Does YouTube Provide Qualified Patient Education Videos About Atrial Fibrillation?

The role of atrial fibrillation in vascular cognitive impairment and dementia: epidemiology, pathophysiology, and preventive strategies

The aging population in Europe faces a substantial burden from dementia, with vascular cognitive impairment and dementia (VCID) being a preventable cause. Atrial fibrillation (AF), a common cardiac arrhythmia, increases the risk of VCID through mechanisms such as thromboembolism, cerebral hypoperfusion, and inflammation. This review explores the epidemiology, pathophysiology, and preventive strategies for AF-related VCID. Epidemiological data indicate that AF prevalence rises with age, affecting up to 12% of individuals over 80. Neuroimaging studies reveal chronic brain changes in AF patients, including strokes, lacunar strokes, white matter hyperintensities (WMHs), and cerebral microbleeds (CMHs), while cognitive assessments show impairments in memory, executive function, and attention. The COVID-19 pandemic has exacerbated the underdiagnosis of AF, leading to an increase in undiagnosed strokes and cognitive impairment. Many elderly individuals did not seek medical care due to fear of exposure, resulting in delayed diagnoses. Additionally, reduced family supervision during the pandemic contributed to missed opportunities for early detection of AF and related complications. Emerging evidence suggests that long COVID may also elevate the risk of AF, further complicating the management of this condition. This review underscores the importance of early detection and comprehensive management of AF to mitigate cognitive decline. Preventive measures, including public awareness campaigns, patient education, and the use of smart devices for early detection, are crucial. Anticoagulation therapy, rate and rhythm control, and addressing comorbid conditions are essential therapeutic strategies. Recognizing and addressing the cardiovascular and cognitive impacts of AF, especially in the context of the COVID-19 pandemic, is essential for advancing public health.

YouTube as a learning source for contact lens insertion and removal

CLINICAL RELEVANCE

Contact lens neophytes often learn about contact lens insertion and removal through YouTube videos of unknown quality.

BACKGROUND

This study evaluates the quality of soft contact lens insertion and removal videos on YouTube.

METHODS

A search for the keywords 'Contact lens insertion', 'Contact lens removal', 'Put in contact lens', and 'Take off contact lens' was performed on YouTube. The first 50 videos for each keyword were evaluated. The number of views, source of the publisher, days since upload, and video quality were scored based on the content in the videos. The maximum score of insertion and removal videos were 7 and 5 respectively. The videos were classified into three groups by publisher category: videos published by eye care professionals, companies and YouTubers.

RESULTS

Only 45 contact lens insertion and 44 removal videos met the inclusion criteria and were analysed. Insertion and removal videos published by YouTubers had the highest view and view rate. However, their quality scores were significantly lower than videos published by eye care professionals and companies. Videos uploaded by companies had the highest scores (insertion: 5.00 ± 1.10; removal: 3.25 ± 0.75). The mean scores of insertion and removal videos published by YouTubers were 1.65 ± 0.93 and 1.00 ± 0.89, respectively, while the insertion and removal videos uploaded by eye care professionals scored 3.58 ± 2.07 and 2.75 ± 1.53, respectively. There was also a negative correlation between the quality scores and view rate (p = 0.008, r = -0.41).

CONCLUSION

Contact lens insertion and removal videos uploaded by YouTubers had the highest view rate but the lowest quality. Videos made by companies included most essential elements.

Assessment of YouTube Videos in Patient Education for Coronary Artery Disease: A DISCERN-Based Cross-Sectional Analysis

Introduction Cardiovascular disease has one of the highest mortality rates and continues to grow. Therefore, it is important for the medical community to get involved in widespread patient education efforts. As technology has steadily advanced, YouTube (Google LLC, Mountain View, California, United States) has become a popular source for patients to gather medical information. In this study, we aim to assess the quality of YouTube videos pertaining to coronary artery disease.  Methods We searched the following key terms on June 20, 2023, using the view count filter: coronary artery disease, coronary artery disease treatment, cardiac catheterization, and coronary artery bypass grafting (CABG). The top twenty videos for each keyword were recorded. After videos that were over 20 minutes, non-English, procedural videos without words, and duplicates were excluded, forty-five videos remained. Each video was assessed by three viewers using the DISCERN criteria (http://www.discern.org.uk). Numerical data was averaged into composite scores. Two-sided t-tests and one-way analysis of variance (ANOVA) tests were used to compare mean ratings between groups. A Spearman correlation was done to compare each of the following terms to one another: overall quality of videos, total likes a video received, and total views.  Results The mean ratings for coronary artery disease, coronary artery disease treatment, cardiac catheterization, and CABG were 2.30, 2.60, 2.05, and 2.92, respectively, with an overall mean of 2.42. The means between coronary artery disease and coronary artery disease treatment were significantly different (p adj = 0.01). The overall rating for videos with board-certified physicians was significantly higher than those without a board-certified physician (p < 0.001). There was a low correlation between likes and overall ratings (0.03) and views and overall ratings (-0.068). Conclusion The videos on coronary artery disease, coronary artery disease treatment, cardiac catheterization, and CABG had poor overall quality based on DISCERN criteria. The overall ratings from videos with board physicians are higher than those from non-physicians, suggesting that physicians should be encouraged to create content about important medical conditions. There was also a low correlation between the overall quality of a video and the likes and views, respectively, indicating a disconnect between what the public values and the actual value of a video.

Assessment of the Quality and Reliability of Content Available on YouTube About Palpitations

Palpitations refer to the sensation of rapid, fluttering, or pounding heartbeats in the chest, the determinants of which may range from hormonal changes to anxiety or arrhythmias. YouTube is one of the most prevailing and accepted web-based platforms people trust to help them understand more about their health conditions. Thus, this study aims to assess whether the quality of content about palpitations on this platform is reliable and sufficient. Seventy-one YouTube videos were analyzed using criteria such as date and time of upload, type of uploader, and type of content. The Global Quality Score (GQS) and modified DISCERN score were used to analyze the quality and reliability of the information provided. Microsoft Excel (Microsoft Corporation, Redmond, WA, US) was used for data analysis, and StataCorp's 2023 Stata Statistical Software (College Station, TX, US) was used for statistical analysis and visualization. Of the 71 videos analyzed, 90.14% were uploaded more than a year ago, 80.28% described the symptomatology in detail, and 81.69% accurately described the etiological factors. Hospitals and doctors were the most common uploaders, constituting 23% and 19% of the uploaded videos, respectively, and had high GQSs (Median GQS = 4). The highest scores also belonged to videos uploaded by patients suffering from the disease (Median GQS = 5). Hospitals and news channels ranked highest on the reliability score (Median DISCERN = 4, respectively). It was determined that despite varied sources, the nature of content provided by the platform contains promotional material and content gaps; YouTube should, therefore, be used critically and as per professional sources.

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.

TikTok video as a health education source of information on heart failure in China: a content analysis

Background

Heart failure (HF) is a complex and life-threatening syndrome associated with significant morbidity and mortality. While TikTok has gained popularity as a social media platform for sharing HF-related information, the quality of such content on TikTok remains unexplored.

Methods

A cross-sectional analysis was conducted on TikTok videos related to HF in China. The sources of the videos were identified and analyzed. The content comprehensiveness of the videos was evaluated using six questions that covered definition, signs and symptoms, risk factors, evaluation, management, and outcomes. The reliability and quality of the videos were assessed using three standardized evaluation instruments: DISCERN, JAMA benchmarks, and the Global Quality Scale. Additionally, the correlation between video quality and video characteristics was further investigated.

Results

Among the video sources, 92.2% were attributed to health professionals, while news agencies and non-profit organizations accounted for 5.7% and 2.1%, respectively. The content comprehensiveness score for the videos was 3.36 (SD 3.56), with news agencies receiving the highest scores of 4.06 (SD 3.31). The median DISCERN, JAMA, and GQS scores for all 141 videos were 26.50 (IQR 25.00-28.750), 2.00 (IQR 2.00-2.00), and 2.00 (IQR 2.00-2.00), respectively. Videos from health professionals had significantly higher JAMA scores compared to those from non-profit organizations (P < 0.01). Correlation analysis between video quality and video characteristics showed positive correlations between content comprehensiveness scores and video duration (r = 0.420, P < 0.001), number of comments (r = 0.195, P < 0.05), and number of shares (r = 0.174, P < 0.05). GQS scores were negatively or positively correlated with the number of days since upload (r = -0.212, P < 0.05) and video duration (r = 0.442, P < 0.001).

Conclusion

The overall quality of the videos was found to be unsatisfactory, with variations in quality scores observed across different video sources. Content comprehensiveness was inadequate, the reliability and quality of the information presented in the videos was questionable. As TikTok continues to grow as a platform for health information, it is essential to prioritize accuracy and reliability to enhance patients' self-care abilities and promote public health.

Clinician-Created Video Education for Patients With AF: A Randomized Clinical Trial

Importance

Patient education is a critical aspect of atrial fibrillation (AF) management. However, there is limited time to provide effective patient education during routine care, and resources available online are of variable quality.

Objective

To determine whether clinician-led creation of video-based AF education is feasible and improves knowledge of AF.

Design, Setting, and Participants

This single-center randomized clinical trial was conducted between 2020 and 2022. Outcomes were assessed prior to their clinic visit and 2 and 90 days after the visit by blinded assessors. Participants included adults with AF and congestive heart failure, hypertension, age at least 75 years (doubled), diabetes, prior stroke or transient ischemic attack or thromboembolism (doubled), vascular disease, age 65 to 74 years, and sex category scores of 1 or greater presenting for routine care at publicly funded outpatient cardiology clinics within a tertiary teaching hospital. Individuals too unwell to participate or with limited English were excluded. Data were assessed as intention to treat and analyzed from December 2022 to October 2023.

Intervention

Intervention participants viewed a series of 4 videos designed and narrated by clinicians that aimed to improve understanding of AF pathophysiology, clinical presentation, diagnosis, and management. After viewing the videos, participants received weekly email links to review the videos. The control group received usual care.

Main Outcomes and Measures

The prospectively selected primary outcome was AF knowledge at 90 days, measured by the validated Jessa Atrial Fibrillation Knowledge Questionnaire (JAFKQ).

Results

Among 657 individuals screened, 208 adults with AF were randomized (mean [SD] age, 65.0 [12.2] years; 133 [65.2%] male) and included in analysis. Participants were randomized 1-to-1, with 104 participants in the control group and 104 participants in the video intervention group. At 90 days after the baseline clinic visit, intervention participants were more likely to correctly answer JAFKQ questions than control participants (odds ratio [OR], 1.23 [95% CI, 1.01-1.49]). The difference was greater in participants who remotely accessed videos on 3 or more occasions during the study (OR, 1.46 [95% CI, 1.14-1.88]).

Conclusions and Relevance

In this randomized clinical trial of patients with AF, remotely delivered, clinician-created video education improved medium-term AF knowledge beyond usual care of standard in-clinic education. The improvement demonstrated in this study provides support for the implementation of clinician-created educational resources across the care continuum. Further work is needed to assess for impact on clinical outcomes.

Trial Registration

anzctr.org.au Identifier: ANZCTRN12620000729921.