Assessment of "YouTube" Content for Distal Radius Fracture Immobilization

Entering the Misinformation Age: Quality and Reliability of YouTube for Patient Information on Liposuction

Background: YouTube is currently the most popular online platform and is increasingly being utilized by patients as a resource on aesthetic surgery. Yet, its content is largely unregulated and this may result in dissemination of unreliable and inaccurate information. The objective of this study was to evaluate the quality and reliability of YouTube liposuction content available to potential patients. Methods: YouTube was screened using the keywords: "liposuction," "lipoplasty," and "body sculpting." The top 50 results for each term were screened for relevance. Videos which met the inclusion criteria were scored using the Global Quality Score (GQS) for educational value and the Journal of the American Medical Association (JAMA) criteria for video reliability. Educational value, reliability, video views, likes, dislikes, duration and publishing date were compared between authorship groups, high/low reliability, and high/low educational value. Results: A total of 150 videos were screened, of which 89 videos met the inclusion criteria. Overall, the videos had low reliability (mean JAMA score = 2.78, SD = 1.15) and low educational value (mean GQS score = 3.55, SD = 1.31). Videos uploaded by physicians accounted for 83.1% percent of included videos and had a higher mean educational value and reliability score than those by patients. Video views, likes, dislikes, comments, popularity, and length were significantly greater in videos with high reliability. Conclusions: To ensure liposuction-seeking patients are appropriately educated and informed, surgeons and their patients may benefit from an analysis of educational quality and reliability of such online content. Surgeons may wish to discuss online sources of information with patients.

Social media as a mechanism of dissemination and knowledge translation among health professions educators: a scoping review

Health professions educators often use social media to share knowledge; however, it is unclear what specific dissemination and knowledge translation (KT) processes are occurring and the implications of this sharing for health professions education (HPE). This study explored how educators have used social media as a mechanism of dissemination and KT in the literature. A critical scoping review methodology, informed by Engeström's Activity Theory, was employed. Twelve databases were searched and studies that: (a) addressed health professions educators; (b) described the use of social media for dissemination or KT; (c) focused on a regulated health profession; (d) focused on undergraduate or graduate education; and (e) were published in English or French between 2011 and 2021 were included. Data were analyzed using numerical and qualitative content analyses. Of the 4859 articles screened, 37 were eligible for inclusion. Social media may facilitate knowledge sharing in HPE, but there is a lack of conceptual clarity on what is meant by 'dissemination' and 'KT'. Who is responsible for sharing knowledge, what knowledge is being shared, and the target audiences are not always clear. Multiple factors (e.g., affordances, opportunity costs) influence how social media is used as a mechanism of dissemination, and it remains unclear whether and how it is used as a mechanism of KT. Concepts like KT and dissemination, which are often borrowed from other disciplines, must be critically evaluated for their relevance and suitability if they are to be appropriately applied to HPE and in particular to social media. Educators looking to use social media to teach students about KT should consider whether this use of technology truly aligns with their stated learning outcomes.

The Most Popular YouTube Videos About Shoulder Replacement Are of Poor Quality for Patient Education

Purpose

To characterize the quality of YouTube total shoulder arthroplasty videos as a source of patient information using the DISCERN instrument.

Methods

An analysis of the YouTube video library was performed, using a string of 6 search terms related to "total shoulder replacement" and "total shoulder arthroplasty" in the YouTube search engine. The first 20 videos from each search (n = 120) were selected. The top 25 most viewed videos were compiled, screened, and evaluated with the DISCERN score in the final analysis. Pearson's correlation coefficients were used to assess the correlation of DISCERN scores and video characteristics. Inter-rater reliability was calculated with the conger kappa score for multiple raters.

Results

Twenty-five videos met inclusion criteria, 13 (52%) were produced by academic institutions, 7 (28%) by physicians, and 5 (20%) by commercial entities. Median total DISCERN score was 33 out of 80 (IQR: 28-44). The overall total DISCERN scores, showed no correlation with video likes or views and was negatively correlated with video power index (r = -0.75, P = .001). No association between total shoulder arthroscopy video source and DISCERN score could be demonstrated. All videos analyzed scored poorly by the DISCERN instrument.

Conclusions

The current most popular shoulder replacement videos on YouTube are low-quality patient education resources. Furthermore, our study found no correlation between video popularity, as measured by the number of views and the DISCERN score.

Clinical Relevance

Successful outcomes following total shoulder arthroplasty may be influenced by the quality of information patients receive.

Evaluation of online video content related to reverse shoulder arthroplasty: a YouTube-based study

BACKGROUND

Reverse shoulder arthroplasty (RSA) has evolved continuously over recent years, with expanded indications and better outcomes. YouTube is one of the most popular sources globally for health-related information available to patients. Evaluating the reliability of YouTube videos concerning RSA is important to ensure proper patient education.

METHODS

YouTube was queried for the term "reverse shoulder replacement." The first 50 videos were evaluated using three different scores: Journal of the American Medical Association (JAMA) benchmark criteria, the global quality score (GQS), and the reverse shoulder arthroplasty-specific score (RSAS). Multivariate linear regression analyses were conducted to determine the presence of a relationship between video characteristics and quality scores.

RESULTS

The average number of views was 64,645.78±264,160.9 per video, and the average number of likes was 414 per video. Mean JAMA, GQS, and RSAS scores were 2.32±0.64, 2.31±0.82, and 5.53±2.43, respectively. Academic centers uploaded the highest number of videos, and surgical techniques/approach videos was the most common video content. Videos with lecture content predicted higher JAMA scores whereas videos uploaded by industry predicted lower RSAS scores.

CONCLUSIONS

Despite its massive popularity, YouTube videos provide a low quality of information on RSA. Introducing a new editorial review process or developing a new platform for patients' medical education may be necessary. Level of evidence: Not applicable.

Social media may cause emergent SARMs abuse by athletes: a content quality analysis of the most popular YouTube videos

OBJECTIVES

Selective Androgen Receptor Modulators (SARMs) social media interest is at an all-time high. The aim of this study is to analyze the: (1) quality; (2) educational content; and (3) reliability of the most relevant YouTube videos on SARMs to explain growing SARMs abuse by recreational and professional athletes.

METHODS

'SARMs' was queried (28 November 2021) through the YouTube video library. The top 100 videos filtered by relevance were categorized by source, type of content, educational quality by Global Quality Score (GQS), reliability by Journal of American Medicine Association (JAMA) criteria, YouTube tags, attitude toward SARMs use, and whether the video provided specific support on how to use SARMs. For all outcome variables, descriptive statistics and comparison among source types and category types were performed.

RESULTS

Mean JAMA score was 1.6 ± 0.7 out of 4. Mean GQS score was 2.5 ± 1.1 out of 5. Patient videos were of lower educational quality than athletic trainer videos (GQS: 2.11 ± 0.95 vs. 2.95 ± 1.00, p < 0.01), and videos categorized as user experience were of lower educational quality than videos categorized as general SARMs information (GQS: 1.92 ± 0.90 vs. 2.72 ± 1.07, p < 0.05). User experience and dosing recommendation videos were statistically significantly more positive in attitude than both general SARMs information and SARMS vs. other PEDs.

CONCLUSION

Quality, content, and reliability of SARMs YouTube videos was low. Social media likely causes SARMs abuse through disseminating biased SARMs misinformation. These results serve to educate public health oversight bodies, healthcare providers, and sports team members to better identify signs of SARMs abuse, and promote discussion to discourage SARMs abuse.

YouTube as a Source of Patient Information for Cubital Tunnel Syndrome: An Analysis of Video Reliability, Quality, and Content

BACKGROUND

This study seeks to examine the reliability, quality, and content of YouTube videos on cubital tunnel syndrome, on which there is presently a paucity of information.

METHODS

The top 50 unique YouTube videos by relevance resulting from the Boolean search term "cubital tunnel + cubital tunnel syndrome" were identified, with video properties for analysis including source, upload date, duration, views, and comments. Content was assessed using the Journal of American Medical Association (JAMA) criteria, the Global Quality Score (GQS), and a "Cubital Tunnel-Specific Score" (CTSS).

RESULTS

The average video saw 72 108 ± 199 362 views, with videos produced by allied (nonphysician) health professionals demonstrating the highest mean views (111 789 ± 294 471 views). Videos demonstrated low mean JAMA scores (2.4/4 ± 0.7), GQS (2.8/5 ± 1.3), and CTSS (7.5/21 ± 4.3), with academic and nonacademic physician videos demonstrating significantly greater mean GQS and CTSS scores when compared with videos by allied health professionals. Positive independent predictors for GQS included academic sources (β = 1.871), nonacademic physician sources (β = 1.651), and video duration (β = 0.102), which were likewise positive predictors for CTSS (β = 4.553, 4.639, 0.374). Content relating to surgical techniques or approaches for cubital tunnel decompression had the greatest CTSS scores (11.2 [4.2]).

CONCLUSIONS

YouTube is a source of highly accessible information on cubital tunnel syndrome, although the average video presents generally poor and inadequate information. Directing patients toward higher quality video resources can be a meaningful component of patient education.

An Assessment of Upper-Extremity Surgical Technique Videos and Their Relationship With Procedural Learning Theory

PURPOSE

Our purpose was to ascertain how well award-winning and highly viewed upper-extremity surgical videos meet the needs of users and adhere to procedural learning theory. We hypothesized that upper-extremity videos hosted on academic society websites meet user needs better than upper-extremity videos hosted on a commercial website.

METHODS

Twenty-five upper-extremity videos were evaluated by 3 reviewers. A standardized scoring sheet was used to assess each video's content, production quality, and adequacy. Video lengths were compared. The inclusion frequencies of specific content categories, the adequacy of content, and meeting certain production standards, all of which assess consistency with procedural learning theory, were reported, stratified by video host. Associations between the video host and video content, production quality, and adequacy were assessed.

RESULTS

The median lengths of academically hosted and commercially hosted videos were similar. Regardless of the video host, no video contained information in all content categories. Sixty percent of the scored categories were present in less than 75% of evaluated videos. Academically hosted videos contained scored content more frequently than commercially hosted videos in 68.4% of categories. There were significant associations between academic hosts and inclusion of a case presentation, surgical indications, outcomes literature, a preoperative examination, follow-up visit intervals, and alternative surgical techniques. Overall, academically hosted videos had a higher percentage of adequate content categories compared with commercially hosted videos.

CONCLUSIONS

Videos on academic websites more consistently meet users' content needs and production expectations, as informed by procedural learning theory, while having higher rates of adequate content compared with videos on commercial websites.

CLINICAL RELEVANCE

While academically hosted videos appear to more consistently adhere to the tenets of procedural learning theory, opportunity exists for video creators to more consistently apply procedural learning theory, allowing for the creation of even more educationally beneficial online surgical videos.

The Role of Online Videos in Teaching Procedural Skills in Postgraduate Medical Education: A Scoping Review

OBJECTIVE

The purpose of this scoping review was to outline the extent of available literature including the prevalence of video quality appraisal tools, characterize how online videos were used, and identify the gaps in the literature with implications for future research.

DESIGN

The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for scoping reviews (PRISMA-ScR). Six databases were searched: (1) MEDLINE (Ovid), (2) EMBASE, (3) Cochrane, (4) ERIC, (5) CINAHL PLUS, and (6) Google Scholar for Medical Subject Headings terms online videos, postgraduate health education, and health professional/s.

RESULTS

A total of 6948 articles were identified, of which 78 were included in the review. The articles included were primarily either experimental or observational studies, with most being from North America. Twelve concepts were identified: (1) procedural skills teaching; (2) video assessment; (3) validation of an assessment tool; (4) video feedback; (5) coaching; (6) broadcasting; (7) learner characteristics; (8) video characteristics; (9) video quality; (10) a quality assessment tool; (11) platforms and video library; and (12) health information governance.

CONCLUSIONS

While there is a diverse and growing body of literature on this area, information is lacking about the quality appraisal of online videos.

YouTube videos provide low-quality educational content about rotator cuff disease

Background: YouTube has become a popular source of healthcare information in orthopedic surgery. Although quality-based studies of YouTube content have been performed for information concerning many orthopedic pathologies, the quality and accuracy of information on the rotator cuff have yet to be evaluated. The purpose of the current study was to evaluate the reliability and educational content of YouTube videos concerning the rotator cuff.Methods: YouTube was queried for the term “rotator cuff.” The first 50 videos from this search were evaluated. Video reliability was assessed using the Journal of the American Medical Association (JAMA) benchmark criteria (range, 0–5). Educational content was assessed using the global quality score (GQS; range, 0–4) and the rotator cuff-specific score (RCSS; range, 0–22).Results: The mean number of views was 317,500.7±538,585.3. The mean JAMA, GQS, and RCSS scores were 2.7±2.0, 3.7±1.0, and 5.6±3.6, respectively. Non-surgical intervention content was independently associated with a lower GQS (β=–2.19, p=0.019). Disease-specific video content (β=4.01, p=0.045) was the only independent predictor of RCSS.Conclusions: The overall quality and educational content of YouTube videos concerned with the rotator cuff were low. Physicians should caution patients in using such videos as resources for decision-making and should counsel them appropriately.

Standardized videos in addition to the surgical curriculum in Medical Education for surgical clerkships: a cohort study

BACKGROUND

Medical students are expected to translate the theoretical knowledge gained during their study to practical knowledge during the clerkships. A surgical educational platform with standardized videos may be the solution. However, the effects of a structured online video-based platform in addition to the standard curriculum on students' self-reported and tested surgical knowledge during the surgical clerkship must be assessed.

METHODS

Fourth-year medical students (n = 178) participated in a 6-week course of theoretical and practical training followed by a 10-week in-hospital clerkship in the Erasmus University Medical Center (Erasmus MC), Rotterdam, The Netherlands and 11 affiliated general hospitals. Ninety students followed the usual surgical curriculum (control group), followed by 88 students who were given voluntary access to a video-based surgical educational platform of Incision Academy (video group). At the start (T0) and end (T1) of the clerkship, both groups filled out a surgical knowledge test and a survey regarding their self-reported surgical knowledge and their access to available study sources. Supervisors were blinded and surveyed concerning students' performance and their acquired knowledge. We analyzed the data using paired and unpaired student t-tests and linear regression.

RESULTS

At the end of the clerkship, students in the video group indicated that they had better resources at their disposal than the control group for surgical procedures (p = 0.001). Furthermore, students in the video group showed a greater increase in self-reported surgical knowledge during their clerkship (p = 0.03) and in more objectively tested surgical knowledge (p < 0.001).

CONCLUSIONS

An online surgical educational platform with standardized videos is a valuable addition to the current surgical curriculum according to students and their supervisors. It improves their test scores and self-reported surgical knowledge. Students feel better prepared and more able to find the information necessary to complete the clerkship.

TRIAL REGISTRATION

Registry not necessary according to ICMJE guidelines.

Quality and reliability evaluation of online videos on carpal tunnel syndrome: a YouTube video-based study

OBJECTIVES

With the increasing popularity of searches for medical information on YouTube, the availability of videos concerning carpal tunnel syndrome (CTS) is increasing. This study aimed to evaluate the quality and reliability of YouTube videos on CTS.

SETTING AND PARTICIPANTS

No participants were included.

PRIMARY AND SECONDARY OUTCOME MEASURES

We searched YouTube on 1 April 2021 using the keywords "carpal tunnel syndrome" and "carpal tunnel release" and evaluated the first 55 retrieved videos. We summarised the video characteristics including Video Power Index (VPI), which was designed to evaluate video popularity based on the number of likes and views. We categorised them based on source and content. Video quality and reliability were evaluated using the Journal of the American Medical Association (JAMA) benchmark criteria, the Global Quality Score (GQS) and the Carpal Tunnel Syndrome-Specific Score (CTS-ss) .

RESULTS

The mean (range: minimum-maximum) of JAMA scores, GQS and CTS-ss were 2.13 (1-4), 2.69 (1-5), and 5.0 (1-15), respectively. The most common source of video was from allied health workers, and academically sourced videos had the highest JAMA score and GQS. Three scores were significantly correlated with each other. Multiple linear regression analysis showed that a higher JAMA score was associated with a higher likes ratio, and a higher GQS was associated with a longer video running time and greater number of comments. However, a higher VPI was not associated with higher video quality or reliability represented by the three scores.

CONCLUSIONS

YouTube videos on CTS have low quality and reliability. Video popularity was not significantly correlated with quality or reliability. Our findings suggest that expert groups should provide and promote high-quality video content to YouTube users and patients.

Low back pain: What is the role of YouTube content in patient education?

The aim of this study was to characterize the educational quality and reliability of YouTube videos related to low back pain (LBP) as well as to identify factors associated with the overall video quality. A review of YouTube was performed using two separate search strings. Video-specific characteristics were analyzed for the first 50 videos of each string. Seventy-seven eligible videos were identified as a result. The mean Journal of the American Medical Association score was 2.25 ± 1.09 (range: 0-4) out of 4. The mean Global Quality Score (GQS) score was 2.29 ± 1.37 (range: 1-4) out of 5. The mean LBP score (LPS) score was 3.83 ± 2.23 (range: 0-11) out of 15. Video power index was a predictor of GQS score (β = 55.78, p = 0.048), whereas the number of likes (β = -2.49, p = 0.047) and view ratio (β = -55.62, p = 0.049) were associated with lower quality scores. Days since initial upload (β = 0.32, p = 0.042) as well as like ratio (β = 0.37, p = 0.019) were independent predictors of higher LPS scores. The results of this study suggest that the overall reliability and educational quality of videos uploaded to YouTube concerning LBP are unsatisfactory. More popular videos demonstrated poorer educational quality than their less popular counterparts. As the prevalence of LBP rises, more accurate and thorough educational videos are necessary to ensure accurate information is available to patients.

Applying Machine Learning to Determine Popular Patient Questions About Mentoplasty on Social Media

PURPOSE

Patient satisfaction in esthetic surgery often necessitates synergy between patient and physician goals. The authors aim to characterize patient questions before and after mentoplasty to reflect the patient perspective and enhance the physician-patient relationship.

METHODS

Mentoplasty reviews were gathered from Realself.com using an automated web crawler. Questions were defined as preoperative or postoperative. Each question was reviewed and characterized by the authors into general categories to best reflect the overall theme of the question. A machine learning approach was utilized to create a list of the most common patient questions, asked both preoperatively and postoperatively.

RESULTS

A total of 2,012 questions were collected. Of these, 1,708 (84.9%) and 304 (15.1%) preoperative and postoperative questions, respectively. The primary category for patients preoperatively was "eligibility for surgery" (86.3%), followed by "surgical techniques and logistics" (5.4%) and "cost" (5.4%). Of the postoperative questions, the most common questions were about "options to revise surgery" (44.1%), "symptoms after surgery" (27.0%), and "appearance" (26.3%). Our machine learning approach generated the 10 most common pre- and postoperative questions about mentoplasty. The majority of preoperative questions dealt with potential surgical indications, while most postoperative questions principally addressed appearance.

CONCLUSIONS

The majority of mentoplasty patient questions were preoperative and asked about eligibility of surgery. Our study also found a significant proportion of postoperative questions inquired about revision, suggesting a small but nontrivial subset of patients highly dissatisfied with their results. Our 10 most common preoperative and postoperative question handout can help better inform physicians about the patient perspective on mentoplasty throughout their surgical course. Level of Evidence V 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 www.springer.com/00266 .

YouTube as a Source of Patient Information for Total Knee/Hip Arthroplasty: Quantitative Analysis of Video Reliability, Quality, and Content

BACKGROUND

YouTube has become a popular platform for disseminating health-related information. However, the quality of such videos has never been assessed based on video source (author). Therefore, the current investigation aimed to quantitatively analyze the (1) accuracy, (2) reliability, (3) quality, and (4) content of total knee (TKA) and hip (THA) arthroplasty videos as a platform for patient information, based on video source.

METHODS

YouTube was queried (May 13, 2020) for TKA and THA videos. Top viewed 55 TKA and 50 THA relevant videos were stratified by source (ie, academic, physician, nonphysician/trainer, patient, and commercial). The Journal of the American Medical Association criteria were used to assess reliability, whereas DISCERN and TKA/THA content-specific scores assessed content quality. Two-sample t-tests and regression analyses assessed score variations based on video sources.

RESULTS

Mean TKA and THA video durations were 11.5 and 13.7 minutes, respectively. TKA and THA academic/physician videos demonstrated higher Journal of the American Medical Association scores relative to nonphysician videos (P < 0.001). Overall, TKA and THA mean DISCERN scores were 50.6 of 80 and 54.7 of 80 points, with significant differences between academic versus nonphysician videos (TKA: 59.9 versus 42.7, THA: 54.7 versus 31.5, P < 0.001). Regression analyses revealed that physician videos had higher odds ratio (OR) of excellent DISCERN score than nonphysician videos for TKA (OR: 8.8; 95% confidence interval: 1.4 to 55.6; P = 0.019) and THA (OR: 10.8; 95% confidence interval: 2.5 to 45.5; P = 0.001). TKA and THA mean content scores were 8.4 of 15 and 8.6 of 15, with significant differences between academic and nonphysician videos (TKA: 10.6 versus 5.8, THA: 8.6 versus 4.6; P < 0.001).

CONCLUSION

Reliability, quality, and content of YouTube TKA and THA videos demonstrate marked variation. Academic and physician videos demonstrated fair to good quality and were more likely to attain a good/excellent score. Healthcare providers may direct patients to view higher quality videos.

The Content Quality of YouTube Videos for Professional Medical Education: A Systematic Review

PURPOSE

To evaluate the content quality of YouTube videos intended for professional medical education based on quality rating tool (QRT) scores and determine if video characteristics, engagement metrics, or author type are associated with quality.

METHOD

The authors searched 7 databases for English-language studies about the quality of YouTube videos intended for professional medical education from each database's inception through April 2019. To be included, studies had to be published in 2005 (when YouTube was created) or later. Studies were classified according to the type of QRT used: externally validated, internally validated, or limited global. Study information and video characteristics and engagement metrics were extracted. Videos were classified by video author type.

RESULTS

Thirty-one studies were included in this review. Three studies used externally validated QRTs, 20 used internally validated QRTs, and 13 used limited global QRTs. Studies using externally validated QRTs had average scores/total possible scores of 1.3/4, 26/80, and 1.7/5. Among the 18 studies using internally validated QRTs, from which an average percentage of total possible QRT score could be computed or extracted, the average score was 44% (range: 9%-71%). Videos with academic-physician authors had higher internally validated QRT mean scores (46%) than those with nonacademic-physician or other authors (26%; P < .05).

CONCLUSIONS

The authors found a wide variation in QRT scores of videos, with many low QRT scores. While videos authored by academic-physicians were of higher quality on average, their quality still varied significantly. Video characteristics and engagement metrics were found to be unreliable surrogate measures of video quality. A lack of unifying grading criteria for video content quality, poor search algorithm optimization, and insufficient peer review or controls on submitted videos likely contributed to the overall poor quality of YouTube videos that could be used for professional medical education.

The Role of Deadlifts in Distal Biceps Brachii Tendon Ruptures: An Alternative Mechanism Described With YouTube Videos

BACKGROUND

The classic injury mechanism of a distal biceps brachii tendon rupture (DBBTR) is eccentric loading to the flexed elbow when the forearm is supinated.

PURPOSE

To determine alternative mechanisms of a DBBTR in powerlifting sports, particularly in deadlift competitions, with the use of YouTube videos.

STUDY DESIGN

Descriptive epidemiology study.

METHODS

A search on YouTube was performed using the search terms "distal biceps tendon rupture" and "distal biceps tendon injury" combined with "competition," "deadlift," and "powerlifting." The videos underwent an evaluation for accuracy by 3 surgeons according to predetermined criteria. Type of sports activity, participant sex, side of the injury, and arm positions at the time of the injury were recorded.

RESULTS

Among the videos reviewed, 35 injuries were found appropriate for an evaluation. All participants were male. The majority of the injuries (n = 25) were observed during the deadlift. Only in 1 deadlift injury were both forearms in supination. In the remaining deadlift injuries (n = 24), all elbows were in extension, with 1 forearm in supination and the other in pronation. Among the deadlift injuries in the mixed-grip position, all ruptures occurred in a supinated extremity: 25% (n = 6) of ruptures occurred on the right side, and 75% (n = 18) of ruptures occurred on the left side; this was a significant difference (P = .014).

CONCLUSION

We described an alternative mechanism for a DBBTR, namely, eccentric loading to an extended elbow when the forearm is supinated during the deadlift. As all the ruptures occurred in a supinated extremity, holding the bar with both forearms in pronation may prevent or decrease the risk of ruptures during the deadlift.

Variability in the Duration of Designated Pediatric Orthopaedic Rotations Among US Residency Programs

Our goal was to assess the variability in the assigned duration of pediatric orthopaedic rotation among US allopathic orthopaedic residency programs to see how pediatrics is incorporated into surgical education.

Social Media Use Among Foot and Ankle Orthopedic Surgeons

Background:

Digital media is an effective tool to enhance brand recognition and is currently referenced by more than 40% of orthopedic patients when selecting a physician. The purpose of this study was to evaluate the use of social media among foot and ankle (F&A) orthopedic surgeons, and the impact of that social media presence on scores of a physician-rated website (PRW).

Methods:

Randomly selected F&A orthopedic surgeons from all major geographical locations across the United States were identified using the AAOS.org website. Internet searches were then performed using the physician’s name and the respective social media platform. A comprehensive social media use index (SMI) was created for each surgeon using a scoring system based on social media platform use. The use of individual platforms and SMI was compared to the F&A surgeon’s Healthgrades scores. Descriptive statistics, unpaired Student t tests, and linear regression were used to assess the effect of social media on the PRW scores.

Results:

A total of 123 board-certified F&A orthopedic surgeons were included in our study demonstrating varying social media use: Facebook (48.8%), Twitter (15.4%), YouTube (23.6%), LinkedIn (47.9%), personal website (24.4%), group website (52.9%), and Instagram (0%). The mean SMI was 2.4 ± 1.6 (range 0-7). Surgeons who used a Facebook page were older, whereas those using a group website were younger (P < .05). F&A orthopedic surgeons with a YouTube page had statistically higher Healthgrades scores compared to those without (P < .05).

Conclusion:

F&A orthopedic surgeons underused social media platforms in their clinical practice. Among all the platforms studied, a YouTube page was the most impactful social media platform on Healthgrades scores for F&A orthopedic surgeons. Given these findings, we recommend that physicians closely monitor their digital identity and maintain a diverse social media presence including a YouTube page to promote their clinical practice.

Level of Evidence:

Level IV.

Editorial Commentary: YouTube Videos Provide Poor-Quality Medical Information: Don't Believe What You Watch!

Providing accurate information to patients regarding health conditions, treatment options, and prognosis is a crucial aspect of medical management and an ethical obligation. Office visits may be limited due to time constraints imposed by scheduling, which may result in missed opportunities to provide extensive information when history, physical examination, review of diagnostic testing, and planning is required. As the Internet is now an established platform and easily accessible, patients are increasingly seeking information from websites out of curiosity and for additional questions pertaining to their health condition. However, the reliability and accuracy of anterior cruciate ligament videos on YouTube are of evidence-based very low quality and reliability.

YouTube as an Educational Resource in Medical Education: a Scoping Review

YouTube has emerged as a growing educational resource for medical learners and educators; yet, its broad implementation may lack guidance from evidence-based evaluations. This article presents a scoping review of the utility, effectiveness, and validity of YouTube video resources in medical education. Of the 113 articles identified, 31 articles met inclusion criteria that focused on use of YouTube in medical education. Only 19.4% of the articles (n = 6) reported evaluative outcomes related to the use of YouTube for instructional purposes. Recommendations are offered for improving the usefulness and quality of YouTube videos as an educational resource in medical education.

YouTube for information about side effects of biologic therapy: A social media analysis

OBJECTIVE

Biologic therapies are one of the most significant breakthroughs in the treatment of rheumatic diseases, although there is still some uncertainty surrounding long-term patient safety. Recently, a growing number of patients browse the Internet as a source of health-related information. We aimed to assess the quality of information available on YouTube videos regarding the side effects of biologic therapy.

METHODS

We used the keywords "biologic therapy side effects," "biologic therapy risks," "biologic therapy safety," "biologic agents side effects," "biologic agents risks," and "biologic agents safety." Also, the generic and commercial names of biologic agents were searched on YouTube in May 2020. The quality and reliability of the videos was assessed according to the global quality score (GQS), DISCERN score. Video Power Index (VPI) used to assess both the view and the like ratios of the videos.

RESULTS

Seventy-five videos were evaluated. According to the GQS, 31 videos (40.3%) were of high quality, 18 videos (23.4%) were of intermediate quality, and 28 videos (36.4%) were of low quality. The GQS was significantly positively correlated with the DISCERN score (P < .001). VPI scores were not correlated with DISCERN (P = .268) and GQS scores (P = .411).

CONCLUSION

YouTube videos on the side effects of biologic therapy are informative for patients and physicians. High-quality videos are more reliable but may not be as popular as expected.

Learning inguinal hernia repair? A survey of current practice and of preferred methods of surgical residents

Purpose

During surgical residency, many learning methods are available to learn an inguinal hernia repair (IHR). This study aimed to investigate which learning methods are most commonly used and which are perceived as most important by surgical residents for open and endoscopic IHR.

Methods

European general surgery residents were invited to participate in a 9-item web-based survey that inquired which of the learning methods were used (checking one or more of 13 options) and what their perceived importance was on a 5-point Likert scale (1 = completely not important to 5 = very important).

Results

In total, 323 residents participated. The five most commonly used learning methods for open and endoscopic IHR were apprenticeship style learning in the operation room (OR) (98% and 96%, respectively), textbooks (67% and 49%, respectively), lectures (50% and 44%, respectively), video-demonstrations (53% and 66%, respectively) and journal articles (54% and 54%, respectively). The three most important learning methods for the open and endoscopic IHR were participation in the OR [5.00 (5.00–5.00) and 5.00 (5.00–5.00), respectively], video-demonstrations [4.00 (4.00–5.00) and 4.00 (4.00–5.00), respectively], and hands-on hernia courses [4.00 (4.00–5.00) and 4.00 (4.00–5.00), respectively].

Conclusion

This study demonstrated a discrepancy between learning methods that are currently used by surgical residents to learn the open and endoscopic IHR and preferred learning methods. There is a need for more emphasis on practising before entering the OR. This would support surgical residents’ training by first observing, then practising and finally performing the surgery in the OR.

Electronic supplementary material

The online version of this article (10.1007/s10029-020-02270-y) contains supplementary material, which is available to authorized users.

YouTube as an information source for clubfoot: a quality analysis of video content

Idiopathic clubfoot is the most common congenital anomaly of the lower extremity. YouTube has emerged as an important source of health-related information for patients and families. Parents seek information about clubfoot on YouTube. However, the quality of these videos remains unknown. Therefore, we decided to evaluate the quality of YouTube videos about clubfoot. We searched YouTube for clubfoot videos using appropriate keywords. English language videos with more than 10 000 views were included. Three fellowship trained pediatric orthopedic surgeons independently assessed the videos and classified them into corporate, hospital, education and private. The quality of information was assessed using the Modified DISCERN and JAMA benchmark scores. The search yielded 12 060 videos of which 42 were analyzed. There were 9 (21%) videos from corporate organizations, 12 (29%) from hospitals, 3 (7%) from educational organizations and 18 (43%) by private individuals. The mean Modified DISCERN score was 2.1 ± 1.07 (range 0.3-4) and mean JAMA benchmark score was 0.9 ± 0.65 (range 0-2). Educational videos had highest mean Modified DISCERN score (3.1 ± 0.85) and private videos, the least (1.43 ± 1). This difference was statistically significant (P = 0.004). Hospital videos had highest mean JAMA benchmark score of 1.3 ± 0.6 as compared with private videos which had the least mean score of 0.5 ± 0.6. This difference was also statistically significant (P = 0.001). The results of our study indicate that the quality of information on idiopathic clubfoot on YouTube needs improvement. Videos from educational and hospital sources should be preferred over private sources.

Quality of Online Video Resources Concerning Patient Education for the Meniscus: A YouTube-Based Quality-Control Study

PURPOSE

To evaluate the reliability and educational content of YouTube videos concerning the menisci.

METHODS

YouTube was queried using the keyword "meniscus." The first 50 videos were evaluated. Eleven video characteristics were extracted, and videos were categorized by source and content. Video reliability was assessed using the Journal of the American Medical Association (JAMA) benchmark criteria (score range, 0-5). Video educational content was assessed using the Global Quality Score (GQS; score range, 0-4) and a meniscus-specific score (MSS; score range, 0-20).

RESULTS

The mean video duration was 551.44 ± 1,046.04 seconds (range, 75-7,282 seconds). The mean number of views was 288,597.7 ± 735,275.9. Collectively, the 50 videos accrued 14,141,285 views. The mean JAMA score, GQS, and MSS were 1.55, 2.12, and 3.67, respectively. The video source was predominately non-physician based (24.49% of source uploaders), whereas video content was predominately concerned with disease information (37.50% of content). Significant between-group effects were observed for the JAMA score and video content (P = .0155), with videos concerning disease information, exercise training, and nonsurgical intervention having the highest mean JAMA scores. Significant between-group effects were also observed for the JAMA score based on video upload source (P < .001), with videos uploaded by physicians receiving the highest mean JAMA scores. The mean GQS and MSS were significantly greater for videos categorized as having disease-specific content (P = .0377 and P = .0404, respectively) and for physician video uploaders (P = .0133 and P = .0100, respectively). The number of video dislikes was a negative independent predictor of the JAMA score (β = -0.007, P = .003). Disease-specific content was a positive independent predictor of the GQS (β = 1.13, P = .042). There were no independent predictors of the MSS.

CONCLUSIONS

Information on the meniscus found in YouTube videos is of low quality and reliability.

CLINICAL RELEVANCE

Orthopaedic health practitioners should caution patients about the inaccuracy of YouTube videos regarding the meniscus given the low quality of content. These health care providers should make efforts to provide patients with higher-quality alternatives.

YouTube as a Source of Information About the Posterior Cruciate Ligament: A Content-Quality and Reliability Analysis

Purpose

The purpose of this study was to evaluate the reliability and educational content of YouTube videos concerning injuries to the posterior cruciate ligament (PCL) of the knee.

Methods

The first 50 videos specific to the PCL identified through the YouTube query posterior cruciate ligament were evaluated by a method of video selection demonstrated to be feasible in prior YouTube studies. Videos were classified by content and upload source. Video reliability was assessed using the Journal of the American Medical Association (JAMA) benchmark criteria (score range 0-5). Video educational content was assessed using the Global Quality Score (GQS) (range 0-4) and the PCL Score (PCLS) (score range 0-18). Analysis of variance was used to determine differences in video reliability and educational content quality based on video content and upload source. Multivariate linear regressions were used to identify predictors of video reliability and educational content quality.

Results

The mean number of views per video was 50,477.9 ± 15,036. Collectively, the 50 videos were viewed 14,141,285 times. Video content was classified primarily as information about disease (62.0%). The most common upload sources were physicians (24.0%) and nonphysician health care providers (26.0%). Significant between-group interactions were found between video source and the JAMA score, with physicians and medical sources having significantly higher mean JAMA scores (P = 0.037). Videos uploaded by physicians were an independent positive predictor of greater JAMA scores (β:1.27; P = 0.008). Videos uploaded by a medical source (β:2.06; P = 0.038) were an independent positive predictor of a greater GQS. There were no independent associations between video content category or upload source and the PCLS.

Conclusions

Videos concerning the PCL were frequently viewed on YouTube, but the educational quality and reliability of these videos were low.

Clinical Relevance

Physicians and health care providers treating PCL pathology should take the initiative to counsel patients about which outside resources are reliable to better inform patients about their treatment decisions. With regard to YouTube videos specifically, providers should caution their patients that this source of information may be unreliable.

Assessing the educational quality of 'YouTube' videos for facelifts

OBJECTIVES

Facelifts are among the most common facial plastic procedures performed. Given the existence of a variety of surgical approaches and the proximity of key anatomical structures, the development of proper surgical skills and knowledge is necessary to ensure positive outcomes. Many surgical learners utilize YouTube videos as supplemental tools in their education. Our aim was to gauge the quality and quantity of available YouTube videos describing the surgical approach to rhytidectomy.

METHODS

The YouTube video platform was searched using predefined keywords. Videos meeting inclusion criteria were reviewed and scored by 3 practicing facial plastic and reconstructive surgeons. Thirteen different intraoperative, pre/postoperative, and video quality characteristics were scored on a binary scale by each grader. Descriptive statistics were obtained and interrater reliability was assessed using Kappa's coefficient.

RESULTS

Thirteen videos met criteria for analysis. A high degree of interrater reliability was confirmed using Kappa's coefficient, with κ values = 0.73, 0.75, and 0.59 for each combination of scorers. In general, YouTube videos were found to be deficient in discussing key criteria of rhytidectomy, particularly with regards to pre/postoperative points such as indications, patient selection, and possible complications. Intraoperative benchmarks were also lacking, with 8/13 videos not discussing the facial nerve and 8/13 failing to demonstrate an appropriate facelift incision.

CONCLUSIONS

YouTube instructional videos depicting rhytidectomy lack discussion of key tenets of successful facelift surgery. Until improvement in the educational quality of such material occurs, surgical trainees should implement discretion when choosing YouTube videos to complement their learning.

LEVEL OF EVIDENCE

Not Applicable.

YouTube as a learning tool for four shoulder tests

AIM

To analyze the use of YouTube videos as educational tools for four physical examinations of the shoulder: the Neer, Hawkins, empty can, and drop arm tests.

BACKGROUND

Video-based education, which is accompanied by text-based education, can be an effective education method, especially in learning medical skills. Medical students and doctors in training often use YouTube videos to share medical education materials, and more systematic review of the reliability of these videos is required.

METHODS

A search of YouTube was conducted using four keywords: 'Neer test,' 'Hawkins test,' 'empty can test,' and 'drop arm test.' Two physicians reviewed each video and recorded a variety of characteristics (date uploaded, number of views, likes and dislikes, and upload source). In addition, they scored and categorized the videos into four groups: 'very useful,' 'somewhat useful,' 'not useful,' and 'misleading.' Videos containing inappropriate content were classified as 'misleading.' Finally, the correlations of each video's usefulness with viewers' preferences and the upload source were analyzed.

RESULTS

A total of 400 videos were assessed and 200 videos were adopted which yield eligible criteria. Out of 200 videos, 51 videos were very useful and 32 were misleading. Significant correlations were observed between the video's usefulness and the uploaded source, as well as between the video's usefulness and viewers' preferences, such as the number of views, views per day, and number of likes. The proportion of videos classified as 'very useful' was highest (58.6%) among those uploaded by physicians and lowest (12.7%) among those uploaded by individuals. Videos uploaded by individuals had significantly lower values reflecting viewer preferences than did videos uploaded by physicians.

CONCLUSION

YouTube videos could be used as learning sources for shoulder physical examinations after the application of appropriate filtering processes, such as review of the upload source and viewers' preferences.