Abstract
Background: YouTube is the most popular video sharing platform, and it is a common source of information for people interested in learning about medical topics. YouTube videos discussing cardiac stress testing have amassed millions of views, but their educational quality has not been thoroughly assessed. We sought to investigate the quality of cardiac stress testing videos on YouTube. Methods: We searched YouTube.com for keywords including “Cardiac Stress Test” and “Exercise Stress Test”. We evaluated 113 videos with at least 15,000 views and excluded 51 videos. The exclusion criteria comprised videos that were unrelated, under 1 minute, not in English, or repeats of a video. The remaining videos were rated by two independent reviewers using the Global Quality Scale (GQS; 4-5 = high quality, 1-3 = low quality), to evaluate usefulness. The view count, modality, upload source and date were used for additional sub-analyses to determine possible associations with the educational quality of videos. Modalities that were analyzed included patient-friendly delivery methods such as patients speaking about their experiences or interviews with patients on their experiences, live patient tests where the patient undergoes cardiac stress testing to educate viewers, or physician-led presentations. Results: The average GQS score was 5 in 4 out of 62 videos (4/62; 6.5%), 4 in 14 videos (14/62; 22.5%), and 0-3 in 44 videos (44/62; 71%) with a mean overall GQS score of 3.04 demonstrating moderate-suboptimal educational quality of videos. Days since upload and view ratio were not associated with educational quality of the videos. Physician-uploaded videos (37/62; 60%) had significantly higher GQS scores compared with non-physicians (3.43 vs. 2.46; p<0.01). When grouped by modality, live patient tests (23/62; 37%) had the highest GQS score of 3.33 while physician-led presentations (28/62; 45%) produced GQS score of 3.13. Patient-friendly delivery methods (interviews and patient stories) (11/62; 18%) had the lowest average GQS score of 2.23. Conclusion: There is an abundance of content about cardiac stress testing on YouTube videos that often deliver low quality information. Healthcare providers need to be cognizant about possible misinformation their patients may encounter. YouTube can be a useful resource for physicians and patients in the future as shared decision-making aids if higher quality videos are uploaded directly by physicians.
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