YouTube as a Source of Medical and Epidemiological Information During COVID-19 Pandemic: A Cross-Sectional Study of Content Across Six Languages Around the Globe

Evaluating YouTube as a source of information on amyotrophic lateral sclerosis

Background

Amyotrophic lateral sclerosis (ALS) is a rare neurodegenerative disease that leads to progressive motor weakness and eventual death. Recent years have seen an increase in online information on ALS, with the popular video platform YouTube becoming a prominent source. We aimed to evaluate the quality, reliability, actionability, and understandability of ALS videos on YouTube.

Methods

A search was performed using the keyword "Amyotrophic Lateral Sclerosis" on YouTube. A total of 240 videos were viewed and assessed by two independent raters. Video characteristics such as type of uploader, views, likes, comments, and Video Power Index were also collected.

Results

Videos had moderate to low quality and reliability (Global Quality Scale [GQS] and modified DISCERN [mDISCERN] median 2.5), and poor understandability and actionability (PEMAT total median 8.5). Among the general video characteristics, only length of video showed a significant positive correlation across the tools (with mDISCERN [p < 0.001]; with GQS [p < 0.001]; with PEMAT [p < 0.001]). Videos from physicians (p = 0.024, sig <0.05), other healthcare professionals (p = 0.017, sig <0.05), and educational channels (p = 0.001, sig <0.05) had better quality when compared to others.

Conclusion

YouTube videos are a poor source of information for ALS as videos tend to have moderate to low quality and reliability and are poorly understandable and actionable. Longer videos, and videos uploaded by those in the healthcare and educational fields, were found to perform relatively better. Thus, when using YouTube, caution and careful attention to the video characteristics are recommended.

YouTube as a source of information on reactive arthritis: a quality analysis

OBJECTIVE

YouTube is often used by patients and healthcare professionals to obtain medical information. Reactive arthritis (ReA) is a type of inflammatory arthritis triggered by infection, usually in the genitourinary or gastrointestinal tract. However, the accuracy and quality of ReA-related information on YouTube are not fully known. This study aimed to assess the reliability and quality of YouTube videos pertaining to ReA.

MATERIALS AND METHODS

A YouTube search was performed on August 1, 2023, using the keywords "reactive arthritis," "Reiter's disease," and "Reiter's syndrome." The number of days since upload; the number of views, likes, and comments; and the duration of videos were recorded. The modified DISCERN tool (mDISCERN) and the global quality scale (GQS) were used to evaluate the reliability and quality of the videos. Two physicians independently classified videos as low, moderate, or high quality and rated them on a five-point GQS (1 = poor quality, 5 = excellent quality). The source of videos was also noted.

RESULTS

Of the 180 videos screened, 68 met the inclusion criteria. The most common topic (61, 89.7%) was "ReA overview." Among the 68 videos analyzed, the main source of uploads was physicians 45 (66.2%), and 66 (97%) were categorized as useful. Around half of the YouTube videos about ReA were of high quality (33, 48.5%) according to the GQS. Upon comparing videos uploaded by rheumatologists, non-rheumatology healthcare professionals, and independent users, significant differences were found in mDISCERN and GQS but not in the number of views, likes, and comments or duration. Upon comparing high-, moderate-, and low-quality videos, significant differences were found in the number of views, likes, and comments; duration; and in mDISCERN and GQS.

CONCLUSION

YouTube is a source of information on ReA of variable quality, with wide viewership and the potential to influence patients' knowledge and behavior. Our results showed that most YouTube videos on ReA were of high quality. Videos presented by physicians had higher quality. YouTube should consider avoiding low-quality videos by using validity scales such as mDISCERN and GQS.

Association Between X/Twitter and Prescribing Behavior During the COVID-19 Pandemic: Retrospective Ecological Study

BACKGROUND

Social media has become a vital tool for health care providers to quickly share information. However, its lack of content curation and expertise poses risks of misinformation and premature dissemination of unvalidated data, potentially leading to widespread harmful effects due to the rapid and large-scale spread of incorrect information.

OBJECTIVE

We aim to determine whether social media had an undue association with the prescribing behavior of hydroxychloroquine, using the COVID-19 pandemic as the setting.

METHODS

In this retrospective study, we gathered the use of hydroxychloroquine in 48 hospitals in the United States between January and December 2020. Social media data from X/Twitter was collected using Brandwatch, a commercial aggregator with access to X/Twitter's data, and focused on mentions of "hydroxychloroquine" and "Plaquenil." Tweets were categorized by sentiment (positive, negative, or neutral) using Brandwatch's sentiment analysis tool, with results classified by date. Hydroxychloroquine prescription data from the National COVID Cohort Collaborative for 2020 was used. Granger causality and linear regression models were used to examine relationships between X/Twitter mentions and prescription trends, using optimum time lags determined via vector auto-regression.

RESULTS

A total of 581,748 patients with confirmed COVID-19 were identified. The median daily number of positive COVID-19 cases was 1318.5 (IQR 1005.75-1940.3). Before the first confirmed COVID-19 case, hydroxychloroquine was prescribed at a median rate of 559 (IQR 339.25-728.25) new prescriptions per day. A day-of-the-week effect was noted in both prescriptions and case counts. During the pandemic in 2020, hydroxychloroquine prescriptions increased significantly, with a median of 685.5 (IQR 459.75-897.25) per day, representing a 22.6% rise from baseline. The peak occurred on April 2, 2020, with 3411 prescriptions, a 397.6% increase. Hydroxychloroquine mentions on X/Twitter peaked at 254,770 per day on April 5, 2020, compared to a baseline of 9124 mentions per day before January 21, 2020. During this study's period, 3,823,595 total tweets were recorded, with 10.09% (n=386,115) positive, 37.87% (n=1,448,030) negative, and 52.03% (n=1,989,450) neutral sentiments. A 1-day lag was identified as the optimal time for causal association between tweets and hydroxychloroquine prescriptions. Univariate analysis showed significant associations across all sentiment types, with the largest impact from positive tweets. Multivariate analysis revealed only neutral and negative tweets significantly affected next-day prescription rates.

CONCLUSIONS

During the first year of the COVID-19 pandemic, there was a significant association between X/Twitter mentions and the number of prescriptions of hydroxychloroquine. This study showed that X/Twitter has an association with the prescribing behavior of hydroxychloroquine. Clinicians need to be vigilant about their potential unconscious exposure to social media as a source of medical knowledge, and health systems and organizations need to be more diligent in identifying expertise, source, and quality of evidence when shared on social media platforms.

Text-Mining and Video Analytics of COVID-19 Narratives Shared by Patients on YouTube

This study explores how individuals who have experienced COVID-19 share their stories on YouTube, focusing on the nature of information disclosure, public engagement, and emotional impact pertaining to consumer health. Using a dataset of 186 YouTube videos, we used text mining and video analytics techniques to analyze textual transcripts and visual frames to identify themes, emotions, and their relationship with viewer engagement metrics. Findings reveal eight key themes: infection origins, symptoms, treatment, mental well-being, isolation, prevention, government directives, and vaccination. While viewers engaged most with videos about infection origins, treatment, and vaccination, fear and sadness in the text consistently drove views, likes, and comments. Visuals primarily conveyed happiness and sadness, but their influence on engagement varied. This research highlights the crucial role YouTube plays in disseminating COVID-19 patient narratives and suggests its potential for improving health communication strategies. By understanding how emotions and content influence viewer engagement, healthcare professionals and public health officials can tailor their messaging to better connect with the public and address pandemic-related anxieties.

The reliability and quality of YouTube videos as a source of breath holding spell

BACKGROUND

Breath holding spells (BHS) are an important non-epileptic condition that is common in childhood and causes concern to families. YouTube is a powerful social media tool for accessing diseases and information such as BHS in child health. The aim of the study was to measure of the quality and reliability levels of the videos published in English on BHS uploaded on YouTube.

METHODS

The key words "infant", "cry", "breath holding spells", holding spells" and "breath spells" were searched on the YouTube on November 14, 2022, in this study. Along with the general features of the videos, their quality and reliability were evaluated according to the global quality score (GQS), mDISCERN score.

RESULTS

Fifty-five videos were evaluated. The mDISCERN and GQS scores of the videos in the useful group were higher than those in the misleading group (p < 0.001, p < 0.001). In the useful group, 87.5% of academic institutions and 93.3% of medical doctors (MDs) uploaded high-score GQS videos, while this rate was 16.7% in independent users (p = 0.005). The positive correlation was found between mDISCERN and GQS scores (p < 0.001).

CONCLUSION

The majority of YouTube videos on BHS contained useful information with sufficient quality. Professional associations such as universities and academic institutes need to produce better quality videos to provide families/users with more accurate and up-to-date information about BHS. We emphasize that YouTube should analyse videos published in the field of health, especially in the field of pediatrics, such as BHS, with committees consisting of expert health professionals, and publish them after evaluation. YouTube should consider collaborating with professional pediatrics health organizations such as American Academy of Pediatrics (AAP), academic institutes and universities in the field of BHS to produce high-quality videos.

Evaluation of the Quality and Reliability of YouTube Videos With Turkish Content as an Information Source for Gynecological Cancers During the COVID-19 Pandemic

Aim During the COVID-19 pandemic, YouTube became a critical information source for people seeking information about several diseases, including benign and malignant gynecological disorders. This study aimed to evaluate the quality and reliability of YouTube videos with Turkish content as an information source for gynecological cancers during the COVID-19 pandemic. Methods The research was performed between December 2nd and 5th, 2020. Two gynecologists searched the terms in Turkish; 'yumurtalık kanseri, COVID-19', 'rahim kanseri, coronavirus', 'rahim ağzı kanseri, COVID-19', 'kadın üreme sistemi kanseri, coronavirus', and 'jinekolojik kanserler, COVID-19'. on YouTube. 'Yumurtalık kanseri', 'rahim kanseri', 'rahim agzı kanseri', 'kadın üreme sistemi kanserleri' and 'jinekolojik kanserler' are the translations for "ovarian cancer, COVID-19", "endometrial cancer, coronavirus", "cervical cancer, COVID-19", "female reproductive system cancers, coronavirus", and "gynecological cancers, COVID-19" in the Turkish language, respectively. Videos were categorized into three groups depending on the upload source: the informative group, the personal experience group, and the news agency group. Moreover, DISCERN, the Medical Information and Content Index (MICI), the Video Information and Quality Index (VIQI) were evaluated. Results A total of 57 videos were categorized as informative. Additionally, 22 videos and 18 videos were classified as patient experience videos and new agency videos, respectively. Patients who experienced videos had a significantly higher view number (p=0.001). The number of dislikes and DISCERN score were markedly better in favor of informative videos (p=0.009 and p=0.001). The MICI score was calculated as 13.0±1.8 for informative videos. The total VIQI score was 11.9 for informative videos, 8.8 for patient experience videos, and 7.2 for new agency videos (p = 0.001). Conclusions YouTube videos with Turkish content about gynecological cancers are easily accessible resources during the COVID-19 pandemic. Patient-published videos are the most preferred YouTube videos by Turkish citizens, and informative videos have a considerably lower dislike rate. According to the MICI score and significantly better DISCERN and VIQI scores, informative videos have acceptable quality.

COVID-19 Information on YouTube: Analysis of Quality and Reliability of Videos in Eleven Widely Spoken Languages across Africa

Introduction

Whilst the coronavirus disease 2019 (COVID-19) vaccination rollout is well underway, there is a concern in Africa where less than 2% of global vaccinations have occurred. In the absence of herd immunity, health promotion remains essential. YouTube has been widely utilised as a source of medical information in previous outbreaks and pandemics. There are limited data on COVID-19 information on YouTube videos, especially in languages widely spoken in Africa. This study investigated the quality and reliability of such videos.

Methods

Medical information related to COVID-19 was analysed in 11 languages (English, isiZulu, isiXhosa, Afrikaans, Nigerian Pidgin, Hausa, Twi, Arabic, Amharic, French, and Swahili). Cohen's Kappa was used to measure inter-rater reliability. A total of 562 videos were analysed. Viewer interaction metrics and video characteristics, source, and content type were collected. Quality was evaluated using the Medical Information Content Index (MICI) scale and reliability was evaluated by the modified DISCERN tool.

Results

Kappa coefficient of agreement for all languages was p < 0.01. Informative videos (471/562, 83.8%) accounted for the majority, whilst misleading videos (12/562, 2.13%) were minimal. Independent users (246/562, 43.8%) were the predominant source type. Transmission of information (477/562 videos, 84.9%) was most prevalent, whilst content covering screening or testing was reported in less than a third of all videos. The mean total MICI score was 5.75/5 (SD 4.25) and the mean total DISCERN score was 3.01/5 (SD 1.11).

Conclusion

YouTube is an invaluable, easily accessible resource for information dissemination during health emergencies. Misleading videos are often a concern; however, our study found a negligible proportion. Whilst most videos were fairly reliable, the quality of videos was poor, especially noting a dearth of information covering screening or testing. Governments, academic institutions, and healthcare workers must harness the capability of digital platforms, such as YouTube to contain the spread of misinformation.

A novel approach based on rough set theory for analyzing information disorder

The paper presents and evaluates an approach based on Rough Set Theory, and some variants and extensions of this theory, to analyze phenomena related to Information Disorder. The main concepts and constructs of Rough Set Theory, such as lower and upper approximations of a target set, indiscernibility and neighborhood binary relations, are used to model and reason on groups of social media users and sets of information that circulate in the social media. Information theoretic measures, such as roughness and entropy, are used to evaluate two concepts, Complexity and Milestone, that have been borrowed by system theory and contextualized for Information Disorder. The novelty of the results presented in this paper relates to the adoption of Rough Set Theory constructs and operators in this new and unexplored field of investigation and, specifically, to model key elements of Information Disorder, such as the message and the interpreters, and reason on the evolutionary dynamics of these elements. The added value of using these measures is an increase in the ability to interpret the effects of Information Disorder, due to the circulation of news, as the ratio between the cardinality of lower and upper approximations of a Rough Set, cardinality variations of parts, increase in their fragmentation or cohesion. Such improved interpretative ability can be beneficial to social media analysts and providers. Four algorithms based on Rough Set Theory and some variants or extensions are used to evaluate the results in a case study built with real data used to contrast disinformation for COVID-19. The achieved results allow to understand the superiority of the approaches based on Fuzzy Rough Sets for the interpretation of our phenomenon.

Superlatives, clickbaits, appeals to authority, poor grammar, or boldface: Is editorial style related to the credibility of online health messages?

Adolescents, as active online searchers, have easy access to health information. Much health information they encounter online is of poor quality and even contains potentially harmful health information. The ability to identify the quality of health messages disseminated via online technologies is needed in terms of health attitudes and behaviors. This study aims to understand how different ways of editing health-related messages affect their credibility among adolescents and what impact this may have on the content or format of health information. The sample consisted of 300 secondary school students (M_age = 17.26; SD_age = 1.04; 66.3% female). To examine the effects of manipulating editorial elements, we used seven short messages about the health-promoting effects of different fruits and vegetables. Participants were then asked to rate the message’s trustworthiness with a single question. We calculated second-order variable sensitivity as the derivative of the trustworthiness of a fake message from the trustworthiness of a true neutral message. We also controlled for participants’ scientific reasoning, cognitive reflection, and media literacy. Adolescents were able to distinguish overtly fake health messages from true health messages. True messages with and without editorial elements were perceived as equally trustworthy, except for news with clickbait headlines, which were less trustworthy than other true messages. The results were also the same when scientific reasoning, analytical reasoning, and media literacy were considered. Adolescents should be well trained to recognize online health messages with editorial elements characteristic of low-quality content. They should also be trained on how to evaluate these messages.

Quality of English-language videos available on YouTube as a source of information on osteoporosis

Osteoporosis awareness is essential for preventing osteoporotic fractures. Social media platforms have enormous potential to both support and deter patients' decisions on healthcare. The current study demonstrated that the majority of YouTube videos on osteoporosis provide useful information with sufficient quality.

PURPOSE

YouTube is the most popular video-sharing platform for patients seeking online information about their medical condition. However, there are concerns regarding the accuracy and quality of YouTube content. We aimed to analyze the quality of English-language YouTube videos on osteoporosis.

METHODS

A YouTube search was performed on April 21, 2021, using the keywords "osteoporosis," "osteoporosis exercise," "osteoporosis diet," and "osteoporosis treatment." The reviewers recorded the content, source, and detailed characteristics of the included videos. The reliability and quality of the videos were analyzed using the modified DISCERN score and Global Quality Scale (GQS) score by a rheumatologist and endocrinologist.

RESULTS

Of the 400 videos screened, 238 were included in the study after applying the exclusion criteria. A total of 205 (86.1%) videos revealed useful information about osteoporosis whereas 33 (13.9%) were misleading. In terms of quality, 48% of the videos were of high quality, 34% were of moderate quality, and 18% were of low quality. The videos posted by universities and professional organizations had the highest modified DISCERN and GQS scores indicating high reliability and quality.

CONCLUSION

This study demonstrated that the majority of YouTube videos on osteoporosis contained useful information with sufficient quality. However, physicians should be aware of misleading information and correct any misinformation during face-to-face meetings with patients. YouTube should consider creating partnerships with professional organizations in the field of osteoporosis to produce high-quality videos in line with their new health content policy.

A Review of You Tube Content to Assess US Mental Health During the Covid-19 Pandemic

Mental health concerns have increased in prevalence since the beginning of the COVID-19 pandemic. Many turn to online resources for relevant information. The purpose of this study is to describe the availability of mental health information on YouTube, and to assess the relevance of the videos' content in relation to the actual need of the population. The 100 most-watched YouTube videos in English resulting from a YouTube search of "COVID-19" and "mental health" were evaluated. Of mental health conditions, anxiety and depression were mentioned in over 50% of the videos. A positive correlation was found between videos that mentioned anxiety and those that mentioned depression (p < 0.001). The numbers of videos focused on anxiety and depression were correlated with themes such as life stressors and social distancing (p < 0.05). Videos that did not make recommendations for dealing with stressors had more positive ratings than videos that did make such recommendations (p = 0.002). The content of YouTube videos addressing mental health issues during COVID-19 reflects the actual prevalence of specific mental health conditions during this same time period. Viewer ratings may be indicative of the public need for information about mental health conditions and validation for difficult experiences on social media sites. YouTube must be better utilized to disseminate information about mental illness.

Reliability and Quality of Korean YouTube Videos for Education Regarding Gout

BACKGROUND

YouTube has become an increasingly popular educational tool and an important source of healthcare information. We investigated the reliability and quality of the information in Korean-language YouTube videos about gout.

METHODS

We performed a comprehensive electronic search on April 2, 2021, using the following keywords-"gout," "acute gout," "gouty arthritis," "gout treatment," and "gout attack"-and identified 140 videos in the Korean language. Two rheumatologists then categorized the videos into three groups: "useful," "misleading," and "personal experience." Reliability was determined using a five-item questionnaire modified from the DISCERN validation tool, and overall quality scores were based on the Global Quality Scale (GQS).

RESULTS

Among the 140 videos identified, 105 (75.0%), 29 (20.7%), and 6 (4.3%) were categorized as "useful," "misleading," and "personal experience," respectively. Most videos in the "useful" group were created by rheumatologists (70.5%). The mean DISCERN and GQS scores in the "useful" group (3.3 ± 1.0 and 3.8 ± 0.7) were higher than those in the "misleading" (0.9 ± 1.0 and 1.9 ± 0.6) and "personal experience" groups (0.8 ± 1.2 and 2.0 ± 0.8) (P < 0.001 for both the DISCERN and GQS tools).

CONCLUSION

Approximately 75% of YouTube videos that contain educational material regarding gout were useful; however, we observed some inaccuracies in the medical information provided. Healthcare professionals should closely monitor media content and actively participate in the development of videos that provide accurate medical information.

The causes, impacts and countermeasures of COVID-19 "Infodemic": A systematic review using narrative synthesis

An unprecedented infodemic has been witnessed to create massive damage to human society. However, it was not thoroughly investigated. This systematic review aims to (1) synthesize the existing literature on the causes and impacts of COVID-19 infodemic; (2) summarize the proposed strategies to fight with COVID-19 infodemic; and (3) identify the directions for future research. A systematic literature search following the PRISMA guideline covering 12 scholarly databases was conducted to retrieve various types of peer-reviewed articles that reported causes, impacts, or countermeasures of the infodemic. Empirical studies were assessed for risk of bias using the Mixed-Methods Appraisal Tool. A coding theme was iteratively developed to categorize the causes, impacts, and countermeasures found from the included studies. Social media usage, low level of health/eHealth literacy, and fast publication process and preprint service are identified as the major causes of the infodemic. Besides, the vicious circle of human rumor-spreading behavior and the psychological issues from the public (e.g., anxiety, distress, fear) emerges as the characteristic of the infodemic. Comprehensive lists of countermeasures are summarized from different perspectives, among which risk communication and consumer health information need/seeking are of particular importance. Theoretical and practical implications are discussed and future research directions are suggested.

Appraising and Handling COVID-19 Information: A Qualitative Study

Background. The coronavirus pandemic brought vast quantities of new information to the public for rapid consumption. This study explored how people most impacted by the pandemic have judged and perceived the quality of information regarding COVID-19 and regulated the information flow. Methods. This was a qualitative study of semi-structured interviews developed as a pragmatic study targeting several groups most impacted by the pandemic. Participants were identified through convenience, purposive, and snowball sampling methods. They were interviewed by phone or video conference. Results. Twenty-five participants were interviewed between 6 April 2020 and 1 May 2020. In terms of verifying information and judging its quality, people judged information by the source. People compared information across sources and attempted to verify the quality. Most felt self-assured about their capacity to judge information. Regarding the quality of information, many participants felt the information was skewed or inaccurate. Contradictory information was confusing, especially with a strong suspicion of ulterior motives of information sources impacting trust in the provided information. Yet, some recognized the iterative process of healthcare-related information. In terms of regulating information flow, many participants perceived flooding with information. To counter information overload, some became selective with types of information input. Many developed the habit of taking breaks periodically. Conclusion. Improving risk communication in a pandemic is of paramount importance. Organizations working in public health must develop ways to regulate information flow in collaboration with trusted community partners. Individuals also must develop strategies to improve information management.

Assessing the quality of COVID-19 vaccine videos on video-sharing platforms

Background

Video-sharing platforms are a common source for health information such as Coronavirus Disease 2019 (COVID-19) vaccines. It is important that they provide good quality, evidence-based information. However, to date, the quality of information surrounding COVID-19 vaccines on video-sharing platforms has not been established.

Objective

This study developed an assessment tool to evaluate the quality of Coronavirus Disease 2019 (COVID-19) vaccine videos on YouTube, Facebook Watch and TikTok.

Methods

Assessment of quality was based on understandability, actionability, accuracy, comprehensiveness and reliability. Videos were searched using the keywords “COVID-19 vaccine”, “Coronavirus vaccine” and “SARS-CoV-2 vaccine”. Seventy-two videos were evaluated. Descriptive statistics, Kruskal-Wallis and Wilcoxon-rank sum tests were used for analysis.

Results

YouTube had the highest median composite score compared to TikTok (36.8% versus 27.5%, p = 0.001). YouTube also had the highest median reliability score (37.5%), but those of Facebook Watch (35.0%) and TikTok (35.0%) were only marginally lower. Median accuracy scores of all platforms were 100%, but their median comprehensiveness scores were low (YouTube 12.5%; Facebook Watch 6.3%; TikTok 6.3%, p = 0.004). Median actionability scores (0%) were the lowest for all platforms. TikTok had the highest median understandability score compared to YouTube and Facebook Watch (96.9% versus 80.0 each, p < 0.001).

Conclusion

The overall quality of videos on all video-sharing platforms were low. All platforms provided accurate COVID-19 vaccine information, but TikTok videos were the most understandable. Most videos did not provide full details about COVID-19 vaccines, thus viewers would need to watch several videos before making a better-informed decision.

Radiotherapy or Surgery? Comparative, Qualitative Assessment of Online Patient Education Materials on Prostate Cancer

As multiple different treatment options are available for prostate cancer (PCa) and YouTube is commonly used as a source for medical information, we performed a systematic and comparative assessment of available videos guiding patients on their choice for the optimal treatment. An independent search for surgical therapy or radiotherapy of PCa on YouTube was performed and the 40 most viewed videos of both groups were analyzed. The validated DISCERN questionnaire and PEMAT were utilized to evaluate their quality and misinformation. The median overall quality of the videos was found to be low for surgery videos, while radiotherapy videos results reached a moderate quality. The median PEMAT understandability score was 60% (range 0-100%) for radiotherapy and 75% (range 40-100) for surgery videos. The radiotherapy videos contained less misinformation and were judged to be of higher quality. Summarized, the majority of the provided videos offer insufficient quality of content and are potentially subject to commercial bias without reports on possible conflict of interest. Thus, most of available videos on YouTube informing PCa patients about possible treatment methods are not suited for a balanced patient education or as a basis for the patient's decision.

Consumer Informatics and COVID-19 Pandemics: Challenges and Opportunities for Research

Objective: To summarise the state of the art during the year 2020 in consumer health informatics and education, with a special emphasis on “Managing Pandemics with Health Informatics - Successes and Challenges”.

Methods: We conducted a systematic search of articles published in PubMed using a predefined set of queries, which identified 147 potential articles for review. These articles were screened according to topic relevance and 15 were selected for consideration of best paper candidates, which were then presented to a panel of international experts for full paper review and scoring. The top five papers were discussed in a consensus meeting. Three papers received the highest score from the expert panel, and these papers were selected to be representative papers on consumer informatics for managing pandemics in the year 2020.

Results: Bibliometrics analysis conducted on words found in abstracts of the candidate papers revealed 4 clusters of articles, where the clustering outcomes explained 77.04% of the dispersion. The first cluster composed of articles related to the use of mobile apps for video consultation and telehealth during the pandemic. The second revealed studies reporting the lived experience of healthcare workers and patients during COVID-19. The third focused on ways people used the internet to seek for health information during the pandemic and the dissemination of fake news. The last cluster composed of articles reporting the use of social listening methods (e.g., via tweet hashtags) to explore the spread of the virus around the world.

Conclusions: The pandemic outbreak of the novel coronavirus disease (COVID-19) constitutes a grave risk to the global community and sparks a significant increase in public interest and media coverage, especially on social media. Consumers are facing a new set of challenges that were not considered before COVID-19, often finding themselves in a world that is constantly changing—blended with facts and fake information—and unable to decide what to do next. Despite most people understanding the good will behind public health policies, one must not forget it is individuals we are supporting and that their personal circumstances may affect how they perceive and comply with these policies. Consumers more than ever need help to make sense of the uncertainty and their situation and we need to help them navigate the best option in a world that is constantly evolving.

Research on the Influencing Factors of Audience Popularity Level of COVID-19 Videos during the COVID-19 Pandemic

(1) Background: During the COVID-19 pandemic, users share and obtain COVID-19 information through video platforms, but only a few COVID-19 videos become popular among most audiences. Therefore, it is a very interesting and important research question to explore the influencing factors of the popularity of COVID-19 videos during the COVID-19 pandemic; (2) Our research collects video data related to the keyword “COVID-19” on video platform, the data are analyzed by content analysis and empirical analysis. We then constructed a theoretical model based on the information adoption model; (3) A total of 251 videos were divided into three categories. The least common category was the data and analysis category (11.2%), followed by the prevention and control status category (13.5%); the knowledge and general science category was the most common (75.3%). From the perspective of video quality, the information sources of most videos are relatively reliable, and the content of medical information is low. The research results showed that short video lengths, longer descriptions, more reliable video sources and lower medical information content were more popular with audiences. Audiences are more likely to be attracted to videos in the prevention and control status category and knowledge and general science category. Videos uploaded by uploaders who have a higher influence are more popular with audiences; (4) Conclusions: During the COVID-19 pandemic, information quality (video length, description length, video content type, and medical information and content index) and source credibility (information source reliability, influence and certification type) all significantly influence the popularity level of COVID-19 videos. Our research conclusions can provide management suggestions for the platform, make videos released by uploaders more popular with audiences, and help audiences better understand COVID-19 information and make prevention and control efforts.

Health authorities' health risk communication with the public during pandemics: a rapid scoping review

BACKGROUND

Responses from the H1N1 swine flu pandemic and the recent COVID-19 coronavirus pandemic provide an opportunity for insight into the role of health authorities' ways of communicating health risk information to the public. We aimed to synthesise the existing evidence regarding different modes of communication used by health authorities in health risk communication with the public during a pandemic.

METHODS

We conducted a rapid scoping review. MEDLINE and EMBASE were searched for publications in English from January 2009 through October 2020, covering both the full H1N1 pandemic and the response phase during the COVID-19 pandemic. The search resulted in 1440 records, of which 48 studies met our eligibility criteria.

RESULTS

The present review identified studies across a broad interdisciplinary field of health risk communication. The majority focused on the H1N1 pandemic and the COVID-19 pandemic. A content analysis of the studies identified three categories for modes of communication: i) communication channels, ii) source credibility and iii) how the message is communicated. The identified studies on social media focused mainly on content and engagement, while studies on the effect of the use of social media and self-protective behaviour were lacking. Studies on the modes of communication that take the diversity of receivers in the field into account are lacking. A limited number of studies of health authorities' use of graphic and audio-visual means were identified, yet these did not consider/evaluate creative communication choices.

CONCLUSION

Experimental studies that investigate the effect of health authorities' videos and messages on social media platforms and self-protective behaviour are needed. More studies are needed across the fields of health risk communication and media studies, including visual communication, web design, video and digital marketing, at a time when online digital communication is central to reaching the public.

The Reliability and Quality of YouTube Videos as a Source of Public Health Information Regarding COVID-19 Vaccination: Cross-sectional Study

BACKGROUND

Recent emergency authorization and rollout of COVID-19 vaccines by regulatory bodies has generated global attention. As the most popular video-sharing platform globally, YouTube is a potent medium for the dissemination of key public health information. Understanding the nature of available content regarding COVID-19 vaccination on this widely used platform is of substantial public health interest.

OBJECTIVE

This study aimed to evaluate the reliability and quality of information on COVID-19 vaccination in YouTube videos.

METHODS

In this cross-sectional study, the phrases "coronavirus vaccine" and "COVID-19 vaccine" were searched on the UK version of YouTube on December 10, 2020. The 200 most viewed videos of each search were extracted and screened for relevance and English language. Video content and characteristics were extracted and independently rated against Health on the Net Foundation Code of Conduct and DISCERN quality criteria for consumer health information by 2 authors.

RESULTS

Forty-eight videos, with a combined total view count of 30,100,561, were included in the analysis. Topics addressed comprised the following: vaccine science (n=18, 58%), vaccine trials (n=28, 58%), side effects (n=23, 48%), efficacy (n=17, 35%), and manufacturing (n=8, 17%). Ten (21%) videos encouraged continued public health measures. Only 2 (4.2%) videos made nonfactual claims. The content of 47 (98%) videos was scored to have low (n=27, 56%) or moderate (n=20, 42%) adherence to Health on the Net Foundation Code of Conduct principles. Median overall DISCERN score per channel type ranged from 40.3 (IQR 34.8-47.0) to 64.3 (IQR 58.5-66.3). Educational channels produced by both medical and nonmedical professionals achieved significantly higher DISCERN scores than those of other categories. The highest median DISCERN scores were achieved by educational videos produced by medical professionals (64.3, IQR 58.5-66.3) and the lowest median scores by independent users (18, IQR 18-20).

CONCLUSIONS

The overall quality and reliability of information on COVID-19 vaccines on YouTube remains poor. Videos produced by educational channels, especially by medical professionals, were higher in quality and reliability than those produced by other sources, including health-related organizations. Collaboration between health-related organizations and established medical and educational YouTube content producers provides an opportunity for the dissemination of high-quality information on COVID-19 vaccination. Such collaboration holds potential as a rapidly implementable public health intervention aiming to engage a wide audience and increase public vaccination awareness and knowledge.

Characteristics of YouTube Videos About Peripheral Artery Disease During COVID-19 Pandemic

Introduction: To examine English language YouTube videos that covered both COVID-19 and peripheral artery disease (PAD).

Methods: The research was planned from October 1 to 5, 2020. Two cardiologists (CB and ES) executed online searches in which the term COVID-19/coronavirus was paired with common keywords about PAD, including ‘peripheral artery disease + COVID-19,’ ‘leg pain + coronavirus,’ ‘leg vascular disease + COVID-19,’ ‘atherosclerosis + COVID-19,’ and ‘claudication + coronavirus.’ For each video, a record was made of the number of days on YouTube, length, number of views and comments, and the number of ‘likes’ and ‘dislikes’. Videos were also categorized according to content as informative videos (with accurate content about the frequency of disease, symptoms, transmission, prevention techniques, and proven treatment methods), patient experience videos (with patient testimonies), or news update videos (i.e., those uploaded by professional news channels). Moreover, DISCERN and Medical Information and Content Index (MICI) were evaluated.

Results: Totally, 91 YouTube videos met study inclusion criteria. News update videos were the most-watched when compared with informative and patient experience videos (63,910 views vs 43,725 views vs19,778 views, p=0.032). The DISCERN score was significantly higher in the informative group: 2.8 for informative videos, 1.7 for patients' experience videos, and 1.8 for news update videos (p= 0.001). The most common theme was clinical symptoms in the informative videos (82.4%). The mean MICI score was calculated as 3.7±1.4 points for informative videos.

Conclusion: YouTube videos about COVID-19 and PAD are widely-viewed information sources for patients. Our study has demonstrated that YouTube videos about COVID-19 and PAD generally had poor quality content.

Evaluation of Scientific Quality of YouTube Video Content Related to Umbilical Hernia

OBJECTIVE

Patients with umbilical hernias frequently refer to the YouTube videos to learn and perhaps apply traditional treatment methods. It is very difficult for these users to distinguish these videos as useful or harmful. In this study, we aimed to evaluate the scientific quality of YouTube video content on umbilical hernia.

METHODS

A total of 50 videos on YouTube pertaining to umbilical hernia were included in the study. All videos were evaluated by two experienced general surgeons. The uploader, video content, length, upload date, time since upload, number of views, numbers of comments, likes, and dislikes and Video Power Index (VPI) rates videos were recorded and evaluated. The videos were scored using the Quality Criteria for Consumer Health Information (DISCERN) and Global Quality Scale (GQS).

RESULTS

A total of 9,836 comments were made to the videos, 118,478 likes were made, and 15,009 dislikes were made. The mean DISCERN score given to the videos by the researchers was 2.57 ± 1.82 (min-max: 1-5) and the average GQS score was 2.62 ± 1.86. A statistically significant difference was found in terms of both DISCERN and GQS scores of videos uploaded by doctors compared to videos uploaded by nondoctors (p < 0.001). A statistically significant level of good agreement was found among investigators in terms of both DISCERN (p < 0.001, r = 0.778) and GQS (p < 0.001, r = 0.807) scores.  Conclusion: Videos with health content should definitely be uploaded by experts. Studies investigating the scientific quality of health videos uploaded on YouTube and similar platforms should be carried out continuously.

YouTube as a source of information on gout: a quality analysis

YouTube is a popular video-sharing platform commonly visited by patients and healthcare professionals for medical information. Gout is the most frequent cause of inflammatory arthritis in adults. However, the accuracy and quality of gout-related information on YouTube are not fully known. Thus, the aim of this study was to assess the reliability and quality of YouTube videos pertaining to gout. A YouTube search was conducted using the keywords "gout", "gout arthritis", "gout treatment", and "gout diet". Of the 240 videos screened, 114 that met the inclusion criteria were included in the study. The number of days since upload, number of views, likes, dislikes, comments and duration of the videos were recorded. A Modified DISCERN tool and the Global Quality Scale (GQS) were used to evaluate the reliability and quality of the videos. Of the 114 analyzed videos, 87.72% were deemed as useful while 12.28% contained misleading information with higher viewership. The most common topic was "gout diet". The majority of the videos demonstrated high quality (57.89%), followed by intermediate quality (28.95%) while the percentage of low-quality videos was 13.16%. Videos posted by academic institutions/professional organizations and physicians had higher modified DISCERN and GQS scores indicating higher reliability and quality. This study demonstrated that the majority of YouTube videos on gout provide useful information. However, physicians should be aware of the limited nature of YouTube and correct any misinformation during face-to-face meetings. YouTube should consider avoiding misleading videos using validity scales such as modified DISCERN and GQS.

Sources of COVID-19-Related Information in People with Various Levels of Risk Perception and Preventive Behaviors in Taiwan: A Latent Profile Analysis

The present study aimed to identify the distinct levels of risk perception and preventive behaviors during the coronavirus disease 2019 (COVID-19) outbreak among people in Taiwan and to examine the roles of information sources in various levels of risk perception and preventive behavior. The online survey recruited 1984 participants through a Facebook advertisement. Their self-reported risk perception, adopted preventive behaviors and COVID-19-related information were collected. We analyzed individuals’ risk perception and adopted preventive behaviors by using latent profile analysis and conducted multinomial logistic regression of latent class membership on COVID-19-related information sources. Four latent classes were identified, including the risk neutrals with high preventive behaviors, the risk exaggerators with high preventive behaviors, the risk deniers with moderate preventive behaviors, and the risk deniers with low preventive behaviors. Compared with the risk neutrals, the risk exaggerators with high preventive behaviors were more likely to obtain COVID-19 information from multiple sources, whereas the risk deniers with moderate preventive behaviors and risk deniers with low preventive behaviors were less likely to obtain COVID-19 information compared with the risk neutrals. Governments and health professions should take the variety of risk perception and adopted preventive behaviors into consideration when disseminating information on COVID-19 to the general public.

An Ethnography Study of a Viral YouTube Educational Video in Ecuador: Dealing With Death and Grief in Times of COVID-19

In Western societies, death is a social and educational taboo. Poor education about death and mourning processes and overprotective family and social attitudes move children away from death to avoid "unnecessary suffering." The COVID-19 outbreak highlighted these shortcomings and the difficult management of grief's complexity under sudden and unexpected scenarios. The need for immediate and constant updates related to COVID-19 benefited from social media coverage's immediacy. The use of YouTube as a digital platform to disseminate/search for knowledge exploded, raising the need to conduct ethnographic studies to describe this community's people and culture and improve the booming social media's educational capacity and quality. The present virtual ethnography studied 255,862 YouTube views/users and their behavior related to "Vuela Mariposa, Vuela," a children's story available online since 2009 (not monetized) about the cycle of life, death, and disenfranchised grief (not acknowledged by society) that went viral (+>999%) on May. To our knowledge, this case study is the first original research that explores the ethnography of (i) a viral video, (ii) on death and grief taboo topics, (iii) for prescholars, and (iv) before and during the COVID pandemic. The quantitative and qualitative analyses identified a change in the users' profiles, engagement, and feedback. During the previous 11 years, the users were 35-44 years old Mexican and Spanish women. Those in grief used narrative comments to explain their vital crisis and express their sorrow. In the pandemic, the analysis pointed to Ecuador as the virality geographical niche in a moment when the tragic scenarios in its streets were yet unknown. The timeline match with the official records confirmed the severity of their pandemic scenario. The viral video reached a broad population, with normal distribution for age, and including male gender. Engagement by non-subscribers, direct search (traffic sources), and mean visualization times suggested educational purposes as confirmed by the users' feedback with critical thinking referring to the cycle of life's meaning and societal mourning. For the youngest users, the video was part of academic assignments. The ethnography pointed at YouTube as a flexible education resource, immediately reaching diverse users, and being highly sensitive to critical events.

Framework for curriculum delivery during COVID-19 pandemic in a health sciences university

This article aims to shed light on the management that was taken by the King Saud Bin Abdulaziz University for Health Sciences to accommodate the immediate needs for online curriculum delivery, in response to the total lockdown due to COVID-19 pandemic. We have described the process done, actions implemented, and challenges faced to manage the curriculum delivery during the pandemic and to plan the subsequent year curriculum delivery. Effective management will be enhanced by focused faculty development, curriculum management, assessment planning, and technical support. We believe that the management done can be taken as a model in similar situations where sudden online curriculum delivery is deemed necessary. Further audit on the effectiveness and implication of these actions is required after the end of the pandemic.