Systematic Assessment of the Quality and Comprehensibility of YouTube Content on Ulnar Collateral Ligament Injury and Management

Abstract

Background: Ulnar collateral ligament (UCL) reconstruction has received a unique level of attention in the press and social media. There has also been an increasing use of the internet by patients to seek medical information. Concern exists regarding the quality and comprehensibility of online information when used for patient education. Purpose: To evaluate the quality and comprehensibility of the most-viewed YouTube videos related to the diagnosis and management of UCL injuries. Based on our new evidence-based scoring rubrics, we hypothesized that the quality and comprehensibility of these videos would be poor. Study Design: Cross-sectional study. Methods: The YouTube platform was searched on September 7, 2021, with the terms “UCL injury,” “ulnar collateral ligament injury,” “UCL surgery,” “ulnar collateral ligament surgery,” and “Tommy John surgery,” and the 50 most-viewed videos from each search were compiled, yielding 250 videos. After removal of duplicates and application of exclusion criteria, the 100 most-viewed videos remained. Basic attributes, including duration of video and number of views, were recorded. Each video was then analyzed by 2 independent reviewers and evaluated for 4 key parameters (quality of diagnostic content [QAR-D], quality of treatment content [QAR-T], presence of inaccurate information, and comprehensibility) and graded on a novel scale from 1 to 4 (4 being the most appropriate for patient education). Results: The mean QAR-D was 4.83 ± 3.41 (fair quality), and the mean QAR-T was 2.76 ± 3.26 (poor quality). Physician-led educational videos had both the highest mean QAR-D (6.37) and the highest mean QAR-T (4.34). No correlation was observed between video quality and views/likes. A total of 12 videos included ≥1 inaccuracy. The mean comprehensibility score was 2.66 ± 1.12, with 39 videos falling below the acceptable comprehensibility threshold (score <3). Conclusion: The overall quality of UCL injury–related YouTube content was low. In addition, the absence of correlation between video quality and views/likes suggests that patients are not preferentially utilizing the limited high-quality content that does exist on the YouTube platform. In addition, inaccurate videos were prevalent (12%), and almost half of all videos were deemed inappropriate for patient education in terms of comprehensibility, as defined by our comprehensibility parameter.

A Comparison of Quality and Reliability of YouTube Videos About the MRI Technique and Its Various Aspects

“…A total of 70 videos were evaluated; only 64 met the inclusion criteria, similar to a study evaluating YouTube video content quality for medical education purposes by Mutlu and Arik that used 65 videos [ 5 ]. In other studies, Batar et al used 52 videos, Crutchfield et al used 142 videos, Di Bello et al 156 videos, and Desai et al 92 videos that met inclusion criteria [ 6 - 9 ].…”

“…This study found that the majority of the uploaded videos 92.2% (n=59) were more than one year old compared to the remaining videos that were more than one week to one year old 7.8% (n=5). In similar studies, there was less emphasis on the publishing time of the video and more focus on content quality [ 5 - 9 ]. Since most of the videos were over a year old, this might imply the potential for physicians, hospitals, and health organizations to use YouTube more efficiently to provide timely information.…”

“…In contrast, the uploader distribution in a study by Mutlu and Arik was doctors 11% (n=7), MRI technologists 7% (n=5), hospitals 8% (n=5), health channels 28% (n= 5), patients 28% (n=18), and others 18% (n= 12) [ 5 ]. Another study by Desai et al categorized videos into physician-led videos 35% (n=35), other medical professionals 20% (n=20), non-medical practitioners 13% (n=13), surgical technique 16% (n=16), patient testimonials 9%(n=9), and news 7%(n=7) [ 9 ]. In a study by Batar et al regarding hallux valgus, the main uploaders were medical companies 28.8% (n=15), non-surgical physicians 38.5% (n=20), and surgeons 30.8% (n=16) [ 6 ].…”

“…While none of the videos provided information on mortality or treatments for claustrophobia, only three (4.69%) videos were promotional content by a pharmaceutical or machine company or by doctors. While Mutlu and Arik’s study found that 30.77% of the content distribution was on MRI-associated claustrophobia, 26.25% on sharing experiences, and 43.08% on overcoming fear, Desai et al, in their study on YouTube quality regarding ulnar collateral injury, found that only 3% of the analyzed videos discussed indications for ulnar collateral ligament repair, with 4% mentioning the need to avoid postoperative stress [ 5 , 9 ]. Similarly, the study by Crutchfield et al found that there was little mention of postoperative restrictions, rehabilitation protocols, or surgical complications in the analyzed videos [ 7 ].…”