YouTube as a Source of Information About Premature Ejaculation Treatment

A systematic review assessing the reliability of studies focusing on urological content on YouTube

INTRODUCTION

In recent years, several publications have focused on analyzing the quality of medical content on YouTube. The current systematic review aimed to summarize and analyze the available studies examining YouTube video content in the urological field.

EVIDENCE ACQUISITION

This is a systematic review including studies examining urological content uploaded on the YouTube platform published before November 2023. The following keywords were combined to capture relevant publications with a title/abstract search: ("Urology" OR "Andrology") AND ("YouTube" OR "Social media").

EVIDENCE SYNTHESIS

According to the inclusion criteria, 84 studies were included. Of all, 74 (88%) studies were published after the COVID-19 pandemic outbreak. A total of 52 (62%) studies used the DISCERN score, 29 (35%) the PEMAT A/V score, 30 (36%) the GQS, 23 (27%) the Misinformation score, 14 (17%) the Likert scale, and 13 (15%) the JAMA score. According to the conclusion, 62 (74%) studies reported poor quality results. Among all, only 10 (12%) studies respected our criteria of best quality methodology, defined as: 1) description of the research time frame; 2) use of incognito status; 3) the description of the inter-rater variability between reviewers; 4) use of at least one quality assessment tool.

CONCLUSIONS

The systematic review highlights significant variability in results and methodologies across studies on the quality analysis of urological content on YouTube. The official urological community should establish guidelines for authors, aiming to enhance the reliability and importance of such publications as valuable resources for daily clinical practice.

The clinical profile of men with premature ejaculation at presentation has changed over the last fifteen years: picture from a longitudinal study

We aimed to assess the clinical characteristics of patients presenting for premature ejaculation (PE) as their primary medical complaint over a 15-year time frame. Data from 257 men seeking first medical help for life-long PE between 2008 and 2022 were analysed. Clinical data and serum hormones were collected in each case. At baseline all patients completed the International Index of Erectile Function (IIEF), the Beck Depression Inventory (BDI), and the Premature Ejaculation Diagnostic Tool (PEDT). Descriptive statistics and linear regression analyses were applied. Median (IQR) age at presentation was 32 (26-37) years, and PEDT, BDI and IIEF-Erectile Function (IIEF-EF) scores were 14 (11-17), 7 (1-11) and 19 (10-26), respectively. Of all, 182 (70.9%) patients reported some degree of erectile dysfunction according to IIEF-EF domain scores. Throughout the 15-year time frame, patient's age at presentation significantly decreased over time (beta -0.4, p < 0.001). In details, patient's age at presentation decreased by 1 year every two years of evaluation. Furthermore, depressive symptoms (beta -0.8, p < 0.001) and the severity of PE at presentation as scored with the PEDT (beta -0.5, p < 0.001) linearly decreased overtime. According to a 5-year group subdivision, age at presentation decreased from 2008-2012 to 2013-2017 (p = 0.04) and further decreased between 2018 and 2022 (p = 0.01). Similarly, baseline BDI scores significantly decreased from 2008-2012 to 2018-2022 (all p < 0.001). PE severity at first assessment was stable between 2008-2012 and 2013-2017 but decreased thereafter (p < 0.01). Patients in a steady couple relationship more frequently asked for medical attention for PE between 2018-2022 compared to 2013-2017 and 2008-2012 (72.0% vs. 43.8% vs. 51.6%, p < 0.001). In conclusion we showed that patients' age has decreased over the last 15 years in men with life-long PE. PE severity and depressive symptoms at presentation showed a significant decline overtime. Men in a steady sexual relationship were more likely to seek medical attention for PE in recent years.

Rabies in Social Media Videos: Comparison of Instagram and YouTube

OBJECTIVE

This study aims to elucidate the informational content related to post-exposure patient education for this disease, emphasizing the significance of social media platforms as sources of information. The goal is to uncover and compare the information available on various social media platforms.

METHODOLOGY

Searches were conducted on Instagram and YouTube using the search terms "Rabies," "Rabies disease," and "Rabies vaccine." A total of 274 videos were examined, with 150 from YouTube and 124 from Instagram. The content of the videos was assessed based on 10 criteria determined by researchers according to the National Rabies Prophylaxis Guidelines, and a scoring system was applied.

RESULTS

Instagram videos had more exclusion criteria. When examined based on uploader characteristics, the number of healthcare professionals on Instagram was higher than on YouTube. For questions related to "What is rabies," "What are the symptoms in animals," and "How should pre-exposure prophylaxis be," Instagram videos received higher scores. Videos uploaded by healthcare professionals received higher scores in questions related to "What is rabies," "How does it spread to humans," "How should wound care be," "Pre-exposure prophylaxis," "Post-exposure prophylaxis," and total score compared to videos uploaded by other independent users.

CONCLUSION

A significant portion of the videos uploaded by various users on social media about rabies were found to be unrelated and lacking in informative content. It was observed that videos on Instagram were more informative compared to YouTube. Health professionals were found to provide more informative and directive content in videos related to rabies.

The spreading information of YouTube videos on Phosphodiesterase 5 inhibitors: a worrisome picture from one of the most consulted internet source

Several previous studies on YouTubeTM information on medical topics have already been published. The current study aimed to evaluate the quality information of YouTubeTM videos on Phosphodiesterase 5 inhibitors (PDE5-is). A systematic search on YouTube™ was conducted using 30 keyword combinations. For each keyword's combination, the first 50 videos were recorded. The quality of videos on YouTube™ was assessed with Patient Education Materials Assessment Tool for audio-visual content (PEMAT A/V), DISCERN score and a specified created Misinformation tool. According to the selection criteria, 229 YouTube™ videos were suitable for the analyses. Videos were stratified according to the five main identified topics: sildenafil [n = 98; 42.79%] vs tadalafil [n = 50; 21.83%] vs vardenafil [n = 44;19.21%] vs avanafil [n = 17; 7.42%] vs PDE5-is in general [n = 20; 8.73%]. The median overall PEMAT A/V Understandability score and Actionability score were 55% (interquartile range [IQR]: 42-75) and 0% (IQR = 0-67), respectively. Specifically, according to our stratification, YouTube Videos on avanafil reached higher values of both Understandability and Actionability (72.7% and 66.7, respectively) in contrast to other categories. According to DISCERN tool, the total overall median score was 29.5 (IQR = 18-41). According to Misinformation scale, the item 1 ('sexual stimulation') harboured an overall median score of 2 (IQR = 1-2); the item 2 ('side effects') an overall median score of 2 (IQR = 1-3); the item 3 ('treatment choices') an overall median score of 1 (IQR = 1-2); the item 4 ('contraindications') an overall median score of 2 (IQR = 1-2). YouTube™ is a fast and open-access source for mass information. The overall quality of the PDE5-is contents provided is sadly unsatisfactory. Nowadays, YouTube™ cannot be recommended as a reliable source of information on PDE5-is.

Quality and Reliability Analysis of Videos About Thulium Laser Enucleation of the Prostate on YouTube

OBJECTIVE

To assess the reliability and quality analyses of thulium laser enucleation of the prostate (ThuLEP) videos on YouTube, as a source of public information.

MATERIALS AND METHODS

In this study, a YouTube search with the keyword "ThuLEP" was performed on November 15, 2022 and 142 videos were listed according to relevance. Video features and source of upload were recorded. The quality of videos was evaluated by using both the Journal of American Medical Association (JAMA) score and the Global Quality Score (GQS); the reliability of videos was evaluated by using 5-point modified DISCERN tool, respectively. The correlation analysis was performed by using Spearman test between video features and these three scores.

RESULTS

Seventy-seven videos were analyzed after exclusion and the most common source of upload were urologists (54.5%) and the videos containing only ThuLEP surgery (74%) were the majority of the videos. The median JAMA score, 5-point modified DISCERN score, and GQS were 2, 1, and 1, respectively. There were no statistical differences in these three scores according to the source of the upload. All three scores were analyzed separately by language and no significant statistical difference was found. There was a positive correlation between the video power index and as well as JAMA, GQS, and m.DISCERN scores.

CONCLUSION

Despite abundant videos on ThuLEP on YouTube, most of these videos are not targeted to public and information provided may not be as useful for patients. Information presented in these videos may be inaccurate and not reliable.

Evaluation of the Current Status of Artificial Intelligence for Endourology Patient Education: A Blind Comparison of ChatGPT and Google Bard Against Traditional Information Resources

Introduction: Artificial intelligence (AI) platforms such as ChatGPT and Bard are increasingly utilized to answer patient health care questions. We present the first study to blindly evaluate AI-generated responses to common endourology patient questions against official patient education materials. Methods: Thirty-two questions and answers spanning kidney stones, ureteral stents, benign prostatic hyperplasia (BPH), and upper tract urothelial carcinoma were extracted from official Urology Care Foundation (UCF) patient education documents. The same questions were input into ChatGPT 4.0 and Bard, limiting responses to within ±10% of the word count of the corresponding UCF response to ensure fair comparison. Six endourologists blindly evaluated responses from each platform using Likert scales for accuracy, clarity, comprehensiveness, and patient utility. Reviewers identified which response they believed was not AI generated. Finally, Flesch-Kincaid Reading Grade Level formulas assessed the readability of each platform response. Ratings were compared using analysis of variance (ANOVA) and chi-square tests. Results: ChatGPT responses were rated the highest across all categories, including accuracy, comprehensiveness, clarity, and patient utility, while UCF answers were consistently scored the lowest, all p < 0.01. A subanalysis revealed that this trend was consistent across question categories (i.e., kidney stones, BPH, etc.). However, AI-generated responses were more likely to be classified at an advanced reading level, while UCF responses showed improved readability (college or higher reading level: ChatGPT = 100%, Bard = 66%, and UCF = 19%), p < 0.001. When asked to identify which answer was not AI generated, 54.2% of responses indicated ChatGPT, 26.6% indicated Bard, and only 19.3% correctly identified it as the UCF response. Conclusions: In a blind evaluation, AI-generated responses from ChatGPT and Bard surpassed the quality of official patient education materials in endourology, suggesting that current AI platforms are already a reliable resource for basic urologic care information. AI-generated responses do, however, tend to require a higher reading level, which may limit their applicability to a broader audience.

Analysis of the quality of information provided by "Dr. YouTube™" on premature ejaculation

Background

YouTube™ is an important online resource to access health-related online information by the public worldwide. However, the quality of information available on it has not been adequately characterized.

Aim

To assess the quality and reliability of information available on the treatment of premature ejaculation (PME) on YouTube™ in the Hindi and English language videos.

Materials and Methods

A total of 151 (Hindi: 109, English: 42) YouTube videos were selected for assessment. The quality was evaluated using structured tools: Patient Education Materials Assessment Tool (PEMAT); and a 5-point modified DISCERN questionnaire (Range: 1-serious shortcomings; 5-minimal shortcomings). PEMAT assesses the understandability and actionability of video as separate percentages.

Results

Three most common treatments suggested for PME were Kegel exercise (22.5%), start-stop technique (21.9%), and antidepressant medications (20.5%). Antidepressant medications, stop-squeeze techniques, and psychotherapy were more frequently suggested in English videos, whereas ayurvedic or herbal medicines were more frequently suggested in Hindi videos. About two-thirds of videos presented information in an easy-to-understand and actionable manner (PEMAT scores ≥70%). Only 6% of videos had a DISCERN score of ≥4, indicating good overall quality of information presented in them.

Conclusion

People likely to encounter poor-quality information when seeking information for PME treatment on YouTube. A large number of videos suggested ineffective or unproven treatment strategies for PME. Healthcare professionals need to be mindful of this while counselling patients, and guide them regarding useful and reliable sources of health information available online.

Size matters: characterizing penile augmentation content from the 100 most popular YouTube videos

Aesthetic penile augmentation is considered investigational and not shown to be safe or efficacious. This study sought to characterize the quality and reliability of YouTube videos on the topic of penile augmentation. A systematic search identifying the 100 most viewed YouTube videos on penile augmentation was conducted. The videos were then evaluated by two independent urologists for reliability and quality using a modified DISCERN scoring system and Global Quality Scale (GQS). The median total views were 530,612 (range 123,478-32,914,713). The median DISCERN and GQS scores for all 100 videos were generally poor at 1.75 (IQR 1-2.63) and 2.5 (IQR 1.5-3.5), respectively. A little under half of the videos had a physician present (44.7%). DISCERN and GQS scores were significantly higher in videos with physicians compared to those without one (p < 0.001 for both). The majority of videos discussed nonsurgical methods of penile augmentation (65.1%) with penile traction devices being the most frequently discussed (19.2%). Urologists and medical organizations should strive to have more of a presence in this space to ensure patients are appropriately educated and counseled before pursuing potentially ineffective or harmful treatments.

Assessment of the quality of oral biopsy procedure videos shared on YouTube

OBJECTIVE

The aim of this study was to assess the quality of free-to-access videos on oral biopsy procedures on the YouTube platform.

MATERIALS AND METHODS

We conducted a search on YouTube using the term "oral biopsy" and selected the first 100 videos in order of relevance. The following exclusion criteria were applied: language other than English, videos that did not cover oral biopsy techniques, videos on nonhuman specimens, postoperative instructions, personal experiences, exfoliative cytology, or "brush biopsy." Forty-seven selected videos were classified based on their duration, country of origin, date of upload to the system, author, information source and number of views, and likes and dislikes. Video quality was analyzed using DISCERN, the Global Quality Scale (GQS), and the Video Information and Quality Index (VIQI).

RESULTS

The majority (78.7%) of analyzed videos were uploaded by dentists, originating from India (48.9%), with a mean duration of 11.8 min (SD, 20.4), with 104.5 likes (SD, 186.4) and 7.1 dislikes (SD, 10.55). The mean values for DISCERN, GQS, and VIQI were 1.3 (SD, 0.52), 2.1 (SD, 1.04), and 9.62 (SD, 1.69), respectively.

CONCLUSION

The majority of videos on oral biopsy published on YouTube are of low quality.

#Penisenlargement on Instagram: a mixed-methods study

This study aims to analyze the reliability of #penisenlargement hashtag on Instagram and to investigate how young adult men perceive their penis size in real-world settings after being exposed to #penisenlargement Instagram postings. In the first phase, the credibility of the 100 most recent publicly accessible postings with the #penisenlargement hashtag was evaluated. Also, the last 1000 posts related to the same hashtag were evaluated to determine follower reach and engagement impacts. In the second phase, men were exposed to the #penisenlargement hashtag for 6 months and completed an online questionnaire examining their motives to undergo augmentation. Only a few (n = 6, 1%) posts had reliable information. At the time of questionnaire completion, participants reported a substantial drop in their genital self-image (22.3 ± 3.6 to 17.8 ± 3.0, p < 0.001) and a significant increase in their media exposure (1.24 ± 1.05 to 2.3 ± 0.74, p < 0.001) compared to their pre-Instagram exposure levels. The most prevalent reason for pursuing penis enlargement following Instagram exposure was to enhance self-perception and confidence. Our findings indicate that penis enlargement methods on Instagram are mostly unreliable. In addition, being exposed to posts pertaining to "penis enlargement" the hashtag can encourage men to seek penis augmentation surgery.

Quality of Pelvic Floor Therapy Videos on YouTube: Does Popularity Predict Reliability?

ABSTRACT

This study reviewed instructional videos on YouTube regarding pelvic floor physical therapy and assessed the association between the videos' popularity and the reliability of the videos' content. YouTube was searched using the terms relevant to pelvic floor muscle training. The first 100 videos for each search term were screened, and relevant metrics were collected for those meeting the inclusion criteria. Videos were assessed by 2 independent, trained health care professionals for reliability using the Medical Quality Video Evaluation (MQ-VET) tool, the modified DISCERN tool, the Journal of American Medical Association benchmark criteria, and the Global Quality Score. Popularity was assessed using the Video Power Index (VPI). Higher values for all scoring systems correlated with greater reliability and greater popularity, respectively. Five hundred videos were screened. Two hundred thirty-four videos were duplicates, and 99 did not meet the inclusion criteria. A total of 167 videos were reviewed. The median VPI and MQ-VET score was 201,114.76 (interquartile range, 7,194,020.29) and 48.00 (interquartile range, 12.75), respectively. Spearman's R value was 0.292 (P < 0.001), demonstrating a weak positive correlation between MQ-VET scores and VPI. The interrater reliability of the MQ-VET was good, with an intraclass correlation coefficient of 0.86 (95% confidence interval, 0.71-0.92). In summary, we identified a statistically significant but weak positive correlation between the reliability and popularity of YouTube videos about pelvic floor physical therapy.

A clinical guide to rare male sexual disorders

Conditions referred to as 'male sexual dysfunctions' usually include erectile dysfunction, ejaculatory disorders and male hypogonadism. However, some less common male sexual disorders exist, which are under-recognized and under-treated, leading to considerable morbidity, with adverse effects on individuals' sexual health and relationships. Such conditions include post-finasteride syndrome, restless genital syndrome, post-orgasmic illness syndrome, post-selective serotonin reuptake inhibitor (SSRI) sexual dysfunction, hard-flaccid syndrome, sleep-related painful erections and post-retinoid sexual dysfunction. Information about these disorders usually originates from case-control trials or small case series; thus, the published literature is scarce. As the aetiology of these diseases has not been fully elucidated, the optimal investigational work-up and therapy are not well defined, and the available options cannot, therefore, adequately address patients' sexual problems and implement appropriate treatment. Thus, larger-scale studies - including prospective trials and comprehensive case registries - are crucial to better understand the aetiology, prevalence and clinical characteristics of these conditions. Furthermore, collaborative efforts among researchers, health-care professionals and patient advocacy groups will be essential in order to develop evidence-based guidelines and novel therapeutic approaches that can effectively address these disorders. By advancing our understanding and refining treatment strategies, we can strive towards improving the quality of life and fostering healthier sexual relationships for individuals suffering from these rare sexual disorders.

The Quality and Reliability of Information in YouTube Videos on Occupational Health and Safety

Background

Education is very important to prevent occupational injuries and accidents, which are almost all completely preventable. The aim of this study was to evaluate training videos on this subject on the YouTube platform.

Methods

Six search terms related to occupational health and safety (OHS) were scanned on May 31, 2021. After the application of exclusion criteria, a total of 176 videos were included for final analysis using the parameters of country origin, source of the video, content, number of views, comments, likes, dislikes, and video duration. The Global Quality Scale (GQS) and modified DISCERN tools were used to evaluate the quality and reliability of the videos in this analytical cross-sectional study.

Results

According to the GQS score, 111 (63.1%) videos were of low quality. Statistically significant differences were found between the low-, moderate-, and high-quality groups with respect to video length, likes, dislikes, comments, likes per day, dislikes per day, comments per day, video category, and the DISCERN scores (P < 0.05). The vast majority of videos contained low-quality information. A large number of videos were uploaded on OHS content from independent users and the USA.

Conclusion

There is a clear need for professionals to play a more active role in uploading and sharing high-quality information on Internet platforms on the subject of OHS.

Educational Quality of YouTube Videos for Patients Undergoing Elective Procedures

INTRODUCTION

YouTube has become a main resource used by patients for self-education on medicine. It is important for surgeons to understand the quality and reliability of videos that patients are likely to view about elective procedures.

METHODS

Videos were categorized by view count and content creators. The top 20 videos for each term, sorted by relevance, were evaluated using DISCERN criteria, a question set externally validated to assess the quality of information regarding health treatment choices. DISCERN score (DS) closer to 5 indicate higher quality information and 1 indicates the opposite. Total scores were given: 15-26 (very poor), 27-38 (poor), 39-50 (fair), 51-62 (very good), and 63-75 (excellent). Search terms included "Wound Care", "Skin Grafting", "Tracheostomy", and "percutaneous endoscopic gastrostomy tube placement".

RESULTS

In total, 80 unique videos were evaluated with a total view of 8,848,796. The mean overall DS was 2.15 and a mean bias DS was 2.46. The median DISCERN total score for each key term was Tracheostomy: 35 (poor), Skin Grafting 26 (very poor), percutaneous endoscopic gastrostomy: 32 (poor), and Wound Care: 40 (fair).

CONCLUSIONS

YouTube videos surrounding elective procedures should be viewed cautiously in patient education despite wide availability. The videos in this study show high levels of bias and low DS. Healthcare providers should be aware of poor-quality consumer health information often disseminated in online media such as YouTube.

Female urinary incontinence on TikTok and YouTube: is online video content sufficient?

INTRODUCTION AND HYPOTHESIS

The objective of the study is to evaluate the reliability and quality of the most-viewed female urinary incontinence-related TikTok and YouTube posts. Our second goal is to analyze the differences in the quality and content of videos between these platforms.

METHODS

We searched for the keyword "female urinary incontinence" on TikTok and YouTube on 1 March 2023. We sorted the videos that appeared out of searches for this keyword by "top" results on TikTok and by "relevance" on YouTube. We excluded the videos that were not in English, whose narrator was unclear, unrelated videos, advertising videos, and duplicate videos. In this study, we included the top 50 videos on both platforms that were directly related to female urinary incontinence. The characteristics of the videos, such as likes, video duration, views, and type of narrator (patient, physician, nonphysician practitioner, and health care company), and DISCERN scores were analyzed.

RESULTS

We observed that the median view count (p<0.001) and the median video duration (p<0.001) were higher and longer respectively on YouTube than on TikTok. In addition, the median DISCERN score of these videos was higher on YouTube than on TikTok (p<0.001). Similarly, the overall quality of videos was higher on YouTube than on TikTok (p=0.002). Only in two TikTok and two YouTube videos have the narrators cited a reference.

CONCLUSIONS

Our findings emphasize the present lack of high-quality content available on TikTok and YouTube from both health care and nonhealth care experts. To address this lack of information, health care providers, especially urologists, should take an active role in creating video content.

Can ChatGPT, an Artificial Intelligence Language Model, Provide Accurate and High-quality Patient Information on Prostate Cancer?

OBJECTIVE

To evaluate the performance of ChatGPT, an artificial intelligence (AI) language model, in providing patient information on prostate cancer, and to compare the accuracy, similarity, and quality of the information to a reference source.

METHODS

Patient information material on prostate cancer was used as a reference source from the website of the European Association of Urology Patient Information. This was used to generate 59 queries. The accuracy of the model's content was determined with F1, precision, and recall scores. The similarity was assessed with cosine similarity, and the quality was evaluated using a 5-point Likert scale named General Quality Score (GQS).

RESULTS

ChatGPT was able to respond to all prostate cancer-related queries. The average F1 score was 0.426 (range: 0-1), precision score was 0.349 (range: 0-1), recall score was 0.549 (range: 0-1), and cosine similarity was 0.609 (range: 0-1). The average GQS was 3.62 ± 0.49 (range: 1-5), with no answers achieving the maximum GQS of 5. While ChatGPT produced a larger amount of information compared to the reference, the accuracy and quality of the content were not optimal, with all scores indicating need for improvement in the model's performance.

CONCLUSION

Caution should be exercised when using ChatGPT as a patient information source for prostate cancer due to limitations in its performance, which may lead to inaccuracies and potential misunderstandings. Further studies, using different topics and language models, are needed to fully understand the capabilities and limitations of AI-generated patient information.

Evaluation of robotic-assisted sacrocolpopexy videos on YouTube

OBJECTIVE

To evaluate the quality and reliability of videos on YouTube about robotic-assisted sacrocolpopexy.

METHODS

YouTube's search function was used to find videos associated with robotic-assisted sacrocolpopexy. On June 1, 2022, systematic research was performed using the term "robotic-assisted sacrocolpopexy". The first 50 videos were included in the study. The quality of the videos was evaluated using the Global Quality Scale (GQS) [a 5-point scale: high quality (4 or 5), acceptable quality (3), low quality (1 or 2)]. The modified DISCERN scale was used to evaluate the reliability of the videos [a 5-point scale: high reliability (5), moderate reliability (3 and 4), low reliability (1 or 2)].

RESULTS

A total of 50 videos associated with robotic-assisted sacrocolpopexy were analyzed. The most frequently discussed topics in the videos were the duration of the surgery (72%), the anatomical success rates (70%), the advantages and disadvantages of the procedure compared to the classical methods (68%), and the postoperative complications (60%). The mean GQS of the videos was 3.04 ± 0.75. The mean DISCERN score of the videos was 2.21 ± 1. No appropriate references were cited in any of the videos. There was no video that received a full score (5 points) from DISCERN.

CONCLUSION

Our study shows that the level of quality in YouTube videos associated with robotic-assisted sacrocolpopexy is at an acceptable and high level, but its reliability is low. Therefore, short and concise videos that contain accurate information and refer to scientific facts should be prepared by urogynecology associations.

Guideline-Nonconformant Investigational Treatments for Erectile Dysfunction: What are Patients Learning?

OBJECTIVE

To evaluate the validity of YouTube content on shockwave, platelet-rich plasma, and stem cell therapies for erectile dysfunction (ED). The consumerization of men's health is particularly notable among regenerative ED treatments, and the popularity of these treatments has been amplified by social media sites such as YouTube.

METHODS

We searched YouTube utilizing the following terms: "shockwave therapy-," "platelet-rich plasma- and "stem cell therapy-" "-for erectile dysfunction." The first 50 resulting videos per query were screened (inclusion criteria: relevant title/content, English language, >100 views) and judged by 2 independent graders using the validated DISCERN instrument for consumer health information. Regression analysis assessed association of video characteristics with DISCERN score.

RESULTS

Seventy-one unique videos met criteria. More content featured non-physicians (37%) or non-urologist physicians (35%) than urologists (28%). Mean DISCERN score was low at 42.8 of 80. DISCERN score significantly differed by video category and characteristics. Educational and urologist-featuring videos were associated with higher score. News reports were associated with lower score. Only 3 videos mentioned investigational/experimental status of the therapies. Only 2 cited society guidelines.

CONCLUSION

Most YouTube videos on regenerative ED therapies are unreliable and from non-urologists. The misrepresentation of proven efficacy may be encouraging patients to seek these still investigational treatments at high fiscal costs to the patient. Videos with urologists were more likely to be higher quality and guideline based. The urological and academic communities should continue to leverage the power of social media to provide evidence-backed consumer health information in this space.

YoutubeTM Content Analysis as a Means of Information in Oral Medicine: A Systematic Review of the Literature

Background: Oral medicine represents a complex branch of dentistry, involved in diagnosing and managing a wide range of disorders. Youtube^TM offers a huge source of information for users and patients affected by oral diseases. This systematic review aims to evaluate the reliability of Youtube^TM oral medicine-related content as a valid dissemination aid. Methods: The MeSH terms “Youtube^TM” and “oral” have been searched by three search engines (PubMed, ISI Web of Science, and the Cochrane Library), and a systematic review has been performed; the PRISMA checklist has been followed in the search operations. Results: Initial results were 210. Ten studies definitely met our selection criteria. Conclusions: Youtube^TM represents a dynamic device capable of easy and rapid dissemination of medical-scientific content. Nevertheless, the most of information collected in the literature shows a lack of adequate knowledge and the need to utilize a peer-reviewing tool in order to avoid the spreading of misleading and dangerous content.

YouTube as a source of information for water treatments

The purpose of the study was to investigate the quality and reliability of YouTube videos as a source of information in water treatments. We searched videos on YouTube ( www.youtube.com ) using the following keywords: "health resort medicine," "spa treatment," "spa therapy," "hydrotherapy," "thermal medicine," "balneology," and "balneotherapy" on June 17th, 2021. The global quality scale (GQS) was used to evaluate the quality of the videos. The assessment of reliability was evaluated using the modified DISCERN tool. Some other video parameters and sources of the videos were also recorded. One hundred twenty-one (121) videos were analyzed. The most common video source was advertisement (46.3%). GQS and modified DISCERN median scores were generally low. They were superior for "hydrotherapy" and "balneotherapy" and were also higher in videos uploaded by health-related persons or organizations (physicians, health-related professionals, and health-related websites). A statistically significant positive correlation was found between investigated parameters (like view ratio, number of likes, video power index, video length) and GQS. Only video length was correlated with modified DISCERN for investigated parameters. The median video power index scores were statistically higher for "spa therapy" and "spa treatment." The YouTube content linked with water treatments has poor quality and reliability most of time. The hydrotherapy and balneotherapy keywords have the best quality and reliability.We think that designers of water treatment videos should involve health professionals more often so that the content of their video will better explain the details of medical conditions or interventions.The scientific experts should ensure a consensus in terminology to straighten the awareness of water treatments for patients and physicians.

Analysis of quality information provided by "Dr. YouTubeTM" on Phimosis

The objective of the current study was to evaluate the quality of the information provided in YouTube^TM videos on phimosis. The term “phimosis” was searched on YouTube^TM, and the Patient Education Materials Assessment Tool (PEMAT) for Audio/Visual Materials (Understandability and Actionability sections, good-quality score of minimum 70%) and misinformation scale (rated from 1 to 5) were used to assess video quality. Quality assessment was investigated over time. Of all, 60 were eligible for analysis. Healthcare providers were the authors of 75.0% of the videos, and 73.3% of the videos were patient-targeted. The median Understandability score was 42.9% (interquartile range [IQR]:34.5–58.9) and ranged from 28.6 to 42.9% (2013–2020). The median Actionability score was 50.0% (IQR:25.0–56.2) and ranged from 25.0 to 50.0% (2013–2020). The median misinformation score was 2.8/5 (IQR:1.6–3.6), and although the score fluctuated over time, the median score was 2.6 both in 2013 and in 2020. According to our results, although an increase of PEMAT over time was observed, the overall quality of the information uploaded on YouTube^TM is low. Therefore, at present, YouTube^TM cannot be recommended as a reliable source of information on phimosis. Video producers should upload higher-quality videos to help physicians and patients in the decision-making process.

YouTube is inadequate as an information source on delayed ejaculation

The prevalence of delayed ejaculation in sexually active men is reportedly 3%. Due to its rarity and uncertain definitions, people seek information about delayed ejaculation on the internet. YouTube is one of the largest video platforms preferred global for gathering medical information. We aimed to determine the quality of YouTube videos on delayed ejaculation. YouTube search was performed with the keywords “delayed and retarded ejaculation”, and we recorded the first 400 videos according to relevance. The search results were saved in the playlist, and the first 400 videos were evaluated by two independent urologists. DISCERN and Global Quality Scale (GQS) were used to assess the reliability and quality of videos. Repeated (n = 17), off-topic (n = 279), non-English videos (n = 37), and videos with no audio (n = 16) were excluded from the study. The remaining 51 videos were evaluated. DISCERN and GQS scores were statistically significantly associated with video durations (r = 0.329, P = 0.018 and r = 0.349, P = 0.012; respectively). A statistically significant association was also observed between and DISCERN and GQS scores with video power index values (r = 0.466, P = 0.001 and r = 0.422, P = 0.002; respectively). 62.7% (n = 32) videos were low quality, 23.5% (n = 12) were intermediate quality, and 13.7% (n = 7) were high quality according to the GQS. Most of the YouTube content on delayed ejaculation was of poor quality. Physicians should be aware of this situation, and take the lead in bringing high-quality videos about delayed ejaculation to the community.

Evaluation of YouTube videos on primary bladder pain syndrome

INTRODUCTION AND HYPOTHESIS

Seeking health information online has drastically increased. As primary bladder pain syndrome (PBPS) is a condition that has no definitive diagnosis and treatment protocol, patients may seek answers on YouTube. We aimed to evaluate the role of the videos related to PBPS hosted on YouTube.

METHODS

We searched PBPS-related YouTube videos using the keywords "primary bladder pain syndrome," "painful bladder syndrome," and "interstitial cystitis." The videos not in English, not relevant, or that do not contain audio were excluded. The characteristics of the videos were collected. The videos were primarily classified as reliable and nonreliable based on the scientifically proven accurate information they contained. The overall quality of the videos was assessed by DISCERN and Global Quality Score (GQS). Intraclass correlation was used to calculate the level of agreement between the two investigators on DISCERN and GQS values.

RESULTS

Of the 300 videos, 175 were excluded. A total of 62 (49.6%) videos were considered reliable and 63 (50.4%) nonreliable. Only video lengths differed statistically in favor of reliable videos (p < 0.001). DISCERN and GQS values were higher in the reliable videos group (p < 0.001 for each). The number of views, likes, dislikes, and comments were slightly lower in the videos uploaded from universities/nonprofit physicians or professional organizations than other groups.

CONCLUSIONS

Although about half of the videos are reliable, most are long and are medical lectures, from which it is difficult for nonhealth professionals and patients to obtain information. On the other hand, most of the videos that patients can follow more easily consist of nonreliable video groups that lack accuracy, detail, and factual content. Therefore, the relevant associations with experts should prepare concise videos containing correct and up-to-date information.

Testicular pain and youtube™: are uploaded videos a reliable source to get information?

Several previous studies on YouTube™ on urological field have already been published. The aim of the current study was to evaluate the quality information of YouTube^TM videos on testicular pain. Using Google Trends tool, the frequency of worldwide YouTube^TM and Google Search on testicular pain was examined from 2010 to 2020. The keywords "testicular pain", "testicular ache" and "scrotal pain" were used on the YouTube platform and the first 100 YouTube^TM videos were analyzed for each one. The Patient Education Materials Assessment Tool (PEMAT) for Audiovisual (A/V) Materials, the DISCERN score and Misinformation tool were used to assess video quality. According to YouTube™ Search the mean relative frequency search for "testicular pain" ranged from 10.5 to 30.0%. According to Google^TM Search it ranged from 73.7 to 91.0%, Of all 300 videos, 117 were eligible for the analysis. The median number of views, thumbs-up and thumbs-down was respectively: 47060 (interquartile range [IQR] = 6297.0-144188.0), 289 (IQR = 40-912) and 19 (IQR = 4-53). Of all videos, 68.4% and 31.6% were produced respectively by Medical Doctors and Other. The median PEMAT Actionability and Understandability scores were 66.7% and 66.7%, respectively. The median DISCERN score ranged from 1 to 5, with an overall median score of 3, defined from question 16. The median misinformation score ranged from 2 to 5. In conclusion, an increased interest on testicular pain was recorded on both YouTube^TM and Google search during the last decade. However, according to the quality assessment tools used, YouTube™ users cannot get trustful and exhaustive information on testicular pain. Therefore, authors with/without medical background should improve the quality of information on YouTube™ videos.

Cross-sectional and comparative analysis of videos on erectile dysfunction treatment on YouTube and TikTok

The aim of this study was to evaluate the quality of information regarding erectile dysfunction (ED) treatment on YouTube and TikTok. The term "erectile dysfunction" was searched on YouTube and TikTok in July 2021. The first 50 videos on each platform that met inclusion were included. Videos were sorted as reliable or unreliable based on accuracy of video content. Quality of information was evaluated using Patient Education Materials Assessment Tool (PEMAT) and 5-point modified DISCERN. TikTok videos were shorter (0.4 minutes vs. 5.2 minutes, p < 0.001) and had more likes (2294 vs. 1000, p = 0.005), views per month (17,281 vs. 3521, p < 0.001) and subscribers/followers (97,500 vs. 23,000, p = 0.016) than YouTube videos. TikTok videos were less reliable than YouTube videos (TikTok 5/50 [10%] vs. YouTube 21/50 [42%], p < 0.001). YouTube mentioned more about phosphodiesterase type 5 inhibitors (32% vs. 10%, p = 0.007), while TikTok mentioned more about alternative supplements (36% vs. 4%, p < 0.001). YouTube had a higher DISCERN (1.99 vs. 0.98, p < 0.001) and PEMAT actionability scores (64.2% vs. 54.0%, p = 0.039) when compared to TikTok. YouTube videos were of higher quality than TikTok videos. Nevertheless, YouTube had a considerable amount of unreliable information. We recommend a collaborative effort from the medical community to improve information regarding ED treatment on YouTube and TikTok.

Kidney Stone Surgery: Assessing Public Interest and Evaluating Social Media Content

An increasing number of patients are utilizing the internet to answer their medical questions. Given the lack of verified stone treatment resources on the web, we sought to evaluate online interest in kidney stone surgical interventions and assess the quality of the most popular resources on social media. Google Trends was used to evaluate public interest in different kidney stone interventions between March 2016 - February 2021 and reported as search volume index (SVI). Next, the social-analysis tool BuzzSumo was used to identify stone surgery content online on the social media platforms YouTube, Instagram, Twitter, Reddit, and Twitter. To evaluate the quality of health information presented in the online resources the DISCERN instrument was employed by three individual raters. Ureteroscopy (URS), Percutaneous Nephrolithotomy (PCNL) and Extracorporeal shock wave lithotripsy (ESWL) were identified as the top search terms on Google Trends with mean SVI's of 47.75, 42.98, and 45.74 respectively (P = 0.012). On YouTube, URS, PCNL, and ESWL had 12,549, 116,222, and 20,717 views respectively. Nine articles and fifteen videos were chosen for analysis using the DISCERN tool with a mean score of 2.82 and 2.27 respectively among three independent evaluators. The result of our study suggests that online users are interested in URS but engaged more often with PCNL content on social media platforms. We found that the quality of online resource related to stone surgery highlights the need for involvement of urologists in the creation of engaging high-quality content and accurate information sharing in a social media driven society.

Assessment of the Quality and Reliability of Intragastric Balloon Videos on YouTube

PURPOSE

There is no mechanism to control the accuracy and quality of videos on YouTube. However, it is essential to evaluate the quality of videos on YouTube to prevent patients from accessing misleading information. The aim of this study was to assess the quality and reliability of the videos available on YouTube concerning intragastric balloon.

MATERIALS AND METHODS

YouTube was searched using the keywords "intragastric balloon" and "gastric balloon." A total of 158 videos were independently analyzed by two bariatric surgeons-endoscopists and were classified as reliable or non-reliable. Video demographics (view, view per day, like, dislike, comment) were analyzed according to the quality and source of the video. The video power index (VPI) was calculated for each video. The modified DISCERN and global quality scores (GQS) were used to rate the reliability and overall quality of the videos.

RESULTS

Of the included videos, 63.9% were described reliable and 36.1% as non-reliable. The median number of dislikes, comments, views, views per day, and video duration on YouTube did not significantly differ between the two reliability groups. The mean length of the videos, GQS and DISCERN scores, and the median number of likes were significantly higher in the reliable group. The highest median VPI value was determined for the videos uploaded by TV programs.

CONCLUSION

The number of reliable videos is higher than non-reliable about intragastric balloon on YouTube. However, the reliability and quality of the videos are generally low. The videos uploaded by TV programs are significantly more popular.

[Sexual health information on social media: a systematic scoping review]

BACKGROUND

Information on sexual and reproductive health is increasingly disseminated via social media and reaches a large audience.

RESEARCH AIM

Against this background, the aim of this paper is to systematically summarize the international state of research on sexual health information on social media for the first time with a scoping review. Seven research questions were explored, relating to the amount (F1), methods (F2: content analysis, F3: quality analysis), and results (F4: providers, F5: target groups, F6: topics, F7: quality of information) of previous studies.

MATERIALS AND METHODS

The study follows the PRISMA framework for scoping reviews as well as the Open Science approach. It is preregistered, and all materials (codebook with reliability coefficients) and data (list of identified studies and coding of studies) are available on the Open Science Foundation server.

RESULTS

A total of 69 studies with 72 data sets were identified, with more than half of the publications referring to YouTube (F1). Qualitative and quantitative methods of content analysis are used equally (F2) and quality analyses are rare (F3). Health laypersons dominate as the information providers (F4). The target groups are mostly unspecified (F5). The health information on social media examined in the previous studies covers a broad range of topics (F6). Where quality assessments were made, they tended to be negative (F7).

DISCUSSION

More research is needed to better understand sexual and reproductive health information on social media and to promote its quality and constructive use.

Online Public Attention Toward Premature Ejaculation in Mainland China: Infodemiology Study Using the Baidu Index

BACKGROUND

Premature ejaculation (PE) is one of the most described psychosocial stress and sexual complaints worldwide. Previous investigations have focused predominantly on the prospective identification of cases that meet researchers' specific criteria. The genuine demand from patients with regard to information on PE and related issues may thus be neglected.

OBJECTIVE

This study aims to examine the online search trend and user demand related to PE on a national and regional scale using the dominant major search engine in mainland China.

METHODS

The Baidu Index was queried using the PE-related terms for the period of January 2011 to December 2020. The search volume for each term was recorded to analyze the search trend and demographic distributions. For user interest, the demand and trend data were collected and analyzed.

RESULTS

Of the 36 available PE search keywords, 4 PE searching topics were identified. The Baidu Search Index for each PE topic varied from 46.30% (86,840,487/187,558,154) to 6.40% (12,009,307/187,558,154). The annual percent change (APC) for the complaint topic was 48.80% (P<.001) for 2011 to 2014 and -16.82% (P<.001) for 2014 to 2020. The APC for the inquiry topic was 16.21% (P=.41) for 2011 to 2014 and -11.00% (P<.001) for 2014 to 2020. For the prognosis topic, the annual APC was 11.18% (P<.001) for 2011 to 2017 and -19.86% (P<.001) for 2017 to 2020. For the treatment topic, the annual APC was 14.04% (P<.001) for 2011 to 2016 and -38.83% (P<.001) for 2016 to 2020. The age distribution of those searching for topics related to PE showed that the population aged 20 to 40 years comprised nearly 70% of the total search inquiries (second was 17.95% in the age group younger than 19 years). People from East China made over 50% of the total search queries.

CONCLUSIONS

The fluctuating online popularity of PE searches reflects the real-time population demands. It may help medical professionals better understand population interest, population concerns, regional variations, and gender differences on a nationwide scale and make disease-specific health care policies. The internet search data could be more reliable when the insufficient and lagging registry data are completed.

A quality analysis of nocturnal enuresis videos on YouTube

INTRODUCTION

The internet is a popular area for collecting medical information and YouTube is one of the largest platforms used worldwide in this regard.

AIM

The aim of the study was to investigate the quality of nocturnal enuresis videos on YouTube.

STUDY DESIGN

In this cross-sectional study, a YouTube search was made by using the keyword "nocturnal enuresis" and the first 200 videos were examined according to their relevance. Video features (like, dislike, number of views, video length, upload source, etc.) were evaluated by 2 independent urologists. Individual correlations and inter-observer agreement of data for each video were statistically analyzed. The education quality of the mentioned videos was evaluated according to the JAMA, Global Quality Scale and DISCERN scoring system.

RESULTS

A total number of 93 videos were analyzed after they were sorted according to the exclusion criteria. Videos were uploaded by the physicians (49.5%) most commonly and the majority of their content was about etiology, symptoms and treatment (33.3%). Good agreement between the 2 urologists in terms of JAMA, GQS and DISCERN scores (0.84, 0.86 and 0.85, respectively) was determined. There was a positive correlation between the duration of the video and GQS/DISCERN scores. Of the 93 videos evaluated, 74 (80%) contained real images (video of the presenter) while 19 (20%) contained animation. There was no statistically significant correlation between the GQS, JAMA and DISCERN scores in terms of VPI values, view rate, number of comments, views, likes and dislikes (Summary Table). Of the 93 videos evaluated, 58% (n = 54) were of low quality, 16.2% (n = 15) were of intermediate quality, and 25.8% (n = 24) were of high quality according to GQS scale. There was a positive correlation between GQS, JAMA and DISCERN scores.

CONCLUSION

Unfortunately, most of the YouTube contents about nocturnal enuresis were determined to have poor quality. Therefore, the healthcare professionals must be aware of the importance of health-related information on YouTube and ensure the flow of correct medical information to patients.

YouTube as a source of information on gonadotropin self-injections

OBJECTIVE

To investigate the comprehensiveness, quality, and reliability of YouTube videos that target teaching patients gonadotropin self-injections.

STUDY DESIGN

Videos demonstrating gonadotropin self-injections were searched using the keywords "Gonal-f injection," "Puregon injection," "Menapur injection," "Merional injection," "Fostimon injection," and "Menagon injection," on December 20th, 2020. The videos were divided into two categories as including "useful information" and "misleading information" by two physicians. A 5-point global quality scale (GQS) and 5-point modified DISCERN scale were used for the assessments of quality and reliability, respectively.

RESULTS

Among 110 videos, 90 (81.8%) were found to include useful information and 20 (18.2%) were found to give misleading information. The kappa statistic for inter-observer agreement was 0.817 (p < 0.001). Useful videos were the most comprehensive and had the highest reliability and quality scores. We found that all videos uploaded by universities or professional organizations included useful information. However, there was no significant difference between useful and misleading videos regarding audience interaction analysis parameters (p > 0.05). On the other hand, mean reliability, GQS, and comprehensiveness scores were higher in the useful information group than in the other group. As the subgroup analysis was performed by source, patient opinion videos had lower reliability, comprehensiveness, and GQS scores than videos created by other sources (p < 0.001).

CONCLUSION

Our analysis revealed that there were a significant number of English-language YouTube videos, with high quality, rich content, and reliability that could be sources of information on the accurate technique of gonadotropin self-injections. However, some misleading information videos may lead to negative outcomes. Therefore, physicians should ensure that online sources are comprehensive and reliable for the use of their patients with infertility. Also, YouTube health videos should be checked for both reliability and ethical standards.

Correlation between Twitter mentions and academic citations in sexual medicine journals

Social media services, especially Twitter, are used as a commonly sharing tool in the scientific world. This widespread use of Twitter would be an effective method in spreading academic publications. So, we aimed to investigate the relationship between Twitter mentions and traditional citations of articles in sexual medicine journals in this study. We reviewed the articles published in seven journals of sexual medicine (2 years after the publication of the articles) between January 2018 and June 2018. In the first half of 2018, 410 articles were extracted. Of these, 352 (85.9%) were original articles, while 58 (14.1%) were review articles. The median number of citations of the articles mentioned at least once on Twitter was 7 (interquartile range: 0-111) for Google Scholar, whereas it was 0 (interquartile range: 0-63) for Scopus, respectively. It was 4 (interquartile range: 0-25) for Google Scholar and 0 (interquartile range: 0-7) for Scopus. The publications mentioned on Twitter were cited more than the non-mentioned publications in the traditional-based citation system (p < 0.001). A significant relationship between the citation numbers and tweet numbers was also observed (p < 0.001). Also, in the linear regression model, the tweet numbers (p < 0.001) and article types (p < 0.001) were found to be related to the Google Scholar citation numbers. In conclusion, using Twitter as a professional tool in academic life would allow information to be propagated and responded quickly, especially for sexual medicine journals.

Is social media reliable as a source of information on Peyronie's disease treatment?

Although YouTube video is one of the most widely used and easily accessible information sharing sources, its widespread use can carry the risk of spreading misleading and unreliable information. We aimed to evaluate the accuracy, reliability, quality, and content of the most viewed YouTube videos related to Peyronie's disease treatment. The keywords of "penile curvature", "penile deformity", "bent penis" "curved penis", and "Peyronie's disease" were searched on YouTube. Among 700 YouTube videos, 267 videos were included in the study. They were categorized by two independent urologists with board certification as accurate information (n = 138, 51.7%) or inaccurate information (n = 129, 48.3%). Accurate videos contained information about the treatment of Peyronie's disease with proven scientific accuracy according to the current guidelines, whereas inaccurate videos contained scientifically unproven or incorrect information and recommendations not in the guidelines. A 5-point modified DISCERN scale and Global Quality Score were used for reliability and quality assessment. Although the accurate information group had a significantly higher DISCERN Score (3, IQR = 3-4 vs. 1, IQR = 1-2, p < .001) and Global Quality Score (5, IQR = 4-5 vs. 2, IQR = 1-3 p < 0.001); the number of views per day (10.37, IQR = 3.01-28.12 vs. 6.65, IQR = 1.55-27.87) and likes (36, IQR = 6-145 vs. 19.5, IQR = 4-121.7) were higher but not significant in the inaccurate information group. The majority of the videos in the inaccurate information group were uploaded by medical advertisement/for profit companies (51.2%) and individual users/patients (38.8%), whereas universities/professional organizations/nonprofit physician/physician groups constituted the majority in the accurate information group (60.9%). According to our findings, videos containing inaccurate information are more popular. People should be made aware that they should not immediately believe the videos containing medical advertisements without consulting nonprofit physicians.

YouTube as a Patient Education Resource for Male Hypogonadism and Testosterone Therapy

Introduction

YouTube is an unregulated platform that patients are using to learn about treatment options.

Aim

To assess the reliability of YouTube videos (YTVs) related to male hypogonadism and testosterone therapy.

Methods

Searching on YouTube by relevance and view count, we analyzed the top 10 videos (80 videos total) for the following search terms: low testosterone, testosterone replacement therapy, AndroGel, and hypogonadism.

Main Outcome Measure

We recorded the number of views for each video, evaluated videos using the DISCERN score (DS) criterion, and compared the DS for videos including board-certified physicians and videos without. A second comparison was made between videos with board-certified physicians in urology, endocrinology, other MD, and those without any physician.

Results

The YTVs analyzed received a total of 38,549,090 views, a median of 25,201 and 17.30 views/day. Videos that featured physicians had significantly fewer views/day than videos that did not (39.48 CI 9,72 vs 1,731 CI 330, 3,132; P = .019). Most YTVs studied were unreliable. The median DS across all videos was 2. However, most videos created by physicians were found to be reliable with a median DS of 4. In addition, YTVs that did not feature a physician were found to be significantly less reliable than videos that featured a physician (3.22 CI 3.06, 4.09 vs 1.87 CI 1.56, 2.18; P < .001). There was no significant difference in the reliability or viewership of YTVs stratified by physician type.

Conclusion

Most YTVs related to male hypogonadism/testosterone therapy were unreliable, but there are reliable YTVs available. Reliable videos usually feature a physician and receive fewer views than unreliable YTVs. Physicians and academic societies should work to provide verified videos to provide patients with reliable information about male hypogonadism and testosterone therapy.

CJ Warren, J Wisener, B Ward, et al. YouTube as a Patient Education Resource for Male Hypogonadism and Testosterone Therapy. Sex Med 2021;9:100324.

Evaluation of YouTube Video Content Related to the Management of Hypoglycemia

Objective

Hypoglycemia is a syndrome characterized by decreased blood glucose levels and can result in morbidity and mortality. Often, patients seek information about hypoglycemia from the Internet and especially YouTube. The objective of this study was to investigate the quality and reliability of the 50 most viewed videos related to hypoglycemia on YouTube.

Methods

The links of 50 videos that met the criteria were copied to spreadsheet software. Attributes of the uploaders, the content of the videos, their screening time, the date they were uploaded, the number of days since the upload date, the number of daily views, comments, likes, dislike, and video power indexes were recorded. The videos were assessed by two independent emergency specialists using DISCERN and global quality scales (GQS).

Results

Of the selection, 27 (54%) videos were uploaded by health channels, 11 (22%) by physicians, nine (18%) by hospital channels, and three (6%) by patients. Furthermore, 30 (60%) of these 50 videos were real-content videos and 20 (40%) were animations. The average DISCERN score given by the researchers to 50 videos was 3.72 ± 0.90 (min-max: 1-5) and the average GQS score was 3.65 ± 0.88. Mean video power index (VPI) value was determined as 92.64 ± 11. According to Pearson’s analysis, there was a good agreement between the two observers.

Conclusion

Videos uploaded by physicians were useful. However, health videos should only be uploaded by physicians. Uploading videos with content that the patients and their relatives can clearly understand is of paramount importance.

YouTube: A good source for retrograde intrarenal surgery?

Purpose

To evaluate the quality of videos for retrograde intrarenal surgery (RIRS) on YouTube (Google, LLC) from the perspective of both patients and physicians.

Materials and Methods

All videos longer than 2 minutes returned by the YouTube search engine in response to the keyword search “retrograde intrarenal surgery” were included in this study. The quality of content was analyzed by using the validated Journal of the American Medical Association Benchmark Score (JAMAS) and the Global Quality Score (GQS). Two surgeons developed the RIRS Scoring System (RIRSSS) to evaluate the technical quality of the videos. A video power index (VPI) was used to score the popularity of the videos.

Results

A total of 63 videos with a median of 389 views were included in the present study. Forty-three videos (68.3%) were provided by health care professionals and 53 videos (84.1%) included technical aspects about RIRS. The median (interquartile range) GQS, JAMAS, RIRSSS, and VPI scores were 2 (1–3), 1 (1–2), 2 (1–5), and 0.41 (0.08–1.29), respectively. Videos with audio had significantly higher GQS and RIRSSS scores than did with videos with no audio (p<0.001, p=0.039, respectively). The GQS of videos providing general information about RIRS was higher, whereas RIRSSS scores were higher for videos detailing technical aspects (p=0.027, p=0.038, respectively).

Conclusions

The quality of YouTube videos containing information about RIRS evaluated in this study was very low. It is necessary for health care organizations to prepare online materials and upload these materials to popular social media platforms to convey accurate information to patients.

Xigua Video as a Source of Information on Breast Cancer: Content Analysis

Background

Seeking health information on the internet is a popular trend. Xigua Video, a short video platform in China, ranks among the most accessed websites in the country and hosts an increasing number of videos with medical information. However, the nature of these videos is frequently unscientific, misleading, or even harmful.

Objective

Little is known about Xigua Video as a source of information on breast cancer. Thus, the study aimed to investigate the contents, quality, and reliability of breast cancer–related content on Xigua Video.

Methods

On February 4, 2020, a Xigua Video search was performed using the keyword “breast cancer.” Videos were categorized by 2 doctors based on whether the video content provided useful or misleading information. Furthermore, the reliability and quality of the videos were assessed using the 5-point DISCERN tool and 5-point global quality score criteria.

Results

Out of the 170 videos selected for the study, 64 (37.6%) were classified as useful, whereas 106 (62.4%) provided misleading information. A total of 41.8% videos (71/170) were generated by individuals compared to 19.4% videos (33/170) contributed by health care professionals. The topics mainly covered etiology, anatomy, symptoms, preventions, treatments, and prognosis. The top topic was “treatments” (119/170, 70%). The reliability scores and global quality scores of the videos in the useful information group were high (P<.001). No differences were observed between the 2 groups in terms of video length, duration in months, and comments. The number of total views was higher for the misleading information group (819,478.5 vs 647,940) but did not reach a level of statistical significance (P=.112). The uploading sources of the videos were mainly health care professionals, health information websites, medical advertisements, and individuals. Statistical differences were found between the uploading source groups in terms of reliability scores and global quality scores (P<.001). In terms of total views, video length, duration, and comments, no statistical differences were indicated among the said groups. However, a statistical difference was noted between the useful and misleading information video groups with respect to the uploading sources (P<.001).

Conclusions

A large number of Xigua videos pertaining to breast cancer contain misleading information. There is a need for accurate health information to be provided on Xigua Video and other social media; health care professionals should address this challenge.

Making surgery safer in an increasingly digital world: the internet-friend or foe?

PURPOSE

The internet has resulted in huge efficiency gains in health care, the ability to deal with massive data accumulation and better manage patient data. However, potential and real pitfalls exist, including breeches in security of data and patient confidentiality, data storage issues, errors, and user interface issues.

METHODS

A MEDLINE review was performed using MeSH terms "health care" and "information technology." Cross-referencing was used to explore the different opportunities and challenges the internet has to offer.

RESULTS

As health professionals, we are fast adopting technologies at our fingertips, such as WhatsApp and video capabilities, into our clinical practice to increase productivity and improve patient care. However, the potential security breaches are significant for the health professional and health service. Further, electronic medical records have theoretical advantages to improve patient care, reduce medication errors, and expedite referrals. The downside is a less personalized approach to patient care, as well as the potential for these systems to be even more cumbersome. In regard to the acquisition of knowledge, there is no doubt the internet is our friend. Health care professionals as well as patients have unlimited resources for learning, including podcasts videos, apps, simulators, and wearable devices. Unfortunately, this comes with a risk of misinformation and poorly referenced data with little to no regulation of content.

CONCLUSION

In this increasing digital world, it is our task as health care providers to embrace these new technologies but develop guidelines and control systems to minimize the pitfalls.