Social media platforms are valuable tools for educating patients about serious health topics, but they can also spread false and biased information with potentially harmful results, according to recent research published by Stacy Loeb, MD, MSc, and colleagues in European Urology. Researchers revealed that some of the most popular YouTube videos on bladder cancer score low on quality.

Stacy Loeb, MD, MSc

“Bladder cancer is the second most common urologic cancer worldwide, but evidence is lacking on the accuracy of information available on YouTube, the most popular social network,” said Dr. Loeb, Professor of Urology and Population Health at NYU Langone Health. “Our findings highlight an urgent need for more accurate, patient-friendly social media content.”

Majority of Videos Score Low on Quality

In the study, Dr. Loeb’s team used two validated instruments—the Patient Education Materials Assessment Tool (PEMAT) and the DISCERN quality criteria for consumer health information—to assess the first 150 out of 242,000 YouTube videos on bladder cancer. They ranked the overall quality as poor to moderate in 67% of the videos, and found that 21% contained a moderate to high amount of misinformation, while 17% showed commercial bias.

The findings are concerning, considering that videos containing a moderate to high amount of misinformation reached a combined audience of more than 1.2 million, the authors noted. In addition, a significant percentage of viewers used the platform to post comments seeking medical advice (20%), providing medical advice (9%), or offering support (19%).

Earlier Study in Prostate Cancer

In an earlier study published in European Urology, Dr. Loeb’s team conducted a similar analysis of the first 150 (out of more than 600,000) YouTube videos about prostate cancer, which had average viewership of 45,000 and audiences ranging up to 1.3 million. They found that 77% contained biased or potentially misinformative content in the video or comments section.

Most videos (75%) described benefits of various treatments, while only about half adequately explained the potential harms and side effects. Another 19% recommended alternative therapies, such as injecting herbs into the prostate to treat cancer, according to the study. Only half of the videos discussed shared decision-making, and many were not updated to reflect the most current screening and treatment guidelines—encouraging more aggressive management than is now deemed medically necessary for low-risk disease.

Combating Bad Information

Notably, both the bladder and prostate cancer studies found that poor quality or misinformative content attracted more viewers compared with higher-quality videos, said Dr. Loeb.

“Having lots of ‘likes’ and views does not mean that a video is medically accurate,” added Dr. Loeb, who is the incoming Chair of the American Urological Association Public Media Committee. “As health-care providers, we can help counter this trend by better communicating with patients and guiding them to trustworthy sources for additional information.”

While it’s not practical to vet every online video for accuracy, there are steps that physicians can take to combat the spread of misinformation about urologic diseases, said Dr. Loeb. She offered the following tips for providers:

• Engage in shared decision-making, clearly outlining the benefits and risks of treatment and offering actionable steps for patients.
• Encourage patients to learn how to spot medical misinformation.
• Arm patients with trustworthy sources of information.
• Actively participate in social media to disseminate accurate, evidence-based content.

The study authors concluded, “From the patient perspective, if the information provided by health-care providers at diagnosis is not enough or the information is not sufficiently specific, this may lead to online searches for additional information. However, patients should be wary of YouTube and other social networks. Even well-intentioned misinformation may occur when a poorly informed patient advises others. Verification of the source and date of the information is critical. Organizations such as the Bladder Cancer Advocacy Network and Urology Care Foundation have YouTube channels with high-quality information. Patients should talk to their physicians not only about the treatment of their bladder, but also about their need for more information.”

Disclosure: For full disclosures of the study authors, visit sciencedirect.com.