Journal Of The American Medical Association Research Articles

Assessing the quality and reliability of YouTube videos as a source of information on inflammatory back pain.

Inflammatory back pain is a chronic condition with localized pain, particularly in the axial spine and sacroiliac joints, that is associated with morning stiffness and improves with exercise. YouTube is the second most frequently used social media platform for accessing health information. This study sought to investigate the quality and reliability of YouTube videos on inflammatory back pain (IBP). The study design was planned as cross-sectional. A search was conducted using the term "inflammatory back pain," and the first 100 videos that met the inclusion criteria were selected on October 19, 2023. The data of the videos selected according to the inclusion and exclusion criteria in the study settings were examined. Videos with English language, with audiovisual content , had a duration >30 s, non-duplicated and primary content related to IBP were included in the study. A number of video parameters such as the number of likes, number of views, duration, and content categories were assessed. The videos were assessed for reliability using the Journal of the American Medical Association (JAMA) Benchmark criteria and the DISCERN tool. Quality was assessed using the Global Quality Score (GQS). Continuous variables were checked for normality of distribution using Shapiro-Wilk test and Kolmogorov-Smirnov test. Kruskal-Wallis test and Mann-Whitney U test were used to analyze the continuous data depending on the number of groups. Categorical data were analyzed using Pearson's chi-square test. Reliability assessment based on JAMA scores showed 21% of the videos to have high reliability. Quality assessment based on GQS results showed 19% of the videos to have high quality. JAMA, DISCERN, and GQS scores differed significantly by source of video (p<0.001, < 0.001, and = 0.002, respectively). Video duration had a moderate positive correlation with scores from the GQS (r=0.418, p<0.001), JAMA (r=0.484, p<0.001), and modified DISCERN (r=0.418, p<0.001). The results of the present study showed that YouTube offers videos of low reliability and low quality on inflammatory back pain. Health authorities have a responsibility to protect public health and should take proactive steps regarding health information shared on social media platforms.

Evaluation of the reliability and accuracy of YouTube™ and TikTok™ contents about storage media for avulsed teeth: A cross-sectional study.

The preservation of avulsed teeth is critical in dental trauma management, necessitating effective storage media to ensure viable tooth reimplantation. The urgent need for accurate information has led both professional and non-professional individuals to increasingly seek guidance from video-sharing platforms such as YouTube™ and TikTok™. These platforms have become key resources for advice on such dental emergencies, but the reliability and accuracy of this information have not yet been systematically evaluated. This study aimed to assess the quality, accuracy, and reliability YouTube™ and TikTok™ of videos regarding storage solutions for avulsion injuries. A search was conducted on YouTube™ and TikTok™ on February 4th, 2023, using terms related to traumatic dental injuries, and 53 videos were included. Video demographics such as platform, duration, type, upload date, likes, and comments were recorded. Video content quality, reliability, and accuracy were measured using the Global Quality Scale (GQS), Journal of the American Medical Association (JAMA) benchmarks, and Video Information and Quality Index (VIQI). Research data were analyzed using SPSS IBM 24.0 at a 95% confidence interval. In total, 53 videos were examined. The average scores were JAMA: 1.70/4.00, modified DISCERN: 54.3/80.00, GQS: 3.88/5.00, and VIQI: 13.8/20.00. According to the modified DISCERN index, there were no "very poor" or "poor" quality videos, 49.05% were "moderate," 22.6% were "good," and 28.3% were "very good." No difference was found between YouTube™ and TikTok™ videos in terms of the modified DISCERN index, JAMA scores, GQS, and VIQI scoring (p > .05). Traumatic dental injuries are a common problem among children, and evaluating the reliability of available contents is becoming crucial for appropriate intervention. The study reveals that despite being sourced mainly from dental professionals, the overall quality of videos on avulsed tooth management was mediocre, underscoring the risks associated with misleading or incomplete information in such critical situations.

Characteristics and Quality of Online Searches for Direct Anterior Versus Posterior Approach for Total Hip Arthroplasty

IntroductionOnline resources are important for patient self-education and reflect public interest. We described commonly asked questions regarding the direct anterior versus posterior approach (DAA, PA) to total hip arthroplasty (THA) and the quality of associated websites. MethodsWe extracted the top 200 questions and websites in Google’s “People Also Ask” section for eight queries on January 8, 2023, and grouped websites and questions into DAA, PA, or comparison. Questions were categorized using Rothwell’s classification (fact, policy, value) and THA-relevant subtopics. Websites were evaluated by information source, Journal of the American Medical Association (JAMA) Benchmark Criteria (credibility), DISCERN survey (information quality), and readability. ResultsWe included 429 question/website combinations (questions: 52.2% DAA, 21.2% PA, 26.6% comparison; websites: 39.0% DAA, 11.0% PA, 9.6% comparison). Per Rothwell’s classification, 56.2% of questions were fact, 31.7% value, 10.0% policy, and 2.1% unrelated. The THA-specific question subtopics differed between DAA and PA (P < 0.001), specifically for recovery timeline (DAA 20.5%, PA 37.4%), indications/management (DAA 13.4%, PA 1.1%), and technical details (DAA 13.8%, PA 5.5%). Information sources differed between DAA (61.7% medical practice/surgeon) and PA websites (44.7% government; P < 0.001). The median JAMA Benchmark score was 1 (limited credibility, interquartile range 1 to 2), with lowest scores for DAA websites (P < 0.001). The median DISCERN score was 55 (“good” quality, interquartile range 43 to 65), with highest scores for comparison websites (P < 0.001). Median Flesch-Kincaid Grade Level scores were 12th grade level for both DAA and PA (P = 0.94). ConclusionPatients’ informational interests can guide counseling. Internet searches that explicitly compare THA approaches yielded websites that provide higher-quality information. Providers may also advise patients that physician websites and websites only describing the DAA may have less balanced perspectives, and limited information regarding surgical approaches is available from social media resources.

A Bibliometric Study on Trends in Chiropractic Research from 1920 to 2023

ObjectiveAn increasing body of evidence suggests a positive role of chiropractic in the treatment of neuro-musculoskeletal disorders. This study aims to explore current research hotspots and trends, providing insights into the broad prospects of this field. MethodsA bibliometric review was conducted on all chiropractic articles included in the Web of Science Core Collection before December 31, 2023. ResultsOver the past century, the volume of research in the field of chiropractic has been fluctuating annually, with four peaks observed in total. The United States, Canada, Australia, and the United Kingdom are leading countries. Chu, Eric Chun-Pu is the author with the most publications, while Bronfort, Gert has the highest total citation count. The University of Southern Denmark has produced the most publications, while Queens University - Canada is the most central institution. The Journal of Manipulative and Physiological Therapeutics is the journal with the most publications and citations, while the Journal of the American Medical Association is the most central journal. The two most-cited articles were both authored by Eisenberg DM. Emerging keywords include "chronic pain" and "skills". The theoretical mechanisms and scientific basis of chiropractic, its clinical practice and safety, education and training, integration with other disciplines, and patient experiences and satisfaction are the frontiers and hotspots of research. ConclusionThis study integrates bibliometric analysis to summarize the current state of research and global network centers in the field of chiropractic, further highlighting the hotspots and trends in this field. However, Individual and national rankings should be interpreted with caution due to our focus on Web of Science rather than PubMed.

TikTok content as a source of health education regarding epicondylitis: a content analysis

PurposeThis study aimed to assess the validity and informational value of TikTok content about epicondylitis. The hypothesis tested herein was that TikTok video content would not provide adequate and valid information.MethodsThe term “epicondylitis” was used as a keyword to comprehensively search for TikTok videos, and the first 100 videos that were retrieved were subsequently included for analysis. The duration, number of likes, number of shares and number of views were recorded for each video. Furthermore, the videos were categorized on the basis of their source (medical doctor, physiotherapist, or private user), type of information (physical therapy, anatomy, clinical examination, etiopathogenesis, patient experience, treatment, or other), video content (rehabilitation, education, or patient experience/testimony), and the presence of music or voice. Assessments of video content quality and reliability were conducted using the DISCERN tool, the Journal of the American Medical Association (JAMA) benchmark criteria, and the Global Quality Score (GQS).ResultsA total of 100 videos were included in the analysis: 78 (78.0%) were published by physiotherapists, 18 were published by medical doctors (18.0%), and 4 were published by private users (4.0%). Most of the information pertained to physical therapy (75; 75.0%) and most of the content was about rehabilitation (75; 75.0%). The mean length of the videos was 42.51 ± 24.75 seconds; the mean number of views was 193,207.78 ± 1,300,853.86; and the mean number of comments, likes, and shares were 22.43 ± 62.54, 1578.52 ± 8333.11, and 149.87 ± 577.73, respectively. The mean DISCERN score, JAMA score, and GQS were 18.12 ± 5.73, 0.80 ± 0.53, and 1.30 ± 0.52, respectively. Videos posted by medical doctors/private users had higher scores (p < 0.05) than videos posted by physiotherapists. Videos that focused on education or patient experience had higher scores (p < 0.05) than videos based on rehabilitation.ConclusionsTikTok can be an unreliable source of information regarding epicondylitis treatment. It is common to find nonphysicians who share medical advice on the platform, with medical treatments demonstrating the weakest level of supporting evidence. Elbow surgeons should advise their patients that treatment recommendations from TikTok may not align with established guidelines.Level of Evidence: Level IV—Cross-sectional study.

Arabic Web-Based Information on Oral Lichen Planus: Content Analysis.

The use of web-based health information (WBHI) is on the rise, serving as a valuable tool for educating the public about health concerns and enhancing treatment adherence. Consequently, evaluating the availability and quality of context-specific WBHI is crucial to tackle disparities in health literacy and advance population health outcomes. This study aims to explore and assess the quality of the WBHI available and accessible to the public on oral lichen planus (OLP) in Arabic. The Arabic translation of the term OLP and its derivatives were searched in three general search platforms, and each platform's first few hundred results were reviewed for inclusion. We excluded content related to cutaneous LP, content not readily accessible to the public (eg, requiring subscription fees or directed to health care providers), and content not created by health care providers or organizations (ie, community forums, blogs, and social media). We assessed the quality of the Arabic WBHI with three standardized and validated tools: DISCERN, Journal of the American Medical Association (JAMA) benchmarks, and Health On the Net (HON). Of the 911 resources of WBHI reviewed for eligibility, 49 were included in this study. Most WBHI resources were provided by commercial affiliations (n=28, 57.1%), with the remainder from academic or not-for-profit affiliations. WBHI were often presented with visual aids (ie, images; n=33, 67.4%). DISCERN scores were highest for WBHI resources that explicitly stated their aim, while the lowest scores were for providing the effect of OLP (or OLP treatment) on the quality of life. One-quarter of the resources (n=11, 22.4%) met all 4 JAMA benchmarks, indicating the high quality of the WBHI, while the remainder of the WBHI failed to meet one or more of the JAMA benchmarks. HON scores showed that one-third of WBHI sources had scores above 75%, indicating higher reliability and credibility of the WBHI source, while one-fifth of the sources scored below 50%. Only 1 in 7 WBHI resources scored simultaneously high on all three quality instruments. Generally, WBHI from academic affiliations had higher quality scores than content provided by commercial affiliations. There are considerable variations in the quality of WBHI on OLP in Arabic. Most WBHI resources were deemed to be of moderate quality at best. Providers of WBHI could benefit from increasing collaboration between commercial and academic institutions in creating WBHI and integrating guidance from international quality assessment tools to improve the quality and, hopefully, the utility of these valuable WBHI resources.

Assessing the Quality and Clarity of YouTube Videos as an Informational Source for Ankle Fractures: A Study of the Turkish Population.

Background and objective The significance of YouTube as a prominent source of healthcare-related information cannot be overstated. Its influence on patient education is substantial. However, despite its popularity, there has been little research into the quality and comprehensibility of videos related to ankle fractures, a condition with increasing incidence rates, particularly in the context of Turkey. To address this gap in the literature and the growing reliance on digital platforms for health information during the coronavirus disease 2019 (COVID-19) pandemic, this study aims to assess the quality, clarity, and pedagogical value of YouTube videos on ankle fractures for the Turkish population. Methodology A comprehensive examination of 150 YouTube videos concerning ankle fractures, employing exacting inclusion and exclusion criteria to identify 52 videos for in-depth analysis was undertaken. The investigation entailed an assessment of content quality, presentation style, and user interaction, utilizing the criteria established by the Journal of the American Medical Association (JAMA) and the Patient Education Materials Assessment Tool (PEMAT), as well as a novel measurement known as the Ankle Fracture Content Score (AFCS). A statistical analysis was executed to gauge the educational value and dependability of the information presented. Results The majority of ankle fracture management videos were found to be uploaded by medical professionals, covering various aspects such as rehabilitation and patient testimonials. However, the overall educational quality was suboptimal, with patient-shared videos lacking in depth and accuracy. Statistical analysis showed no significant differences in content quality across different uploader categories, except for notably lower educational quality in videos shared by patients. Conclusions The findings underscore a significant need for healthcare professionals and academic institutions in Turkey to produce and share high-quality, reliable, and comprehensible videos on ankle fractures. Leveraging YouTube's extensive reach can significantly improve health literacy among the Turkish public, ensuring access to accurate and trustworthy health information.

Is it safe to learn about vital pulp capping from YouTube™ videos? A content and quality analysis

AimTo evaluate YouTube videos on vital pulp capping (VPC) for content, quality, source, usefulness, and reliability. Materials and MethodsThis study assessed 249 English-language videos on vital pulp therapy using the Total Content Score (TCS), Video Information and Quality Index (VIQI), Global Quality Scale (GQS), Journal of the American Medical Association (JAMA) score and modified DISCERN score. Videos were categorized based on communication quality, duration, likes and dislikes, views, source, and video type. Of the videos analyzed, 22.1% met the inclusion criteria. Data were analyzed using Shapiro-Wilk, Kruskal-Wallis, and post hoc Bonferroni tests. Sperman's correlation, Kendal tau tests for correlations, and Fisher's exact test were used to assess associations between categorical variables. ResultsThe study identified significant correlations between various parameters. A higher TCS was correlated with increased VIQI (p = 0.005) and GQS scores (r = 0.685, p < 0.05). A moderate positive correlation was found between GQS scores and TCSs (r = 0.577, p < 0.05). VIQI scores were significantly and positively correlated with TCS (r = 0.573, p < 0.05) and comment count (r = 0.306, p < 0.05). JAMA scores were positively correlated with upload time (r = 0.304, p < 0.05), comment count (r = 0.337, p < 0.05), and likes (r = 0.301, p = 0.05). ConclusionsYouTube videos provided low-to-average quality VPC information and tended to be inaccurate. Therefore, public videos may be incorrect, incomplete, and low-quality. Clinicians and patients should seek reliable information from specialists.

'The world was going through what we go through everyday': The experiences of women with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) living with their partners during the COVID-19 lockdown in the United Kingdom.

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a long-term debilitating illness characterised by profound and persistent fatigue (JAMA: The Journal of the American Medical Association, 313, 2015, 1101). The current study aims to explore the experiences of women with ME/CFS living with their partners during the COVID-19 pandemic in the United Kingdom. The study adopted a qualitative design comprising semi-structured interviews with participants. Interviews were analysed using thematic analysis (TA). Participants were women with ME/CFS (n = 21) recruited through ME/CFS support groups in the United Kingdom. All participants were in romantic relationships and lived with their partners. Data were organised into three themes: (1) lockdown disrupting routine, (2) reducing difference and (3) fear of getting COVID-19. People with ME/CFS found that lockdown disrupted their well-established routines. Although routines were disrupted by partners and increased working-from-home practices, participants found having partners at home helpful. People with ME/CFS believed that the changes induced by the pandemic reduced the differences between themselves and the outside world which, prior to lockdown, had felt prominent. They were fearful of getting COVID-19 as they believed this would make their ME/CFS worse. This meant that for people with ME/CFS, the lifting of the lockdown restrictions was an anxiety-provoking time, hence impacting symptoms. People with ME/CFS continued to adhere to government guidelines after national restrictions were eased. This study outlines the experiences of women with ME/CFS during COVID-19, alongside the long-term impact this has had due to the changes that the pandemic imposed. These findings may have implications for those with long COVID.

Health information in short videos about metabolic dysfunction-associated steatotic liver disease: Analysing quality and reliability.

Short videos, crucial for disseminating health information on metabolic dysfunction-associated steatotic liver disease (MASLD), lack a clear evaluation of quality and reliability. This study aimed to assess the quality and reliability of MASLD-related videos on Chinese platforms. Video samples were collected from three platforms (TikTok, Kwai and Bilibili) during the period from November 2019 to July 2023. Two independent reviewers evaluated the integrity of the information contained therein by scoring six key aspects of its content: definition, epidemiology, risk factors, outcomes, diagnosis and treatment. The quality and reliability of the videos were assessed using the Journal of the American Medical Association (JAMA) criteria, the Global Quality Score (GQS) and the modified DISCERN score. A total of 198 videos were included. The video content exhibited an overall unsatisfactory quality, with a primary emphasis on risk factors and treatment, while diagnosis and epidemiology were seldom addressed. Regarding the sources of the videos, the GQS and modified DISCERN scores varied significantly between the platforms (p = .003), although they had generally similar JAMA scores (p = .251). Videos created by medical professionals differed significantly in terms of JAMA scores (p = .046) compared to those created by nonmedical professionals, but there were no statistically significant differences in GQS (p = .923) or modified DISCERN scores (p = .317). The overall quality and reliability of the videos were poor and varied between platforms and uploaders. Platforms and healthcare professionals should strive to provide more reliable health-related information regarding MASLD.

Meniscus-Related Videos on TikTok Are Widely Viewed and Shared but the Educational Quality for Patients Is Poor

PurposeTo evaluate the quality of meniscus-related TikTok videos to better understand their value for patient education. MethodsThe term “meniscus” was used as the keyword for an extensive online search of video content on the TikTok on November 14, 2023. The first 100 videos were used for analysis. The duration of the videos, and the number of likes, shares and views were recorded for each video. Furthermore, videos were categorized based on the source (health workers, private user), the type of subject (patient experience, physcal therapy, anatomy, clinical examnation, surgical technique and injury mechanism), type of content (patient experience/testimony, education, rehabilitation) and the presence of music or voice. The quality and reliability assessments of video contents were conducted using the DISCERN instrument, the Journal of the American Medical Association (JAMA) benchmark criteria, and Global Quality Score (GQS). ResultsOf the 100 videos included in this study, 62 (62.0%) videos were published by health workers, 38 by private users (38.0%). Most of the information regarded patient experience (36–36.0%), followed by physical therapy (32–32.0%), anatomy (14–14.0%), clinical examination (8–8.0%), surgical technique (6–6.0%), and injury mechanism (4–4.0%). Video content reported patient experience in 39 (39.0%) videos, rehabilitation in 31 (31.0%) videos, and education in the remaining 30 (30.0%). The mean length of the videos was 39.12±49.56 seconds. The mean number of views was 1383001.65±5291822.28, while the mean numbers of comments, likes and shares were 408.53±1976.90, 54763.43±211823.44 and 873.70±2802.01, respectively. The mean DISCERN score, JAMA score and GQS were 17.93±5.07, 0.24±0.47 and 1.15±0.41, respectively. ConclusionsMeniscus-related videos on TikTok are widely viewed and shared, but the overall educational value to patients was poor.

An Assessment of the Arabic-Language Informational Resources Available to Colon Cancer Patients Online

Background: The internet has become a primary source of health information, particularly for cancer patients. This study evaluated the quality of online health information related to colon cancer in Arabic. Objective: To assess the reliability, accountability, legitimacy, and readability of Arabic websites providing information on colon cancer. Methods: A search was conducted on major search engines using Arabic keywords related to colon cancer. After initial screening, 13 websites were selected for evaluation. The Journal of the American Medical Association (JAMA) benchmarks, DISCERN instrument and website certification (Health on the Net - HON code) were used for assessment. Readability was analyzed using the Flesch Reading Ease Score and Flesch-Kincaid Grade Level. Results: Non-government websites, particularly Wikipedia, msdmanuals.com, and primomedico.com, demonstrated higher compliance with JAMA benchmarks. Six websites scored high on the DISCERN instrument, indicating reliable treatment information. Only one website was HON-code certified. Readability analysis revealed that text comprehension is challenging for most websites. Conclusion: Private agencies and hospitals managed non-government websites generally outperformed government websites' reliability, quality, and readability. However, overall improvement in Arabic's online health information landscape is essential to enhance accessibility and credibility for colon cancer patients

Distinguishing Clinical from Statistical Significances in Contemporary Comparative Effectiveness Research.

To determine the prevalence of clinical significance reporting in contemporary comparative effectiveness research (CER). In CER, a statistically significant difference between study groups may or may not be clinically significant. Misinterpreting statistically significant results could lead to inappropriate recommendations that increase healthcare costs and treatment toxicity. CER studies from 2022 issues of Annals of Surgery, Journal of the American Medical Association, Journal of Clinical Oncology, Journal of Surgical Research, and Journal of the American College of Surgeons were systematically reviewed by two different investigators. The primary outcome of interest was whether authors specified what they considered to be a clinically significant difference in the Methods. Of 307 reviewed studies, 162 were clinical trials and 145 were observational studies. Authors specified what they considered to be a clinically significant difference in 26 studies (8.5%). Clinical significance was defined using clinically validated standards in 25 studies and subjectively in 1 study. Seven studies (2.3%) recommended a change in clinical decision-making, all with primary outcomes achieving statistical significance. Five (71.4%) of these studies did not have clinical significance defined in their methods. In randomized controlled trials with statistically significant results, sample size was inversely correlated with effect size (r=-0.30, P=0.038). In contemporary CER, most authors do not specify what they consider to be a clinically significant difference in study outcome. Most studies recommending a change in clinical-decision making did so based on statistical significance alone, and clinical significance was usually defined with clinically validated standards.

Readability and credibility evaluation of most-visited health websites based on eBizMBA and Alexa global ranking

Introduction: Online health information is one of the most important and widely used sources of information. Currently, a significant number of individuals use the internet for health-related information to learn about health, disease, health promotion, and threats to their health.Material and Methods: This research examined the top 15 health websites based on their popularity in eBizMBA and Alexa rank from January to February 2022. A total of 30 health websites (15 from each category) were evaluated in terms of credibility by the use of Journal of the American Medical Association (JAMA) and health on the net foundation (HON) code. Also, the readability of the mentioned websites was evaluated by the use of four readability tools.Results: Most of the websites ranked by both Alexa and eBizMBA met the “Authority” and” Complementarity" criteria. When it comes to the readability of the 30 most visited health websites according to eBizMBA and Alexa analytics in the world, the analysis demonstrated that the readability of highly-ranked health websites was higher than the recommended level.Conclusion: Some of the websites had deficiencies according to the HONcode and JAMA criteria, and the average readability of the websites did not meet the gold standard. Despite the increasing use of the internet for medical information, these resources' poor quality and readability remain a barrier to informed decision-making of patients.

Quality and comprehensiveness of YouTube videos on back pain during pregnancy.

Back pain during pregnancy is a common issue that impacts the quality of life for many women. YouTube has become an increasingly popular source of health information. Pregnant women often turn to YouTube for advice on managing back pain, but the quality of available videos is highly variable. This study aimed to assess the quality and comprehensiveness of YouTube videos related to back pain during pregnancy. A YouTube search was conducted using the keyword "back pain in pregnancy",and the first 100 resulting videos were included in the study. After a thorough review and exclusion of ineligible videos, the final sample consisted of 71 videos. Various parameters such as the number of views, likes, viewer interaction, video age, uploaded source (healthcare or nonhealthcare), and video length were evaluated for all videos. Regarding the source of the videos, 44 (61.9%) were created by healthcare professionals, while 27 (38%) were created by nonprofessionals. Videos created by healthcare professionals had significantly higher scores in terms of DISCERN score, Journal of the American Medical Association (JAMA) score, and Global Quality Scale (GQS) (P < 0.001). Our findings indicate a statistically significant and strong positive correlation among the three scoring systems (P < 0.001). Videos created by healthcare professionals were generally of higher quality, but many videos were still rated as low-moderate quality. The majority of videos focused on self-care strategies, with fewer discussing other treatment options. Our findings highlight the need for improved quality and comprehensiveness of YouTube videos on back pain during pregnancy.

Assessment of the Quality, Accountability, and Readability of Online Patient Education Materials for Optic Neuritis

ABSTRACT Most cases of optic neuritis (ON) occur in women and in patients between the ages of 15 and 45 years, which represents a key demographic of individuals who seek health information using the internet. As clinical providers strive to ensure patients have accessible information to understand their condition, assessing the standard of online resources is essential. To assess the quality, content, accountability, and readability of online information for optic neuritis. This cross-sectional study analyzed 11 freely available medical sites with information on optic neuritis and used PubMed as a gold standard for comparison. Twelve questions were composed to include the information most relevant to patients, and each website was independently examined by four neuro-ophthalmologists. Readability was analyzed using an online readability tool. Journal of the American Medical Association (JAMA) benchmarks, four criteria designed to assess the quality of health information further were used to evaluate the accountability of each website. Freely available online information. On average, websites scored 27.98 (SD ± 9.93, 95% CI 24.96–31.00) of 48 potential points (58.3%) for the twelve questions. There were significant differences in the comprehensiveness and accuracy of content across websites (p < .001). The mean reading grade level of websites was 11.90 (SD ± 2.52, 95% CI 8.83–15.25). Zero websites achieved all four JAMA benchmarks. Interobserver reliability was robust between three of four neuro-ophthalmologist (NO) reviewers (ρ = 0.77 between NO3 and NO2, ρ = 0.91 between NO3 and NO1, ρ = 0.74 between NO2 and NO1; all p < .05). The quality of freely available online information detailing optic neuritis varies by source, with significant room for improvement. The material presented is difficult to interpret and exceeds the recommended reading level for health information. Most websites reviewed did not provide comprehensive information regarding non-therapeutic aspects of the disease. Ophthalmology organizations should be encouraged to create content that is more accessible to the general public.

Assessing the Accuracy and Reliability of AI-Generated Responses to Patient Questions Regarding Spine Surgery

Background: In today’s digital age, patients increasingly rely on online search engines for medical information. The integration of large language models such as GPT-4 into search engines such as Bing raises concerns over the potential transmission of misinformation when patients search for information online regarding spine surgery. Methods: SearchResponse.io, a database that archives People Also Ask (PAA) data from Google, was utilized to determine the most popular patient questions regarding 4 specific spine surgery topics: anterior cervical discectomy and fusion, lumbar fusion, laminectomy, and spinal deformity. Bing’s responses to these questions, along with the cited sources, were recorded for analysis. Two fellowship-trained spine surgeons assessed the accuracy of the answers on a 6-point scale and the completeness of the answers on a 3-point scale. Inaccurate answers were re-queried 2 weeks later. Cited sources were categorized and evaluated against Journal of the American Medical Association (JAMA) benchmark criteria. Interrater reliability was measured with use of the kappa statistic. A linear regression analysis was utilized to explore the relationship between answer accuracy and the type of source, number of sources, and mean JAMA benchmark score. Results: Bing’s responses to 71 PAA questions were analyzed. The average completeness score was 2.03 (standard deviation [SD], 0.36), and the average accuracy score was 4.49 (SD, 1.10). Among the question topics, spinal deformity had the lowest mean completeness score. Re-querying the questions that initially had answers with low accuracy scores resulted in responses with improved accuracy. Among the cited sources, commercial sources were the most prevalent. The JAMA benchmark score across all sources averaged 2.63. Government sources had the highest mean benchmark score (3.30), whereas social media had the lowest (1.75). Conclusions: Bing’s answers were generally accurate and adequately complete, with incorrect responses rectified upon re-querying. The plurality of information was sourced from commercial websites. The type of source, number of sources, and mean JAMA benchmark score were not significantly correlated with answer accuracy. These findings underscore the importance of ongoing evaluation and improvement of large language models to ensure reliable and informative results for patients seeking information regarding spine surgery online amid the integration of these models in the search experience.

Validity of Material Related to the Anterior Cruciate Ligament on TikTok.

Video material is one of the most common types of digital information on social media platforms. To assess the validity and informational value of TikTok videos with regard to the anterior cruciate ligament (ACL). Cross-sectional study. Using the terms "anterior cruciate ligament" AND/OR "ACL," 420 TikTok videos were retrieved, of which 100 videos were included in the analysis. The video duration and the number of likes, shares, and views were recorded. Videos were categorized based on the source (private user, physical therapist, surgeon, and researcher), subject type (patient experience, physical therapy, injury mechanism, anatomy, clinical test, and surgical technique), content (patient experience/testimony, education, and rehabilitation), and any background audio (music or voice). Video quality assessments were conducted using the DISCERN instrument, The Journal of the American Medical Association (JAMA) benchmark criteria, and the Global Quality Score (GQS). Associations between quantitative variables were tested using the Spearman rank correlation. One-way analysis of variance or Mann-Whitney test was performed to assess whether video quality differed by video characteristics. A total of 41 videos were published by private users (41%), 34 by physical therapists (34%), 23 by surgeons (23%), and 2 by researchers (2%). Most of the information regarded patient experience (34%), followed by physical therapy (20%), injury mechanism (19%), anatomy (11%), clinical test (9%), and surgical technique (7%). The mean video length was 40.55 ± 41.58 seconds. The mean number of views was 151,084.39 ± 487,150.02, while the mean numbers of comments, likes, and shares were 72.80 ± 249.68, 6781.49 ± 29,163.96, and 98.71 ± 307.76, respectively. The mean DISCERN, JAMA, and GQS scores were 15.73 ± 1.44, 0.19 ± 0.39, and 1.16 ± 0.37, respectively, indicating the poorest quality on all 3 indices. The number of views, likes, shares, comments, and video lengths were all positively correlated with DISCERN (except the number of shares), JAMA, and GQS scores (P < .05). A significant difference was found in DISCERN scores between videos by private users and those by surgeons (15.37 ± 0.98 vs 16.22 ± 1.57; P = .007). Our analysis has demonstrated that the educational value of these videos on the ACL on TikTok is poor. Given the rapid growth of TikTok, further research is needed.

YouTube Content on Shoulder Arthroplasty is Highly Viewed but is of Poor Educational Quality

IntroductionYouTube videos on shoulder arthroplasty cover a broad range of topics, from patient testimonials to surgical techniques. Inherent to this platform, there are no quality control measures to monitor this content. The purpose of this study is to evaluate the quality and popularity of videos on shoulder arthroplasty on YouTube, using both previously described scores and a proposed novel shoulder arthroplasty specific score assessing educational content. MethodsA search was performed using the keywords “shoulder arthroplasty” and “shoulder replacement” on YouTube. Videos were sorted by relevance and the first 50 videos for each keyword were included in a playlist. The videos in the playlist were then sorted by popularity and the first 50 were included for analysis. Videos in a non-English language, duplicate videos, or those lacking audio were excluded. Video source, content, time since upload, duration, like and dislike count, were inputted for analysis. The view ratio and video power index (VPI) were used to assess for popularity. Quality, reliability and educational content were evaluated with the Global Quality Score (GQS), Journal of the American Medical Association (JAMA), and the novel Shoulder Arthroplasty Content Score (SAVC), respectively. ResultsThe 50 videos had an average of 285,375 views and a mean duration of 10.8 minutes. Video content was comprised of primarily surgical technique (46%) and patient experience (44%), with most of the videos uploaded from university-affiliated physicians (30%), non-affiliated physicians (28%), and medical (i.e., animations from health websites) (26%) sources. Mean GQS (i.e., quality) and JAMA (i.e., reliability) scores for all videos were 3.2±1.2 out of 5 and 2.4±1.4 out of 4, respectively. Median GQS was comparable across sources, content, and procedure type. Although median JAMA scores were similar among procedure and content type, academic and medical sources showed significantly higher scores among video source categories (p=0.04). The mean SAVC score was 19.5±10.7 out of 45 possible points. While there was no significant difference in SAVC scores when categorized by procedure type, a significant difference was observed when assessed by source (p = 0.02) and content (p = 0.01). Specifically, medical sources had the highest median score for video source and patient experience for content. ConclusionShoulder arthroplasty videos on YouTube reach a considerable audience, but the educational content and reliability are low. Understanding this can help caution patients on the limitations of educational content on YouTube.

Evaluating the Understandability and Actionability of Online Information on Anemia in Japanese

ABSTRACT Background The medical information about anemia prevention produced by health-care professionals is difficult to understand because of its complicated terminology. Purpose To evaluate quantitatively for the first time the clarity of existing online information about anemia prevention in Japanese. Methods On January 20, 2023, we used the keyword “anemia” to evaluate 200 websites, followed by use of the Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P) and the Clear Communication Index (CCI) to evaluate understandability and actionability. The PEMAT-P and CCI were both evaluated as excellent in terms of understandability and actionability, with cutoff values of 70% or higher and 90% or higher, respectively. We also evaluated readability using jReadability and quality using the Journal of the American Medical Association (JAMA) Benchmark Criteria and The Global Quality Scale (GQS). Results The PEMAT-P scores for understandability and actionability exceeded the cutoff value in 59 (29.5%) and 36 cases (18.0%), respectively, while the CCI exceeded the cutoff value in two cases (1.0%). With respect to web pages, nine (4.5%) were considered “readable” and 96 (48.0%) “neutral.” Discussion These findings suggest that websites on anemia in Japanese have poor “understandability,” “actionability,” and “readability,” and are therefore inaccessible to the general public. Translation to Health Education Practice Improving existing anemia websites using indicators such as the PEMAT-P could improve behaviors related to anemia prevention.