Is YouTube a reliable source of health-related information? A systematic review

Abstract

Background: YouTube is a valuable source of health-related educational material which can have a profound impact on people's behaviors and decisions. However, YouTube contains a wide variety of unverified content that may promote unhealthy behaviors and activities. We aim in this systematic review to provide insight into the published literature concerning the quality of health information and educational videos found on YouTube.

Methods: We searched Google Scholar, Medline (through PubMed), EMBASE, Scopus, Direct Science, Web of Science, and ProQuest databases to find all papers on the analysis of medical and health-related content published in English up to August 2020. Based on eligibility criteria, 202 papers were included in our study. We reviewed every article and extracted relevant data such as the number of videos and assessors, the number and type of quality categories, and the recommendations made by the authors. The extracted data from the papers were aggregated using different methods to compile the results.

Results: The total number of videos assessed in the selected articles is 22,300 (median = 94, interquartile range = 50.5-133). The videos were evaluated by one or multiple assessors (median = 2, interquartile range = 1-3). The video quality was assessed by scoring, categorization, or based on creators' bias. Researchers commonly employed scoring systems that are either standardized (e.g., GQS, DISCERN, and JAMA) or based upon the guidelines and recommendations of professional associations. Results from the aggregation of scoring or categorization data indicate that health-related content on YouTube is of average to below-average quality. The compiled results from bias-based classification show that only 32% of the videos appear neutral toward the health content. Furthermore, the majority of the studies confirmed either negative or no correlation between the quality and popularity of the assessed videos.

Conclusions: YouTube is not a reliable source of medical and health-related information. YouTube's popularity-driven metrics such as the number of views and likes should not be considered quality indicators. YouTube should improve its ranking and recommender system to promote higher-quality content. One way is to consider expert reviews of medical and health-related videos and to include their assessment data in the ranking algorithm.

Keywords: Bias; Health information; Medical videos; Quality assessment; YouTube.

Fig. 1

PRISMA Flow chart of literature screening and selection for reviewed articles

Fig. 2

Fields addressed by reviewed studies and number of papers in the respective field

Fig. 3

Common scoring systems for assessing the content’s quality

Fig. 4

The average quality measures from three general standard scores: GQS, JAMA, and DISCERN

Fig. 5

The most common quality categories for the content as used in the reviewed papers

Fig. 6

The classification of the reviewed papers according to bias classes

Fig. 7

The correlation between video quality and popularity as described in the reviewed papers

Fig. 8

Recommendations derived from the reviewed papers and their frequency