The benefit of online education in twin-to-twin transfusion syndrome: could it be an eye-opening platform?

Abstract

Objective This study intends to objectively review the quality and reliability of laser photocoagulation for twin-to-twin transfusion syndrome (TTTS) videos on the YouTube® platform in terms of integrity and educational value for patients and medical professionals. Methods YouTube® (http://www.youtube.com) search was performed for videos pertaining to fetal laser surgery in TTTS, using the terms fetoscopic laser ablation or/and fetoscopic laser surgery or/and fetoscopic laser twin-to-twin transfusion syndrome. A total of 42 videos were analyzed. Video sources were categorized as follows: INDIVIDUAL, ACADEMIC INSTITUTION, and COMMERCIAL. Source of videos, time since upload (days), total duration of videos (seconds), total views, and likes were recorded. Video power index (VPI) was used to report video popularity. Educational quality and integrity were reviewed using the DISCERN, JAMA, GQS, and a novel YouTube® TTTS content - integrity score (TTTS-IS). Results The mean duration was 336.43±351.8 seconds, and the total views were 172.076±82.6. Surgical risks were stated only in 33% of videos, and the success rate of surgery was mentioned in 35%. In all groups, the median value of DISCERN scores is 32.50, 42, and 26, which refers to poor, fair, and very poor quality, respectively. Videos uploaded by an academic institution had statistically insignificant DISCERN and JAMA scores along with lower GQS and TTTS-IS (p>0.05). In regards to the video source, academic institutions were prominent (47.6%), and the most popularized videos were conducted by commercial websites and individuals related to VPI. The VPI was poorly correlated with all scoring systems. Negative correlations were detected between total views and JAMA scores and positive correlations were determined with the GQS and TTTS-IS. Conclusion Despite having VPI score highly in each group, YouTube® provides low-quality videos regarding fetal laser surgery of TTTS. There is an urgent need to regulate the context of those videos according to medical guidelines.