Is knee pain information on YouTube videos perceived to be helpful? An analysis of user comments and implications for dissemination on social media

Are dental x-rays safe? Content analysis of English and Chinese YouTube videos

Objective

This study provided a content analysis of English and Chinese YouTube videos related to dental radiation safety.

Method

The search string, entered in English and Chinese respectively, was: (dental x-ray safe). The searches were performed and exported with Apify YouTube scraper. By screening the resultant videos and their related videos (as recommended by YouTube), a total of 89 videos were screened. Finally, 45 videos (36 English and nine Chinese) were included and analyzed. The specific information regarding dental radiation was evaluated. The Patient Education Material Assessment Tool for Audiovisual Materials was used to assess understandability and actionability.

Results

There was no significant difference between the English and Chinese videos in terms of view count, like count, comment count, and video duration. Half of the videos explicitly reassured the audience that dental x-rays are safe. Two of the English videos specifically stated that dental x-rays do not cause cancers. Numerous analogies were made in regard to radiation dose, such as equivalence to taking a flight or eating some bananas. About 41.7% of the English videos and 33.3% of the Chinese videos mentioned that patients could be further protected from scatter radiation by wearing a lead apron and thyroid collar. Videos had a good understandability score (91.3) but a poor actionability score (0).

Conclusions

Some of the analogies and the claimed radiation dose were questionable. One Chinese video even wrongly stated that dental x-rays are nonionizing radiation. The videos generally did not mention their information sources or the underlying radiation protection principles.

Quality of healthcare information on YouTube: psoriatic arthritis

BACKGROUND

YouTube is an increasingly used platform for medical information. However, the validity of health-related information on psoriatic arthritis (PsA) on YouTube has not been determined.

OBJECTIVE

The purpose of this study was to evaluate the accuracy and quality of YouTube videos concerning PsA.

MATERIALS AND METHODS

A YouTube search was performed on April 18, 2021, using the keyword "psoriatic arthritis." Two independent raters accessed the content, source, and detailed characteristics of the included videos. The reliability and quality of the videos were analyzed using the modified DISCERN score, Journal of the American Medical Association benchmark criteria score, and global quality scale score.

RESULTS

Of the 200 videos screened, 155 were included in the study after applying the exclusion criteria. A total of 132 (85.2%) videos revealed useful information about PsA, whereas the remaining 23 (14.8%) were misleading. Video interaction parameters including the median number of views, views per day, likes, dislikes, and comments demonstrated no significant difference between the two groups. The videos posted by universities and professional organizations displayed the highest reliability and quality scores.

CONCLUSION

The majority of YouTube videos on PsA contained useful information. However, physicians should alert patients to the possibility of misinformation and non-validated sources. Professional organizations in the field of rheumatology, such as the American College of Rheumatology and European League Against Rheumatism, should consider collaborating with YouTube to deliver high-quality content.

Primary care physicians' perceptions of the utility of novel education materials for patients with knee osteoarthritis

PURPOSE

To support primary care physicians (PCPs) and their patients with knee osteoarthritis (OA), we created a series of evidence-based whiteboard educational videos for patients with knee OA. In a previous study we piloted these videos with patients to understand their acceptability and impact. The purpose of this study was to explore PCPs' perspectives to understand the utility of novel patient education videos to support management.

MATERIALS AND METHOD

We conducted a qualitative descriptive study using semi-structured interviews of newly practicing and resident PCPs after watching a series of patient education videos. A thematic analysis approach was used combining both inductive and research question driven coding, category formation, and theme identification.

RESULTS

Ten participants were included. Barriers to optimal management were identified including the challenge of patient adherence and access to non-operative treatments. PCPs indicated that the videos would support their management of patients with knee OA by (1) supporting credibility and building trust with their patient, (2) reinforcing patient understanding, and (3) enhancing their own management of patients.

CONCLUSION

Future implementation of these resources with attention to barriers that may limit uptake is necessary and may optimize management of knee OA in primary care.IMPLICATIONS FOR REHABILITATIONThe provision of patient educational materials may support patient buy-in regarding appropriate management, enhance patient understanding, and improve physicians' future practice.Viewing these videos could potentially improve physicians' future resource use, recommendation of non-operative treatments, and the quality of their total knee replacement referrals, which has benefits to both the patient and the healthcare system.Perceived barriers to implementing evidence-based recommendations may pose a challenge for patients and clinicians and should be considered to help facilitate the uptake of educational interventions.

The Internet Knows More Than My Doctor: A Qualitative Study of People with Rare Diseases and How They Use Online Support Groups (Preprint)

Background

Patients struggling with rare diseases may face challenges caused by care providers being unfamiliar with their condition. The life span of people with rare diseases may be the same as that of healthy people, but their quality of life is different. Patients with chronic pain are constantly looking for ways to mitigate their pain. Pain killers are not a permanent solution. In addition to the medical and nonmedical costs of rare diseases for both patients and health care providers, there is a need for sustainable sources of information that are available to help with pain and improve their quality of life, with the goal of reducing physician visits and hospital admissions.

Objective

This study investigated the challenges that patients with genetic disorders face in managing their health conditions and finding disease-related information as well as the effect of online peer support groups on pain mitigation and care management.

Methods

Interviews were conducted via Zoom between July 2021 and December 2021. Eligible participants were those who were aged >18 years, had a medical diagnosis of any type of Ehlers-Danlos syndrome (EDS) with chronic pain, and were members of any support group. Participants were recruited through an announcement in the research and survey section of The Ehlers-Danlos Syndrome Society web page. Interviews were analyzed using the framework approach. Data were systematically searched to identify patterns, analyze them, and identify themes. Interview audio files were transcribed and independently coded by two researchers (SA and AT). Through an iterative process, a final coding table was agreed upon by the researchers and used to thematically analyze the data.

Results

We interviewed 30 participants (mean age 37.7, SD 15 years; n=28, 93% were women; n=23, 77% were residing in the United States). Thematic analysis revealed that participants (patients with EDS) were constantly in pain and most of them have not received accurate and timely diagnoses for many years. They expressed their challenges with health care providers regarding diagnosis and treatment, and complained about their providers’ lack of support and knowledge. Participants’ main sources of information were web-based searches, academic journals, The Ehlers-Danlos Syndrome Society web page, and online peer support groups on Facebook, Reddit, Twitter, and Instagram. Although pain killers, cannabis, and opioids are providing some pain relief, most patients (28/30, 93%) focused on nonmedical approaches, such as hot or ice packs, physical therapy, exercises, massage, mindfulness, and meditation.

Conclusions

This study highlights the information gap between health care providers and patients with genetic disorders. Patients with EDS seek access to information from different web-based sources. To meet the needs of patients with genetic disorders, future interventions via web-based resources for improving the quality of care must be considered by health care professionals and government agencies.

Telehealth adoption during the COVID-19 pandemic: A social media textual and network analysis

Objective

The telemedicine industry has rapidly grown during the COVID-19 pandemic, and telemedicine has become a common form of care. The present study looks at the online conversation regarding telemedicine at the beginning of the pandemic and one year later. The Technology Acceptance Model is utilized to explain the findings.

Methods

Brandwatch and NUVI software captured social mentions on Twitter regarding telemedicine during the beginning of the pandemic (March 15, 2020–April 20, 2020) and one year later (March 12, 2021–April 19, 2021). SAS text-mining software analyzed the social mentions and organized them into ten unique topics for each time period. The research team analyzed the topics and organized them into themes. A network analysis was also performed to examine structure and influence within the network.

Results

In March–April 2020, the themes focused on the use of telehealth in general, telehealth for mental health applications, and Medicare covering telehealth services. In March–April 2021, the themes focused on news events regarding telehealth and the rise in prominence of telehealth services. The network analysis shows a shift in the distribution of telehealth information among influential accounts and reveals that the network became more connected, with a change in the control of information spread.

Conclusions

Technology Acceptance Model explains the social acceptance and spread of telemedicine. The transition in the conversation about telemedicine suggests a pattern of greater system use consistent with the Technology Acceptance Model. Telemedicine may have greatly increased in use because of the pandemic, but data suggests that its use may persist after the pandemic subsides.

Use of YouTube to watch health-related videos and participation in online support groups among US adults with heart disease, diabetes, and hypertension

Objective

Social media use has grown over time. However, it is unclear how people with a self-reported history of cardiovascular disease or cardiovascular disease-related risk factors such as diabetes and hypertension use social media.

Methods

Data from the 2020 Health Information National Trends Survey (HINTS 5, Cycle 4) were analyzed (N = 3865). Only respondents with complete data for all variables of interest were included in the analyses, resulting in 306 respondents with a heart condition, 1291 with hypertension, and 608 with diabetes. We explored associations between two dependent variables: (1) participated in an online forum or support group and (2) watched a health-related video on YouTube, and sociodemographic factors and patient-provider communication. Analyses were conducted separately by medical condition. Odds ratios, 95% confidence intervals, and p-values were calculated.

Results

In respondents with a heart condition, hypertension, or diabetes, 5.4%, 8.4%, and 10.3% had participated in an online support group and 29.6%, 40.4%, and 36.6% had watched health-related videos on YouTube, respectively. Univariately, the odds of using online support groups was associated with younger age (vs. > = 65) in people with a heart condition and hypertension, but not diabetes. Regarding YouTube, younger age was associated with watching health-related videos across all three medical conditions, with additional gender and education associations observed in those with hypertension. There were no associations between social media use and patient-provider communication.

Conclusions

These findings may inform the selection of social media platforms for behavioral interventions depending on the intended patient population and goals (e.g. social support vs. video-based health education).

Applications of Digital Health Technologies in Knee Osteoarthritis: A Narrative Review (Preprint)

Background

With the increasing adoption of high-speed internet and mobile technologies by older adults, digital health is a promising modality to enhance clinical care for people with knee osteoarthritis (KOA), including those with knee replacement (KR).

Objective

This study aimed to summarize the current use, cost-effectiveness, and patient and clinician perspectives of digital health for intervention delivery in KOA and KR.

Methods

In this narrative review, search terms such as mobile health, smartphone, mobile application, mobile technology, ehealth, text message, internet, knee osteoarthritis, total knee arthroplasty, and knee replacement were used in the PubMed and Embase databases between October 2018 and February 2021. The search was limited to original articles published in the English language within the past 10 years. In total, 91 studies were included.

Results

Digital health technologies such as websites, mobile apps, telephone calls, SMS text messaging, social media, videoconferencing, and custom multi-technology systems have been used to deliver interventions in KOA and KR populations. Overall, there was significant heterogeneity in the types and applications of digital health used in these populations. Digital patient education improved disease-related knowledge, especially when used as an adjunct to traditional methods of patient education for both KOA and KR. Digital health that incorporated person-specific motivational messages, biofeedback, or patient monitoring was more successful at improving physical activity than self-directed digital interventions for both KOA and KR. Many digital exercise interventions were found to be as effective as in-person physical therapy for people with KOA. Many digital exercise interventions for KR incorporated both in-person and web-based treatments (blended format), communication with clinicians, and multi-technology systems and were successful in improving knee range of motion and self-reported symptoms and reducing the length of hospital stays. All digital interventions that incorporated cognitive behavioral therapy or similar psychological interventions showed significant improvements in knee pain, function, and psychological health when compared with no treatment or traditional treatments for both KOA and KR. Although limited in number, studies have indicated that digital health may be cost-effective for these populations, especially when travel costs are considered. Finally, although patients with KOA and KR and clinicians had positive views on digital health, concerns related to privacy and security and concerns related to logistics and training were raised by patients and clinicians, respectively.

Conclusions

For people with KOA and KR, many studies found digital health to be as effective as traditional treatments for patient education, physical activity, and exercise interventions. All digital interventions that incorporated cognitive behavioral therapy or similar psychological treatments were reported to result in significant improvements in patients with KOA and KR when compared with no treatment or traditional treatments. Overall, technologies that were blended and incorporated communication with clinicians, as well as biofeedback or patient monitoring, showed favorable outcomes.

Suggestions for Advancing Pragmatic Solutions for Dissemination: Potential Updates to Evidence-Based Repositories

Evidence-based program repositories (EBPR) report intervention characteristics and how to implement the intervention. These EBPR are a dissemination strategy to address questions such as, "I have cancer, what programs can I join?" or "What evidence-based programs for weight loss are a good fit for my community?" However, these EBPR fall short of realizing their potential and are not seen as particularly interactive, robust, or relevant to stakeholders who may benefit from their content. We propose 2 solutions for existing EBPR to enhance dissemination of evidence-based information. Addressing this critical dissemination need is one strategy for health promotion.

YouTube Video Comments on Healthy Eating: Descriptive and Predictive Analysis

Background

Poor nutrition and food selection lead to health issues such as obesity, cardiovascular disease, diabetes, and cancer. This study of YouTube comments aims to uncover patterns of food choices and the factors driving them, in addition to exploring the sentiments of healthy eating in networked communities.

Objective

The objectives of the study are to explore the determinants, motives, and barriers to healthy eating behaviors in online communities and provide insight into YouTube video commenters’ perceptions and sentiments of healthy eating through text mining techniques.

Methods

This paper applied text mining techniques to identify and categorize meaningful healthy eating determinants. These determinants were then incorporated into hypothetically defined constructs that reflect their thematic and sentimental nature in order to test our proposed model using a variance-based structural equation modeling procedure.

Results

With a dataset of 4654 comments extracted from YouTube videos in the context of Malaysia, we apply a text mining method to analyze the perceptions and behavior of healthy eating. There were 10 clusters identified with regard to food ingredients, food price, food choice, food portion, well-being, cooking, and culture in the concept of healthy eating. The structural equation modeling results show that clusters are positively associated with healthy eating with all P values less than .001, indicating a statistical significance of the study results. People hold complex and multifaceted beliefs about healthy eating in the context of YouTube videos. Fruits and vegetables are the epitome of healthy foods. Despite having a favorable perception of healthy eating, people may not purchase commonly recognized healthy food if it has a premium price. People associate healthy eating with weight concerns. Food taste, variety, and availability are identified as reasons why Malaysians cannot act on eating healthily.

Conclusions

This study offers significant value to the existing literature of health-related studies by investigating the rich and diverse social media data gleaned from YouTube. This research integrated text mining analytics with predictive modeling techniques to identify thematic constructs and analyze the sentiments of healthy eating.

Quality of Information Available on YouTube Videos Pertaining to Thyroid Cancer

The purpose of the present study was to assess the quality of information available on YouTube videos pertaining to thyroid cancer. A search of YouTube (http://www.youtube.com) was performed on February 12, 2018, using the search terms "thyroid cancer" and "thyroid cancer treatment." The first 50 videos that appeared on each search were reviewed and 52 videos were included in the analysis. Videos were independently analyzed by two authors for video characteristics including publishing source of upload, continent of origin, presence of animation, and numbers of views, likes, and dislikes. The quality of information provided was assessed using the DISCERN and JAMA benchmark scores, while video power index was also calculated. The median (min-max) DISCERN score was 19.5 (4-71) for reviewer 1 and 20.0 (4-72) for reviewer 2. The median (min-max) JAMA benchmark score was 2.0 (1-4) for both reviewers. JAMA scores were positively correlated with video power index in both reviewer 1 (r = 0.310, p = 0.025) and reviewer 2 (r = 0.356, p = 0.010) assessment. JAMA and DISCERN scores were positively correlated with duration of videos in both reviewer 1 (r = 0.454, p = 0.001 and r = 0.533, p < 0.001, respectively) and reviewer 2 (r = 0.541, p < 0.001 and r = 0.519, p < 0.001, respectively) assessment. In conclusion, our findings revealed poor quality of information provided by YouTube videos pertaining to thyroid cancer based on DISCERN and JAWA scores. Videos with longer duration and higher video power index seem to be associated with higher quality scores, whereas no impact of using animation was shown on quality scores as well as no association between video duration and video power index.

What does digitalization hold for the creation of real-world evidence?

Health-related information is increasingly being collected and stored digitally. These data, either structured or unstructured, are becoming the ubiquitous assets that might enable us to comprehensively map out a patient's health journey from an asymptomatic state of wellness to disease onset and its trajectory. These new data could provide rich real-world evidence for better clinical care and research, if they can be accessed, linked and analyzed-all of which are possible. In this review, these opportunities will be explored through a case vignette of a patient with OA, followed by discussion on how this digitalized real-world evidence could best be utilized, as well as the challenges of data access, quality and maintaining public trust.

Pharmacy students can improve access to quality medicines information by editing Wikipedia articles

BACKGROUND

Pharmacy training programs commonly ask students to develop or edit drug monographs that summarize key information about new medicines as an academic exercise. We sought to expand on this traditional approach by having students improve actual medicines information pages posted on Wikipedia.

METHODS

We placed students (n = 119) in a required core pharmacy course into groups of four and assigned each group a specific medicines page on Wikipedia to edit. Assigned pages had high hit rates, suggesting that the topics were of interest to the wider public, but were of low quality, suggesting that the topics would benefit from improvement efforts. We provided course trainings about editing Wikipedia. We evaluated the assignment by surveying student knowledge and attitudes and reviewing the edits on Wikipedia.

RESULTS

Completing the course trainings increased student knowledge of Wikipedia editing practices. At the end of the assignment, students had a more nuanced understanding of Wikipedia as a resource. Student edits improved substantially the quality of the articles edited, their edits were retained for at least 30 days after course completion, and the average number page views of their edited articles increased.

CONCLUSIONS

Our results suggest that engaging pharmacy students in a Wikipedia editing assignment is a feasible alternative to writing drug monographs as a classroom assignment. Both tasks provide opportunities for students to demonstrate their skills at researching and explaining drug information but only one serves to improve wider access to quality medicines information. Wikipedia editing assignments are feasible for large groups of pharmacy students and effective in improving publicly available information on one of the most heavily accessed websites globally.