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American Association for Hand Surgery

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A Quality Assessment of YouTube Content on Cubital Tunnel Syndrome
Christopher J. Lama, MS1, Joseph C. Donnelly, BS2, Davis A. Hartnett, BS1, Lindsay R. Kosinski, MD1, Julia A. Katarincic, MD3 and Joseph A. Gil, MD1, (1)Brown University, Providence, RI, (2)Warren Alpert Medical School of Brown University, Providence, RI, (3)Department of Orthopaedic Surgery, Brown University, Providence, RI

Introduction
YouTube is a widely used video resource for patients seeking online health information, yet there is little oversight on uploaded content. Cubital tunnel syndrome (CTS) is the second most common upper extremity entrapment neuropathy, and can lead to significant disability if untreated. The purpose of this study was to assess the quality, accuracy and reliability of educational content regarding CTS on the online video platform YouTube. We hypothesize that the quality of YouTube video content on CTS will be deficient as a health informational source.
Materials & Methods
YouTube was queried using the Boolean search term "cubital tunnel+cubital tunnel syndrome" and the first 50 videos were included for analysis. Videos were categorized by source and content, with twelve video characteristics extracted. To assess video accuracy and reliability, the Journal of American Medical Association (JAMA) benchmark criteria (0-4) was used. Educational quality and content of the videos were assessed via the Global Quality Score (GQS; 1-5) and a self-generated Cubital Tunnel-Specific Score (CTSS; 0-21). The data was analyzed by two trained observers.
Results
Collectively, the 50 videos observed had 3,605,396 views (mean, 72,108 ± 199,361.60). The average duration was 5.94 minutes (range, 0.83-24.32 min) and only 26% of the videos included medical disclaimers. Videos were primarily from non-physician allied health professional sources (38%) and had content relating to the pathology of CTS (66%) (Figure 1). The interobserver mean JAMA score was 2.42 ± 0.67, with the highest scores coming from academic-affiliated sources. The interobserver mean GQS and CTSS scores were 2.76 ± 1.28 and 7.42 ± 4.31. The mean CTSS score was greatest in videos from non-academic physicians (11.06 ± 3.75) and videos on surgical technique (11.20 ± 3.96) (Figure 2). Academic sources (β = 4.39, P<0.001) and length of video (β = 0.001, P<0.001) were positive predictors of GQS, while videos from allied health professionals (β = -1.86, P<0.001), commercials (-2.58, P=0.003), patients (β = -2.10, P=0.023) and trainer sources (β = -3.48, P<0.001) were negative predictors. Similarly, academic sources (β = 10.05, P=0.023) and length of video (β = 0.006, P<0.001) were positive predictors of CTSS, and allied health professionals (β = -4.62, P=0.001) and trainer sources (β = -7.60, P=0.038) were negative predictors.
Conclusions
YouTube videos on CTS are generally of low quality, accuracy, and reliability. Providers should be aware of these inaccuracies and caution patients on using YouTube as a source of information for CTS.


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