With the increase in the use of the internet and social media in recent years, patients have started to prefer to use online resources instead of consulting their physicians to get information about their personal health status [19]. The variability and irregularity of online information quality can lead to misdirection of patients and negatively affect the clinician-patient relationship. Therefore, it is important for clinicians to be aware of the content and quality of online information. YouTube has been constantly updating its content for 14 years; it’ s use and popularity is increasing day by day for obtaining information because it is easily accessible, free and independent [20]. In the literature, there are many studies evaluating the content and quality of YouTube videos in recent years. There is no study in the literature examining the quality and reliability of the information provided by YouTube videos about treatment of keratoconus.
Keratoconus usually affects people in adolescence and early adulthood. Therefore, YouTube is an important source of information for this specific disease that affects the age group that uses the internet the most. In our study, when we look at the sources that upload the videos, we see that 60.3% are uploaded by health professionals and 22.9% are uploaded by patients. Compared to the previous studies, the abundance of videos uploaded by healthcare professionals ensures that video content is of higher quality and reliability [20,21].
In previous studies many different scoring system was used to assess the quality and reliability of videos [22,23]. In our study, we used DISCERN, JAMA, GQS and usefulness scoring systems and the mean values of which were 42.92 ± 18.14, 2.7 ± 0.73, 3.07 ± 1.25 and 2.99 ± 1.44, respectively. These score values show that the treatment of keratoconus videos are of high quality. In a similar study by Kalayci et al. in which the keyword 'keratoplasty for patients' was used, the DISCERN, JAMA, GQS, and usefulness scores were reported as 42.11, 1.82, 2.35, and 2.01, respectively, and our results were slightly higher when compared to this study [21]. When we look at the results of the 26 videos uploaded by the physician and the data which was evaluated in the study of Kalayci et al., we see that the scores were similar to our study. We think that this difference may be due to the use of a more specific topic based on diagnosis as a keyword in our study.
In our study, when we examine the data separately according to the sources from which the videos were uploaded, we see that the DISCERN, JAMA, GQS and usefulness scores of the videos uploaded by physicians and institutions are significantly higher. This high score is also supported by previous studies [24,25]. However, in a study by Khatri et al., it was stated that the videos uploaded by the health channel uploaded in the local language are more popular than the videos uploaded by physicians and health institutions [26]. In our study, the values of the videos uploaded by the health channel are below the working average. Therefore, even if there is an inconsistency in the videos uploaded by the health channel in the literature, the videos uploaded by physicians and health institutions should be seen as quality information sources. In our study, the number of videos uploaded by healthcare professionals were high. In most of the similar studies, we see that there are many videos uploaded by nonphysicians [16,20,21,27,28]. It is important to motivate and encourage health professionals to upload videos to video sharing platforms in order for the audience to reach better quality and accurate information.
The number of views of the videos is an important parameter that shows the popularity of the videos [29]. Daily viewing rates are very valuable in showing the up-to-dateness of videos. However, the number of views and daily views can be easily manipulated by video uploaders. It has been suggested that the correlation analysis between daily viewing rates and likes, dislikes and comments can provide us with more objective data to guide us [30]. In our study, we found that there was a strong positive correlation between daily viewing rates and likes, dislikes and comments, supporting this view.
When we look at the origins of the countries where the videos were uploaded, we see that 73.5% were uploaded from the USA. It has been suggested that this high rate may be due to the fact that the selection of only videos in English has a great effect, as well as the use of social media platforms by private institutions in the USA health system to make themselves advantageous [20].
This study has certain limitations. First of all, using only English videos and evaluating all videos can make the results more objective, although the number of non-English videos is low. Second, YouTube is an interactive video sharing platform, so editing, deleting uploaded videos or uploading new videos may change the results. Third, the scoring system was not used to evaluate the image and sound quality of the videos. Finally, the results may vary depending on the software of the search keyword and the geographical region it is written in. Similarly, the search history of the searcher also affects the ranking of the videos. Despite all these limits, the examination of the videos by two different ophthalmologists and the statistically significant strong correlation between them makes the data valuable.
In conclusion, YouTube is an important platform that patients can use to get information about treatment of keratoconus. It is important to watch videos uploaded from reliable sources to avoid misleading information. Therefore, ophthalmologists should guide their patients who want to get information via YouTube to watch videos uploaded by health professionals.