YouTube is the most famous online video platform, and its content is growing day by day (14). YouTube is being used not only for entertainment purposes but also for educational purposes. Patients and the parents of patients are using YouTube to obtain information regarding diseases that they or their children have (15). DDH is one of the most frequent disorders in newborns, and it can cause serious complications such as osteoarthritis (16). Many concerned parents want to learn more about the disease, and they commonly use YouTube to search for information. However, most parents are not capable of evaluating the quality of the medical content of YouTube videos. Poor quality videos may mislead the parents and could impair the relationship between the parents and their physicians. The purpose of this study was to investigate the quality and reliability of YouTube videos regarding DDH.
GQSs are used to evaluate the quality and the educational quality of the videos, and the JAMAS was used to evaluate the accuracy of the source of information (10). As a DDH-specific quality evaluation, we created a new scoring system called DDHS, as have other studies in the literature (7, 11). We found positive correlations between GQS and DDHS (p: 0.001 r: 65.8%). However, in DDHS, the ICC value was 0.78, and in GQS, the ICC was 0.62. Thus, DDHS provided more objective results than GQS did in the YouTube videos regarding DDH.
There are a number of studies that have investigated the quality of YouTube videos regarding medical information (21). These studies found that YouTube videos regarding medical information had poor quality. In our study, the mean JAMAS, GQS, and DDHS of the videos were 1.37 (SD: 0.7), 2.46 (SD: 1.09), 4.63 (SD: 5.00), respectively. This result suggests that the videos regarding DDH were of poor quality as well, which is consistent with the literature.
In our study, on the basis of the source, most of the videos (49%) were shared by physicians. In M.N. Erdem et al.’s study investigating the quality of YouTube videos regarding kyphosis (7), in Loeb S et al.’s (22) study investigating the quality of YouTube videos regarding prostate cancer, and in M.F. Ferhatoglu et al.’s (8) study investigating the quality of YouTube videos regarding sleeve gastrectomy, the videos were shared mostly by non-physicians. This difference in the source of the videos could result from the following factors: the diagnosis and the treatment of these three diseases must occur under the supervision of a doctor, there is no natural treatment for the disease, and there is a limited rehabilitation process for the disease.
In our study, in the videos evaluated using VPI scores, there were no significant differences between the groups. By contrast, the literature regarding YouTube videos dealing with medical information has shown that the popularity of the videos decreases when the source of the videos is academic or physicians (7, 8, 11, 4, 22). This inconsistency with the literature shows us that despite demonstrated trends, concerned parents of patients with DDH watched the videos sourced by physicians and academics to obtain more information.
When evaluating the videos based on content, most of the videos were information regarding the disease (36.5%), and the DDHS and GQS were higher in the information regarding the disease group than in the parent experience group and the advertisement group. When evaluating the videos based on source, DDHS and GQS were higher in the academic and physician groups than in the parent and commercial groups. This result showed that the videos regarding parent experience and the videos with commercial concerns had poor quality, whereas the videos sourced by an academic or a physician had higher quality, which is again consistent with the literature (7, 8, 11, 22).
There are limitations to this study. First, YouTube is a growing platform. Thus, different results could be obtained if the search was made at a later time. Second, we assessed only the first 52 videos that were returned by YouTube in response to a search for DDH. Although it is a limitation, there is a study in the literature showing that Internet users only consider the first two pages that they obtain when searching for a keyword (23). Third, we assessed the videos that are returned by YouTube as an answer to the term “developmental dysplasia of the hip” (DDH) only, so as not to divert our study from its purpose. DDH is a relatively a new term for the disease, and parents can also search the disease using the term “developmental hip dislocation.” However, we intended to assess the quality of YouTube videos. Thus, the search for “developmental hip dislocation” should produce similar results as the search for DDH if the videos have medical quality. Fourth, when evaluating the videos with DDHS, the videos regarding a subtitle of DDH could get a minor point because DDHS assesses all of the subtitles of DDH. That is why we evaluated the videos with GQS. Lastly, we assessed only videos that were in the English language.
The videos on YouTube regarding DDH generally had poor quality, which means that the information that parents obtain from YouTube can be misleading, which could be challenging for physicians. Parents and patients have the right to access free and easily accessible information regarding medical situations on the Internet and YouTube. Thus, to maintain the optimal parent–physician or patient–physician relationship, we suggest that international health societies make their own educational videos for parents, patients, and fellow physicians. Videos from proper sources that have high-quality information can be translated into multiple languages to reach more people.