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

#GenderAffirmingHormoneTherapy and Health Information on TikTok: Thematic Content Analysis

Background

Transgender and gender diverse people often turn to online platforms for information and support regarding gender-affirming hormone therapy (GAHT); however, analysis of this social media content remains scarce.

Objective

We characterized GAHT-related videos on TikTok to highlight the implications relevant to GAHT prescribers.

Methods

We used a web scraper to identify TikTok videos posted under the hashtags #genderaffirminghormonetherapy and #genderaffirminghormones as of November 2023. We identified recurrent themes via qualitative content analysis and assessed health education videos with the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V) scale and a modified Currency, Relevance, Authority, Accuracy, and Purpose (CRAAP) test.

Results

Out of 69 videos extracted, 71% (49/69) were created by GAHT users, 24.6% (17/69) were created by health care workers, and 21.7% (15/69) were created to provide health education. Themes included physical changes on testosterone, GAHT access, and combating misinformation and stigma surrounding GAHT. Health education videos scored highly on PEMAT-A/V items assessing understandability (mean 88.3%, SD 11.3%) and lower on actionability (mean 60.0%, SD 45.8%). On the CRAAP test, videos scored highly on the relevance, authority, and purpose domains but lower on the currency and accuracy domains.

Conclusions

Discussions of GAHT on TikTok build community among transgender and gender diverse users, provide a platform for digital activism and resistance against legislation that limits GAHT access, and foster patient-provider dialogue. Educational videos are highly understandable and are created by reliable sources, but they vary in terms of currency and quality of supporting evidence, and they lack in actionability.

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.

Nocturnal mouth-taping and social media: A scoping review of the evidence

OBJECTIVE

Across social media, nocturnal mouth-taping has been credited with benefits from increased energy and immunity to improved dental health. This scoping review summarizes the literature on mouth-taping and prominent social media claims pertaining to this practice.

DATA SOURCES

PubMed and Embase were searched using terms related to nocturnal mouth-taping. A search of TikTok was performed using the term "mouth taping."

REVIEW METHODS

Studies yielded by this literature search were reviewed for relevance and excluded if they did not assess mouth-taping during sleep. Study characteristics were extracted for analysis. TikTok videos discussing mouth-taping during sleep were evaluated, and videos lacking spoken or written words were excluded. The first fifty videos meeting inclusion and exclusion criteria were reviewed for claims regarding mouth-taping and presenter type.

RESULTS

One hundred and seventy-seven unique studies were identified; nine met inclusion and exclusion criteria. Two studies found significant improvements in obstructive sleep apnea (OSA) metrics, one with mouth-taping alone and one with mouth-taping plus a mandibular advancement device. A study of non-OSA patients reported improved snoring with mouth-taping combined with other measures. A study of mouth-taping in asthma found no benefit. However, one study found that mouth-taping effectively reduced mouth leak during bilevel ventilation. The most common proposed advantages of mouth-taping on TikTok were improved sleep and oral health.

CONCLUSION

This is the first comprehensive literature review on mouth-taping. The literature on this subject is markedly heterogeneous, and there is little consensus on mouth-taping's benefits. Few TikTok claims regarding the practice have been evaluated. However, some research indicates that mouth-taping may be advantageous in OSA, snoring, and bilevel ventilation. Additional high-quality research is necessary to elucidate the role and efficacy of this practice.

TikTok and pediatric nephrology: content quality assessment of videos related to pediatric kidney disease and kidney transplant

BACKGROUND

Social media platforms such as TikTok™ are key sources of health information for young patients and caregivers. Misinformation is prevalent on TikTok™ across healthcare fields, which can perpetuate false beliefs about medical care. Limited data exists on the reliability of pediatric nephrology TikTok™ content. This study aimed to describe the quality of medical content of TikTok™ Videos (TTVs), related to pediatric kidney disease and transplant.

METHODS

TTVs were selected using specific search terms and categorized into pediatric kidney disease and kidney transplant, excluding duplicate and adult-related content. The top 100 TTVs in each category, based on views, were analyzed. TTV characteristics were stratified by account type (physician, non-physician healthcare professional (HCP), non-HCP) and video aim (personal story, education, entertainment). DISCERN scoring, a validated questionnaire evaluating health information reliability, was conducted by 4 independent raters. Inter-rater reliability was assessed using a 2-way random effects model, and differences between content creator types were evaluated using one-way ANOVA and post-Hoc Tukey test.

RESULTS

TTVs had a total of 12.5 million likes and 113.1 million views. Over 70% of videos were created by non-HCPs (n = 147/200). DISCERN scoring revealed low reliability of medical information across content creator types. TTVs created by physicians and non-physician HCPs about kidney disease had significantly higher mean DISCERN scores compared to those created by non-HCPs (2.85, p < 0.001 and 2.48, p = 0.005, respectively).

CONCLUSIONS

Educators within the pediatric nephrology community must keep in mind the lack of reliability of medical information available on TikTok™ and coordinate collective efforts to consider utilizing TikTok™ for patient education.

Health-related Internet Use Among New Urology Clinic Patients

OBJECTIVE

To assess internet usage among new patients seen by urologists and impact on post-consultation understanding for 4 common conditions: kidney stones, elevated prostate-specific antigen, male voiding, and female voiding.

METHODS

We performed a prospective study of new urology patients at our diverse urban, academic urology practice for the above conditions over a 1-year period. A voluntary questionnaire assessed patients' internet use related to referred conditions prior to encounters. Questions evaluated quality of information and patient understanding of symptoms/condition at baseline, after online searches, and after their urology visit. A patient-reported Likert scale of 1 (poor) to 10 (excellent) was used and internet "searchers" were compared to "non-searchers."

RESULTS

Two hundred fifteen patients participated. Most respondents were Latino (41%) or Black (35%) and English-speaking (81%). Cohorts comprised 130 searchers (60%) and 85 non-searchers (40%). Searchers were significantly younger (median 53 vs 63 years, P <.001), more likely to have home internet access (P <.001), and more general medical internet use (P <.001). Overall, patients' understanding of visit diagnoses increased after their encounters (median pre-visit rating 5 vs post-visit rating 10). Searchers reported a greater post-visit understanding compared to non-searchers (median rating 10 vs 9, P <.001), and a greater change in understanding from baseline (median +4 vs +3, P = .02).

CONCLUSION

Internet use is common amongst younger patients referred to urologists and may be associated with improved understanding of their condition after urologic consultation. Continued investigation of patient uses and attitude towards popular online resources can help urologists curate resources to benefit patients and providers alike.

Quality and benefits of the erectile dysfunction information on websites, social-media, and applications

Erectile Dysfunction (ED) is defined as the persistent inability to obtain and maintain an erection that enables satisfactory sexual intercourse. ED prevalence vary across age groups, affecting approximately 1-9% of men under 40, 2-9% of those aged 40-59, and increasing to 20-40% for those aged 60-69. However, it remains a frequently untreated or insufficiently treated condition. Especially due to the feeling of discomfort and guilt, patients often avoid consulting their physicians; in this context, digital innovation could potentially play a pivotal role in the diagnosis and management of ED. This narrative review depicts the ongoing status of digital innovations in ED focusing on websites, social media platforms and mobile health applications (MHA). We examined Google, social media platforms (Facebook, Twitter, YouTube, and TikTok), and the recently developed MHA apps on Google Play Store and Apple App Store. Websites provide readily available but sometimes difficult to understand information, while social media is easy to understand and act on. MHA apps are the most complete and trustworthy tool for self-care management. In conclusion, digital innovations are a continuously growing source of information and therapeutic tools.

Analysis of patient education materials on TikTok for erectile dysfunction treatment

Erectile dysfunction (ED) is widely prevalent and has diverse management options which are poorly understood and accessed by patients. This cross-sectional TikTok study aimed to evaluate the quality of ED educational materials and define trends in healthcare provider content development. Three reviewers independently analyzed 50 videos. Variables of interest included author characteristics, viewer engagement, content accuracy, and video quality, understandability, and actionability. Quantitative analysis was performed using the validated PEMAT and DISCERN screening tools. A wide range of treatment options were presented among the 26 healthcare and 24 non-healthcare videos, including behavioral techniques, herbs/ supplements, dietary modifications, pharmacology, and interventions. Healthcare authors tended to focus on pharmacology and intervention, and when they did discuss behavioral, herbal, or dietary options, accuracy significantly exceeded non-healthcare authors (96.2% vs. 12.5%, p < 0.001). Although healthcare-authored videos were superior in accuracy and understandability scores (p < 0.001), they had low actionability and reduced user engagement including likes (1195 vs. 4723, p = 0.050) and bookmarks (114 vs. 839, p = 0.010). Our findings indicate that despite the availability of high-quality ED treatment resources created by healthcare professionals on TikTok, engagement and actionability remain alarmingly low. Furthermore, there is substantial, readily accessible misinformation produced by non-healthcare entities. Modernized medical education paradigms, communications research, and awareness may optimize social media as a public health tool.

Evaluating HPV Vaccination-Related Content on a Burgeoning Social Media Platform: Insufficient Quality of TikTok

Objective

Assessing the quality of human papillomavirus (HPV) vaccination-related content on TikTok is crucial due to its popularity among adolescents. We assessed these videos while comparing the content and quality of videos with and without physician involvement.

Study Design

Cross-sectional cohort analysis.

Setting

HPV vaccination-related TikTok videos.

Methods

The TikTok library was queried using the search terms #HPVvaccine, #HPVvaccination, #Gardasil, #Gardasilvaccine, and #Gardasilvaccination. Video quality was evaluated using the DISCERN scale, assessing treatment-related information quality. Descriptive statistics were used to characterize our cohort. t Test and Fischer's exact test were used to assess for differences in video content and quality based on physician involvement. Significance was set at P < .05.

Results

Our search yielded 131 videos, averaging 68,503.12 views, 2314.27 likes, and 89.28 comments per video. Videos frequently involved physicians (48.09%), focused on education (54.96%) or advocacy (22.90%), and were US-made (68.90%). Otolaryngologists were rarely featured (3.17%). While most videos mentioned the HPV vaccine protected against cancer generally (86.26%), and cervical cancer specifically (67.94%), few discussed its protective effect against head and neck cancer (26.72%). Videos infrequently discussed updated eligibility among all adults ≤45 years of age (26.72%) or that men can also receive the vaccine (28.24%). Physician-involved videos were more focused on education (P < .001) and focused less on patient experiences (P < .001) and advocacy (P = .036). Overall DISCERN scores were low among physician (mean = 2.46, SD = 1.13) and nonphysician (mean = 2.09, SD = 1.02) content.

Conclusion

TikTok HPV vaccination content is poor in quality, even with physician involvement. Enhancing content quality and increasing otolaryngologist participation can boost HPV awareness and vaccination rates.

An analysis of oral contraceptive related videos on TikTok

Background

TikTok has increasingly become a source of information about reproductive health. Patients seeking health information about oral contraception on TikTok may be influenced by videos containing misinformation or biased information.

Objective

This social media infodemiological study aims to provide a descriptive content analysis of the quality and reliability of oral contraceptive health information on TikTok.

Study Design

Researchers screened 1,000 TikTok videos from December 2022 to March 2023 retrieved under various search terms related to oral contraceptives. Data, including engagement metrics such as views, likes, comments, saves, and shares, were recorded. Video content including contraceptive methods discussed, efficacy, tolerability, and side effects were recorded. Two reviewers independently used a modified DISCERN criteria and Global Quality Scale (GQS) to assess the quality and reliability of information for each video.

Results

Five hundred seventy-four videos were analyzed after applying exclusion criteria. Videos had a median length of 27 seconds (Q1=13sec, Q3=57sec) and received a median of 35,000 total views (Q1=4856 views, Q3=411,400 views) and 166 views per day (Q1=28 views per day, Q3=2021 views per day). Video creators were 83.3% female and 58.7% white. The mean modified DISCERN score was 1.63 (SD=1.06) and the mean GQS score was 2.28 (SD=1.37). Video creators were 83.3% female and 58.7% white. The mean modified DISCERN score was 1.63 (SD=1.06) and the mean GQS score was 2.28 (SD=1.37). The most common topic discussed in the videos was the effects of contraception. Healthcare professionals had significantly higher DISCERN and GQS scores (p<.001) than non-healthcare professionals. However, they received fewer views, likes, and comments on their videos (p<.001). Healthcare professionals were 86 times more likely than non-healthcare professionals to post educational videos (p<.001). However, non-educational content received significantly more views, likes, and comments than educational content (p<.001).

Conclusion

TikTok videos related to oral contraceptive health had low quality and reliability of information. The majority of videos were made by non-healthcare providers, and the most common topic discussed was the effects of contraception. Videos made by healthcare professionals contained more reliable contraceptive information, but received less engagement than videos made by non-healthcare professionals. Healthcare providers should consider the prevalence of poor-quality information about oral contraceptives on social media when counseling and educating patients about reproductive health.

The evaluation and analysis of irritable bowel syndrome-related short videos on social media (TikTok)

BACKGROUND

TikTok is one of the fastest growing social media platforms. Irritable bowel syndrome (IBS) has recently become a trending topic of interest among TikTok users.

AIM

To better understand the quality and accuracy of information presented in the most popular IBS-relevant videos on TikTok.

METHODS

We reviewed videos with the tag 'IBS'. We excluded those not relevant to IBS or lasting <10 s or >10 min. Baseline characteristics about the videos were collected. Two independent reviewers assessed each video using DISCERN and Patient Education Materials and Assessment Tool (PEMAT) tools, two validated instruments to assess the quality of patient education materials.

RESULTS

Of 100 videos, 33% were uploaded by participants with a defined medical background. The median DISCERN score of videos uploaded by participants with a medical background was 2.43 (2.00-3.10); from participants with a non-medical background, it was 1.37 (1.23-1.70) (p < 0.01). The median PEMAT Understandability scores of videos uploaded by participants with or without a medical background were 92.86 (86.61-95.00) and 80.95 (75.76-89.58), respectively (p < 0.01). The median PEMAT Actionability scores of videos uploaded by participants with or without a medical background were 100.00 (66.67-100.00) and 0.00, respectively (0.00-45.83; p < 0.01).

CONCLUSION

Videos posted by medical professionals are easier to understand and to act on, and are more reliable and unbiased, and more likely to recommend shared decision making about treatment.

YouTube/ Bilibili/ TikTok videos as sources of medical information on laryngeal carcinoma: cross-sectional content analysis study

BACKGROUND

YouTube, a widely recognized global video platform, is inaccessible in China, whereas Bilibili and TikTok are popular platforms for long and short videos, respectively. There are many videos related to laryngeal carcinoma on these platforms. This study aims to identify upload sources, contents, and feature information of these videos on YouTube, Bilibili, and TikTok, and further evaluate the video quality.

METHODS

On January 1, 2024, we searched the top 100 videos by default sort order (300 videos in total) with the terms "laryngeal carcinoma" and "throat cancer" on YouTube, "" on Bilibili and TikTok. Videos were screened for relevance and similarity. Video characteristics were documented, and quality was assessed by using the Patient Education Materials Assessment Tool (PEMAT), Video Information and Quality Index (VIQI), Global Quality Score (GQS), and modified DISCERN (mDISCERN).

RESULTS

The analysis included 99 YouTube videos, 76 from Bilibili, and 73 from TikTok. Median video lengths were 193 s (YouTube), 136 s (Bilibili), and 42 s (TikTok). TikTok videos demonstrated higher audience interaction. Bilibili had the lowest ratio of original contents (69.7%). Treatment was the most popular topic on YouTube and Bilibili, while that was the prognosis on TikTok. Solo narration was the most common video style across all platforms. Video uploaders were predominantly non-profit organizations (YouTube), self-media (Bilibili), and doctors (TikTok), with TikTok authors having the highest certification rate (83.3%). Video quality, assessed using PEMAT, VIQI, GQS, and mDISCERN, varied across platforms, with YouTube generally showing the highest scores. Videos from professional authors performed better than videos from non-professionals based on the GQS and mDISCERN scores. Spearman correlation analysis showed no strong relationships between the video quality and the audience interaction.

CONCLUSIONS

Videos on social media platforms can help the public learn about the knowledge of laryngeal cancer to some extent. TikTok achieves the best flow, but videos on YouTube are of the best quality. However, the video quality across all platforms still needs enhancement. We need more professional uploaders to ameliorate the video quality related to laryngeal carcinoma. Content creators also should be aware of the certification, the originality, and the style of video shooting. As for the platforms, refining the algorithm will allow users to receive more high-quality videos.

Quality assessment of health science-related short videos on TikTok: A scoping review

OBJECTIVE

The aims of this review are to clarify the current state of research in terms of assessment tools and assessors of the quality of health science-related short videos on TikTok, to identify limitations in existing research; and to provide a reference for future studies.

METHODS

A scoping review was conducted. The Cochrane Library, PubMed, MEDLINE, Web of Science, Embase, Scopus, EBSCO, CNKI, VIP, Wanfang Data, and CBM databases were searched from September 2016 to November 2022. Manual searching was also performed to identify additional eligible studies. A total of 2620 documents were initially retrieved, and 29 were ultimately included. The literature was screened and collected, and data were extracted and summarized by 2 researchers.

RESULTS

(1) The quality evaluation tools used in the 29 papers included the DISCERN, PEMAT(A/V), GQS, JAMA, HONcode, guidelines and self-developed tools. Twenty-four of the included articles used the DISCERN for quality assessment, which was the most frequently used evaluation tool. However, most of these tools were not developed to assess health science-related short videos, lacked credibility tests, and had poor applicability; therefore, the accuracy of the evaluation results might be biased. (2) The assessors of the quality of health science-related short videos on TikTok were mainly experts in related fields and medical students, with doctors (12/14) being the most common evaluators. Fifteen studies did not report the identity of the evaluators, and 12 studies did not report interrater reliability.

CONCLUSION

This scoping review found that there is a lack of specific quality assessment tools for health science-related short videos on TikTok. Second, the current quality assessors of health science-related short videos on TikTok are limited. Future research should focus on the development of reliable, scientific quality assessment tools for health science-related short videos; unifying the evaluation standards; inviting users with different backgrounds and different health literacy levels to conduct quality assessments; exploring the quality assessment of health science-related short videos on TikTok from different perspectives.

Evaluation of TikTok videos on acute pancreatitis: content quality and reliability analysis

BACKGROUND

Acute pancreatitis (AP) is a common acute digestive system disorder, with patients often turning to TikTok for AP-related information. However, the platform's video quality on AP has not been thoroughly investigated.

OBJECTIVE

The main purpose of this study is to evaluate the quality of videos about AP on TikTok, and the secondary purpose is to study the related factors of video quality.

METHODS

This study involved retrieving AP-related videos from TikTok, determining, and analyzing them based on predefined inclusion and exclusion criteria. Relevant data were extracted and compiled for evaluation. Video quality was scored using the DISCERN instrument and the Health on the Net (HONcode) score, complemented by introducing the Acute Pancreatitis Content Score (APCS). Pearson correlation analysis was used to assess the correlation between video quality scores and user engagement metrics such as likes, comments, favorites, retweets, and video duration.

RESULTS

A total of 111 TikTok videos were included for analysis, and video publishers were composed of physicians (89.18%), news media organizations (13.51%), individual users (5.41%), and medical institutions (0.9%). The majority of videos focused on AP-related educational content (64.87%), followed by physicians' diagnostic and treatment records (15.32%), and personal experiences (19.81%). The mean scores for DISCERN, HONcode, and APCS were 33.05 ± 7.87, 3.09 ± 0.93, and 1.86 ± 1.30, respectively. The highest video scores were those posted by physicians (35.17 ± 7.02 for DISCERN, 3.31 ± 0.56 for HONcode, and 1.94 ± 1.34 for APCS, respectively). According to the APCS, the main contents focused on etiology (n = 55, 49.5%) and clinical presentations (n = 36, 32.4%), followed by treatment (n = 24, 21.6%), severity (n = 20, 18.0%), prevention (n = 19, 17.1%), pathophysiology (n = 17, 15.3%), definitions (n = 13, 11.7%), examinations (n = 10, 9%), and other related content. There was no correlation between the scores of the three evaluation tools and the number of followers, likes, comments, favorites, and retweets of the video. However, DISCERN (r = 0.309) and APCS (r = 0.407) showed a significant positive correlation with video duration, while HONcode showed no correlation with the duration of the video.

CONCLUSIONS

The general quality of TikTok videos related to AP is poor; however, the content posted by medical professionals shows relatively higher quality, predominantly focusing on clinical presentations and etiologies. There is a discernible correlation between video duration and quality ratings, indicating that a combined approach incorporating the guideline can comprehensively evaluate AP-related content on TikTok.

YouTube™ as a source of information on prostatitis: a quality and reliability analysis

It was aimed to analyze the YouTube™ videos on prostatitis regarding their source, content, and information included. The term "prostatitis" was searched by relevance and the first 200 video links and features were recorded. Using the 5-point modified DISCERN tool, Global Quality Score (GQS), and Journal of American Medical Association (JAMA) score, the quality and reliability of the information were assessed by two urologists. Inter-rater agreement for DISCERN, JAMA, and GQS had Cohen's kappa coefficients of 0.883, 0.887, and 0.885, respectively. The most common source of upload was doctors/medical institutions (33.0%), and the majority of the content was about general information (27.0%). The mean modified DISCERN, GQS and JAMA scores were 3.24 ± 1.23 (1.00-5.00), 3.25 ± 1.26 (1.00-5.00) and 2.17 ± 1.36 (0.00-4.00), respectively. These scores were correlated with each other (r = 0.914, p < 0.001 between JAMA and GQS; r = 0.954, p < 0.001 between JAMA and modified DISCERN; and r = 0.885, p < 0.001 between GQS and modified DISCERN, Spearman test) and were the highest in the videos uploaded by doctors/medical institutions (p < 0.001, Kruskal-Wallis test). Of the videos, 25.5% were poor, 30.5% were moderate and 44.0% were high quality. The high quality videos were significantly shorter than those with poor quality (p = 0.039, Kruskal-Wallis test). The poor quality videos had the highest view ratio (50.49 ± 127.74 (0.03-618.91), p = 0.036, Kruskal-Wallis test). Most YouTube™ videos on prostatitis are short and high quality videos uploaded by doctors/medical institutions. However, these videos have less view ratios than those with poor quality.

The broad reach and inaccuracy of men's health information on social media: analysis of TikTok and Instagram

Social media (SoMe) offers great potential to expand access to health information, but a significant proportion of users consume its content instead of consulting a physician. We sought to quantify the volume and characterize the accuracy of men's health-related content on TikTok and Instagram. We searched TikTok and Instagram for the terms: testosterone, erectile dysfunction, male infertility, semen retention, Peyronie's disease, and vasectomy. The top 10 hashtags for each term were used to estimate the total impressions for each term on each platform, and posts were then characterized by creator type, content type, and accuracy (1 to 5 scale). TikTok had 2,312,407,100 impressions and Instagram had 3,107,300 posts across all topics. Semen retention had the most impressions on TikTok (1,216,074,000) and posts on Instagram (1,077,000). Physicians created only a small portion of total TikTok and Instagram posts (10.3% and 12.9%, respectively). Across all topics, the accuracy of content was poor (2.6 ± 1.7), however, physician posts were more accurate than non-physician posts (mean 4.2 ± 1.2 vs 2.3 ± 1.6, p < 0.001, respectively). Men's health content is popular on TikTok and Instagram but is not accurate. We recommend that physicians actively engage in SoMe to address misinformation.

Scrolling for Answers About Breast Implant Illness: Application of Validated Tools to Assess the Quality of Content on YouTube and TikTok

Introduction: Popular video-sharing platforms YouTube and TikTok offer a plethora of information on the topic of breast implant illness (BII). As a largely patient-driven phenomenon, it is important to understand the influence of social media on patient knowledge regarding BII. This study sought to evaluate the quality, reliability, visibility, and popularity of YouTube and TikTok videos about BII. Methods: Two validated tools for health information, DISCERN and the Patient Education Materials Assessment Tool (PEMAT), were utilized to evaluate the quality of information regarding the topic of BII on YouTube and TikTok. High DISCERN score indicates content of superior quality and reliability, while elevated PEMAT scores signify content that is easily understandable and actionable for viewers. The search phrase "breast implant illness" was used to screen videos, which were sorted based on relevance and view count. The first 100 videos that fulfilled inclusion criteria were independently graded by three reviewers. Results: TikTok videos of longer duration, a higher number of shares, and in the patient education category were all significantly associated with a higher total DISCERN score (P < 0.05). YouTube videos that included a provider or a patient were significantly more likely to have a higher total DISCERN and PEMAT understandability score (all P < 0.05). Discussion of physician education, operation details, and patient experience was significantly associated with higher total DISCERN and PEMAT understandability scores (all P < 0.05). Conclusions: Total DISCERN and PEMAT scores for videos regarding BII on two popular social media platforms are low. Video length, patient experience categorization, and the presence of a provider are worth considering when developing high-quality online content for breast reconstruction and augmentation patients.

Understanding PCOS-Related Content across Social Media Platforms-A Cross-Sectional Analysis

INTRODUCTION

Polycystic ovarian syndrome (PCOS) is commonly diagnosed in adolescence, and information about the condition is often shared online. We aimed to assess the extent, content, and engagement of PCOS-related information across social media platforms.

METHODS

We performed a cross-sectional content analysis of PCOS-related posts on TikTok, Instagram, and Reddit. Top PCOS posts were collected from TikTok and Instagram (N = 100). Two researchers independently coded all posts using a codebook including symptoms, interventions, and qualities. Logistic regression assessed the relationship between user engagement and creator conflicts of interest. On Reddit, posts from 2020 to 2022 (N = 34,208) were collected. Topic modeling using latent Dirichlet allocation and non-negative matrix factorization (NMF) was applied to discover topics in the textual data.

RESULTS

PCOS content received high engagement across all platforms, with an average of 1.8 million views on TikTok. "Weight" and "Diet" were the most frequently mentioned topics on TikTok and Instagram, and interactions with medical providers were discussed in 30% of posts. A financial conflict of interest was present in 45% of TikTok posts and 89% of Instagram posts. NMF identified 15 coherent topics, including symptoms, interventions, interactions with the medical system, and information-seeking. Reddit posts under "Symptom Management" received the most comments.

DISCUSSION

PCOS content is present and pervasive across social media platforms, suggesting the ability of information from non-clinician sources to reach and engage with a large population using novel modes of health information sharing. Further studies of this content will allow for a deeper understanding of patient perceptions, misconceptions, and knowledge of PCOS, with the potential to inform patient-centered counseling.

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.

A cross-sectional quality assessment of TikTok content on benign prostatic hyperplasia

BACKGROUND

With an increasing reliance on online sources for medical information, we studied the quality and completeness of health literacy videos on TikTok regarding BPH.

METHODS

A cross-sectional systematic evaluation of TikTok videos using the search term "Benign Prostatic Hyperplasia" was performed on 14th April 2023, and included 49 patient information and educational videos. The videos were then analysed by two reviewers and scored using two instruments: the DISCERN instrument and a completeness analysis.

RESULTS

Of the 49 videos, 38 were created by healthcare professionals (HCPs). The average length of each video was 62.7 ± 59.3 s, with a large average number of total views (24,990.1 ± 109,534.9 views). The DISCERN score trended higher in every category in videos published by HCPs compared to non-HCPs, with HCPs providing a statistically significant increase in reliability (19.0,14.6, p < 0.05) and total score (29.4,23, p < 0.05). Majority of videos were deemed as poor or worse (91.8%) in quality. The completeness of the videos' content was also evaluated across five categories with an average score of 2.53 ± 2.1 out of the maximum 12. The DISCERN scores did not correlate with the degree of completeness of the videos (r = 0.226).

CONCLUSION

BPH videos on TikTok have a wide reach, but the videos are mostly of low quality and completeness. Future videos should be made with quality and completeness in mind given the large viewership and more can be done to evaluate the extent of BPH misinformation and its impact on patients.

Evaluation of the quality and reliability of anal cancer and its precancerous lesions-related content on YouTube: a cross-sectional study

OBJECTIVES

This research aims at evaluating the quality of anal cancer and its precancerous lesions-related videos on YouTube.

DESIGN

Cross-sectional survey design.

SETTING

USA.

PARTICIPANTS

The top 150 videos on YouTube were selected for analysis based on three search terms. The duplicate, irrelevant, commercial, operation-related and audio-free videos were excluded. Finally, 105 relevant videos were included.

METHODS

We assessed the completeness of video content from six dimensions and marked the men having sex with men (MSM)-related videos. To measure the video quality, DISCERN, Journal of the American Medical Association (JAMA) Benchmark Criteria, Patient Education Materials Assessment Tool (PEMAT) and Global Quality Scale (GQS) were used. The correlation between DISCERN classification and duration, JAMA, PEMAT and GQS scores were recorded.

RESULTS

The video content was mainly about the management of the disease (mean score 1.086). Overall, the quality of videos uploaded by the non-profit organisation was relatively high. A correlation existed between each other of the JAMA, DISCERN and GQS scores (p<0.001). Moreover, they were positively correlated with video duration and PEMAT scores (p<0.001).

CONCLUSIONS

Although the overall quality of information about anal cancer and its precancerous lesions videos on YouTube is acceptable, it might not fully meet the health information needs of patients. Therefore, they should exercise caution when using YouTube as a source of anal cancer-related information, especially the MSM population.

Content Quality of Web-Based Short-Form Videos for Fire and Burn Prevention in China: Content Analysis

BACKGROUND

Web-based short-form videos are increasingly popular for disseminating fire and burn prevention information, but their content quality is unknown.

OBJECTIVE

We aimed to systematically assess the characteristics, content quality, and public impact of web-based short-form videos offering primary and secondary (first aid) prevention recommendations for fires and burns in China between 2018 and 2021.

METHODS

We retrieved short-form videos offering both primary and secondary (first aid) information to prevent fire and burn injuries published on the 3 most popular web-based short-form video platforms in China: TikTok, Kwai, and Bilibili. To assess video content quality, we calculated the proportion of short-form videos that included information on each of the 15 recommendations for burn prevention education from the World Health Organization (WHO; P1) and that correctly disseminated each recommendation (P2). High P1 and P2 indicated better content quality. To assess their public impact, we calculated the median (IQR) of 3 indicators: the number of comments, likes, and saves as a favorite by viewers. Chi-square test, trend chi-square test, and Kruskal-Wallis H test examined differences in indicators across the 3 platforms, years, content, and time duration of videos and between videos disseminating correct versus incorrect information.

RESULTS

Overall, 1459 eligible short-form videos were included. The number of short-form videos increased by 16 times between 2018 and 2021. Of them, 93.97% (n=1371) were about secondary prevention (first aid) and 86.02% (n=1255) lasted <2 minutes. The proportion of short-form videos including each of the 15 WHO recommendations ranged from 0% to 77.86% (n=1136). Recommendations 8, 13, and 11 had the highest proportions (n=1136, 77.86%; n=827, 56.68%; and n=801, 54.9%, respectively), whereas recommendations 3 and 5 were never mentioned. Among the short-form videos that included the WHO recommendations, recommendations 1, 2, 4, 6, 9, and 12 were always disseminated correctly, but the other 9 recommendations were correctly disseminated in 59.11% (120/203) to 98.68% (1121/1136) of videos. The proportion of short-form videos including and correctly disseminating the WHO recommendations varied across platforms and years. The public impact of short videos varied greatly across videos, with a median (IQR) of 5 (0-34) comments, 62 (7-841) likes, and 4 (0-27) saves as a favorite. Short-form videos disseminating correct recommendations had larger public impact than those disseminating either partially correct or incorrect knowledge (median 5 vs 4 comments, 68 vs 51 likes, and 5 vs 3 saves as a favorite, respectively; all P<.05).

CONCLUSIONS

Despite the rapid increase in the number of web-based short-form videos about fire and burn prevention available in China, their content quality and public impact were generally low. Systematic efforts are recommended to improve the content quality and public impact of short-form videos on injury prevention topics such as fire and burn prevention.

Assessment of quality, absorbability, and educational value of YouTube videos regarding ankle fractures

Aims & objectives

YouTube is a non-peer-reviewed platform with a large library of healthcare-related videos which attempt to provide educational content. The goal of this study is to analyze the quality, absorbability, and educational content of videos available to patients on YouTube regarding ankle fractures.

Materials & methods

On May 31, 2022, over 550 videos populated the initial search of "ankle fracture" within YouTube's platform. The first 100 videos were reviewed, and 62 videos were included in the final analysis. Video characteristics were recorded and evaluated. Videos were assessed using three objective scoring systems: (1) the Journal of American Medical Association (JAMA) benchmark criteria, (2) the Patient Education Materials Assessment Tool for audio and visual materials (PEMAT), and (3) the novel Ankle Fracture Content Score (AFCS).

Results

Each scoring system had high internal consistency and interrater reliability. The mean JAMA, PEMAT understandability, PEMAT actionability, and AFCS were 2.92, 61.85%, 16.38%, and 4.67, respectively. No association was seen between video popularity metrics and quality of information. The understandability of the patient-targeted videos was greater than those targeted at healthcare professionals (P = 0.049).

Conclusion

The information regarding ankle fractures available on YouTube for patient education is poor with no correlation between quality and popularity. This study illustrates the need for future collaboration between YouTube and trusted medical societies to provide patients with the highest quality information.

Accuracy of prostate cancer screening recommendations for high-risk populations on YouTube and TikTok

Objectives

This study aimed to evaluate content quality and racial/ethnic representation, particularly of high-risk cohorts, of prostate cancer screening videos on YouTube (YT) and TikTok (TK).

Materials and Methods

The top 50 videos populated for the search term 'prostate cancer screening' on YT and TK that met inclusion criteria were retrieved in a cache-cleared browser. Three reviewers analysed all videos using validated criteria for the quality of consumer health information (DISCERN and Patient Education Materials Assessment Tool [PEMAT]). High quality was defined as follows: DISCERN ≥ 4, PEMAT understandability ≥75% and PEMAT actionability ≥75%. A 5-point Likert scale was used to demonstrate the level of misinformation compared to American Urological Association and National Comprehensive Cancer Network guidelines. Perceived race and ethnicity of people in the videos were assessed by consensus approach.

Results

TK videos were shorter (median 3.7 vs. 0.5 min, p < 0.001) and had more views per month (5437.5 vs. 19.3, p = 0.03) than YT videos. Perceived Black and Hispanic representation was present in 10% and 6% of YT videos and 20% and 12% of TK videos, respectively. High-risk racial/ethnic groups were explicitly discussed in 46% of YT videos and 8% of TK videos. A total of 98% of YT videos and 100% of TK videos had low- to moderate-quality consumer health information, and 88% of YT videos and 100% of TK videos had moderate to high levels of misinformation based on screening guidelines.

Conclusions

YT and TK videos about prostate cancer screening are widely viewed but do not provide quality consumer health information. Black and Hispanic men remain under-represented on both platforms, and high-risk racial groups were not discussed in most videos despite the importance for screening criteria. The low understandability and actionability, significant misinformation and lack of diversity in online videos support the need for higher quality videos with adequate attention to high-risk ethnic cohorts.

The Assessment of TikTok as a Source of Quality Health Information on Varicoceles

OBJECTIVE

To evaluate the quality of varicocele information on TikTok, a popular video platform that adolescent patients are now turning to as a source of medical information before visiting a doctor.

METHODS

Using the key word "varicocele," we retrieved the top 225 videos listed on TikTok in May 2022. We extracted general video and engagement data. Video information was coded and analyzed for the completeness of different types of content (definition, symptoms, evaluation, management, and outcomes). The quality of consumer health information was rated using the DISCERN instrument.

RESULTS

Thirty-six videos met inclusion criteria; 17 were created by general users, 16 by healthcare professionals or systems (2 by urologists), and 3 by scientific communities. Healthcare professionals had more views than non-healthcare (P = .05). The quality of health information using the DISCERN instrument was "poor" from health care professional videos and "very poor" from non-health care professionals. However, the quality of information provided by healthcare professionals was statistically better than that of non-healthcare (P< .05). Video content mainly focused on symptoms: 50% of videos from healthcare providers had some or extensive content and 41% of non-healthcare had some content. 23% of videos had misinformation.

CONCLUSION

The overall quality of information for varicoceles on TikTok is not acceptable and does not meet patient needs. It is imperative that urologists create robust, accurate content, and partner with these platforms to connect users with higher quality information. TikTok users should also be mindful that information may not be medically accurate.

Quality of Internet Videos Related to Pediatric Urology in Mainland China: A Cross-Sectional Study

Background

Pediatric urological diseases pose serious threats to children's physical and mental health. The COVID-19 pandemic has resulted in poor pediatric outcomes for cryptorchidism, hypospadias, and testicular torsion. Presently, many people tend to seek health information via social media platforms. This study aims to quantitatively assess the quality of videos as an information source for pediatric urology in mainland China.

Methods

In this cross-sectional study, a search was performed on social media platforms (Tiktok, Bilibili, and Weibo) with the search terms “cryptorchidism”, “hypospadias”, and “testicular torsion”. The first 30 results with any search term listed by relevance were selected in each platform. Video features (duration, number of likes, comments, and shares) and video sources were collected. Each video included in the study was assessed using DISCERN, Journal of the American Medical Association (JAMA) Benchmark Criteria, and Hexagonal Radar Schema. A correlation analysis was performed considering video features, video source, DISCERN scores and JAMA scores.

Results

A total of 152 videos were included and analyzed. The majority of videos were from physicians (65.8%). According to the DISCERN classification, most videos were rated as “very poor” (48.0%) and “poor” (36.8%). The mean DISCERN and JAMA scores were 36.56 and 2.68, respectively. The duration of videos uploaded by physicians was the shortest (P < 0.001). The video source had no relevance to numbers of “likes”, “comments”, “shares”, DISCERN scores, and JAMA scores (all P-values > 0.05). Other than video duration (P < 0.001), there was no statistically significant difference between groups for any of the recorded or calculated video data (all P values > 0.05). Hexagonal Radar Charts showed the severe imbalance and deficiency of video information. In general, Tiktok videos with the shortest duration received the most numbers of “likes”, “comments”, and “shares”, whereas the overall quality of videos on Weibo was relatively high.

Conclusions

Despite most of the videos on social media platforms being uploaded by medical authors, the overall quality was poor. The misleading, inaccurate and incomplete information may pose a health risk to the viewers, especially during the COVID-19 pandemic. Much effort needs to be undertaken to improve the quality of health-related videos regarding pediatric urology.