Searching for a solution – is YouTube a reputable source for men investigating treatment for erectile dysfunction?

Abstract

ABSTRACT Introduction The Internet is the most readily accessible medium for patients to access information. YouTube is the second most popular website in the world behind Google and has a growing influence in the distribution of health information1. It is a readily available, free medium for patients to search health conditions, however, there is no governance in the quality of the content provided. Objective The aim of this study was to assess the content and quality of information available to patients on YouTube when searching ‘erectile dysfunction’. Methods Two independent reviewers, both medical practitioners, searched ‘erectile dysfunction’ on YouTube in April 2021 and evaluated the first 50 videos listed, reflecting the content patients are most likely to view. Information related to views, video producer, quality of content, understandability and actionability for viewers was assessed. The videos were assessed using the validated Patient Education Materials Assessment Tool (PEMAT)2 and the DISCERN criteria3. PEMAT is a tool which assesses the understandability and actionability of audio-visual content. Thirteen areas of understandability and four areas of actionability are graded to generate a total score. The DISCERN criteria assesses the quality of consumer health information, focusing on the sourcing, bias and reliability of information provided. The content is assessed across 16 areas, rated overall from a score of 1 (serious or extensive shortcomings) to 5 (minimal bias). R software was used for statistical analysis, including, univariate analysis of PEMAT and DISCERN scores. Results The first 50 videos listed by YouTube when searching ‘erectile dysfunction’ were produced between December 2011 to February 2021. 90% of content provided medical information, though only 56% had been produced by recognised medical institutions. Viewers seemed engaged with reported content with median likes of 209 per video compared to median of 18 dislikes per video. Viewer engagement seemed to be encouraged with 82% of videos allowing viewers to write comments which video producers could respond to. There was a significant difference in the understandability and the actionability of content, as reflected by median PEMAT scores of 91% (range 23-100%) and 25% (range 0-100%), respectively. On univariate analysis, there was an association with video content produced by medical practitioners with higher overall DISCERN and PEMAT scores (p = 0.03) but no association with the numbered listing on YouTube (p = 0.681), the number of likes (p = 0.883) or number of views (p = 0.786). Conclusion Whilst the majority of video content was readily understandable, there were significant deficiencies in the citation of sources, discussion of treatment options including benefits and risks and a logical action plan for patients seeking treatment. Most notably the quality of content provided was not associated with viewer engagement. Patients need to be counselled that while information is available on this platform, the overall quality of the content is poor. Consultation with a medical practitioner is advised, where referral to appropriate additional sources of information can be provided. If patients are seeking more information, they should seek videos produced by recognised medical institutions as an initial screening tool. Disclosure Work supported by industry: no.