Conflict of Interest Disclosures: Dr Pomeranz reported being a paid member of the scientific advisory board of Procter & Gamble and receiving royalties from UpToDate. Dr Femia reported receiving royalties from UpToDate. No other disclosures were reported.
Overview of TikTok's most viewed dermatologic content and assessment of its reliabilityTo the Editor: Around 80% of people seek medical information online, and #45% report that social media influences their decisions to seek medical care. 1,2 With [2 billion total downloads, TikTok is the world's fastest growing social media platform. This popular app allows users to create and share short videos on numerous topics, including health care. Previous studies have analyzed the dermatologic content posted on Instagram, Twitter, and YouTube. 3 This study is the first to characterize the content, sources, and reliability of the most popular dermatology videos on TikTok.Based on the National Ambulatory Medical Care Survey, we generated a list of the top 20 most commonly diagnosed dermatologic conditions. 4 On September 18, 2020, these diagnoses were queried as hashtags on TikTok, and the 8 diagnoses with the most videos were evaluated (Table I). The top 25 videos per diagnosis were identified based on engagement, a TikTok metric based on views, likes, comments, and shares. Videos unrelated to dermatology, paid advertisements, and non-English videos were excluded. Two investigators classified the remaining videos into $1 categories based on content. Interrater reliability was calculated using Cohen . Educational videos were subcategorized and compared with American Academy of Dermatology (AAD) guidelines to determine reliability. 5 Four board-certified dermatologists reviewed content assessment. The identities of content creators were confirmed through biographic information on TikTok or other linked social media platforms; board-certified dermatologists were confirmed through the AAD. Identity confirmation required $2 sources of congruent biographic information. Statistical analysis was performed using the z score test for 2 population proportions. P \.05 was considered statistically significant.Of the 200 videos identified, 171 were included. These videos amassed [521 million views. Videos were most often related to patient experiences/ testimonies, followed by education, clinical demonstrations/live procedures, and product reviews/nonpaid advertisements (Table I). Cohen yielded 0.988, showing excellent interrater reliability on content categorization. Content creators were most commonly patients (48.0%), board-certified dermatologists (25.8%), and estheticians (4.8%) (Table I). Board-certified dermatologists were the main source of educational videos (41.3%), adhering to AAD guidelines 96.8% of the time (Table II).Percentages are based on 171 total videos. *Videos were classified into $1 categories. y Defined as information about prevention, cause, diagnosis, and treatment of skin disease. z Defined as advice on skin appearance, and use/application of beauty and skin care products.x Makeup artists, barbers, relatives of patients, and unidentified posters.
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