Analyzing the quality and educational value of Achilles tendinopathy-related videos on TikTok

A systematic review of the quality and engagement of TikTok videos of resistance exercises for the management of lateral elbow tendinopathy

BACKGROUND

Resistance exercise is considered first-line management for lateral elbow tendinopathy (LET). TikTok enables sharing of short-form videos with algorithms distributing videos with higher engagement (e.g., views/likes).

PURPOSE

To assess resistance exercise video quality for LET on TikTok between general users and self-identified health care professionals and explore associations between engagement and video quality.

STUDY DESIGN

Social media review using a systematic review framework.

METHODS

TikTok was searched using five hashtags. Included videos were in English and focused on resisted exercise. Creator and video engagement metrics were extracted, with viewing index and engagement rate calculated. The DISCERN and Tennis Elbow Exercise Education Score (TEEES) were used to assess video quality. A Kruskal-Wallis test examined differences between general users and self-identified health care professionals and Spearman's rho (rs) correlations explored associations between video quality and engagement metrics. Median (interquartile range) were reported.

RESULTS

Ninety-eight videos were included with no significant differences in engagement between general users and self-identified health care professionals. Overall, resistance exercise video quality was poor with no significant differences between general users (DISCERN 26 [22-29] out of 75, TEEES 8 [5-10] out of 25) and self-identified health care professionals (DISCERN 25 [21-27], TEEES 7 [5-9]; p = 0.37 and p = 0.35, respectively). Video quality was weakly correlated with video likes, favourites, and viewing index (rs = 0.23, p = 0.03; rs = 0.23, p = 0.02; rs = 0.21, p = 0.04, respectively).

CONCLUSIONS

The quality of resistance-based exercise videos for LET on TikTok was poor, regardless of user profile. While some engagement metrics were associated with video quality, viewers should not rely on these metrics to indicate video quality.

Exploring TikTok's influence on surgical patient education

INTRODUCTION

Social media platforms, especially rapidly growing ones like TikTok, are increasingly used to disseminate health information. Its interactive features promote user participation, allowing for the sharing of experiences and raising awareness about specific medical conditions, while also simplifying complex procedures. This study aimed to explore the possible influence of TikTok short-video application on the education of surgical patients.

METHODS

A systematic search was performed in compliance with the PRISMA checklist. The research protocol was registered with the PROSPERO register (CRD42024551646). A search was performed in the PubMed and ScienceDirect databases from inception to 2024. The search terms used were "TikTok AND Surgery," "TikTok AND Surgical Education," and "TikTok AND surgery AND patient."

RESULTS

The present systematic search resulted in 697 citations, of which 50 relevant citations were included. The search revealed that TikTok has widely used among patients from different surgical specialties and has an influence on their education. The platform facilitates public health awareness, allowing surgeons to share educational content, including surgical techniques and patient-oriented information.

CONCLUSION

As one of the rapidly growing social media platforms, TikTok is increasingly utilised to disseminate health information. It has been adopted across various surgical specialties. While the platform presents a great opportunity to improve the education of surgical patients, it presents challenges related to the accuracy of information, potential misinformation, and lack of regulation. Surgeons and healthcare professionals should actively participate in creating accurate, evidence-based content that enhances patient education and promotes public health awareness.

[Online resources for ankle sprains : A German language web analysis]

BACKGROUND

With the Internet as the main source of information for health content, the quality of websites with medical information is of high importance.

OBJECTIVE

This study analysed 250 websites on acute ankle sprain (ASD), one of the most common musculoskeletal disorders, for their quality and readability. Based on the results, a guide for patients was created.

METHOD

The quality of the websites was assessed using a 25-item content score and the EQIP36 score for medical information material. The reading level could be determined using the Flesch-Kincaid index and the calculated readability. The best three websites were evaluated in a user survey.

RESULTS

Of the 250 websites recorded 77 were included in the study. The quality of these varied significantly, with none achieving the maximum score. Sources in the healthcare system showed higher quality, while commercially influenced sites were below average in terms of completeness of content. Only 14% of the websites reached the recommended reading level. A significant negative correlation was found between completeness of content and readability. The user survey showed a mixed level of satisfaction and participants with previous medical knowledge were more critical than laypersons.

CONCLUSION

Online resources about ASD are suboptimal and differ considerably. Deficiencies in content, readability and structure were identified, which limit the effective use by patients. Health information publishers should work harder to improve the comprehensibility and quality of the information provided.

Evaluating the Quality and Reliability of Total Knee Arthroplasty Rehabilitation Exercises on the Social Media Platform TikTok

Background

The utilization of social media for health-related purposes has surged, especially during the COVID-19 pandemic. TikTok, a short-form video platform, has seen substantial growth, becoming a prominent medium for health information dissemination. However, the lack of regulation poses challenges in evaluating the validity of TikTok content.

Methods

This cross-sectional study assesses TikTok videos related to total knee arthroplasty rehabilitation exercises. Search terms identified 84 videos, with 64 meeting the inclusion criteria. Engagement metrics and quality scores were analyzed, utilizing the DISCERN tool and the Total Knee Replacement Exercises Education Score.

Results

The analyzed videos accumulated nearly 6 million views, with a median of 10,293.5 (interquartile range = 4139.3-26,100.0). Health-care professionals contributed 48% of the content. Despite higher engagement metrics for health-care professional videos, the overall quality, as indicated by DISCERN and Total Knee Replacement Exercises Education scores, remained poor. No videos achieved an "excellent" rating, with the majority categorized as "poor."

Conclusions

This study underscores TikTok's substantial role in total knee arthroplasty rehabilitation information dissemination but reveals a critical deficit in content quality and reliability. Health-care professionals marginally outperformed general users but displayed overall inadequacy. The study emphasizes the necessity for improving the quality of health-related content on emerging social media platforms, especially within the realm of orthopaedic surgery.

Level of Evidence

Level III, Cross-sectional study.

TikTok and frozen shoulder: a cross-sectional study of social media content quality

PURPOSE

This study aimed to assess the validity and informational value of the material provided on TikTok regarding frozen shoulders. The hypothesis was that the video content on this platform would not provide adequate and valid information.

METHODS

The current study focused on frozen shoulder videos on the TikTok social media platform. The terms "frozen shoulder" and/or "adhesive capsulitis" were used as keywords for an extensive online search of video content on TikTok, and the first 100 videos were included. Out-of-topic, non-English, and duplicated videos were excluded from the analysis. The duration and numbers of likes, shares, and views were recorded for each video. Further, videos were categorized based on the source (physiotherapist/osteopath, medical doctor, or private user), type of information (physical therapy, etiopathogenesis, anatomy, clinical examination, patient experience, or symptoms), video content (rehabilitation, education, or patient experience/testimony), and the presence of music or a voice. The assessment of the video content's quality and reliability was performed by two experienced shoulder surgeons using the DISCERN instrument, the Journal of the American Medical Association (JAMA) benchmark criteria, and the Global Quality Score (GQS).

RESULTS

A total of 100 videos were included in the analysis, of which 86 (86.0%) were published by physiotherapists/osteopaths. Most of the information and video content focused on physical therapy and rehabilitation (83.0% and 84.0%, respectively). Eighty-four (84.0%) videos included voice comments, while the remaining featured music. The mean number of views was 2,142,215.32 ± 6,148,794.63, while the mean numbers of likes, comments, and shares were 58,438.67 ± 201,863.54, 550.81 ± 1712.22, and 3327.43 ± 7320.81, respectively. The mean video duration was 110.20 ± 116.43 s. The mean DISCERN score, JAMA score, and GQS were 16.17 ± 2.36, 0.61 ± 0.51, and 1.18 ± 0.41, respectively. Videos posted by medical doctors or private users received higher scores than those posted by physiotherapists/osteopaths (p < 0.05).

CONCLUSIONS

The educational value of videos published on TikTok was poor; videos posted by medical doctors exhibited better quality and educational value than those of physiotherapists or osteopaths. It is the responsibility of orthopedic surgeons to investigate the potential benefits, consequences, and implications of TikTok video content for the health of frozen shoulder patients and to propose necessary adjustments. Given the rapid growth of TikTok, further research is needed.

LEVEL OF EVIDENCE

Level IV-cross-sectional study.

How Useful Is TikTok for Patients Searching for Carpal Tunnel Syndrome-Related Treatment Exercises?

Since orthopedic surgery has been slower to acknowledge the rise of social media for distributing medical information, this study aims to evaluate TikTok videos' quality and educational value in relation to carpal tunnel syndrome treatment exercises. TikTok was searched using the hashtags "#carpaltunnelexercises", "#carpaltunnelremedies", "#carpaltunnelrehab", and "#physicaltherapyforcarpaltunnel". The engagement indicators were documented and the video content quality was assessed using the DISCERN, CTEES, JAMA, and GQS grading scales. There were 101 videos included, which accumulated 20,985,730 views. The videos received 1,460,953 likes, 15,723 comments, 243,245 favorites, and 159,923 shares. Healthcare professionals were responsible for 72% of the video uploads, whereas general users contributed 28%. More healthcare professionals' videos were graded as "poor" (79%) compared to general users (21%). General users received slightly more video grades of "very poor" (52%) than healthcare professionals (48%). For the DISCERN grading, the videos by healthcare professionals were significantly better than those by general users in terms of reliability, achieving aims, and relevancy. They were also superior in the overall composition of the health information derived from the total DISCERN score. However, no significant differences were found between the two groups when using the CTEES, JAMA, and GQS grading scales. Overall, despite the emergence of TikTok as a medical information tool, the quality and educational value of the carpal tunnel syndrome exercise videos were poor.

TikTok content as a source of health education regarding epicondylitis: a content analysis

PURPOSE

This study aimed to assess the validity and informational value of TikTok content about epicondylitis. The hypothesis tested herein was that TikTok video content would not provide adequate and valid information.

METHODS

The term "epicondylitis" was used as a keyword to comprehensively search for TikTok videos, and the first 100 videos that were retrieved were subsequently included for analysis. The duration, number of likes, number of shares and number of views were recorded for each video. Furthermore, the videos were categorized on the basis of their source (medical doctor, physiotherapist, or private user), type of information (physical therapy, anatomy, clinical examination, etiopathogenesis, patient experience, treatment, or other), video content (rehabilitation, education, or patient experience/testimony), and the presence of music or voice. Assessments of video content quality and reliability were conducted using the DISCERN tool, the Journal of the American Medical Association (JAMA) benchmark criteria, and the Global Quality Score (GQS).

RESULTS

A total of 100 videos were included in the analysis: 78 (78.0%) were published by physiotherapists, 18 were published by medical doctors (18.0%), and 4 were published by private users (4.0%). Most of the information pertained to physical therapy (75; 75.0%) and most of the content was about rehabilitation (75; 75.0%). The mean length of the videos was 42.51 ± 24.75 seconds; the mean number of views was 193,207.78 ± 1,300,853.86; and the mean number of comments, likes, and shares were 22.43 ± 62.54, 1578.52 ± 8333.11, and 149.87 ± 577.73, respectively. The mean DISCERN score, JAMA score, and GQS were 18.12 ± 5.73, 0.80 ± 0.53, and 1.30 ± 0.52, respectively. Videos posted by medical doctors/private users had higher scores (p < 0.05) than videos posted by physiotherapists. Videos that focused on education or patient experience had higher scores (p < 0.05) than videos based on rehabilitation.

CONCLUSIONS

TikTok can be an unreliable source of information regarding epicondylitis treatment. It is common to find nonphysicians who share medical advice on the platform, with medical treatments demonstrating the weakest level of supporting evidence. Elbow surgeons should advise their patients that treatment recommendations from TikTok may not align with established guidelines.

LEVEL OF EVIDENCE

Level IV-Cross-sectional study.

Evaluating the Distribution, Quality, and Educational Value of Videos Related to Knee Instability Exercises on the Social Media Platform TikTok

Introduction TikTok, a globally popular short-form video platform, offers a unique space for healthcare professionals to share advice, particularly under common conditions such as knee pain or instability. Despite its popularity, doubts persist regarding the reliability of medical information disseminated on TikTok. This study aimed to evaluate the quality of TikTok videos as a source of patient information on knee instability, recognizing the need for a comprehensive assessment of potential misinformation on this influential social media platform. Methods A search for "knee stability exercises" on TikTok yielded 448 videos, of which 187 met the inclusion criteria. These videos were categorized by source and evaluated using the Knee Exercise Education Scoring Tool (KEEST) and an information analysis questionnaire, DISCERN. Results General user videos (69.84%) had notably lower DISCERN scores than healthcare professional videos (29.1%) across all categories (P < 0.001, P = 0.282, P = 0.131, and P = 0.010). The DISCERN scores were inversely linked to video metrics (views, likes, comments, favorites, and shares). General user videos were largely of poor quality (66.4%), whereas healthcare professional videos spanned poor (61.8%), fair (28.2%), good (9.1%), and excellent (1.8%) categories. Both general users (12.31/25) and healthcare professionals (12.18/25) exhibited average quality according to KEEST standards (P = 0.809), with an intriguing inverse correlation between video popularity and DISCERN score. Conclusion Healthcare professionals demonstrated superior evidence-based content (DISCERN), whereas both groups were comparatively educated on treatment plans and effects (KEEST). TikTok's prevalent knee instability videos lack quality, proper sourcing, treatment risk information, and explanation. Moreover, popularity is inversely correlated with quality, and healthcare professionals appear to offer better evidence-based content. TikTok's role in healthcare highlights the importance of ensuring accurate information and implementing content quality regulations.

Validity of Material Related to the Anterior Cruciate Ligament on TikTok

Background

Video material is one of the most common types of digital information on social media platforms.

Purpose

To assess the validity and informational value of TikTok videos with regard to the anterior cruciate ligament (ACL).

Study Design

Cross-sectional study.

Methods

Using the terms "anterior cruciate ligament" AND/OR "ACL," 420 TikTok videos were retrieved, of which 100 videos were included in the analysis. The video duration and the number of likes, shares, and views were recorded. Videos were categorized based on the source (private user, physical therapist, surgeon, and researcher), subject type (patient experience, physical therapy, injury mechanism, anatomy, clinical test, and surgical technique), content (patient experience/testimony, education, and rehabilitation), and any background audio (music or voice). Video quality assessments were conducted using the DISCERN instrument, The Journal of the American Medical Association (JAMA) benchmark criteria, and the Global Quality Score (GQS). Associations between quantitative variables were tested using the Spearman rank correlation. One-way analysis of variance or Mann-Whitney test was performed to assess whether video quality differed by video characteristics.

Results

A total of 41 videos were published by private users (41%), 34 by physical therapists (34%), 23 by surgeons (23%), and 2 by researchers (2%). Most of the information regarded patient experience (34%), followed by physical therapy (20%), injury mechanism (19%), anatomy (11%), clinical test (9%), and surgical technique (7%). The mean video length was 40.55 ± 41.58 seconds. The mean number of views was 151,084.39 ± 487,150.02, while the mean numbers of comments, likes, and shares were 72.80 ± 249.68, 6781.49 ± 29,163.96, and 98.71 ± 307.76, respectively. The mean DISCERN, JAMA, and GQS scores were 15.73 ± 1.44, 0.19 ± 0.39, and 1.16 ± 0.37, respectively, indicating the poorest quality on all 3 indices. The number of views, likes, shares, comments, and video lengths were all positively correlated with DISCERN (except the number of shares), JAMA, and GQS scores (P < .05). A significant difference was found in DISCERN scores between videos by private users and those by surgeons (15.37 ± 0.98 vs 16.22 ± 1.57; P = .007).

Conclusion

Our analysis has demonstrated that the educational value of these videos on the ACL on TikTok is poor. Given the rapid growth of TikTok, further research is needed.

Evaluating the Quality and Usability of Artificial Intelligence-Generated Responses to Common Patient Questions in Foot and Ankle Surgery

Background

Artificial intelligence (AI) platforms, such as ChatGPT, have become increasingly popular outlets for the consumption and distribution of health care-related advice. Because of a lack of regulation and oversight, the reliability of health care-related responses has become a topic of controversy in the medical community. To date, no study has explored the quality of AI-derived information as it relates to common foot and ankle pathologies. This study aims to assess the quality and educational benefit of ChatGPT responses to common foot and ankle-related questions.

Methods

ChatGPT was asked a series of 5 questions, including "What is the optimal treatment for ankle arthritis?" "How should I decide on ankle arthroplasty versus ankle arthrodesis?" "Do I need surgery for Jones fracture?" "How can I prevent Charcot arthropathy?" and "Do I need to see a doctor for my ankle sprain?" Five responses (1 per each question) were included after applying the exclusion criteria. The content was graded using DISCERN (a well-validated informational analysis tool) and AIRM (a self-designed tool for exercise evaluation).

Results

Health care professionals graded the ChatGPT-generated responses as bottom tier 4.5% of the time, middle tier 27.3% of the time, and top tier 68.2% of the time.

Conclusion

Although ChatGPT and other related AI platforms have become a popular means for medical information distribution, the educational value of the AI-generated responses related to foot and ankle pathologies was variable. With 4.5% of responses receiving a bottom-tier rating, 27.3% of responses receiving a middle-tier rating, and 68.2% of responses receiving a top-tier rating, health care professionals should be aware of the high viewership of variable-quality content easily accessible on ChatGPT.

Level of Evidence

Level III, cross sectional study.