YouTube as a source of patient information for abdominal aortic aneurysms

Diverticulosis and Diverticulitis on YouTube: Is Popular Information the Most Reliable?

Background Patients utilize online health information to inform their medical decision-making. YouTube is one of the most popular media platforms with abundant health-related resources, yet the quality of the disseminated information remains unclear. This study aims to evaluate the quality and reliability of content pertaining to diverticulosis and diverticulitis on YouTube. Methods One author queried the terms "diverticulosis," "diverticulitis," "acute diverticulitis," and "chronic diverticulitis" on YouTube. The first 50 videos per search were selected for analysis. Duplicates, non-English videos, or procedural content were excluded. Video characteristics including view count, likes, comments, duration, days since upload, view ratio, video power index, and video sources (professional organizations (POs), health information websites (HIWs), and entertainment/independent users (EIUs)) were collected. Videos were scored using the mDISCERN and Global Quality Score (GQS). Results Sixty-four videos were included. DISCERN scores significantly differed between POs (n=20, mean=4.35), HIWs (n=29, mean=2.97), and EIUs (n=15, mean=1.83). GQS also significantly differed between POs (n=20, mean=4.47), HIWs (n=29, mean=3.62), and EIUs (n=15, mean=2.5). Video characteristics significantly differed between groups, with most user engagement seen in EIUs. Conclusion POs and HIWs disseminate higher quality health information about diverticular disease on YouTube. The higher viewer engagement with EIUs is concerning, as these sources were found to have lower quality content. Although YouTube has the capability to provide valuable information on diverticulosis and diverticulitis, enhanced content screening is needed to ensure accuracy and validation.

Study of the Correlation between Streaming Video Platform Content on Food Production Processes and the Behavioral Intentions of Generation Z

With an estimated 2.4 million cases of foodborne illnesses recorded annually in the UK alone, food safety has become a paramount concern among stakeholders. Modern technology has positioned streaming platforms as pivotal conduits for disseminating information. Channels such as YouTube offer detailed recordings of the food production process, granting consumers extensive visibility of the food journey from farm to table. This increased transparency not only promotes vigilant monitoring of food safety practices but also solicits consumer feedback regarding the public exposure to food processing videos. Based on the Theory of Planned Behavior (TPB), this study augments its framework with constructs, such as perceived trust, perceived risk, community experience, and brand identity, to evaluate Taiwan's Generation Z consumer behavioral intentions. With 226 valid responses amassed, structural equation modeling facilitated elucidation of the relationships among the constructs. This analysis yielded three salient insights. First, Generation Z's engagement with food processing videos on streaming platforms is positively correlated with their subsequent purchasing behavior. Second, enriched community experience was correlated with strengthened brand identification. Third, both perceived trust and perceived risk had a constructive impact on behavioral intentions within Gen Z's demographic data. Based on these outcomes, food industry enterprises should proactively develop and bolster community experiential value, thereby encouraging streaming platform users to transform into brand consumers and advocates.

Audiovisual information of oral epithelial dysplasia: Quality, understandability and actionability

OBJECTIVES

Online information on oral epithelial dysplasia (OED) is insufficient and of low quality. While only written information has been previously assessed, this study aims to evaluate the content and quality of audiovisual (AV) online information about OED.

METHODS

One hundred and twenty-seven materials were initially considered using six key words across two search engines (YouTube and Google). Ultimately, 29 materials remained for the final assessment. These materials were then analysed for content, quality (DISCERN instrument, JAMA benchmarks), understandability and actionability.

RESULTS

Most contents were scientific (n = 25), while three videos were educational, and one video was a personal experience with OED. On a scale of 1-5, the overall DISCERN score was (mean ± SD = 2.26 ± 0.79), suggesting poor quality of information. Regarding JAMA benchmarks, there was no single material that fulfilled or lacked all four benchmarks. The overall mean understandability score was 82% and the actionability mean score was significantly low at 29%.

CONCLUSION

Although the vast majority of AV materials on OED were primarily produced for scientific purposes, these materials could be helpful as resources for patient education. Keeping in mind, however, that the desired quality and essential patient information about OED available online remains largely poor and missing.

Current Quality of Videos on Colorectal Cancer Screening for General Public

BACKGROUND

One-third of American adults encompassed by current colorectal cancer screening guidelines fail to obtain recommended screening evaluations. Educational videos are a valuable medium through which to educate and encourage recommended health behaviors in patients.

METHODS

A cross-sectional study reviewing the quality of patient education videos addressing colorectal cancer screening. Video quality was assessed in 3 domains: accountability, content, and production.

RESULTS

Forty-four videos met inclusion criteria. Out of 33 possible points, videos scored a median of 15.0 (interquartile range 12.9-16.6). Videos scored 1.0 (interquartile range .8-1.0) out of 4.0 for accountability, 6.0 (interquartile range 4.4-8.0) out of 20 for content, and 8.0 (interquartile range 7.4-8.0) out of 9.0 for production. Colonoscopy was the most frequently discussed method of screening (38, 86%). While 13 (34%) videos discussed the risk of colorectal cancer in the general population and 15 (32%) discussed the risk in those with a family history, few videos addressed those with other risk factors. Most (31, 70%) videos discussed the medical consequences of not receiving screening, but only 1 (2%) video discussed the social consequences. Similarly, medical benefits were discussed in 34 (77%) videos while other benefits were not discussed by any video. Only one-fifth of the videos address three or more barriers to screening.

CONCLUSIONS

Videos on colorectal cancer screening have excellent production quality but need improvement in the domains of accountability and content. The videos included in this analysis did not adequately address the concerns of viewers nor the benefits of colorectal cancer screening.

YouTube as a Source of Patient and Trainee Education in Vascular Surgery: A Systematic Review

Objective

Due to its video based approach, YouTube has become a widely accessed educational resource for patients and trainees. This systematic review characterised and evaluated the peer reviewed literature investigating YouTube as a source of patient or trainee education in vascular surgery.

Data sources

A comprehensive literature search was conducted using EMBASE, MEDLINE, and Ovid HealthStar from inception until 19 January 2023. All primary studies and conference abstracts evaluating YouTube as a source of vascular surgery education were included.

Review methods

Video educational quality was analysed across several factors, including pathology, video audience, and length.

Results

Overall, 24 studies were identified examining 3 221 videos with 123.1 hours of content and 37.1 million views. Studies primarily examined YouTube videos on diabetic foot care (7/24, 29%), peripheral arterial disease (3/24, 13%), carotid artery stenosis (3/24, 13%), varicose veins (3/24, 13%), and abdominal aortic aneurysm (2/24, 8%). Video educational quality was analysed using standardised assessment tools, author generated scoring systems, or global author reported assessment of quality. Six studies assessed videos for trainee education, while 18 studies evaluated videos for patient education. Among the 20 studies which reported on the overall quality of educational content, 10/20 studies deemed it poor, and 10/20 studies considered it fair, with 53% of studies noting poor educational quality for videos intended for patients and 40% of studies noting poor educational quality in videos intended for trainees. Poor quality videos had more views than fair quality videos (mean 27 348, 95% CI 15 154-39 543 views vs. 11 372, 95% CI 3 115-19 629 views, p = .030).

Conclusion

The overall educational quality of YouTube videos for vascular surgery patient and trainee education is suboptimal. There is significant heterogeneity in the quality assessment tools used in their evaluation. A standardised approach to online education with a consistent quality assessment tool is required to better support online patient and trainee education in vascular surgery.

Educational quality of YouTube content on brachial plexus injury and treatment

INTRODUCTION

While surgical literature exists on birth-related brachial plexus injury (BPI), there are not validated sources of information on BPI for patients, which can impact patient autonomy and decision-making. With YouTube as a popular source for patients to research diagnoses, this study aims to evaluate the quality of information regarding BPI and its treatment available on the platform.

MATERIALS AND METHODS

BPI YouTube videos were screened independently by two reviewers. Videos were categorized by source: (1) academic, government, and non-profit organizations; (2) private practices, companies, and for-profit organizations; (3) independent users. Each video was evaluated for reliability, credibility, and quality using the modified DISCERN criteria (scale, 0-5), Journal of the American Medical Association (JAMA) criteria (scale, 0-4), and Global Quality Scale (GQS; scale, 1-5). Surgical treatment videos were analyzed by the senior author using a modified "treatment" DISCERN criteria (scale, 8-40). Non-English videos were excluded from this study. Analysis of variance tests were used to compare means.

RESULTS

One hundred and fifteen videos were selected for final analysis. The mean modified DISCERN score was 3.26; JAMA was 2.31; GQS was 3.48. Videos were subdivided according to source. Group 1, 2, and 3 had 45, 24, and 46 videos, respectively. Modified DISCERN score was greater for Group 1 than Group 2 (3.58 vs. 3.04, p < .001) and Group 3 (3.58 vs. 3.07, p < .001). JAMA score was greater for Group 1 than Group 2 (2.63 vs 2.15, p = .041) and Group 3 (2.63 vs. 2.08, p = .002). GQS score was greater for Group 1 than Group 2 (3.93 vs. 3.31, p = .031) and Group 3 (3.93 vs. 3.13, p < .001). Of the 34 videos (44.7%) that mentioned treatment, the DISCERN score was 14.32.

CONCLUSION

The videos analyzed were found to have moderate reliability, credibility, and quality. The reliability of information regarding treatments for BPI was poor. Healthcare providers should supply additional information on treatment of BPI.

Analysis of YouTube content on substance use disorder treatment and recovery

BACKGROUND AND AIM

Emerging literature suggests the role of social media in substance use disorders (SUD). This study aimed to explore the content of YouTube videos for persons on SUD treatment/recovery, describing the users' exposure and engagement metrics and understanding viewers' perspectives.

METHODS

We generated a set of 10 key phrases to search on YouTube. Eighty eligible videos were analyzed using a mixed-methods approach. Content analysis of all videos and thematic analysis of 30 videos were done using the three most viewed videos from each key phrase. The reliability of videos was assessed using a modified DISCERN. The total number of views, likes, dislikes, and comments were noted and created engagement metrics. The linguistic analysis of viewers' comments was done to assess their perspectives.

RESULTS

Sixty-three (78.8%) videos were from the US, and 59 (73.8%) were intended for persons or families with substance misuse. Persons in recovery uploaded 23 (28.7%) videos. We identified five themes - reasons for using drugs, symptoms of addiction, consequences of drug use, how to stop drug use, and expressed tone in the language. The positivity and relative positivity ratios were highest for videos developed by persons in recovery. There was a negative correlation between the relative positivity ratio and content fostering internalized stigma. Words with negative emotional experiences dominated the viewers' comments.

CONCLUSION

YouTube content on SUD treatment and recovery is popular and revolves around the biopsychosocial understanding of addiction. There is an urgent need for a language policy and regulation of non-scientific content.

Information provision and decision-making in the treatment of abdominal aortic aneurysm: A qualitative study of patient experience

INTRODUCTION

Shared decision making (SDM) refers to patients and health care professionals working together to reach a decision about treatment/care. In abdominal aortic aneurysm (AAA) treatment options are influenced by patients' clinical characteristics, their preferences, and potential trade-offs between alternative interventions. This is a prime example of where SDM is essential to ensure the right decision is made for the right patient, yet we have little understanding of what happens in practice. This study explored patient experiences to understand SDM practice in AAA surgery.

METHODS

We used a qualitative approach to describe, and identify improvements to, current treatment decision making in abdominal aortic aneurysm (AAA) surgery. Two groups of patients were interviewed: those at the point of discussing treatment options (with corresponding digitally recorded consultation data) and following surgical intervention from one hospital. Framework analysis was used.

RESULTS

Fifteen patients were interviewed, seven at the point of discussing treatment options and eight following surgical intervention. Timing, format and sources of information, verbal framing of interventions and level of patient engagement were key themes. Four areas for improvement were identified: earlier provision and more detailed written information along with signposting to quality on-line information; both intervention options, risks, benefits, and consequences, were not always discussed; some clinicians were somewhat directive in the decision-making process; and patients' treatment values/preferences were not explored-the only example was in one of the eight recorded consultations. Patients could feel overwhelmed by the information and decision and fearful of the impending surgery.

CONCLUSIONS

More emphasis should be placed on the provision of full information and the exploration of patient values and preferences for treatment. Clinician training and support for patients, including decision aids, could facilitate the decision-making process. Providing written information earlier and guidance on reliable on-line resources would benefits patients and their families.

Evaluating YouTube as a Source of Education for Patients Undergoing Surgery: A Systematic Review

OBJECTIVE

The objective of this systematic review is to characterize the peer-reviewed literature investigating YouTube as a source of patient education for patients undergoing surgery.

SUMMARY BACKGROUND DATA

YouTube is the largest online video sharing platform and has become a substantial source of health information that patients are likely to access before surgery, yet there has been no systematic assessment of peer-reviewed studies. A comprehensive literature search was conducted using EMBASE, MEDLINE, and Ovid HealthStar from inception through to December of 2021.

METHODS

All primary studies evaluating YouTube as a source of patient education relating to surgical procedures (general, cardiac, urology, otolaryngology, plastic, vascular) were included. Study screening and data extraction occurred in duplicate with two reviewers. Characteristics extracted included video length, view count, upload source, overall video educational quality, and quality of individual studies.

RESULTS

Among 6,453 citations, 56 studies were identified that examined 6,797 videos with 547 hours of content and 1.39 billion views. There were 49 studies that evaluated the educational quality of the videos. A total of 43 quality assessment tools were used, with each study using a mean of 1.90 assessment tools. Per the global rating for assessments, 34/49 studies (69%) concluded that the overall quality of educational content was poor.

CONCLUSIONS

While the impact of non-peer-reviewed YouTube videos on patient knowledge for surgery is unclear, the large amount of online content suggests that they are in demand. The overall educational content of these videos is poor, however, and there is substantial heterogeneity in the quality assessment tools used in their evaluation. A peer-reviewed and standardized approach to online education with video content is needed to better support patients.

Are Social Media Platforms Appropriate Sources of Information for Patients Regarding the Topic of Facial Trauma?

BACKGROUND

Internet technologies have made a wide variety of information available to the public. Social media platforms (SMPs) can also be used as a source of information for patients seeking health care information. However, the quality of health information on SMPs is not clear and standardized.

PURPOSE

To evaluate the content, reliability, and quality levels of videos reporting on facial trauma on a SMP (YouTube [Google LLC, San Bruno, California]) regarding patients' information.

STUDY DESIGN, SETTING, SAMPLE

This was a cross-sectional study, and the sample is composed of videos found on a SMP based on searching the keyword "facial trauma." English-language videos with acceptable audiovisual quality and content related to facial trauma were included in the study.

PREDICTOR VARIABLE

The descriptive features such as number of views, number of likes, number of comments, video duration, date of uploading, and the demographic features such as source and uploader were recorded.

MAIN OUTCOME VARIABLES

The primary outcome variable was content level. Secondary outcome variables were reliability and quality levels measured by DISCERN and Global Quality Scale.

COVARIATES

The name and uniform resource locator of the videos were recorded as additional data.

ANALYSES

The Mann-Whitney U test was used to compare low-content and high-content videos with a significance level of P < .05. The Kappa test was used to assess the inter-rater reliability.

RESULTS

The sample was composed of 50 videos that met study's inclusion. The mean total content score for the videos was 2.87 (range: 0 to 7), with 64% of all videos (n = 32) classified as low-content. The reliability and quality levels of videos classified as high-content were significantly superior (P < .001). In addition, the video duration was significantly higher in the high-content videos (P = .045). High-content videos were uploaded by health care professionals with a ratio of 39%, and the sources of these videos were predominantly oral and maxillofacial surgeons; however, low-content videos were mostly uploaded by clinics (75%), with the sources of these videos predominantly laypersons.

CONCLUSION AND RELEVANCE

Given the generally low content, reliability, and quality of online videos regarding facial trauma, clinicians should be cautious in recommending or referring patients to SMPs.

Evaluation of the Quality and Reliability of YouTube Videos With Turkish Content as an Information Source for Gynecological Cancers During the COVID-19 Pandemic

Aim During the COVID-19 pandemic, YouTube became a critical information source for people seeking information about several diseases, including benign and malignant gynecological disorders. This study aimed to evaluate the quality and reliability of YouTube videos with Turkish content as an information source for gynecological cancers during the COVID-19 pandemic. Methods The research was performed between December 2nd and 5th, 2020. Two gynecologists searched the terms in Turkish; 'yumurtalık kanseri, COVID-19', 'rahim kanseri, coronavirus', 'rahim ağzı kanseri, COVID-19', 'kadın üreme sistemi kanseri, coronavirus', and 'jinekolojik kanserler, COVID-19'. on YouTube. 'Yumurtalık kanseri', 'rahim kanseri', 'rahim agzı kanseri', 'kadın üreme sistemi kanserleri' and 'jinekolojik kanserler' are the translations for "ovarian cancer, COVID-19", "endometrial cancer, coronavirus", "cervical cancer, COVID-19", "female reproductive system cancers, coronavirus", and "gynecological cancers, COVID-19" in the Turkish language, respectively. Videos were categorized into three groups depending on the upload source: the informative group, the personal experience group, and the news agency group. Moreover, DISCERN, the Medical Information and Content Index (MICI), the Video Information and Quality Index (VIQI) were evaluated. Results A total of 57 videos were categorized as informative. Additionally, 22 videos and 18 videos were classified as patient experience videos and new agency videos, respectively. Patients who experienced videos had a significantly higher view number (p=0.001). The number of dislikes and DISCERN score were markedly better in favor of informative videos (p=0.009 and p=0.001). The MICI score was calculated as 13.0±1.8 for informative videos. The total VIQI score was 11.9 for informative videos, 8.8 for patient experience videos, and 7.2 for new agency videos (p = 0.001). Conclusions YouTube videos with Turkish content about gynecological cancers are easily accessible resources during the COVID-19 pandemic. Patient-published videos are the most preferred YouTube videos by Turkish citizens, and informative videos have a considerably lower dislike rate. According to the MICI score and significantly better DISCERN and VIQI scores, informative videos have acceptable quality.

Quality and Reliability of YouTube Videos on Myocardial Infarction: A Cross-Sectional Study

INTRODUCTION

This study aims to assess the quality and reliability of the disease information available on YouTube (www.youtube.com) about "heart attacks" or myocardial infarctions, using a Global Quality Score (GQS) for quality, a DISCERN score for reliability, and a Video Power Index (VPI) for popularity.

METHODOLOGY

In this cross-sectional observational study, the YouTube videos were analyzed in terms of the type of uploader, content, and other factors. The GQS, DISCERN score, and Video Power Index (VPI) were utilized to assess the quality, reliability, and popularity of the information, respectively.

RESULTS

The majority of the videos (78.44%) were uploaded over a year ago. Only 33.34% and 7.84% were uploaded by doctors and healthcare organizations, respectively. Around 72.55% of the videos contained information about symptoms, 66.67% discussed the causes, 52.94% covered treatment, and 47.06% focused on prevention. Additionally, 41.18% provided details on investigations, while only 19.61% touched upon mortality. Patient-created videos accounted for 19.61% of the content, and 15.69% of the videos included promotional material.

CONCLUSION

The main outcome of our study indicates that the YouTube videos examined regarding myocardial infarctions exhibit high-quality content, as supported by a higher average GQS score. The consistent quality of information discovered in our study suggests that YouTube can serve as an additional platform for sharing knowledge and educating individuals about this important health condition. By raising awareness and delivering accurate information, these videos can help in early detection, prevention, and better outcomes for individuals who are at risk of experiencing a myocardial infarction.

Study on the Quality, Relevance, and Comparability of YouTube Videos Expressing Stroke and Its Consequences From Various Sources

Background and objective Stroke-related deaths have been one of the major causes of death worldwide due to its rising risk factors. As a result, several people rely on YouTube as a great source of information on stroke without knowing the genuineness of the content. This study aims to assess the quality and reliability of the information on stroke uploaded on the YouTube platform using the Global Quality score (GQS) and DISCERN score (DS), respectively. Methodology A cross-sectional observational study was conducted in April 2023. Stroke-related keywords were used to search for videos on YouTube. Videos that met inclusion criteria were evaluated for baseline characteristics (likes, comments, views, duration of video, time since posted, and uploader type) and type of information in the video about stroke (symptoms, etiology, treatment, and other parameters). These videos were then evaluated for quality and reliability of information using GQS and DS, respectively. Results After applying inclusion and exclusion criteria and removing the duplicates, 73 YouTube videos were selected. The videos had a total number of 23,927,445 views, 385,324 likes, and 31,927 comments. Maximum videos were uploaded by hospitals (25, 34.2%). Several videos described the symptoms (54, 73.97%), treatment (50, 68.49%), and etiology (49, 67.12%) of stroke. The reach of videos measured by the Video Power Index (VPI) was highest for videos uploaded by healthcare organizations (mean VPI = 120.11). There was no statistically significant difference (P > 0.05) in the quality (GQS score) and reliability (DS) of videos uploaded by doctors, hospitals, healthcare organizations, and news channels.  Conclusions YouTube can become an important source to disseminate information about health-related conditions like stroke if the videos uploaded are of high quality (GQS score) and reliable (DS).

The Reliability and Quality of YouTube Videos as a Source of Information on Buerger's Disease: A Cross-Sectional Study

BACKGROUND

Patients are increasingly referring to the internet after a diagnosis of vascular disease. This study was performed to quantitatively define the accuracy and reliability of information on YouTube regarding Buerger's Disease (BD).

METHODS

A systematic search of YouTube was conducted using BD and thromboangiitis obliterans keywords. The default YouTube search setting of "relevance" was used to replicate an average search attempt, and the first 50 results from each keyword search were reviewed and analyzed by 2 independent reviewers. Descriptive characteristics, Journal of the American Medical Association Score (JAMAS), modified DISCERN score, Global Quality Score (GQS) were used to record data.

RESULTS

A total of 50 videos were reviewed for the study. The mean JAMAS, modified DISCERN, and GQS values among the videos were 2.06/4.00 (standard deviation [SD], 0.91), 2.36/5.00 (SD, 1.39), and 2.6/5.00 (SD, 1.16) respectively. When the videos were analyzed according to the user types uploading them, the modified DISCERN score was found to be significantly higher (3.57/5.00 SD, 0.97) in the videos uploaded by vascular surgeons (P = 0.029). High-quality videos were determined as more recent (P = 0.048). It was observed that the modified DISCERN and JAMA scores increased as the video quality increased.

CONCLUSIONS

While variable in source and content, the completeness and reliability of the information presented on YouTube about BD is poor. We believe that these videos should be uploaded more up-to-date and comprehensively by medical professionals, especially medical doctors.

Evaluating YouTube videos on sialendoscopy as an educational resource for patients

Objectives

Patients are increasingly relying on YouTube for health information. We objectively evaluated the quality and comprehensiveness of sialendoscopy YouTube videos available to patients. We further investigated the relationship between video content and video popularity.

Methods

We identified 150 videos using the search term "sialendoscopy." Videos were excluded if they were lectures for medical professionals, operating room (OR) recordings, unrelated, non-English, or non-audio. Video quality and comprehensiveness were evaluated using modified DISCERN criterion (range: 5-25) and novel sialendoscopy criterion (NSC, range: 0-7), respectively. Secondary outcomes included standard video metrics and Video Power Index to measure popularity. Videos were classified binarily by uploader type as from an academic medical center or from other sources.

Results

Twenty-two (14.7%) of 150 videos were included for review, with 7 (31.8%) uploaded from academic medical institutions. One hundred-nine (72.7%) videos were excluded as lectures for medical professionals or OR recordings. Overall mean modified DISCERN (13.45 ± 3.42) and NSC (3.05 ± 0.96) scores were low; however, videos uploaded by academic medical institutions were significantly more comprehensive (NSC mean difference = 0.98, 95% CI: 0.16-1.80, p = .02). There were no significant correlations between video popularity and objective measures of quality or comprehensiveness.

Conclusions

This study highlights the paucity and low quality of sialendoscopy videos for patients. More popular videos are not higher quality, and most videos are targeted more toward physicians rather than patients. As YouTube becomes increasingly used by patients, there is opportunity for otolaryngologists to produce more informative videos for patients while implementing targeted strategies to increase viewership.

Level of Evidence

NA.

COVID-19 Information on YouTube: Analysis of Quality and Reliability of Videos in Eleven Widely Spoken Languages across Africa

Introduction

Whilst the coronavirus disease 2019 (COVID-19) vaccination rollout is well underway, there is a concern in Africa where less than 2% of global vaccinations have occurred. In the absence of herd immunity, health promotion remains essential. YouTube has been widely utilised as a source of medical information in previous outbreaks and pandemics. There are limited data on COVID-19 information on YouTube videos, especially in languages widely spoken in Africa. This study investigated the quality and reliability of such videos.

Methods

Medical information related to COVID-19 was analysed in 11 languages (English, isiZulu, isiXhosa, Afrikaans, Nigerian Pidgin, Hausa, Twi, Arabic, Amharic, French, and Swahili). Cohen's Kappa was used to measure inter-rater reliability. A total of 562 videos were analysed. Viewer interaction metrics and video characteristics, source, and content type were collected. Quality was evaluated using the Medical Information Content Index (MICI) scale and reliability was evaluated by the modified DISCERN tool.

Results

Kappa coefficient of agreement for all languages was p < 0.01. Informative videos (471/562, 83.8%) accounted for the majority, whilst misleading videos (12/562, 2.13%) were minimal. Independent users (246/562, 43.8%) were the predominant source type. Transmission of information (477/562 videos, 84.9%) was most prevalent, whilst content covering screening or testing was reported in less than a third of all videos. The mean total MICI score was 5.75/5 (SD 4.25) and the mean total DISCERN score was 3.01/5 (SD 1.11).

Conclusion

YouTube is an invaluable, easily accessible resource for information dissemination during health emergencies. Misleading videos are often a concern; however, our study found a negligible proportion. Whilst most videos were fairly reliable, the quality of videos was poor, especially noting a dearth of information covering screening or testing. Governments, academic institutions, and healthcare workers must harness the capability of digital platforms, such as YouTube to contain the spread of misinformation.

YouTube as a source of patient information for pterygium surgery

Background

Patients use the YouTube platform to get information about pterygium surgery, and this affects the treatment decisions of the patients.

Objectives

The purpose of this study was to analyze the quality and reliability of YouTube videos as educational resources about pterygium surgery.

Design

This is a register-based retrospective study.

Methods

This was a retrospective, record-based study. A YouTube search was performed using the terms 'pterygium surgery' and 'pterygium eye surgery', resulting in the evaluation of a total of 200 videos. In the end, 122 English-language videos about pterygium surgery were recruited to study. All videos were rated with the DISCERN, the Journal of the American Medical Association (JAMA), and the Global Quality Score (GQS) systems.

Results

The mean DISCERN, JAMA, and GQS values were 38.9 ± 10.9, 1.8 ± 0.8, and 2.2 ± 1, respectively. The YouTube videos about pterygium surgery had been uploaded by a physician in 63 (51.6%) and non-physicians in 59 (48.4%) cases. There was no significant difference between the two groups in terms of general characteristics and scores.

Conclusions

Our results show that YouTube videos about pterygium surgery have low quality and credibility and are not sufficient in terms of providing patient information.

Registration

Not applicable.

Increase the Number of Views and Shares of COVID-19 Videos: Content Relevance and Emotional Consistency with Virus Variant Topics

(1) Background: The coronavirus variants have posed serious challenges for the prevention and control of the COVID-19 pandemic. Individuals selectively watch and forward videos that help them reduce the damage caused by the virus. Therefore, the factors influencing video viewing and sharing in the context of the COVID-19 pandemic caused by virus variation must be explored. (2) Method: Based on a combination of uncertainty reduction theory and functional emotion theory, this paper designed hypotheses regarding how content relevance and emotional consistency affect video views and shares. We used the support vector machine (SVM) classification algorithm to measure the content relevance between videos and virus variant topics. We performed sentiment analysis of video text to evaluate the emotional consistency between videos and virus variant topics. Then, we used empirical analysis to build the model. (3) Results: The trained SVM classifier was effective in judging whether the video text was related to virus variant topics (F = 88.95%). The content relevance between COVID-19 videos and virus variant topics was generally low. The results showed that the higher the content relevance, the more views (IRR = 1.005, p = 0.017) and shares (IRR = 1.008, p = 0.009) the video received. Individuals were more willing to view (IRR = 1.625, p < 0.001) and share (IRR = 1.761, p < 0.001) COVID-19 videos with high emotional consistency with virus variant topics. (4) Conclusions: The results of empirical analysis showed that content relevance and emotional consistency between videos and virus variant topics significantly positively impacted video views and shares. The trained SVM classifier can support public health departments in monitoring and assessing the COVID-19 pandemic. Our study provides management advice while helping individuals reduce harm and inform next-step decisions.

Assessment of reliability and information quality of YouTube videos about root canal treatment after 2016

Background

This study aimed to assess and update the content, reliability, and information quality of content related to root canal treatment (RCTx) on YouTube and evaluate the correlation between each evaluation index.

Methods

YouTube was searched using two terms related to RCTx (“root canal and endodontic treatment”). A total of 240 videos (120 for each search term) were screened. Exclusion criteria were as follows: no sound or visuals, non-English, irrelevant to the search term, longer than 15 min, duplicate, or old (uploaded before 2016). After exclusion, 50 videos of “root canal treatment” and 45 videos of “endodontic treatment” were analyzed. Video length, total number of views, likes, dislikes, comments, and days since upload were recorded using descriptive video data. Viewers’ interaction, reliability and information quality of the video, and quality of video content were measured using nondescriptive video data. The interaction index and video power index were used for viewer interactions, and the modified DISCERN index, JAMA criteria, and Global Quality Score were used to assess the reliability and information quality of the video. The quality of the video content was measured using the completeness score.

Results

The videos of the “root canal treatment” group had a significantly higher completeness score for the etiology and symptoms (p < 0.05), and videos of the “endodontic treatment” group showed a higher interaction index, completeness score for the procedure (p < 0.05). Videos for dentists had significantly higher completeness scores for the procedure, while videos for laypersons had higher completeness scores for etiology, anatomy, symptoms, and prognosis (p < 0.05). Furthermore, the total completeness score and the interaction index of the videos for laypersons were significantly higher (p < 0.05). The videos uploaded by the university had a significantly higher modified DISCERN index (p = 0.044), and the JAMA score was significantly higher in the commercial group (p = 0.001).

Conclusions

Although the accuracy of videos related to RCTx was higher in videos by universities and professionals, the total completeness of YouTube videos was low regardless of the video source. Therefore, professionals should be responsible for providing more accurate and reliable videos.

YOUTUBE AS A SOURCE OF INFORMATION ABOUT GONORRHEA

Introduction: The purpose of this study was to systematically evaluate the quality of videos on YouTube related to gonorrhea. Methods: Using the search term “gonorrhea”, the first 200 relevant videos on YouTube were saved to a file. All video parameters, including the number of views, likes, dislikes and comments were recorded. The Global Quality Scale (GQS) was used to evaluate the quality of the videos. Results: After exclusions, 144 videos were selected and evaluated by two independent observers. The median duration of the videos was calculated as 3.97 minutes. Most videos were provided by physicians (59 videos). According to the GQS scores, 47.9% (n=69) of the videos were evaluated as high quality, 19.4% (n=28) as intermediate quality, and 32.6% (n=47) as low quality. There were significant differences in video length between the high, intermediate, and low-quality groups (p<0.001). Conclusion: YouTube can be considered an important source of gonorrhea videos.

An investigation of the reliability of YouTube videos on undescended testis

INTRODUCTION AND OBJECTIVE

There are thousands of patient information videos published on YouTube, the most watched video sharing platform; however, most of these videos contain incomplete or incorrect information. Interestingly, some videos with incomplete or incorrect information have a higher view rate. This study aimed to evaluate the quality of patient information videos on 'undescended testis' published on YouTube.

MATERIAL AND METHOD

A search was conducted on YouTube using the keywords 'undescended testis' and 'cryptorchidism', and a total of 373 videos were found. Among these, 122 patient information videos presented in the English language were examined. Four different scoring systems were used to evaluate the quality of the videos: Patient Education Materials Assessment Tool for Audiovisual Materials, Global Quality Score, Journal of American Medical Association score, and modified DISCERN scoring system. Whether the videos contained accurate and sufficient information was evaluated using a scoring system developed based on the patient information booklet prepared by the European Association of Urology (EAU) on undescended testis.

RESULTS

The median duration (sec), number of views and number of likes of the videos were 269 (11-2484), 589 (6-1.563561) and 7 (0-4.200), respectively. According to the EAU-patient information scoring (EAU-PIS), while 32 (26.2%) of the total 122 videos contained a good level of informativeness (score: 8-10), the view rate of these videos was only 4.1% among all videos. When the top 10 most watched videos were evaluated, their mean EAU-PIS was 5.9 ± 2.81, and these videos contained a moderate level of informativeness. On the positive side, 90% of all the videos recommended surgery as a treatment option.

DISCUSSION

Although YouTube is a widely used video-sharing platform, it is also a website where people or institutions can easily upload non-standardized videos due to the absence of regulations. Therefore, although it is an easily accessible source of information, it has many gaps in terms of reliability. As shown in our study, the rate of videos with accurate information was very low. It would be beneficial for viewers to be aware of this and accept YouTube as a source where they can have a general idea about a subject in which they are interested rather than using it as a reference information site. In future, YouTube can become a reference source in the medical field, especially with the standardization of medical videos through the collaboration of various organizations.

Does YouTube Provide Qualified Patient Education Videos About Atrial Fibrillation?

Objective

Patients utilize the internet as a pathway to acquire knowledge of specific diseases. However, there are limited oversight and review mechanisms to ensure the authenticity of online information. This study aimed to evaluate the quality of video-based resources used to obtain information about atrial fibrillation (AF).

Methods

Multiple AF-specific keywords were used to perform a systematic search of YouTube. Two independent reviewers reviewed the top 50 results of each keyword search. To record data, the Journal of the American Medical Association (JAMA) score, modified DISCERN score, AF-specific score (AFSS), and essential score (Escore) were used. The Kruskal-Wallis test was used for intergroup comparisons.

Results

A total of 74 videos that met the inclusion criteria were included in the analysis. In terms of video quality, 68% were poor, 19% were moderate, and 13% were exceptional. Videos submitted by publishers with a medical background were much less popular (p < 0.05) than those submitted by publishers without a medical background. The video quality did not differ among those included in this study.

Conclusions

Some videos on YouTube that are of real value are not as popular as those with low-quality content submitted by news agencies/media publishers. Furthermore, videos submitted by those with a medical background do not receive as much attention as others. It is important to acknowledge that video platforms should establish content and quality auditing mechanisms for videos. Furthermore, publishers should ensure that viewers receive accurate and complete knowledge and use more concise and accessible images or animations that are tailored to the audience.

Review of the Quality of YouTube Videos Recommending Exercises for the COVID-19 Lockdown

Background: The world is experiencing a pandemic caused by COVID-19. Insufficient physical activity can increase the risk of illness. Trying to replicate a normal search that any user/patient could do in YouTube, the objective of this study was to evaluate the quality of YouTube videos related to home exercises during lockdown and their adherence to World Health Organization (WHO) recommendations. Methods: A simple search was carried out on YouTube. The first 150 videos were selected. After applying exclusion criteria, 68 videos were analyzed and evaluated. Two statistical analyses based on machine learning techniques were carried out. Videos were classified according to principal component analysis (PCA) models as ‘Relevant’ and ‘Non-Relevant’. Popularity was assessed using the video power index (VPI). Information’s quality and accuracy were gauged using the DISCERN scale and global quality score (GQS). Reliability and credibility of information that can be found on health-related websites was assessed using the Health On the Net Code (HONCode). Exercises were evaluated according to WHO recommendations. Results: DISCERN, HONCode, and GQS scored a mean of 2.29, 58.95, and 2.32, respectively. The PCA calculation allowed videos to auto-classify into high- and low-quality videos. Conclusions: The quality of YouTube videos recommending exercises during lockdown is low and doesn’t reflect WHO recommendations. Effective strategies and tools capable of indicating the quality of this information are needed to filter out erroneous or non-rigorous information that may affect people’s health. These tools should help any user/viewer to distinguish videos of high and low quality.

Quality of Internet Videos Related to Pediatric Urology in Mainland China: A Cross-Sectional Study

Background

Pediatric urological diseases pose serious threats to children's physical and mental health. The COVID-19 pandemic has resulted in poor pediatric outcomes for cryptorchidism, hypospadias, and testicular torsion. Presently, many people tend to seek health information via social media platforms. This study aims to quantitatively assess the quality of videos as an information source for pediatric urology in mainland China.

Methods

In this cross-sectional study, a search was performed on social media platforms (Tiktok, Bilibili, and Weibo) with the search terms “cryptorchidism”, “hypospadias”, and “testicular torsion”. The first 30 results with any search term listed by relevance were selected in each platform. Video features (duration, number of likes, comments, and shares) and video sources were collected. Each video included in the study was assessed using DISCERN, Journal of the American Medical Association (JAMA) Benchmark Criteria, and Hexagonal Radar Schema. A correlation analysis was performed considering video features, video source, DISCERN scores and JAMA scores.

Results

A total of 152 videos were included and analyzed. The majority of videos were from physicians (65.8%). According to the DISCERN classification, most videos were rated as “very poor” (48.0%) and “poor” (36.8%). The mean DISCERN and JAMA scores were 36.56 and 2.68, respectively. The duration of videos uploaded by physicians was the shortest (P < 0.001). The video source had no relevance to numbers of “likes”, “comments”, “shares”, DISCERN scores, and JAMA scores (all P-values > 0.05). Other than video duration (P < 0.001), there was no statistically significant difference between groups for any of the recorded or calculated video data (all P values > 0.05). Hexagonal Radar Charts showed the severe imbalance and deficiency of video information. In general, Tiktok videos with the shortest duration received the most numbers of “likes”, “comments”, and “shares”, whereas the overall quality of videos on Weibo was relatively high.

Conclusions

Despite most of the videos on social media platforms being uploaded by medical authors, the overall quality was poor. The misleading, inaccurate and incomplete information may pose a health risk to the viewers, especially during the COVID-19 pandemic. Much effort needs to be undertaken to improve the quality of health-related videos regarding pediatric urology.

Quality Assessment of YouTube Videos as an Information Source for Testicular Torsion

Background

Testicular torsion is an acute scrotal disease requiring urgent management, and the COVID-19 pandemic has been demonstrated to lead to poor outcomes for this disease. Presently, many people tend to seek health information via YouTube. This study aims to quantitatively assess the quality of English YouTube video content as an information source of testicular torsion.

Methods

In this cross-sectional study, a search was performed with the search term "testicular torsion" on YouTube, and the first 100 videos listed by relevance were selected for our analysis. Duplicate, non-English, videos without audio and surgical videos were excluded. Video features (duration, number of days online, views, likes, comments), source of the video, and author's country were collected. Each video included in the study was assessed using DISCERN and Journal of the American Medical Association (JAMA) Benchmark Criteria. A correlation analysis was performed considering video features, video source, DISCERN scores and JAMA scores.

Results

A total of 66 videos were included and analyzed. The most common video content was general information, including etiology, symptoms, and treatment. The majority of videos were from education and training websites (30%), physicians (23%), and independent users (21%). The mean DISCERN and JAMA scores were 36.56 and 2.68, respectively. According to DISCERN, the quality of video uploaded by physicians was relatively high (P < 0.001), and the quality of video uploaded by independent users was relatively low (P < 0.001). The JAMA score had no relevance to the video source (P = 0.813). The correlation between the video features, DISCERN and JAMA scores was controversial by different assessment methods.

Conclusions

Despite most of the videos on YouTube being uploaded by medical or education-related authors, the overall quality was poor. The misleading, inaccurate and incomplete information may pose a health risk to the viewers, especially during the COVID-19 pandemic. Much effort needs to be undertaken to improve the quality of health-related videos regarding testicular torsion.

Health Literacy and Web-Based Audiovisual Multimedia in Pituitary and Endoscopic Skull Base Surgery

Introduction The internet presents a rich milieu of multimedia options relating to pituitary and endoscopic skull base surgery (ESBS). Misinformation can create discordance between patient and provider expectations. The purpose of this study is to analyze the understandability and actionability of available ESBS and pituitary surgery audiovisual information on YouTube and Google.

Methods The top 50 videos generated by searching “pituitary surgery/transsphenoidal surgery” and “endoscopic skull base surgery” in both YouTube and Google were sorted by relevance. Two independent reviewers evaluated each for understandability and actionability based on the Patient Education Materials Assessment Tool for audiovisual material (PEMAT-A/V). Source, authorship, audience, and education/advertisement variables were collected. Chi-square test followed by univariate and multivariate regression analyses assessed the association between these variables and quality.

Results A total of 85 videos (52 YouTube and 33 Google) met inclusion criteria for analysis. There was no significant difference in the presence of the aforementioned variables between YouTube and Google (p < 0.05). Also, 72% of videos targeted patients and 28% targeted surgeons. Academic institutions uploaded 58% of videos. Surgeon-targeted videos were more educational (p = 0.01) and patient-targeted videos involved more advertisement (p = 0.01). Understandability and actionability scores were below the 70% threshold for both YouTube (65 ± 15, 38 ± 33, p = 0.65) and Google (66 ± 12, 38 ± 26, p = 0.94). Patient-targeted videos (p = 0.002) were more understandable, while surgeon- (p < 0.001) and education-focused videos (p < 0.001) were more actionable.

Conclusion Understandability and actionability of YouTube and Google audiovisual patient information on ESBS and pituitary surgery is poor. Consideration should be given to the formation of a standardized patient information resource.

Validity and Usefulness of YouTube Videos Related to Endoscopic Transsphenoidal Surgery for Patient Information

Objectives  This article evaluates the completeness and accuracy of YouTube videos related to endoscopic transsphenoidal surgery (ETS) as a source for patient information. Design  YouTube was searched using relevant terms pertaining to ETS. Videos were evaluated independently by two physician reviewers experienced in ETS. Video demographics including uploader source along with validity scores based on predetermined checklists were captured. Setting  Internet. Participants  Not applicable. Main Outcome Measures  A novel ETS scoring checklist, the modified DISCERN criteria, and Journal of the American Medical Association (JAMA) benchmark score were used to measure completeness and accuracy of videos. video power index (VPI) was calculated to reflect popularity. Intraclass correlation coefficient was calculated for rater agreement. Results  Seventy-nine videos were included in final scoring and analysis. The ETS score, DISCERN, JAMA, and mean VPI across all included videos were 5.0 ± 2.7, 2.4 ± 0.83, 2.19 ± 0.62, and 8.92 ± 18.1, respectively. Based on the ETS score checklist, 31 (39%) of the videos were rated as poor, 30 (38%) were moderately useful, 17 (22%) were useful, and 1 (1%) was exceptional. There was a significant positive correlation between the ETS, DISCERN, and JAMA scores ( p  < 0.001), but no correlation with VPI and the validity scores. There were no significant differences comparing validity scores based on the uploader source. Conclusion  YouTube videos related to ETS have limited usefulness and poor overall validity for patient information. Clinicians should direct patients to other validated sources of information and aim to improve the comprehensiveness of ETS-related videos.

The Current State of Vascular Surgery Presence in Bilibili Video Platform of China

Background

With the development of the Internet, more and more patients search for disease-related information on video platforms during the treatment process, and physicians also look for learning materials through these video platforms. Bilibili is one of the most popular video platforms in China. This study evaluated information on various interesting topics, and related surgical procedures searched through Bilibili.

Method

The Bilibili platform was independently queried for 12 common vascular diseases or related surgical procedures between October and November 2021 by two independent authors using the Baidu search engine. Information about the video and uploader was collected, and descriptive analyses of the overall and first-page results were performed.

Results

A total of 3,998 search results were retrieved by searching 12 vascular-related topics, of which 2,225 actual videos (55.7%) were finally confirmed to be related to medicine. Videos for the public accounted for 84.8% of these 2,225 videos. In addition, 50.5% of the video results were uploaded by vascular surgeons, 12.4% by other specialties, 17.7% by organizations, and 19.4% by other individuals. The total number of videos searched for varicose vein and peripheral vascular diseases was the largest, and the total number of leg amputation videos was the smallest. The largest number of videos for medical professionals was about pulmonary embolism, and the smallest was about leg amputation. On the first pages, 168 results (70.0%) were actually medically relevant, and only 7.7% of the videos were uploaded by vascular surgeons.

Conclusion

On the Bilibili platform, videos about vascular diseases are extensive but not comprehensive. The videos uploaded by vascular surgeons are rare, and the results searched are not precise. The online presence of vascular surgeons needs to be improved, which may partially solve the problem of low-quality videos due to the lack of strict management and censorship.

See many, do one, teach many more: Assessing quality and reliability of publicly available endoscopic videos in rhinology

OBJECTIVES

The use of video recording is commonplace in rhinology given the increased use of endoscopes when evaluating patients in the office and the operating room and for its educational potential. This study aimed to determine the quality of publicly available endoscopic videos in rhinology.

METHODS

A video search was performed on YouTube in April 2020 and included all videos since its inception in 2005 using terms related to rhinology found in the Accreditation Council for Graduate Medical Education (ACGME) Case Log Coding Guide. Videos which met inclusion criteria were evaluated for video metrics and quality using validated scoring systems: Video Power Index (VPI), modified Journal of American Medical Association (JAMA) benchmark criteria, modified global quality score (GQS), and modified DISCERN criteria.

RESULTS

A total of 138 videos were evaluated, 114 of which were uploaded independently, and 24 videos were uploaded by an academic institution. Academic-affiliated videos have higher like ratio at 91.7 ± 7.55% compared with 86.27 ± 17.44% (p = 0.018). Academic-affiliated videos have higher JAMA benchmark scores, DISCERN criteria scores, and GQS values (1.71 ± 0.55 vs. 1.66 ± 0.49 [p = 0.66]), (3.33 ± 0.56 vs. 2.85 ± 0.65 [p < 0.001]), (4.38 ± 0.81 vs. 3.43 ± 1.01 [p < 0.001])], respectively. There was no significant difference in VPI (p = 0.73).

CONCLUSIONS

Endoscopic videos are rapidly growing in prominence and remain an important part of surgical education, but overall are heterogeneous in quality and reliability, necessitating an effort to establish both video sharing regulations and objective standards of quality.

Amyotrophic lateral sclerosis in social media: Content analysis of YouTube videos

The purpose of this study is to analyze the characteristics, content, and quality of information available on YouTube regarding amyotrophic lateral sclerosis (ALS), and explore the search results and number of views and quality of the videos. A search was performed on YouTube on 10 June 2020, using the search term ''Lou Gehrig's disease" in the Korean language, and the first 100 videos were targeted for analysis. General characteristics (e.g., number of views, video length, etc.) were collected, and upload source, target audience, subject of the video, and quality of the videos using a global quality score (GQS) were assessed. About two-thirds of the videos were for the general public (62.0%), while the other third were made for patients and their families with ALS (38.0%). The mean GQS was 3.70 ± 1.42, and 60 videos were classified as high-quality videos. ALS-related videos on YouTube play a role in raising awareness among the general public of this devastating disease, however, practical information regarding disease management for patients and family is relatively insufficient. The quality and characteristics of the videos varied greatly and sometimes the lowest quality videos were shown in the top pages of search results.

YouTube as a source of misinformation on COVID-19 vaccination: a systematic analysis

Introduction

Vaccines for SARS-CoV-2 have been accessible to the public since December 2020. However, only 58.3% of Americans are fully vaccinated as of 5 November 2021. Numerous studies have supported YouTube as a source of both reliable and misleading information during the COVID-19 pandemic. Misinformation regarding the safety and efficacy of COVID-19 vaccines has negatively impacted vaccination intent. To date, the literature lacks a systematic evaluation of YouTube’s content on COVID-19 vaccination using validated scoring tools. The objective of this study was to evaluate the accuracy, usability and quality of the most widely viewed YouTube videos on COVID-19 vaccination.

Methods

A search on YouTube was performed on 21 July 2021, using keywords ‘COVID-19 vaccine’ on a cleared-cache web browser. Search results were sorted by ‘views’, and the top 150 most-viewed videos were collected and analysed. Duplicate, non-English, non-audiovisual, exceeding 1-hour duration, or videos unrelated to COVID-19 vaccine were excluded. The primary outcome was usability and reliability of videos, analysed using the modified DISCERN (mDISCERN) score, the modified Journal of the American Medical Association (mJAMA) score and the COVID-19 Vaccine Score (CVS).

Results

Approximately 11% of YouTube’s most viewed videos on COVID-19 vaccines, accounting for 18 million views, contradicted information from the WHO or the Centers for Disease Control and Prevention. Videos containing non-factual information had significantly lower mDISCERN (p<0.001), mJAMA (p<0.01) and CVS (p<0.001) scores compared with videos with factual information. Videos from government sources had higher mJAMA and CVS scores, but averaged three times the ratio of dislikes to likes, while videos containing non-factual information averaged 14 times more likes than dislikes.

Conclusion

As the COVID-19 pandemic evolves, widespread adoption of vaccination is essential in reducing morbidity, mortality, and returning to some semblance of normalcy. Providing high-quality and engaging health information from reputable sources is essential in addressing vaccine hesitancy.

Evaluating the Usefulness of YouTube as a Source of Patient Information for Neurosurgical Care in Africa: A Study Protocol

BACKGROUND

A significant proportion of the public rely on the internet for their health information, and social media has emerged as the principal information source. YouTube is the world's largest and most popular video library, and it has emerged as a primary health information source because it offers animated and interactive content. However, little is known of its usefulness of neurosurgery videos to African YouTube users. We aim with this study to evaluate the usefulness of YouTube as a source of patient information for neurosurgical care in Africa.

METHODOLOGY

This observational study will be conducted using YouTube. A search will be carried out to identify neurosurgery videos suggested to African YouTube viewers from inception to September 2021. An internet browser (Google Chrome, Google Inc., CA, USA) with its cache cleared will be used to execute the search. The default YouTube search setting of "relevance" will be used to replicate what a search attempt performed by a patient would be. The first 50 results from each keyword search will be registered in a Microsoft Excel spreadsheet (Microsoft, WA, USA). The primary outcome measure is the reliability of the videos. Data will be analyzed using SPSS version 26 (IBM, WA, USA). Odds ratios and their 95% confidence intervals will be calculated. The statistically significant level will be set at 0.05. Also, a linear regression analysis will be performed to examine the effects of independent variables on continuous dependent variables.

DISSEMINATION

The study findings will be published in an academic peer-reviewed journal, and the abstract will be presented at an international conference. English and French visual and video abstracts of the methods and key findings will be designed and disseminated widely on social media.

HIGHLIGHTS

A significant proportion of the public rely on the internet and social media for health information.YouTube has emerged as the world's largest video library, and has emerged as a primary health information source.There are few safeguards to avoid dissemination of false or biased information on the platform this could negatively influence health seeking behaviorWe aim to evaluate the usefulness of YouTube as a source of patient information for neurosurgical care in Africa.The findings of this study will help evaluate the volume and quantity of African neurosurgical video content and identify best practices.

Evaluation of quality and educational effect of microsurgery videos on YouTube: a randomized controlled trial

Widespread use of smartphones and wireless internet have made YouTube an easily accessible educational modality. Many residents use YouTube to acquire knowledge regarding microsurgical techniques; however, its quality and effect has not been verified. We included 22 residents working in the Department of Plastic and Reconstructive Surgery at our institute. Using block randomization, seven were allocated to a textbook group (TG), eight to a free-searching group (FSG), and seven to a designated-video group (DVG). After reviewing textbooks, YouTube videos, or designated videos, respectively, each group performed microsurgical anastomosis using artificial vessels. The total procedure time, Objective Structured Assessment of Technical Skills (OSATS), operative errors, and degree of leakage were assessed by blinded evaluators. Self-confidence rates were also compared. The YouTube groups (FSG and DVG) performed better than the TG. Although procedure time was significantly longer in the DVG (p = .006), the performance of DVG was better than that of TG in all assessments (OSATS: p = .012; operative errors: p = .002; leakage: p = .010). FSG showed more operative errors (p = .004) and leakage (p = .007) compared to DVG, but had higher OSATS (p = .008) and fewer operative errors (p = .002) than TG. The post-intervention confidence rates were significantly higher in FSG and DVG compared to TG (p = .002 and p = .001, respectively). Although there are concerns regarding the reliability of YouTube videos, microsurgery videos on YouTube had positive effects on microsurgery practice. Therefore, YouTube may help to improve the microsurgical skills of residents. If a quality control system is introduced for YouTube videos, their educational effects may be enhanced.

Most YouTube Videos About Carpal Tunnel Syndrome Have the Potential to Reinforce Misconceptions

BACKGROUND

Studies of online health information have addressed completeness and adherence to evidence, which can be difficult because current evidence leaves room for debate about etiology, diagnosis, and treatment. Fewer studies have evaluated whether online health information can reinforce misconceptions. It can be argued that information with the potential to harm health by reinforcing unhelpful misconceptions ought to be held to a higher standard of evidence.

QUESTIONS/PURPOSES

(1) What is the prevalence and nature of health information in YouTube videos with the potential to reinforce common misconceptions about symptoms and treatment associated with carpal tunnel syndrome (CTS)? (2) What factors (such as the number of views, likes, and subscribers) are associated with Potential Reinforcement of Misconception scores of YouTube videos about CTS?

METHODS

After removing all personalized data, we searched for the term "carpal tunnel syndrome" on YouTube, reviewed the first 60 English-language videos that discussed the diagnosis and treatment of CTS, and collected available metrics. The primary outcome was the number of statements that could reinforce misconceptions about CTS, rated by two authors using a checklist. As a secondary outcome, we counted the number of statements that could help patients by reorienting or balancing common misconceptions, providing agency, and facilitating decisions, and we subtracted the number of potential misconceptions from this count. A modified version of the DISCERN instrument (a validated scoring system designed to gauge the quality and reliability of health information) was used to evaluate each video. We sought factors associated with the Potential Reinforcement of Misconception score-in both the negative-only and combined (positive and negative) variations-accounting for various YouTube metrics (such as the number of views, number of likes and dislikes, and duration) and the modified DISCERN score. The interrater reliability was excellent for both the Potential Reinforcement of Misconceptions checklist (ICC = 0.97; Pearson correlation [r] = 0.97) and DISCERN information quality score (ICC = 0.96; r = 0.97).

RESULTS

Seventy-eight percent of the YouTube videos (47 of 60 videos) contained at least one statement that could reinforce common misconceptions about CTS. The median number of potentially misconception-reinforcing statements was two (range one to three), with the most common statements being that CTS is caused by hand use (38%; 23 of 60 videos) and that splints can alter the natural history of the disease (37%; 22 videos). Videos that were more popular (higher number of views or likes) did not contain less potential reinforcement of misconceptions. In the multivariable analysis, we found a strong association between the DISCERN score and the CTS Potential Reinforcement of Misconceptions score (regression coefficient = 0.67; 95% CI 0.22-1.2; partial r2 = 0.13; p = 0.004) and a lower number of subscribers (calculated per one million subscribers: regression coefficient = -0.91; 95% CI -1.8 to -0.023; p = 0.045).

CONCLUSION

Potential reinforcement of misconceptions is prevalent in YouTube videos about CTS, more so in videos with lower information quality scores.

CLINICAL RELEVANCE

Online health information should be held to a standard of accuracy (alignment with best evidence), and where such evidence leaves room for debate, it should be held to a standard by which unhealthy misconceptions are not reinforced.

Quality Analysis of YouTube Videos Presenting Pelvic Floor Exercises after Prostatectomy Surgery

Background: Prostate cancer (PC) is a major cause of disease and mortality among men. Surgical treatment involving the removal of the prostate may result in temporary or permanent erectile dysfunction (ED) and urinary incontinence (UI), with considerable impact on quality of life. Pelvic floor muscle training (PFMT) is one of the recommended techniques for the prevention, treatment, and rehabilitation of postoperative complications. The aim of this observational study was to assess the quality of YouTube videos—accessible to any patient—related to exercises after prostatectomy surgery. Methods: A systematic search was performed on YouTube on 24 September 2020. One hundred and fifty videos were selected and analyzed. Two statistical analyses were conducted based on machine-learning techniques, and videos were classified as ‘Relevant’ or ‘Non-Relevant’ using Principal Component Analysis (PCA) models. Two reviewers conducted independent analyses. Inter-observer agreement and individual correlations of video data were evaluated with the Intraclass Correlation Coefficient (ICC). Information quality, reliability, and accuracy were measured using the DISCERN Scale and Global Quality Score (GQS), while video popularity was evaluated using the Video Power Index (VPI). Results: DISCERN scored a mean of 3.35 and GQS scored 3.38. Average number of views was 124,354, mean duration was 14:42 min, mean days online was 1777, mean view ratio was 138.30, mean Likes was 1082, mean Dislikes was 68.58, and mean VPI was 92.28. Conclusions: The quality of the videos available on YouTube regarding the recommended pelvic floor exercises in PC surgery, according to the scores obtained, is High. Educational and health institutions, health professionals, government health authorities, and policy makers need to be involved in the proper development of policies to improve the information available on the web in order to have a positive impact on the healthy behavior of the population.

YouTube as a source of information about pulpotomy and pulp capping: a cross sectional reliability analysis

Objectives

The purpose of this study was to critically evaluate the quality, reliability and educational content of the information of vital pulp treatment videos available on YouTube.

Materials and Methods

The keywords “pulpotomy” and “pulp capping” were searched on YouTube on 5th July 2020, until 60 English language videos of each search term with a duration shorter than 15 minutes were acquired. Video characteristics were recorded and Video Power Index (VPI) was calculated. Reliability and educational quality of videos were evaluated using the Modified DISCERN score, the Journal of American Medical Association (JAMA) benchmark criteria and Global Quality Scores (GQS). Videos were categorized by uploading source.

Results

Regarding pulpotomy, 31.7% of the videos were uploaded by specialists and 68.3% were directed by non-specialists. In the case of pulp capping, the corresponding percentages were 45% and 55%, respectively. Videos uploaded by specialists had significantly higher modified DISCERN, JAMA and GQS scores compared to those uploaded by non-specialists. Endodontists tended to have the highest reliability and VPI scores.

Conclusions

YouTube videos on vital pulp treatment contain low educational quality or incomplete information. Low popularity of dental pulp capping and pulpotomy videos may be attributed to the specialized nature of these procedures. As YouTube represents an important source for patient information about different health topics, reliable informative videos should be uploaded by specialized dental professionals.

TikTok as a Health Information Source: Assessment of the Quality of Information in Diabetes-Related Videos

Background

Diabetes has become one of the most prevalent chronic diseases, and many people living with diabetes use social media to seek health information. Recently, an emerging social media app, TikTok, has received much interest owing to its popularity among general health consumers. We notice that there are many videos about diabetes on TikTok. However, it remains unclear whether the information in these videos is of satisfactory quality.

Objective

This study aimed to assess the quality of the information in diabetes-related videos on TikTok.

Methods

We collected a sample of 199 diabetes-related videos in Chinese. The basic information presented in the videos was coded and analyzed. First, we identified the source of each video. Next, 2 independent raters assessed each video in terms of the completeness of six types of content (the definition of the disease, symptoms, risk factors, evaluation, management, and outcomes). Then, the 2 raters independently assessed the quality of information in the videos, using the DISCERN instrument.

Results

In regard to the sources of the videos, we found 6 distinct types of uploaders; these included 3 kinds of individual users (ie, health professionals, general users, and science communicators) and 3 types of organizational users (ie, news agencies, nonprofit organizations, and for-profit organizations). Regarding content, our results show that the videos were primarily about diabetes management and contained limited information on the definition of the disease, symptoms, risk factors, evaluation, and outcomes. The overall quality of the videos was acceptable, on average, although the quality of the information varied, depending on the sources. The videos created by nonprofit organizations had the highest information quality, while the videos contributed by for-profit organizations had the lowest information quality.

Conclusions

Although the overall quality of the information in the diabetes videos on TikTok is acceptable, TikTok might not fully meet the health information needs of patients with diabetes, and they should exercise caution when using TikTok as a source of diabetes-related information.

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.

Quality Analysis of YouTube Videos Presenting Shoulder Exercises after Breast Cancer Surgery

<b><i>Background:</i></b> The prolonged immobilization suggested after breast cancer (BC) surgery causes morbidity. Patients search the Internet, especially social networks, for recommended exercises. <b><i>Objective:</i></b> The aim of this observational study was to assess the quality of YouTube videos, accessible for any patient, about exercises after BC surgery. <b><i>Methods:</i></b> A systematic search was performed on YouTube. One hundred and fifty videos were selected and analyzed. Two statistical analyses were conducted based on machine-learning techniques. Videos were classified as “Relevant” and “Non-Relevant” using principal component analysis models. Popularity was evaluated by Video Power Index (VPI), informational quality and accuracy were measured using the DISCERN Scale and Global Quality Scale (GQS). Scoring criteria for exercises were established according to the exercises recommended by the Oncology Section of the American Physical Therapy Association (APTA). Interobserver agreement and individual correlations were statistically examined. <b><i>Results:</i></b> DISCERN scored a mean of 50.97 (standard deviation [SD] 19.19). HONcode scored 78.30 (11.02) and GQS scored 3.49 (0.74). Average number of views was 53,963 (SD 67,376), mean duration was 9:42 min (9:15), mean days online was 2,158 (922), mean view ratio was 27.14 (30.24), mean likes was 245 (320.5), mean dislikes was 13.4 (14.2), and mean VPI was 93.48 (5.42). <b><i>Conclusion:</i></b> The quality of YouTube videos of recommended exercises post-BC surgery is high and can be a translational activity to improve patients’ behavior. Health institutions and NGOs, with higher popularity levels than academic institutions, should consider this information when implementing new policies focused on video quality which can contribute to adaptive behavior in patients.

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.

A Proposed Approach for Conducting Studies That Use Data From Social Media Platforms

The prominence of social media in contemporary society has extended significantly into the health care arena, where both patients and health care providers have used social media platforms to gather, communicate, learn, and share medical content and personal experience in real time. The medical literature has also seen an exponential increase in the number of studies that use data derived from social media coverage of various medical issues and topics. In this guide, we present a step-by-step framework for health care professionals and researchers to conduct studies that use data from social media platforms. We present 6 overarching steps: focus on framing a question that is appropriate for social media evaluation, identification of social media outlet and selection criteria of content, systematic data extraction, assessment of quality of content and sources of bias, analysis of data, and interpretation of study findings. Each step is illustrated with published examples.

A randomized clinical trial of an eHealth intervention on anxiety in patients undergoing abdominal aortic aneurysm surgery

BACKGROUND

The potential benefit of eHealth interventions in patients with abdominal aortic aneurysm (AAA) is uncertain. The primary aim of this study was to investigate the effect of an eHealth intervention on anxiety in patients with AAA undergoing surgery.

METHODS

A single-centre randomized clinical trial of patients with AAA scheduled for surgical repair was undertaken. The intervention group received an eHealth tool and psychosocial support besides standard care. The control group received standard care. The analysis of treatment effects was performed as intention-to-treat and per protocol analysis. The primary outcome measure was anxiety mean score (Hospital Anxiety and Depression Scale Anxiety (HADS)-A). Secondary outcomes measures were HADS Depression and short-form 12-item health survey mean scores.

RESULTS

Some 120 participants were randomized. No effect on anxiety mean scores was found in the intention-to-treat analysis (-1.21 versus -0.54, P = 0.330). Among those randomized to the intervention, only 30 of 60 participants used the eHealth tool (application (app) users). The app users were younger and had a higher educational level. A decrease in anxiety mean scores was noted in those who used the app in the per protocol analysis (-2.00 versus -0.54, P = 0.028). The intervention group stated a lower physical-component health-related quality of life (HRQoL) (-4.32 versus -1.16, P = 0.042) but mental-component HRQoL and depressive symptoms were unchanged.

CONCLUSIONS

Delivery of an eHealth intervention in this RCT did not result in an improvement in anxiety scores in patients awaiting AAA surgery. Uptake of the eHealth tool was low, although it resulted in lower anxiety scores in those participants who actually used it.

CLINICAL TRIAL REGISTRATION NUMBER

NCT03157973 (http://www.clinicaltrials.gov).

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.

An Assessment of Available Information on the World Wide Web for Patients with Lower Limb Arterial Disease

OBJECTIVE

The quality of patient information relating to intermittent claudication (IC) and peripheral arterial disease (PAD) on the World Wide Web was assessed.

METHODS

The quality of websites and YouTube videos was assessed using the search terms "intermittent claudication" and "peripheral arterial disease". The first 50 hits screened for each search term from the three largest search engines by market share, and the first 20 videos from YouTube were screened. Website quality was scored using the University of Michigan Consumer Health Website tool (maximum score 80). Readability was calculated using the Flesch Reading Ease (FRE) score (maximum score 100). Videos were classified by content and upload source. Video reliability was assessed using the JAMA benchmark criteria. Video educational content was assessed using the Global Quality Score (GQS). Subjective content assessment was undertaken.

RESULTS

Seventy-six websites were analysed. The majority of websites for both IC (51.7%) and PAD (72.3%) were rated as weak. The median Michigan score for IC (27; interquartile range [IQR] 15, 32.5) was lower that the score for PAD (31; IQR 25.5, 38.8; p = .030). The majority of websites for both IC (69%) and PAD (68.1%) were rated as requiring an above average reading level. The overall median FRE score was 55.9 (IQR 46.6, 60.6) for IC and 55.3 (IQR 44.6, 59.3) for PAD. Twenty-two videos were analysed. Of the 14 videos evaluated as part of the PAD search, the median JAMA score was 2 (2 - 3), the median GQS score was 3 (3 - 3) and the evaluation of content score was 8.5 (7.25 - 11.5). The equivalent scores for the IC search were 2 (2 - 2), 3 (3 - 4), and 5.5 (5 - 8).

CONCLUSION

The educational quality and reliability of information both in written and video form on the internet is low. Attention needs to focus on improving the quality of all forms of information delivery to allow proper advocacy for patients.

The current state of vascular surgery presence and educational content in Google and YouTube internet search results

BACKGROUND

Information on the internet regarding vascular disease has not been extensively assessed. Our goal was to compile and appraise the information available via Google and YouTube searches regarding various topics of interest for vascular surgeons (VS) and related procedures with a focus on the role of the VS.

METHODS

The Google and YouTube platforms were independently queried for 25 keywords/phrases relating to common vascular diagnoses and procedures by two separate researchers from March to July 2019. Paid advertisements or a Society for Vascular Surgery (SVS) webpage or affiliated video in the first 25 results was documented. Results were reviewed for information regarding the responsible medical specialty and the target audience, and disease-related information (screening, risk factors, risk reduction, diagnostic testing, operative treatment, alternative treatment, follow-up, complications, and recovery).

RESULTS

From the Google search, 357 unique domains of 1241 total webpages were identified with 75% directed toward the public. An SVS page was present in 56% of the first-page results and least likely to be present in searches for claudication, gangrene, carotid stent, rib resection, and thrombolysis. VS were mentioned as referral physicians in 56% of the 68% of websites that mentioned a specialty, endovascular specialists/interventional radiology in 20%, and cardiothoracic surgeons in 19%. Only 4% of the websites contained information from all categories, with the greatest number for aortic dissection. Advertisements were present in 18% of all searches (most commonly for "varicose vein," "varicose vein surgery," and "inferior vena cava filter"). From YouTube, 1247 search results (613 unique videos) were evaluated with 64% directed toward the public. An SVS affiliated video was present in 36% of searches. In the 47% of videos where a specialty was mentioned, 56% mentioned VS, interventional radiology in 10%, and cardiothoracic surgeons in 7%. Only 0.24% of the videos contained information from all categories. The greatest number of content categories was in videos related to peripheral arterial disease. Across both platforms, dialysis access searches yielded results with the least number of content categories.

CONCLUSIONS

Patient-related information regarding vascular surgical topics is readily available on the internet, but the content is highly variable and not comprehensive. Only half of the searches mention VS as the referral physician of choice or authority for these medical conditions. Further efforts should focus on developing the online presence of vascular surgery, improving the quality of education of vascular disease on the internet, and directing patients to the vascular specialists to treat these conditions.