YouTube for Cosmetic Plastic Surgery: An Effective Patient Resource?

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

PURPOSE

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

METHODS

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

RESULTS

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

CONCLUSION

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

The Ethics and Responsibilities of Social Media Usage by Plastic Surgeons: A Literature Review

BACKGROUND AND OBJECTIVES

Social media has revolutionised how plastic surgeons advertise their work and promote their services, but concerns have been raised regarding the ethics of these practices. This review aims to identify said concerns and develop measures to address them.

METHODS

PubMed, Cochrane and Medline were searched for studies assessing the ethics of social media use by plastic surgeons. Five search terms were used and 23 studies identified. Results were catalogued according to which principle of medical ethics was infringed.

RESULTS

Autonomy: Patients must not be coerced into allowing their operative media to be shared and content anonymised by removing identifiable features and scrubbing metadata. Beneficence: It is difficult to balance the benefit to patients of posting photographs for educational purposes with the risk of identifiable features being present, particularly within craniofacial surgery. Non-maleficence: Taking operative media could be a distraction from the patient and lengthen the procedure which could lead to harm. Any content posted on social media should be adapted to avoid trivialisation or sexualisation. Justice: Surgeons should not entertain their audience to increase their following at the expense of patients.

CONCLUSIONS

Greater oversight of social media use by plastic surgeons is required to avoid patient harm and tarnishing of the specialty's professional standing. Professional bodies should be tasked with devising a course dedicated to the responsible use of these platforms. This should ensure the public's trust in the specialty does not become eroded and patients are not harmed by unethical social media use. This review highlights the relevant shortfalls of SoMe use by plastic surgery Several proposals are made to reduce the incidence of these shortfalls and to ensure SoMe is used in a professional and responsible manner It also lists areas of the specialty where SoMe is underused and could be of help, such as academia LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .

Assessing Laryngectomy Patient Education on YouTube: Investigating Quality and Reliability

Objective

This study aimed to characterize the quality of laryngectomy-related patient education on YouTube and understand factors impacting video content quality.

Study Design

Cross-sectional cohort analysis.

Setting

Laryngectomy-related videos on YouTube.

Methods

YouTube was anonymously queried for various laryngectomy procedure search terms. Video quality was evaluated using the validated DISCERN instrument which assesses treatment-related information quality. Descriptive statistics were used to characterize our cohort. Univariate and multivariable linear regression were used to assess factors associated with increased DISCERN score. Significance was set at P < .05.

Results

Our 78-video cohort exhibited moderate levels of engagement, averaging 13,028.40 views (SD = 24,246.93), 69.79 likes (SD = 163.75), and 5.27 comments (SD = 18.81). Videos were most frequently uploaded to accounts belonging to physicians (43.59%) or health care groups (41.03%) and showcased operations (52.56%) or physician-led education (20.51%). Otolaryngologists were featured in most videos (85.90%), and most videos originated outside the United States (67.95%). Laryngectomy videos demonstrated poor reliability (mean = 2.35, SD = 0.77), quality of treatment information (mean = 1.92, SD = 0.86), and overall video quality (mean = 1.97, SD = 1.12). In multivariable linear regression, operative videos were associated with lower video quality relative to nonoperative videos (β = -1.63, 95% confidence interval [CI] = [-2.03 to -1.24], P < .001); the opposite was true for videos from accounts with higher subscriber counts (β = 0.02, 95% CI = [0.01-0.03], P = .005).

Conclusion

The quality and quantity of YouTube's laryngectomy educational content is limited. There is an acute need to increase the quantity and quality of online laryngectomy-related content to better support patients and caregivers as they cope with their diagnosis, prepare for, and recover from surgery.

Educational Quality of YouTube Videos for Patients Undergoing Elective Procedures

INTRODUCTION

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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

BACKGROUND

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

A comprehensive evaluation of ChatGPT consultation quality for augmentation mammoplasty: A comparative analysis between plastic surgeons and laypersons

OBJECTIVES

ChatGPT has gained significant popularity as a source of healthcare information among the general population. Evaluating the quality of chatbot responses is crucial, requiring comprehensive and qualitative analysis. This study aims to assess the answers provided by ChatGPT during hypothetical breast augmentation consultations across various categories and depths. The evaluation involves the utilization of validated tools and a comparison of scores between plastic surgeons and laypersons.

METHODS

A panel consisting of five plastic surgeons and five laypersons evaluated ChatGPT's responses to 25 questions spanning consultation, procedure, recovery, and sentiment categories. The DISCERN and PEMAT tools were employed to assess the responses, while emotional context was examined through ten specific questions. Additionally, readability was measured using the Flesch Reading Ease score. Qualitative analysis was performed to identify the overall strengths and weaknesses.

RESULTS

Plastic surgeons generally scored lower than laypersons across most domains. Scores for each evaluation domain varied by category, with the consultation category demonstrating lower scores in terms of DISCERN reliability, information quality, and DISCERN score. Plastic surgeons assigned significantly lower overall quality ratings to the procedure category compared to other question categories. They also gave lower emotion scores in the procedure category compared to laypersons. The depth of the questions did not impact the scoring.

CONCLUSIONS

Existing health information evaluation tools may not be entirely suitable for comprehensively evaluating the quality of individual responses generated by ChatGPT. Consequently, the development and implementation of appropriate evaluation tools to assess the appropriateness and quality of AI consultations are necessary.

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 dental x-rays safe? Content analysis of English and Chinese YouTube videos

Objective

This study provided a content analysis of English and Chinese YouTube videos related to dental radiation safety.

Method

The search string, entered in English and Chinese respectively, was: (dental x-ray safe). The searches were performed and exported with Apify YouTube scraper. By screening the resultant videos and their related videos (as recommended by YouTube), a total of 89 videos were screened. Finally, 45 videos (36 English and nine Chinese) were included and analyzed. The specific information regarding dental radiation was evaluated. The Patient Education Material Assessment Tool for Audiovisual Materials was used to assess understandability and actionability.

Results

There was no significant difference between the English and Chinese videos in terms of view count, like count, comment count, and video duration. Half of the videos explicitly reassured the audience that dental x-rays are safe. Two of the English videos specifically stated that dental x-rays do not cause cancers. Numerous analogies were made in regard to radiation dose, such as equivalence to taking a flight or eating some bananas. About 41.7% of the English videos and 33.3% of the Chinese videos mentioned that patients could be further protected from scatter radiation by wearing a lead apron and thyroid collar. Videos had a good understandability score (91.3) but a poor actionability score (0).

Conclusions

Some of the analogies and the claimed radiation dose were questionable. One Chinese video even wrongly stated that dental x-rays are nonionizing radiation. The videos generally did not mention their information sources or the underlying radiation protection principles.

YouTube as a source for information on newborn male circumcision: Is YouTube a reliable patient resource?

INTRODUCTION

YouTube is the most popular open access media-sharing platform and is the second most visited websites worldwide. However, due to a lack of peer-review, YouTube is largely unregulated and can be susceptible to the spread of biased or misleading information.

OBJECTIVE

To evaluate the quality and potential bias of videos pertaining to newborn male circumcision (NMC) on YouTube.

MATERIALS & METHODS

A YouTube search was performed on August 27, 2021 using the search term 'circumcision', and the top 100 videos were analyzed by two independent reviewers. Videos were categorized into groupings based on their source, and each video was evaluated for bias and was determined to be either pro-circumcision, anti-circumcision or neutral. Video quality was assessed using the DISCERN instrument (1-5 scale) and the Global Quality Scale (GQS) (1-5 scale). Video popularity was measured using the video power index (VPI).

RESULTS

We found that the overall quality of videos on YouTube pertaining to NMC is generally low (DISCERN: 2.9 ± 0.7, GQS: 2.9 ± 1.1). When describing potential bias, 56% of videos were neutral and 44% were biased, of which 30% being anti-circumcision and 14% being pro-circumcision. Videos which were neutral, produced by health channels, or which featured physicians were associated with the highest quality ratings. However, when correlating total video views and likes with our quality assessments, we observed a significant negative correlation between the overall popularity of a video and its DISCERN (ρ = -0.297, p = 0.031) and GQS quality ratings (ρ = -0.274, p = 0.048).

CONCLUSION

Information pertaining to NMC on YouTube is generally of low quality and has a high potential for bias. Lower quality content is overrepresented on YouTube and tended to be more popular than higher quality content. Patients and their families should be cautious when accessing YouTube for health information pertaining to NMC.

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.

Going Viral: A Systematic Review of Google Trends in Plastic Surgery and a Recommended Framework for Its Use

As the leading global search engine with billions of daily queries, Google and its open-source Google Trends (Google, Mountain View, CA) represent an emerging and powerful tool for epidemiological and medical research. Within the field of plastic surgery, Google Trends has yielded insights into online interest for facial feminization surgery, gender-affirmation surgery, cosmetic body procedures, and breast reconstruction, among other common procedures. The existing literature of Google Trends in plastic surgery was systematically reviewed following established Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Google Trends' 4 input variables-keyword, region, period, and category-were assessed. Seventeen plastic surgery studies employing Google Trends were reviewed. There was strong inter-rater reliability (Cohen's kappa = 0.68). Analyzing keyword syntax, only 3 of 17 studies (17.6%) used the "+" function to combine terms, which can significantly improve sensitivity. For the region variable, 12 of 16 studies (75%) conducted worldwide searches; yet, none of the studies used any non-English keywords, introducing significant bias. For the period, 88.2% of studies utilized a timespan of greater than 5 years, resulting in monthly intervals between data points in Google Trends. For the "category" variable, none of the studies appear to have employed the "surgery," "cosmetic surgery" or "health" categories to improve specificity. Google Trends is presented as an emerging methodology in plastic surgery research. The strengths and limitations of Google Trends as a resource for plastic surgeons and medical professionals are discussed, and a recommended step-by-step guide for conducting and interpreting Google Trends research is outlined.

YouTube as a resource for surgical education with a focus on plastic surgery - a systematic review

Surgery trainees use videos as a means to learn about surgical procedures. YouTube is the biggest online video platform and used for educational content as well but the medical information provided does not undergo peer review or other forms of scientific screening and can thus be of poorer quality. We performed a systematic review that examined the quality of educational videos about surgery and plastic surgery in particular on YouTube. The focus was towards studies on the benefit of YouTube videos for surgical trainees. A literature review was performed to determine the educational quality of plastic surgery videos found on YouTube. Articles reviewing the educational quality of videos about surgical procedures, their accuracy, and their utility for surgical trainees were included. An additional review was performed evaluating the literature about the quality of educational plastic surgery videos. Eleven articles were selected reviewing the educational quality of videos about surgical procedures. Six studies were fully assessed and evaluated concerning the quality of educational plastic surgery videos. There currently seems to be a lack of comprehensive educational surgery and in particular plastic surgery-related information on YouTube. The popularity of YouTube among surgical trainees is high. The quality of available educational surgical video content varies widely. It is in the interest of plastic surgery teaching institutions to provide trainees with high-quality educational video material.