Assessing the Quality of Patient Information for Vestibular Schwannoma on the Open Source Video Sharing Platform YouTube

Experiences of Patients Living with Retrograde Cricopharyngeal Dysfunction

OBJECTIVES

Retrograde cricopharyngeal dysfunction (RCPD) is a newly described condition resulting from failure of cricopharyngeal sphincter relaxation during periods of esophageal distension that results in the inability to burp. Patients' perspectives on symptom experiences, barriers to care, and treatment benefits were investigated.

STUDY DESIGN

Qualitative semi-structured interviews were conducted with patients diagnosed with RCPD who had been treated with botulinum toxin injection into the cricopharyngeus muscle. Interview questions centered on their experience living with RCPD. Conventional content analysis was performed on interview transcripts.

RESULTS

Thematic saturation was reached with 13 participants. All participants were diagnosed with RCPD by an otolaryngologist and underwent botulinum toxin injection into the cricopharyngeus muscle with or without dilation of the upper esophageal sphincter in the operating room. Participants described having no memories of ever being able to burp, and all started experiencing RCPD symptoms during adolescence. Patients with RCPD experienced increased social isolation, lost productivity, and worsened mental health. Unanimously, participants first learned about RCPD on social media. All patients were seen by physicians in non-otolaryngology specialties regarding their symptoms prior to learning about their RCPD diagnosis and undergoing treatment by an otolaryngologist. Dilation and chemodenervation resulted in complete resolution of RCPD symptoms for 84.6% of participants. Participants emphasized a desire for more health providers to learn about RCPD and the impact it has on quality-of-life.

CONCLUSION(S)

The lived experience of patients with RCPD significantly impacts quality of life and is often met with diagnostic barriers in the medical community. Although social media plays a significant role in increasing awareness of RCPD, physician education about the impact of RCPD is essential to improve diagnosis and treatment.

LEVEL OF EVIDENCE

4 Laryngoscope, 134:2136-2143, 2024.

A quality assessment of YouTube as an information resource for tonsillectomy

PURPOSE

Online resources are increasingly being utilised by patients to guide their clinical decision making, as an alternative or supplement to the traditional clinical-patient relationship. YouTube is an online repository of user and community generated videos, which is one of the most popular websites globally. We undertook a study to examine the quality of information presented in YouTube videos related to tonsillectomy.

METHODS

We completed a systematic search of YouTube in May 2023 and identified 88 videos for inclusion in our study. Videos were published in the English language, focussing on tonsillectomy and tonsillectomy recovery, and were greater than 2 min in length. We recorded video quality metrics and two authors independently analysed the quality of information using three validated quality assessment tools described in the literature including the modified DISCERN, Global Quality Score, and the JAMA Benchmark Criteria.

RESULTS

The overall quality of the information was low with mean quality scores of Modified DISCERN (1.8 ± 1.3), GQS (2.6 ± 1.2), and JAMA Benchmark Criteria (1.6 ± 0.7). Information published by medical sources including medical professionals, healthcare organisations, and medical education channels scored significantly higher compared to non-medical sources across all quality measures and were of moderate overall quality and usefulness: Modified DISCERN (2.5 ± 1.1 vs 0.8 ± 0.9, z = -6.0, p < 0.001), GQS (3.2 ± 1.0 vs 1.7 ± 0.9, z = -5.7, p < 0.001), and JAMA (1.9 ± 0.8 vs 1.1 ± 0.3, z = -5.2, p < 0.001). Videos published during or after 2018 scored higher on Modified DISCERN (z = -3.2,p = 0.001) but not on GQS or JAMA. Video quality metrics such as total view count, likes, and comments, and channel subscriber count, did not correlate with higher video quality. However, amongst videos published by authoritative medical sources, total view count correlated positively with higher Modified DISCERN quality scores (p = 0.037).

CONCLUSION

The overall quality and usefulness of YouTube videos on tonsillectomy is of low quality, but information published by authoritative medical sources score significantly higher. Clinicians should be mindful of increasing use of online information sources such as YouTube when counselling patients. Further research is needed in the medical community to create engaging, high-quality content to provide guidance for patients.

Retrograde Cricopharyngeal Dysfunction: A Review

Retrograde cricopharyngeal dysfunction (RCPD), also referred to as retrograde cricopharyngeus dysfunction, is a condition characterized by the inability to burp. The pathophysiology of this condition is thought to result from failure of cricopharyngeal sphincter relaxation during periods of esophageal distension, which leads to patients' bothersome symptoms. RCPD negatively impacts patients' quality of life and is associated with bloating, gurgling, avoidance of carbonation, self-imposed dietary and lifestyle changes designed to minimize discomfort, and flatulence. Complaints often start during adolescence, and many patients search for a diagnosis for years before obtaining treatment. A recent increase in awareness through patient-led social media discussion boards describing the 'no burp' syndrome is leading to an increasing incidence of presentations, often with patients making a self-diagnosis. The increased incidence of RCPD is fueling a larger case series investigating treatment options and outcomes. In this review, we discuss what is known about the pathophysiology of this condition, the otolaryngologic perspective on diagnosis and treatment, the patients' lived experience of this condition, and the influence of social media on RCPD.

Social Media Utilization in Otolaryngology: A Scoping Review

OBJECTIVE

Social media (SM) is an increasingly popular medium for the medical community to engage with patients, trainees, and colleagues. This review aimed to identify reported uses of SM in otolaryngology-head and neck surgery (OHNS), assess the quality of evidence supporting these uses, and identify gaps in the literature. With the relative lack of regulatory guidelines for the development of SM content, we hypothesized that the quality of content available on SM would be highly variable.

DATA SOURCES AND METHODS

A scoping review was performed of English-language peer-reviewed studies published to date discussing SM use in any form within OHNS. Three reviewers independently screened all abstracts. Two reviewers independently extracted data of interest from the full text of articles identified from the preliminary abstract screen.

RESULTS

171 studies were included, with 94 (54.9%) studies published between 2020 and 2022. 104 (60.8%) studies were conducted in the US. 135 (78.9%) used cross-sectional or survey-based methodology; only 7 (4.1%) were controlled studies. SM was most commonly employed for professional networking (n = 37 [21%]), and within subspecialties of otology (n = 38 [22%]) and rhinology/allergy (n = 25 [15%]). Facebook was most frequently used for study recruitment (n = 23 [13.5%]), YouTube for patient education (n = 15 [14.6%]), and Twitter for professional networking (n = 16 [9.4%]).

CONCLUSION

SM use within OHNS is increasing rapidly, with applications including patient education, professional networking, and study recruitment. Despite myriad articles, there remains a paucity of well-controlled studies. As SM becomes integrated into healthcare, particularly for applications directly impacting patient care, higher levels of evidence are needed to understand its true impact. Laryngoscope, 133:2447-2456, 2023.

A content analysis of YouTube videos on tinnitus in South Korea

More people use the internet for medical information, especially YouTube. Nevertheless, no study has been conducted to analyze the quality of YouTube videos about tinnitus in Korea. This study aims to review the contents and quality of YouTube videos on tinnitus. The top 100 Korean YouTube videos on tinnitus were reviewed by a tinnitus expert. This study assessed video details: title, creator, length, and popularity indicators-subscribers, views, and likes. The contents of the video clips were analyzed to determine the relevance, understandability, actionability, and quality of information. Out of 100 tinnitus videos, 27 were created by otolaryngologists, 25 by traditional Korean medicine doctors, 25 by other medical professionals, and 3 by lay persons. Sensorineural tinnitus was frequently dealt, and hearing loss, stress, and noise were introduced as main causes of tinnitus. Otolaryngologists' videos covered verified treatments, but others suggested unproven therapies including herbal medicine or acupressure. Otolaryngologists' videos showed significantly higher understandability and quality of information compared to others (p < 0.001). This study found that tinnitus YouTube videos frequently present low-quality and incorrect material, which could have an adverse effect on patients. Results highlight the need for tinnitus specialists to provide accurate information.

Assessing the Quality of Patient Information for Cholesteatoma on the Video Sharing Platform YouTube

INTRODUCTION

Cholesteatoma is common chronic ear condition that usually requires surgical treatment and long-term follow-up. The Internet helps patients find information about their medical conditions and assists in shared clinical decision making. This work aims to assess the quality of information on YouTube for cholesteatoma. We aim to assess the quality of the most popular cholesteatoma videos on YouTube using recognized scoring systems and determine if quality correlated with video likes and views.

METHODS

The YouTube website was systematically searched on separate days with a formal search strategy to identify videos relevant to cholesteatoma. Each video was viewed and scored by three independent assessors using a novel Essential and Ideal Video Completeness criteria for cholesteatoma and the validated DISCERN tool. Popularity metrics were analyzed and compared with video popularity.

RESULTS

A total of 90 YouTube videos were analyzed with an average 55,292 views per video with an average of 271 likes and 22 dislikes. The interrater correlation was moderate with Fleiss kappa score 0.42 ( p < 0.01) using the Essential and Ideal Video Completeness criteria for cholesteatoma and interrater correlation coefficient was 0.78 (95% confidence interval, 0.58-0.90), indicating good reliability for DISCERN scores. The overall video quality was poor with higher DISCERN scores found from academic institutions.

CONCLUSION

YouTube content with regard to cholesteatoma is of poor quality. Videos with unclassified sources or more dislikes correlated with poor quality. Otology societies should be encouraged to publish high-quality YouTube videos on cholesteatoma and other ear conditions.

Social Media Use in Hearing Loss, Tinnitus, and Vestibular Disorders: A Systematic Review

Background:

People are increasingly using social media outlets for gathering health-related information. There has also been considerable interest from researchers and clinicians in understanding how social media is used by the general public, patients, and health professionals to gather health-related information. Interest in the use of social media for audiovestibular disorders has also received attention, although published evidence synthesis of this use is lacking. The objective of this review article was to synthesize existing research studies related to social media use concerning hearing loss, tinnitus, and vestibular disorders.

Method:

Comprehensive searches were performed in multiple databases between October and November 2020 and again in June 2021 and March 2022, with additional reports identified from article citations and unpublished literature. This review article was presented using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Results:

A total of 1,512 articles were identified. Of these, 16 publications met the inclusion criteria. Overall, social media offered people the platform to learn about hearing loss, tinnitus, and vestibular disorders via advice and support seeking, personal experience sharing, general information sharing, and relationship building. Research studies were more common on information and user activities seen on Facebook Pages, Twitter, and YouTube videos. Misinformation was identified across all social media platforms for each of these conditions.

Conclusions:

Online discussions about audiovestibular disorders are evident, although inconsistencies in study procedures make it difficult to compare these discussion groups. Misinformation is a concern needing to be addressed during clinical consultations as well as via other public health means. Uniform guidelines are needed for research regarding the use of social media so that outcomes are comparable. Moreover, clinical studies examining how exposure to and engagement with social media information may impact outcomes (e.g., help seeking, rehabilitation uptake, rehabilitation use, and satisfaction) require exploration.

Supplemental Material:

https://doi.org/10.23641/asha.20667672