we conducted seven virtual focus groups with Black patients with prostate cancer (n = 22). Transcripts were independently analyzed by two experienced researchers using a constant comparative method. Online sources were commonly used by participants throughout their cancer journey, although informational needs varied over time. Patient factors affected use (e.g., physical health and experience with the internet), and family members played an active role in online information-seeking. The internet was used before and after visits to the doctor. Key topics that participants searched for online included nutrition and lifestyle, treatment options, and prostate cancer in Black men. Men reported many downstream benefits with internet use including feeling more empowered in decision-making, reducing anxiety about treatment and providing greater accountability for research. However, they also reported negative impacts such as feeling overwhelmed or discouraged sorting through the information to identify high-quality content that is personally relevant, as well as increased anxiety or loss of sleep from overuse. In summary, online sources have the potential to positively impact the cancer journey by reinforcing or supplementing information from health care providers, but can be harmful if the information is poor quality, not representative, or the internet is overused.

Mapping automatic social media information disorder. The role of bots and AI in spreading misleading information in society

This paper presents an analysis on information disorder in social media platforms. The study employed methods such as Natural Language Processing, Topic Modeling, and Knowledge Graph building to gain new insights into the phenomenon of fake news and its impact on critical thinking and knowledge management. The analysis focused on four research questions: 1) the distribution of misinformation, disinformation, and malinformation across different platforms; 2) recurring themes in fake news and their visibility; 3) the role of artificial intelligence as an authoritative and/or spreader agent; and 4) strategies for combating information disorder. The role of AI was highlighted, both as a tool for fact-checking and building truthiness identification bots, and as a potential amplifier of false narratives. Strategies proposed for combating information disorder include improving digital literacy skills and promoting critical thinking among social media users.

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.

The broad reach and inaccuracy of men's health information on social media: analysis of TikTok and Instagram

Social media (SoMe) offers great potential to expand access to health information, but a significant proportion of users consume its content instead of consulting a physician. We sought to quantify the volume and characterize the accuracy of men's health-related content on TikTok and Instagram. We searched TikTok and Instagram for the terms: testosterone, erectile dysfunction, male infertility, semen retention, Peyronie's disease, and vasectomy. The top 10 hashtags for each term were used to estimate the total impressions for each term on each platform, and posts were then characterized by creator type, content type, and accuracy (1 to 5 scale). TikTok had 2,312,407,100 impressions and Instagram had 3,107,300 posts across all topics. Semen retention had the most impressions on TikTok (1,216,074,000) and posts on Instagram (1,077,000). Physicians created only a small portion of total TikTok and Instagram posts (10.3% and 12.9%, respectively). Across all topics, the accuracy of content was poor (2.6 ± 1.7), however, physician posts were more accurate than non-physician posts (mean 4.2 ± 1.2 vs 2.3 ± 1.6, p < 0.001, respectively). Men's health content is popular on TikTok and Instagram but is not accurate. We recommend that physicians actively engage in SoMe to address misinformation.

Characterization of the dissemination of canine cancer misinformation on YouTube

YouTube is the third most popular app in the world and continues to grow each year while it reaches over 2 billion users a month. A variety of veterinary topics are addressed on YouTube but to date there have been no studies analysing misinformation of various canine cancer topics on YouTube or social media. This study described the characteristics of 99 unique videos and used the validated DISCERN quality criteria for consumer health information and the Patient Education Materials Assessment Tool (PEMAT) to characterize their usefulness. The overall median DISCERN quality score was 3 (out of 5), the median PEMAT understandability score was 72%, and 61% of videos contained little to no misinformation. 53% of videos were created by veterinarians and this subset had significantly higher PEMAT understandability and DISCERN quality scores compared with client-created content (p = .0228 and p ≤ .0001, respectively). Videos with little to no misinformation had statistically significant higher DISCERN quality scores (3 vs. 2, p = .0001). There was no statistical significance between misinformation levels and video length, PEMAT understandability, thumbs up/view, or views/mo. These data reveal similar rates of misinformation in videos on canine cancer compared to that reported for various human cancer topics. This study highlights the need for veterinarians to guide clients to more reliable and understandable information regarding their pet's health.

Cancer: A model topic for misinformation researchers

Although cancer might seem like a niche subject, we argue that it is a model topic for misinformation researchers, and an ideal area of application given its importance for society. We first discuss the prevalence of cancer misinformation online and how it has the potential to cause harm. We next examine the financial incentives for those who profit from disinformation dissemination, how people with cancer are a uniquely vulnerable population, and why trust in science and medical professionals is particularly relevant to this topic. We finally discuss how belief in cancer misinformation has clear objective consequences and can be measured with treatment adherence and health outcomes such as mortality. In sum, cancer misinformation could assist the characterization of misinformation beliefs and be used to develop tools to combat misinformation in general.

Prostate cancer and podcasts: an analysis and assessment of the quality of information about prostate cancer available on podcasts

Podcasts represent a new source of information for patients and families dealing with prostate cancer, but no studies have been conducted evaluating the quality of information in them. Evaluating for: (1) quality based on the validated DISCERN criteria, (2) understandability and actionability based on the Patient Education Materials Assessment Tool (PEMAT), (3) misinformation, and (4) commercial bias, we concluded that podcasts are currently not good sources of information for lay health consumers.

The status quo of short videos as a source of health information regarding bowel preparation before colonoscopy

Background

For high-quality colonoscopies, adequate bowel preparation is a prerequisite, closely associated with the diagnostic accuracy and therapeutic safety of colonoscopy. Although popular-science short videos can help people quickly access health information, the overall quality of such short videos as a source of health information regarding bowel preparation before colonoscopy is unclear. Therefore, we intend to conduct a cross-sectional study to investigate the quality of bowel preparation information before colonoscopy through short videos taken on TikTok and Bilibili.

Methods

The Chinese phrases "colonoscopy" and "bowel preparation" were used as keywords to search for and screen the top 100 videos in the comprehensive rankings on TikTok and Bilibili. The Global Quality Score (GQS) and the modified DISCERN score were used to assess the quality of the information provided in these short videos.

Results

A total of 186 short videos were included in this study; 56.5% of them were posted by health professionals, whereas 43.5% of them were posted by nonhealth professionals. The overall quality of these videos was unsatisfactory, with a median DISCERN score of 3 (2-4) and a median GQS of 3 (3-4). The radar maps showed that videos posted by gastroenterologists had higher completeness scores regarding outcomes, management, and risk factors, while nongastroenterologists had higher completeness scores concerning adverse effects, symptoms, and definitions of bowel preparation. Additionally, the median DISCERN score and GQS of the videos posted by gastroenterologists were 3 (3-4) and 3 (3-4), respectively, whereas the quality of the videos posted by patients was the worst, with a median DISCERN score of 2 (1-2) and a median GQS of 2 (1.25-3).

Conclusion

In conclusion, the overall quality of health information-related videos on bowel preparation before colonoscopy posted on specified short video platforms was not satisfactory. Gastroenterologists provide more information on the outcomes, management, and risk factors for bowel preparation before colonoscopy, while nongastroenterologists focus on adverse effects, symptoms, and definitions of bowel preparation.

Tumor Immunotherapy-Related Information on Internet-Based Videos Commonly Used by the Chinese Population: Content Quality Analysis

BACKGROUND

Tumor immunotherapy is an innovative treatment today, but there are limited data on the quality of immunotherapy information on social networks. Dissemination of misinformation through the internet is a major social issue.

OBJECTIVE

Our objective was to characterize the quality of information and presence of misinformation about tumor immunotherapy on internet-based videos commonly used by the Chinese population.

METHODS

Using the keyword "tumor immunotherapy" in Chinese, we searched TikTok, Tencent, iQIYI, and BiliBili on March 5, 2022. We reviewed the 118 screened videos using the Patient Education Materials Assessment Tool-a validated instrument to collect consumer health information. DISCERN quality criteria and the JAMA (Journal of the American Medical Association) Benchmark Criteria were used for assessing the quality and reliability of the health information. The videos' content was also evaluated.

RESULTS

The 118 videos about tumor immunotherapy were mostly uploaded by channels dedicated to lectures, health-related animations, and interviews; their median length was 5 minutes, and 79% of them were published in and after 2018. The median understandability and actionability of the videos were 71% and 71%, respectively. However, the quality of information was moderate to poor on the validated DISCERN and JAMA assessments. Only 12 videos contained misinformation (score of >1 out of 5). Videos with a doctor (lectures and interviews) not only were significantly less likely to contain misinformation but also had better quality and a greater forwarding number. Moreover, the results showed that more than half of the videos contain little or no content on the risk factors and management of tumor immunotherapy. Overall, over half of the videos had some or more information on the definition, symptoms, evaluation, and outcomes of tumor immunotherapy.

CONCLUSIONS

Although the quality of immunotherapy information on internet-based videos commonly used by Chinese people is moderate, these videos have less misinformation and better content. Caution must be exercised when using these videos as a source of tumor immunotherapy-related information.

Unmet Sexual Health Resource Needs and Preferences for Interventions to Address These Needs Among Female Partners of Patients With Prostate Cancer

OBJECTIVE

To characterize unmet sexual health resource needs and preferences for interventions to address unmet needs among female partners of patients with prostate cancer (PCa), given the significant negative impact of PCa on the sexual health of partners.

METHODS

We conducted an exploratory sequential mixed methods study of female partners recruited from multiple U.S. clinical locations, websites, and support groups for caregivers. We first conducted semistructured in-depth interviews. Qualitative results informed development of a cross-sectional survey, which was administered to a larger sample of partners.

RESULTS

Overall, 12 and 200 female partners participated in the qualitative and quantitative portions of the study. Major emergent themes from interviews were the benefits and drawbacks of technology-based interventions, the importance of sexual health resources throughout the PCa journey, and a desire for sexual health support groups that include partners. In the survey, the most common sexual health topics that partners wanted more information about were male libido problems (30.0%), erectile dysfunction (26.5%), and female libido and arousal problems (24.5%). Additionally, 41.5% wanted more information about sexual health websites, 35.0% about partners-only support groups, 29.5% about support groups for couples, and 23.5% about sexual medicine specialists.

CONCLUSIONS

To our knowledge, this is the largest study to date on female partners' unmet sexual health resource needs and preferences for sexual health interventions. Partners prefer technology-based interventions, desire sexual health-focused support groups, and want more information about a variety of sexual issues and specialists who treat them.

A Cross-Sectional Descriptive Analysis of Speech, Hearing, and Feeding in YouTube Videos: A Brief Communication

OBJECTIVE

Healthcare information on YouTube is often inaccurate or insufficient. However, parents turn to social media for answers about their children's health conditions. Understanding the nature of content in specified scope of practice areas can help professionals clarify misinformation or utilize quality YouTube content in clinical context. This research examined: (1) meta-data and upload source; (2) understandability and actionability; and (3) content quality and clinical utility of YouTube videos related to speech, hearing, and feeding with children with cleft lip and palate (CLP).

DESIGN

A cross-sectional design was used.

MAIN OUTCOME MEASURE(S)

Videos related to speech, hearing, and feeding with children with CLP were obtained. Meta-data and upload source were identified. The Patient Education Material Assessment Tool-AudioVisual (PEMAT-AV) was used to assess understandability and actionability. The DISCERN instrument was used to evaluate content quality. Responses to open-ended questions were used to evaluate clinical utility.

RESULTS

Of 652 videos reviewed for potential inclusion, only 33 met the inclusion criteria. Of those, only 17 met adequate levels of both understandability and actionability. Results of DISCERN indicated that the videos were of fair quality. Analysis of clinical utility indicated that none of the videos should be used as stand-alone parent education materials.

CONCLUSIONS

Videos pertaining to speech, hearing and feeding issues are not viewed as frequently as videos addressing other areas of CLP. Our findings are consistent with previous reports that the videos related to CLP may be limited in their clinical utility. Professionals are needed to interpret the offerings and guide families to appropriate videos.

Quality Assessment of YouTube Videos on Complementary and Alternative Medicine (CAM) for Cancer Using a Newly Developed Tool

BACKGROUND

The global burden of cancer continues to rise and complementary and alternative medicine (CAM) is attracting a lot of interest. However, quality of online information on CAM, particularly on platforms like YouTube, remains questionable. This study aimed to create a comprehensive assessment tool to assess the quality of CAM-related YouTube videos, crucial for informed decision-making in oncology.

METHODS

The assessment tool was developed by adapting existing criteria for website content analysis to video rating. A YouTube search was conducted using German-language terms related to CAM ("complementary medicine (CM) for cancer" and "alternative medicine (AM) for cancer"). In total 25 videos were assessed based on the defined criteria and assigned to five different types of providers (journalism, healthcare organization, hospital or health insurance, independent person, non-medical organization). Statistical analysis was conducted using IBM SPSS Statistics 27.

RESULTS

Interrater reliability analysis showed an Intraclass Correlation Coefficient (ICC) of .91, indicating good to excellent agreement. The average video result was of poor quality, with none of the videos meeting all criteria. The videos achieved a mean rating of 38.2 points (SD: 6.5 points; possible range: 20-60 points). Journalism-based videos showed the most views per days, particularly surpassing those from hospitals or health insurance providers (Kruskal-Wallis-Test: z = 3.14, P = .02). However, there was no statistically significant correlation between video quality and the type of provider or interaction indices. Videos retrieved under the search term "CM" generally scored higher in quality than those under "AM" (Mann-Whitney U test: U = 39.5, P = .04). Nonetheless, "CM" videos were less frequently viewed (Mann-Whitney U test: U = 31.0, P = .01).

CONCLUSION

This study, the first of its kind focusing on CAM in cancer care emphasized the challenges in identifying credible sources on social media platforms such as YouTube. The developed assessment tool offers a more detailed evaluation method for health-related videos but requires further refinement and testing. Collaboration between healthcare and media entities is suggested to improve the dissemination of reliable information on platforms like YouTube.

How Well Do Artificial Intelligence Chatbots Respond to the Top Search Queries About Urological Malignancies?

Artificial intelligence (AI) chatbots are becoming a popular source of information but there are limited data on the quality of information on urological malignancies that they provide. Our objective was to characterize the quality of information and detect misinformation about prostate, bladder, kidney, and testicular cancers from four AI chatbots: ChatGPT, Perplexity, Chat Sonic, and Microsoft Bing AI. We used the top five search queries related to prostate, bladder, kidney, and testicular cancers according to Google Trends from January 2021 to January 2023 and input them into the AI chatbots. Responses were evaluated for quality, understandability, actionability, misinformation, and readability using published instruments. AI chatbot responses had moderate to high information quality (median DISCERN score 4 out of 5, range 2-5) and lacked misinformation. Understandability was moderate (median Patient Education Material Assessment Tool for Printable Materials [PEMAT-P] understandability 66.7%, range 44.4-90.9%) and actionability was moderate to poor (median PEMAT-P actionability 40%, range 0-40%The responses were written at a fairly difficult reading level. AI chatbots produce information that is generally accurate and of moderate to high quality in response to the top urological malignancy-related search queries, but the responses lack clear, actionable instructions and exceed the reading level recommended for consumer health information. PATIENT SUMMARY: Artificial intelligence chatbots produce information that is generally accurate and of moderately high quality in response to popular Google searches about urological cancers. However, their responses are fairly difficult to read, are moderately hard to understand, and lack clear instructions for users to act on.

Internet research of utilization of social media in patients with urological disease and their families in Japan

OBJECTIVES

To survey the utilization of social media (SoMe) in patients with urological disease and their families.

METHODS

Among the panel members registered in NEO Marketing Inc. (Tokyo, Japan), 300 people who or whose families were visiting the urological department regularly were included. Study subjects were randomly chosen and surveyed using the questionnaire over the internet.

RESULTS

This study included 203 (68%) males and 97 (32%) females. The mean age was 62 (21-85) in males and 49 (22-75) in females. One hundred and ten subjects (37%) had no account for any SoMe. The account holders of YouTube, Twitter, Facebook, Instagram, and TikTok were 119 (40%), 117 (39%), 101 (34%), 90 (30%), and 33 (11%), respectively. The proportions of account holders were different depending on gender, age, and platforms. Frequent viewers on YouTube, Twitter, Facebook, Instagram, and TikTok were 100 (84%), 89 (76%), 63 (62%), 66 (73%), and 24 (73%), respectively. Of 190 who had accounts for any SoMes, 64 (34%) found any information about urological diseases of themselves or their families. Among the all subjects, 162 (54%) thought that they would like to view the medical contents on SoMes submitted by medical societies.

CONCLUSIONS

Patients with urological disease and their families in Japan occasionally utilize SoMe to obtain information on their diseases and prefer professional medical information on SoMe. The gender and age of SoMe users and the optimal platform should be considered when posting medical information on SoMe.

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.

Educational Quality of YouTube Videos for Patients Undergoing Elective Procedures

INTRODUCTION

YouTube has become a main resource used by patients for self-education on medicine. It is important for surgeons to understand the quality and reliability of videos that patients are likely to view about elective procedures.

METHODS

Videos were categorized by view count and content creators. The top 20 videos for each term, sorted by relevance, were evaluated using DISCERN criteria, a question set externally validated to assess the quality of information regarding health treatment choices. DISCERN score (DS) closer to 5 indicate higher quality information and 1 indicates the opposite. Total scores were given: 15-26 (very poor), 27-38 (poor), 39-50 (fair), 51-62 (very good), and 63-75 (excellent). Search terms included "Wound Care", "Skin Grafting", "Tracheostomy", and "percutaneous endoscopic gastrostomy tube placement".

RESULTS

In total, 80 unique videos were evaluated with a total view of 8,848,796. The mean overall DS was 2.15 and a mean bias DS was 2.46. The median DISCERN total score for each key term was Tracheostomy: 35 (poor), Skin Grafting 26 (very poor), percutaneous endoscopic gastrostomy: 32 (poor), and Wound Care: 40 (fair).

CONCLUSIONS

YouTube videos surrounding elective procedures should be viewed cautiously in patient education despite wide availability. The videos in this study show high levels of bias and low DS. Healthcare providers should be aware of poor-quality consumer health information often disseminated in online media such as YouTube.

Misinformation About Orthopaedic Conditions on Social Media: Analysis of TikTok and Instagram

Introduction Social media outlets such as TikTok (TT) and Instagram (IG) have surged as a method to disseminate information. More recently, healthcare professionals have targeted this space as a means to provide medical education and advice. With the ever-growing content on these applications, there is significant variability and quality of material available, which can lead to the dissemination of misinformation. This study aims to evaluate the accuracy and popularity of content on common orthopaedic pathology on TT and IG. Methods Content on TT and IG related to six common orthopaedic conditions - achilles tendon tear, ACL tear, meniscus tear, tennis elbow, rotator cuff tear, and ankle sprains - was evaluated between April and June 2022. The top ten posts for the top two associated hashtags for each condition were reviewed. The quality of each post was analyzed using the DISCERN instrument, rating each on a scale of 1 to 5. Each post was characterized by the author's profession (physician, physical therapist, chiropractor, etc.) and content type (educational, testimonial, personal, promotional, and entertainment). Popularity and engagement metrics such as "comments," "likes," and "shares" were also collected. Results There were 165,666,490 views on TT and 9,631,015 views on IG amongst the six common aforementioned orthopaedic conditions. Content created by physicians had less overall engagement (16.1%) compared to content created by non-physicians (83.9%). The quality of content on average was low (mean misinformation index 2.04 ± 1.08 (1-5)1. Physician-created posts in comparison to non-physician posts were significantly more accurate (mean misinformation index score 3.38 ± 1.12 vs 1.89 ± 0.94, p<0.0001). Conclusions Common orthopaedic conditions such as Achilles tendon tears, ACL tears, and meniscus tears are frequently the focus of content posted on TT and IG; however, this information is often not medically accurate. Increased physician engagement may help to rectify this misinformation.

Assessment of YouTube Videos about Urethral Stricture and Its Management

PURPOSE

To evaluate the reliability, transparency, usability and technical quality of videos about urethral stricture and its management in the most common video-sharing website "YouTube".

METHODS

We performed a video search on YouTube using the keywords "Urethral Stricture", "Internal Urethrotomy" and "Urethroplasty". After excluding the videos that did not meet the inclusion criteria, demographic data of each video was recorded and assessed with the validated DISCERN questionnaire, the Journal of the American Medical Association Benchmark Score (JAMAs) and the Global Quality Score (GQS). Additionally, the Urethral Stricture Video Score was developed by two experienced surgeons to assess the technical aspects. Videos were also compared with a view to their source of upload.

RESULTS

A total of 177 videos were analysed. Videos from "University" and "Other" had a significantly higher view ratio and video power index (VPI) than the rest (all p<0.05). For all mentioned scores, even though the video sources of "Society" and "University" had significantly higher scores than the rest (all p<0.05), all scores remained at a low to moderate level at each group.

CONCLUSION

Even though universities, societies and organisations tend to upload better videos about the management of urethral stricture in terms of general quality, reliability, transparency and technical aspects, the online visual content about urethral stricture and its management needs to be improved in order to provide more reliable and qualified information for both clinicians and patients.

Marketing yourself in social media as a global health organization: lessons to be learned

PURPOSE

To evaluate whether X, formerly known as Twitter, is being used effectively to advance the goals of International Volunteers in Urology (IVUmed). How is X activity associated with end-user engagement?

METHODS

Monthly analytics of the X account @IVUmed were reviewed between September 2014 and November 2022 using https://analytics.twitter.com/ . Outcomes included tweets, mentions, impressions, engagements, interactions, followers, and profile visits. Statistical analysis using Mann-Whitney U test and Spearman's rank-order correlation was performed. Top tweet content between December 2020 and November 2022 was also analyzed and assigned one of seven different categories: research, workshops, mission statement, educational materials, fundraising, individual spotlight, and other.

RESULTS

Of @IVUmed's 1668 followers, 1334 (80.0%) were individuals. One thousand one hundred twenty-six (84.4%) individuals listed their locations with the majority (79.8%) residing in high-income countries. Tweet impressions have increased over time; they were significantly higher (p < 0.01) on average after the onset of COVID-19 in March 2020. From December 2020 to November 2022, new followers were positively correlated with tweet impressions (p < 0.01), total mentions (p < 0.01), and profile visits (p < 0.01). Profile visits were positively correlated with total tweets (p < 0.01). The content categories for monthly top tweets that proportionally garnered the most engagements were workshops (50%) and individual spotlight (29%), despite not being the most tweeted about content categories.

CONCLUSION

Non-profit organizations wishing to increase their web-based outreach can benefit from increased primary X activity. While not evaluated in this study, it may also improve fundraising capabilities. Nevertheless, periodic review of account activity is important to ensure engagement of the targeted audience.

Content Quality of YouTube Videos About Metastatic Breast Cancer in Young Women: Systematic Assessment

BACKGROUND

Young women with metastatic breast cancer (MBC) are part of a digitally connected generation yet are underserved in terms of information needs. YouTube is widely used to find and identify health information. The accessibility of health-related content on social media together with the rare and marginalized experiences of young women with MBC and the digital media practices of younger generations imply a considerable likelihood that young women with MBC will seek information and community on the internet.

OBJECTIVE

This study aims to assess the content quality of MBC YouTube videos and to identify themes in the experiences of young women with MBC based on YouTube videos.

METHODS

A systematic assessment of MBC YouTube videos using the search term "metastatic breast cancer young" was conducted in August 2021. The search was performed in an incognito browser and with no associated YouTube or Google account. Search results were placed in order from most to least views. Title, date uploaded, length, poster identity, number of likes, and number of comments were collected. Understandability and actionability were assessed using the Patient Education Materials Assessment Tool (PEMAT); information reliability and quality were assessed with DISCERN. Themes, sponsorships, and health care professionals' and patients' narratives were reported.

RESULTS

A total of 101 videos were identified. Of these, 78.2% (n=79) included sponsorships. The mean PEMAT scores were 78.8% (SD 15.3%) and 43.1% (SD 45.2%) for understandability and actionability, respectively. The mean DISCERN score was 2.44 (SD 0.7) out of 5. Identified themes included treatment (n=67, 66.3%), family relationship (n=46, 45.5%), and motherhood (n=38, 37.6%).

CONCLUSIONS

YouTube videos about young women with MBC are highly understandable but demonstrate moderate rates of actionability, with low reliability and quality scores. Many have a commercial bias. While web-based materials have limitations, their potential to provide patient support is not fully developed. By acknowledging their patients' media habits, health care professionals can further develop a trusting bond with their patients, provide a space for open and honest discussions of web-based materials, and avoid any potential instances of confusion caused by misleading, inaccurate, or false web-based materials.

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.

Female urinary incontinence on TikTok and YouTube: is online video content sufficient?

INTRODUCTION AND HYPOTHESIS

The objective of the study is to evaluate the reliability and quality of the most-viewed female urinary incontinence-related TikTok and YouTube posts. Our second goal is to analyze the differences in the quality and content of videos between these platforms.

METHODS

We searched for the keyword "female urinary incontinence" on TikTok and YouTube on 1 March 2023. We sorted the videos that appeared out of searches for this keyword by "top" results on TikTok and by "relevance" on YouTube. We excluded the videos that were not in English, whose narrator was unclear, unrelated videos, advertising videos, and duplicate videos. In this study, we included the top 50 videos on both platforms that were directly related to female urinary incontinence. The characteristics of the videos, such as likes, video duration, views, and type of narrator (patient, physician, nonphysician practitioner, and health care company), and DISCERN scores were analyzed.

RESULTS

We observed that the median view count (p<0.001) and the median video duration (p<0.001) were higher and longer respectively on YouTube than on TikTok. In addition, the median DISCERN score of these videos was higher on YouTube than on TikTok (p<0.001). Similarly, the overall quality of videos was higher on YouTube than on TikTok (p=0.002). Only in two TikTok and two YouTube videos have the narrators cited a reference.

CONCLUSIONS

Our findings emphasize the present lack of high-quality content available on TikTok and YouTube from both health care and nonhealth care experts. To address this lack of information, health care providers, especially urologists, should take an active role in creating video content.

ChatGPT and most frequent urological diseases: analysing the quality of information and potential risks for patients

PURPOSE

Artificial intelligence (AI) is a set of systems or combinations of algorithms, which mimic human intelligence. ChatGPT is software with artificial intelligence which was recently developed by OpenAI. One of its potential uses could be to consult the information about pathologies and treatments. Our objective was to assess the quality of the information provided by AI like ChatGPT and establish if it is a secure source of information for patients.

METHODS

Questions about bladder cancer, prostate cancer, renal cancer, benign prostatic hypertrophy (BPH), and urinary stones were queried through ChatGPT 4.0. Two urologists analysed the responses provided by ChatGPT using DISCERN questionary and a brief instrument for evaluating the quality of informed consent documents.

RESULTS

The overall information provided in all pathologies was well-balanced. In each pathology was explained its anatomical location, affected population and a description of the symptoms. It concluded with the established risk factors and possible treatment. All treatment answers had a moderate quality score with DISCERN (3 of 5 points). The answers about surgical options contain the recovery time, type of anaesthesia, and potential complications. After analysing all the responses related to each disease, all pathologies except BPH achieved a DISCERN score of 4.

CONCLUSIONS

ChatGPT information should be used with caution since the chatbot does not disclose the sources of information and may contain bias even with simple questions related to the basics of urologic diseases.

Approaches to Research Ethics in Health Research on YouTube: Systematic Review

BACKGROUND

YouTube has become a popular source of health care information, reaching an estimated 81% of adults in 2021; approximately 35% of adults in the United States have used the internet to self-diagnose a condition. Public health researchers are therefore incorporating YouTube data into their research, but guidelines for best practices around research ethics using social media data, such as YouTube, are unclear.

OBJECTIVE

This study aims to describe approaches to research ethics for public health research implemented using YouTube data.

METHODS

We implemented a systematic review of articles found in PubMed, SocINDEX, Web of Science, and PsycINFO following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. To be eligible to be included, studies needed to be published in peer-reviewed journals in English between January 1, 2006, and October 31, 2019, and include analyses on publicly available YouTube data on health or public health topics; studies using primary data collection, such as using YouTube for study recruitment, interventions, or dissemination evaluations, were not included. We extracted data on the presence of user identifying information, institutional review board (IRB) review, and informed consent processes, as well as research topic and methodology.

RESULTS

This review includes 119 articles from 88 journals. The most common health and public health topics studied were in the categories of chronic diseases (44/119, 37%), mental health and substance use (26/119, 21.8%), and infectious diseases (20/119, 16.8%). The majority (82/119, 68.9%) of articles made no mention of ethical considerations or stated that the study did not meet the definition of human participant research (16/119, 13.4%). Of those that sought IRB review (15/119, 12.6%), 12 out of 15 (80%) were determined to not meet the definition of human participant research and were therefore exempt from IRB review, and 3 out of 15 (20%) received IRB approval. None of the 3 IRB-approved studies contained identifying information; one was explicitly told not to include identifying information by their ethics committee. Only 1 study sought informed consent from YouTube users. Of 119 articles, 33 (27.7%) contained identifying information about content creators or video commenters, one of which attempted to anonymize direct quotes by not including user information.

CONCLUSIONS

Given the variation in practice, concrete guidelines on research ethics for social media research are needed, especially around anonymizing and seeking consent when using identifying information.

TRIAL REGISTRATION

PROSPERO CRD42020148170; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=148170.

Assessment of Artificial Intelligence Chatbot Responses to Top Searched Queries About Cancer

Importance

Consumers are increasingly using artificial intelligence (AI) chatbots as a source of information. However, the quality of the cancer information generated by these chatbots has not yet been evaluated using validated instruments.

Objective

To characterize the quality of information and presence of misinformation about skin, lung, breast, colorectal, and prostate cancers generated by 4 AI chatbots.

Design, Setting, and Participants

This cross-sectional study assessed AI chatbots' text responses to the 5 most commonly searched queries related to the 5 most common cancers using validated instruments. Search data were extracted from the publicly available Google Trends platform and identical prompts were used to generate responses from 4 AI chatbots: ChatGPT version 3.5 (OpenAI), Perplexity (Perplexity.AI), Chatsonic (Writesonic), and Bing AI (Microsoft).

Exposures

Google Trends' top 5 search queries related to skin, lung, breast, colorectal, and prostate cancer from January 1, 2021, to January 1, 2023, were input into 4 AI chatbots.

Main Outcomes and Measures

The primary outcomes were the quality of consumer health information based on the validated DISCERN instrument (scores from 1 [low] to 5 [high] for quality of information) and the understandability and actionability of this information based on the understandability and actionability domains of the Patient Education Materials Assessment Tool (PEMAT) (scores of 0%-100%, with higher scores indicating a higher level of understandability and actionability). Secondary outcomes included misinformation scored using a 5-item Likert scale (scores from 1 [no misinformation] to 5 [high misinformation]) and readability assessed using the Flesch-Kincaid Grade Level readability score.

Results

The analysis included 100 responses from 4 chatbots about the 5 most common search queries for skin, lung, breast, colorectal, and prostate cancer. The quality of text responses generated by the 4 AI chatbots was good (median [range] DISCERN score, 5 [2-5]) and no misinformation was identified. Understandability was moderate (median [range] PEMAT Understandability score, 66.7% [33.3%-90.1%]), and actionability was poor (median [range] PEMAT Actionability score, 20.0% [0%-40.0%]). The responses were written at the college level based on the Flesch-Kincaid Grade Level score.

Conclusions and Relevance

Findings of this cross-sectional study suggest that AI chatbots generally produce accurate information for the top cancer-related search queries, but the responses are not readily actionable and are written at a college reading level. These limitations suggest that AI chatbots should be used supplementarily and not as a primary source for medical information.

Prostate cancer, online health information and communication technology - Bibliometric analysis of field with research frontiers

OBJECTIVES

The purpose of this study is to conduct the first bibliometric analysis which examines eHealth communication technologies in prostate cancer care, and the utilization of internet-based health information and communication technology by men with prostate cancer.

METHODS

Original articles were extracted from the Science Citation Index Expanded (SCI-E) on Web of Science (WOS) and analyzed concerning their distributions. Quantitative guidance directed investigation of findings from previous studies and trending issues within the field. The WOS, VOSViewer and CiteSpace IV were used for information analysis.

RESULTS

302 articles were included in the final analysis. There has been a 165 % increase in productivity over the past decade. The leading country by publication was the USA (145 articles = 48.02 %). Journals which published the highest number of original articles were the Journal of Medical Internet Research (6.95 %), and Patient Education and Counseling (4.64 %).

DISCUSSION AND PRACTICE IMPLICATIONS

The field of research which examines utilization and impacts of internet-based health information on men with prostate cancer is growing and diverse. Research frontiers are 'Information quality and diversity', 'eHealth literacy', 'decision making', and 'survivorship and advanced disease'. Clinicians should be aware of several significant limitations which exist within the current field of research.

Polycystic Ovary Syndrome (PCOS): A Cross-Sectional Observational Study Analyzing the Quality of Content on YouTube

INTRODUCTION

Polycystic ovary syndrome (PCOS), a chronic multifactorial disorder in women of reproductive age group, is a major public health problem. With most women resorting to platforms like "YouTube" that form a perfect source of edutainment, our aim was to analyze the quality of content available regarding the same.

AIMS

The aims and objectives of this study were to assess the quality and reliability of content related to PCOS on YouTube by analyzing the DISCERN score, global quality score (GQS), and video power index (VPI).

METHODOLOGY

It was a facility-based cross-sectional study undertaken on a single day with each author reviewing 10 videos from YouTube on PCOS using predetermined keywords. The number of likes, dislikes, views, comments, and uploader backgrounds were evaluated. DISCERN score, GQS, and VPI were also calculated for each video. While data entry was done using Microsoft Excel 2020 (Microsoft Corporation, Washington, United States), the analysis was carried out using SPSS Statistics version 16 (SPSS Inc. Released 2007. SPSS for Windows, Version 16.0. Chicago, SPSS Inc.). Categorical variables were expressed as frequency and percentages, and statistical significance was determined using the Kruskal-Wallis test/one-way ANOVA.

RESULTS

A total of 80 videos that fit the inclusion criteria were analyzed. A majority of the videos (80%) were posted a year back with no updates. Only 28.8% of the video content was posted by doctors. Though most videos (96.25%) shared information pertaining to symptomatology, only 45% spoke regarding prevention. Promotional content was noted in 28.75% of the video content. GQS and VPI were better with information being provided by doctors, hospitals, and healthcare organizations (p-value 0.033 and 0.006, respectively).

CONCLUSIONS

With women reaching out to edutainment platforms like YouTube to clarify their concerns surrounding lifestyle diseases such as PCOS in the digital era, it becomes relevant to evaluate the quality of content available on such platforms. The findings of the study form a prototype for addressing the existing gaps in the knowledge available on YouTube. Furthermore, the findings warrant frequent monitoring of such available web-based content and delivery of such content only from qualified wellness experts.

Assessing the Educational Value of Pancreatic Cancer Videos on YouTube®

Online resources such as YouTube® can serve as the go-to resource for patients and their caregivers after a life-changing diagnosis of pancreatic cancer. There is a need to analyze the content and educational value of these videos for patients with pancreatic cancer. The top 100 most viewed videos on pancreatic cancer on YouTube® were assessed and data were collected on various variables such as views, likes, dislikes, and comments. Videos categorized as patient educational videos were further analyzed for their content, source, and educational value. Videos uploaded by patients were the most discussed (p = 0.014) and liked (p = 0.0028) videos on YouTube®. The content of the videos (personal experience, advertisement, patient education, medical professional education, alternative treatments, and increased pancreatic cancer awareness) varied depending on the uploader (patients, healthcare providers, professional societies, media) of the videos (p = 0.0007). Patient education videos were poor in being comprehensive on their education of pancreatic cancer based on our rubric (mean score of 7.67 ± 2.63 of 20 possible points). The current study shows that the educational values of YouTube® videos related to pancreatic cancer remain limited. There is significant room for healthcare providers to use the platform to develop and share comprehensive videos that can be used as more effective sources of patient education.

Quality and reliability of YouTube videos in Arabic as a source of patient information on prostate cancer

Background

Prostate cancer remains a major public health challenge in the Arab world with few population-based screening programmes, a high incidence of advanced disease at diagnosis, and limited patient access to sub-specialist care. A large number of patients diagnosed with prostate cancer use the (World Wide Web) internet to learn more about the disease and treatment options; however, material in the Arabic language is scarce. This study aims to objectively assess the quality and reliability of the information on YouTube™, which is the most globally used video platform, pertaining to prostate cancer videos published in Arabic.

Methods

A total of 100 videos were identified by searching specific keywords in Arabic (Prostate cancer, prostate cancer treatment and prostate). Retrieved videos were analysed and categorised into four groups according to content as useful, misleading, personal experience, or irrelevant. Useful videos were assessed using the global quality scale (GQS) as a validated measure of quality, which is graded on a 5-point Likert scale, with 1 representing poor quality and 5 representing excellent quality. The modified DISCERN tool was used as a measure of reliability. The tool has a potential total score of 5 points, with higher scores indicating higher reliability.

Results

Most of the speakers in these videos identified themselves as health workers (77%). Only 8% of the videos sources were hospital or medical organisations. Of the 100 retrieved videos, 86% were found to have useful content, while 14% were found to be misleading or irrelevant. The median GQS score of the useful videos was 4 (IQR: 4-5), while the median modified DISCERN tool was 4 (IQR: 3-4).

Conclusion

To our knowledge, this is the first in-depth study to objectively assess the quality and reliability of information pertaining to prostate cancer in the Arabic language on YouTube™. More efforts are needed to improve the quality of prostate cancer educational materials and videos in the Arabic language on YouTube™. Patient focus groups are planned as the next step to address the information gap for patients with prostate cancer in the Arabic language.

The Effect of Racial Concordance on Patient Trust in Online Videos About Prostate Cancer: A Randomized Clinical Trial

Importance

Black men have a higher risk of prostate cancer compared with White men, but Black adults are underrepresented in online content about prostate cancer. Across racial groups, the internet is a popular source of health information; Black adults are more likely to trust online health information, yet have more medical mistrust than White adults.

Objective

To evaluate the association between racial representation in online content about prostate cancer and trust in the content and identify factors that influence trust.

Design, Setting, and Participants

A randomized clinical trial was conducted from August 18, 2021, to January 7, 2022, consisting of a 1-time online survey. Participants included US men and women aged 40 years and older. Data were analyzed from January 2022 to June 2023.

Interventions

Participants were randomized to watch the same video script about either prostate cancer screening or clinical trials presented by 1 of 4 speakers: a Black physician, a Black patient, a White physician, or a White patient, followed by a questionnaire.

Main Outcomes and Measures

The primary outcome was a published scale for trust in the information. χ2 tests and multivariable logistic regression were used to compare trust according to the video's speaker and topic.

Results

Among 2904 participants, 1801 (62%) were men, and the median (IQR) age was 59 (47-69) years. Among 1703 Black adults, a greater proportion had high trust in videos with Black speakers vs White speakers (72.7% vs 64.3%; adjusted odds ratio [aOR], 1.62; 95% CI, 1.28-2.05; P < .001); less trust with patient vs physician presenter (64.6% vs 72.5%; aOR, 0.63; 95% CI, 0.49-0.80; P < .001) and about clinical trials vs screening (66.3% vs 70.7%; aOR, 0.78; 95% CI, 0.62-0.99; P = .04). Among White adults, a lower proportion had high trust in videos featuring a patient vs physician (72.0% vs 78.6%; aOR, 0.71; 95% CI, 0.54-0.95; P = .02) and clinical trials vs screening (71.4% vs 79.1%; aOR, 0.57; 95% CI, 0.42-0.76; P < .001), but no difference for Black vs White presenters (76.8% vs 73.7%; aOR, 1.11; 95% CI, 0.83-1.48; P = .49).

Conclusions and Relevance

In this randomized clinical trial, prostate cancer information was considered more trustworthy when delivered by a physician, but racial concordance was significantly associated with trust only among Black adults. These results highlight the importance of physician participation and increasing racial diversity in public dissemination of health information and an ongoing need for public education about clinical trials.

Trial Registration

ClinicalTrials.gov Identifier: NCT05886751.

Is Arabic Information on YouTube About Erectile Dysfunction Based on Scientific Evidence?

Background

Online medical education is critical for public health literacy and physician efficacy, but it must be trustworthy. Although it has the potential to be a useful resource for medical education, users must be able to identify reliable content.

Objective

To assess the scientific quality of Arabic-language video content related to erectile dysfunction that is available on YouTube to learn what information our patients can handle online.

Materials and Methods

A comprehensive search of the YouTube database was carried out to identify videos related to erectile dysfunction published in Arabic. The search was conducted using the following keywords: "Erectile dysfunction", "Sexual dysfunction" and "Impotence". Without a time, limit, the search was carried out until January 1, 2023. The quality assessment of the videos was done using the Kappa score.

Results

The videos in our sample had up to one million views (average 2,627,485.6), and the kappa index was 0.86 (p <0.001). Of these videos, 16% were considered scientific evidence-based (SEB), and 84% were considered not scientific evidence-based (NSEB) (p <0.001). The NSEB group addressed details concerning natural remedies, the Psychosocial sphere, and lifestyle, whereas the SEB group tended to be more concerned with physiopathology, etiology, endothelial dysfunction, diagnosis, psychosocial treatment, oral treatment, injections, or prosthesis.

Conclusion

On social media, misleading or incorrect information about erectile dysfunction is widely disseminated. This research may support urological and technical oversight and emphasizes guiding patients to the best men's health options.

Video Consensus and Radical Prostatectomy: The Way to Chase the Future?

In the age of information, new platforms are consulted by patients to acquire consciousness about medical treatments. The aim of this study was to assess the level of understanding and feasibility of video consensus (VC) administration in patients scheduled for radical prostatectomy (RP), comparing it with standard informed consensus (SIC). According to the European Association of Urology Patient Information, we set up a video content for RP that was translated in Italian and implemented with information about possible perioperative and postoperative complications, days of hospitalization etc. From 2021 to 2022, all patients undergoing RP at our institution were prospectively included in this study. Patients received an SIC and after that, a VC about RP. After two consensuses were administered, patients received a preformed Likert 10 scale and STAI questionnaires. On the RP dataset, 276 patients were selected and 552 questionnaires for both SIC and VC were evaluated. Out of these, the median age was 62 years (IQR 60-65). Patients reported a higher overall satisfaction for VC (8.8/10) compared to the traditional informed consent (6.9/10). Therefore, VC may play a role in the future of surgery, improving the consciousness and satisfaction of patients and reducing preoperative anxiety.