YouTube as a source of information on varicose veins

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.

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.

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.

Cross-sectional study on the quality of oral lichen planus videos on YouTube™

BACKGROUND

YouTube™ is one of the most used platforms for patients looking for health-related information. The purpose of this cross-sectional study was to analyze the available information about oral lichen planus on YouTube™ and how users interact with it.

METHODS

A YouTube™ search for oral lichen planus was performed, setting English UK (language) and United Kingdom (country). Two hundred and fifteen results were screened, and 36 videos met the inclusion criteria. Videos' quality was evaluated using the DISCERN and the Global Quality Scale tools, and by categorizing them through quality assessment, source, duration, views, likes, and dislikes of each video were noted.

RESULTS

According to quality assessments, 55.6% of the videos were classified as useful, while the 35.1% were classified as misleading/dangerous. The DISCERN and GQS values were generally low (31.56 ± 10.38 and 2.33 ± 1.07, respectively); DISCERN and GQS were positively correlated with the video length and negatively correlate with the data of upload (p < 0.05).

CONCLUSIONS

This study corroborates the results of others that a great number of health-related videos available on YouTube™ feature misleading or potentially dangerous information; although the quality seems to slightly improve over time, medical associations and researchers ought to plan strategies aimed at improving the quality of the information delivered through YouTube™ and other social media.

Medical Student Decision-Making: Standard Surgical Excision or Mohs Micrographic Surgery to Manage Basal Cell Carcinoma

Context

As future physicians, osteopathic medical students will play a critical role in helping patients make informed decisions regarding treatment options.

Objective

To examine the influence that the time, cost, and cosmetic effects associated with treatment options for basal cell carcinoma (BCC), along with students' demographic characteristics, have on treatment decision-making. The influence that different sources of information have on students was also studied.

Methods

Medical students were recruited from the Nova Southeastern University College of Osteopathic Medicine for this cross-sectional study. Students were presented with a case scenario in which they were a patient with primary nodular BCC in a low-risk zone, and they were asked to select standard surgical excision (SSE) or Mohs micrographic surgery (MMS) as a treatment option. They also completed an anonymous survey that assessed the way that factors associated with the treatment options (time, cost, and cosmetic effects) influenced their treatment choice, along with the influence that different sources of information have. Measures of central tendency, frequencies, and other descriptive analyses were used to define the characteristics of the sample. χ2 analysis, correlational analysis, and t tests were used to examine the associations between the treatment decision, treatment-related factors (time, cost, cosmetics), and year in medical school. Statistical significance was set at P≤.05.

Results

A total of 450 students completed the survey and were included in the bivariate analysis. Three hundred forty-five students (76.7%) selected MMS as a treatment option and 105 (23.3%) selected SSE. Significant differences were found in the influence of time, cost, and cosmetic effects associated with treatment between students who selected MMS and those who selected SSE (P<.001). Cost played a more influential role in treatment decision-making for students who selected SSE than for those who selected MMS. Time and cosmetic effects played a more influential role in treatment choice for those who selected MMS. The most influential sources of information were health care professionals and medical literature, with 398 (88.4%) and 313 (69.6%) students, respectively, indicating that these sources were highly influential when making medical treatment decisions. The internet had a low influence over students' treatment decision-making (238 [52.9%]).

Conclusions

This study represents an initial step toward understanding factors that influence patients' treatment decision-making in a situation in which there is no medically preferred treatment option. The findings point to the importance of time, cost, and cosmetics as influential factors for patients choosing between different treatment options.

Quality of Erector Spinae Plane Block Educational Videos on a Popular Video-sharing Platform

Introduction The Erector Spinae Plane (ESP) block is a novel inter-fascial block developed in 2016, which has several clinical indications. YouTube (www.youtube.com; YT) is a popular American video-sharing platform. YT permits every user to view, share, and comment the videos uploaded by other users. The aim of the study was to evaluate the educational value and the technical video quality of didactic videos for the ESP block on a popular video-sharing platform, to evaluate the difference in quality between academic and nonacademic videos, and to evaluate the correlation between the views and quality of the videos, the length, and the time since upload. Methods We performed a search on YT trying to detect all relevant educational videos for the ESP block. Both the educational value and the technical video quality were assessed independently by three assessors. Assessors were asked to watch the videos and to fill in two questionnaires, the first one regarding the technical and educational aspects of ESP block, the second one regarding the video-editing quality. The video length, academic origin, views, and time from upload were also registered. Results We identified 62 videos and 21 videos entered the final analysis. The educational material for the ESP block had an overall low quality. Academic videos have a higher quality than non-academic ones. The video views are correlated with time since upload but not with the video quality. Conclusions The educational material for the ESP block on YT has a limited technical and video quality. For this reason, we recommend physicians to be very cautious in using video-sharing platforms as a unique source of medical knowledge.

Analysis of YouTube as a Source of Information for Diabetic Foot Care

BACKGROUND

Increasing amounts of diabetes-focused content is being posted to YouTube with little regulation as to the quality of the content. Diabetic education has been shown to reduce the risk of ulceration and amputation. YouTube is a frequently visited site for instructional and demonstrational videos posted by individuals, advertisers, companies, and health-care organizations. We sought to evaluate the usefulness of diabetic foot care video information on YouTube.

METHODS

YouTube was queried using the keyword phrase diabetic foot care. Original videos in English, with audio, less than 10 min long within the first 100 video results were evaluated. Two reviewers classified each video as useful or nonuseful/misleading. A 14-point usefulness criteria checklist was used to further categorize videos as most useful, somewhat useful, or nonuseful/misleading. Video sources were categorized by user type, and additional video metrics were collected.

RESULTS

Of 87 included videos, 56 (64.4%), were classified as useful and 31 (35.6%) as nonuseful/misleading. A significant difference in the mean length of useful videos vs nonuseful/misleading videos was observed (3.33 versus 1.73 min; P < .0001). There was no significant difference in terms of popularity metrics (likes, views, subscriptions, etc) between useful and nonuseful/misleading videos.

CONCLUSIONS

This study demonstrates that although most diabetic foot care videos on YouTube are useful, many are still nonuseful/misleading. More concerning is the lack of difference in popularity between useful and nonuseful videos. Podiatric physicians should alert patients to possibly misleading information and offer a curated list of videos.

YouTube as a source of patient information for varicose vein treatment options

OBJECTIVE

The purpose of this study was to analyze the quality of content and potential sources of bias in videos available on YouTube pertaining to interventional treatment for varicose veins.

METHODS

Searches were performed on YouTube to identify videos pertaining to interventional treatment for varicose veins. Videos that met eligibility criteria were analyzed and rated according to predetermined criteria by two independent assessors, with a third independent assessor to resolve any discrepancy. Each video was rated for its informational quality (good, fair, poor) and stance (for, neutral, against, unclear) toward the treatment option discussed.

RESULTS

 = 9.308; df = 2; P = .010), with videos from private companies generally receiving poorer quality ratings than other videos. There was no association between quality and viewing frequency of videos (P = .379).

CONCLUSIONS

On the whole, the videos available on YouTube are neither sufficiently comprehensive nor adequately balanced to be recommended as patient education material regarding interventional treatment options for varicose veins.

YouTube as a potential source of information on deep venous thrombosis

Background

No work has been reported on the use of video websites to learn about deep vein thrombosis and the value of education using them. We examined the characteristics and scientific accuracy of videos related to deep vein thrombosis on YouTube.

Methods

YouTube was surveyed using no filter and the key words ‘deep vein thrombosis’ and ‘leg vein clot’ in June 2016. The videos evaluated were divided into three groups in terms of their scientific content, accuracy, and currency: useful, partly useful, and useless.

Results

Of the 1200 videos watched, 715 (59.58%) were excluded with the exclusion criteria. Although most of the videos uploaded (22.9%, n = 111) were created by physicians, the number of views for website-based videos was significantly higher (p = 0.002). When the uploaded videos were assessed in terms of their usefulness, videos from physicians and hospitals were statistically more useful than other videos (p < 0.001).

Conclusions

For videos created by medical professionals to be of higher quality, we believe they should be more up-to-date and comprehensive, and contain animations about treatment modalities and early diagnosis in particular.