Assessment of Content Quality and Reliability of Chinese Short Videos about Constipation on TikTok and Bilibili: A Cross-Sectional Study

Assessment of Content Quality and Reliability of Chinese Short Videos about Constipation on TikTok and Bilibili: A Cross-Sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Assessment of Content Quality and Reliability of Chinese Short Videos about Constipation on TikTok and Bilibili: A Cross-Sectional Study Qiu Li, Junhua Zhu, Yuchen Wang, Bitao Wang, Hui Luo, Chengcheng Pei This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8556425/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Constipation is a common functional bowel disorder where self-management and reliable health information are important. Short video platforms are a key health information source, but their content quality varies. This study evaluated the quality and reliability of constipation Chinese short videos on TikTok and Bilibili, comparing platform, source, and content type. The top 100 eligible videos from each platform were retrieved on November 1, 2025, using the keyword “constipation” and assessed with GQS and mDISCERN tools. Among 200 videos, Bilibili content scored significantly higher in quality (median GQS 3.00 vs. 2.00) and reliability (median mDISCERN 3.00 vs. 2.00) than TikTok (P < 0.001). Videos produced by medical professionals received the highest scores, whereas those from general users received the lowest (P < 0.001). Furthermore, disease knowledge videos significantly outperformed videos in other content categories (P < 0.001). Engagement metrics showed no correlation with information quality. Overall, video quality requires improvement. Content on Bilibili, from professionals, and focusing on disease knowledge performed better, but popularity did not indicate quality. Platforms should optimize review and recommendation systems, encourage professional contributions, and improve public health literacy to support accurate information dissemination. Health sciences/Gastroenterology Health sciences/Health care Health sciences/Medical research Constipation short videos information quality reliability TikTok Bilibili Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Introduction Constipation is a highly prevalent functional bowel disorder, affecting approximately 14% of the global population chronically, significantly burdening patients’ quality of life and healthcare systems 1 , 2 . Its chronic and recurrent nature makes reliance solely on medical interventions insufficient. Science popularization and education can improve public understanding of constipation, promote self-management, facilitate tiered diagnosis and treatment, reduce misconceptions, and decrease healthcare burdens, holding important clinical and public health significance 3 . In recent years, short video platforms have become a major source of health information for the general public due to their rapid dissemination, broad reach, and engaging format 4 – 6 . Patients and the public have a continuous need for information on constipation etiology, management strategies, and treatment options. However, the open and low-threshold nature of social media content also poses significant challenges regarding uneven information quality 7 – 9 . Previous studies have shown that health information on platforms such as YouTube, TikTok, and Bilibili regarding various diseases (e.g., COPD, diabetes, COVID-19) may be inaccurate, one-sided, or even misleading 10 – 12 . Poor or inaccurate information compromises public perception and self-management practices, as well as hinders standardized diagnosis and treatment 13 . Currently, there is a lack of systematic evaluation of information quality about constipation content on mainstream Chinese short video platforms. Therefore, this cross-sectional study aims to assess the content quality and reliability of constipation short videos on TikTok and Bilibili, with in-depth comparisons across platforms, video sources, and content categories. The findings aim to reveal the current status and issues in online health science communication, providing evidence for platform governance, professional content creation, and public health education. Methods Search Strategy and Data Collection This cross-sectional study used newly registered accounts without browsing history to minimize bias from personalized recommendations. On November 1, 2025, the Chinese keyword “便秘” (constipation) was searched on TikTok and Bilibili, sorted by default comprehensive ranking. The top 100 short videos from each platform that satisfied the exclusion criteria were collected as the initial sample (Fig. 1 ). Exclusion criteria were: (1) upload within one week; (2) duration less than 10 seconds; (3) irrelevant language; (4) duplicate videos; (5) unrelated content; (6) advertisement videos. Data Extraction and Variable Definitions Basic video data were extracted from each included video, including platform, source, content, duration, days dince upload, and engagement data (likes, favorites, comments, shares). Professional credentials were verified through platform details and hospital websites. All data were recorded in Excel (Microsoft Corporation, Redmond, USA). Two researchers (Bitao Wang and Hui Luo) independently extracted and cross-checked the data. All data were recorded on the day of collection to minimize bias due to video removal or data changes. Video sources were categorized into: medical professionals (doctors, nurses, pharmacists, dietitians, etc.), science communicators (health communication or knowledge sharing bloggers without explicit medical certification), and general users (patients or individuals without professional health backgrounds). Video content was classified into: disease knowledge (etiology, classification, symptoms, harms, diagnosis, etc.), drug therapy (mechanism of action, usage, pros/cons, precautions of constipation medications), Non-drug therapy (acupuncture, acupressure, colonic hydrotherapy, pelvic floor biofeedback, magnetic therapy, etc.), self-management skills (dietary adjustments, regular exercise, bowel movement techniques, abdominal massage, simple exercises, etc.), and personal experiences (constipation experiences, feelings, healthcare visits, etc.). Quality and Reliability Assessment Tools Two validated tools were used for independent assessment: Global Quality Scale (GQS) 14 : Used to evaluate the overall educational quality and structure of videos. This 5-point scale (1 = very poor, 5 = excellent) rates content based on logical flow, completeness, and usefulness to viewers. Modified DISCERN tool (mDISCERN) 15 : Used to assess the reliability of video information. This tool contains 5 yes/no questions covering clarity, balance, source citation, mention of additional sources, and explanation of uncertainties. Each “yes” scores 1 point, with total scores ranging 0–5. Higher scores indicate greater reliability. Two researchers (Qiu Li and Yuchen Wang) independently watched and scored all videos using GQS and mDISCERN. They received consistency training beforehand. Videos with scoring discrepancies were reviewed and finalized by a senior researcher (Junhua Zhu). Cohen’s Kappa coefficient was used to assess inter-rater reliability: >0.8 indicated excellent agreement, 0.6–0.8 high agreement, 0.4–0.6 moderate agreement, and < 0.4 poor agreement. Statistical Analysis IBM SPSS 24.0 was used for statistical analysis. The Shapiro–Wilk test was used to assess normality of continuous variables. Normally distributed variables were expressed as mean ± standard deviation (SD); non-normally distributed variables as median and 25th–75th percentiles (M[P25, P75]). Group comparisons (platform, source, content) used Mann–Whitney U or Kruskal–Wallis H tests, with Bonferroni correction for post-hoc pairwise comparisons. Spearman correlation analysis assessed relationships between audience engagement and video quality, with correlation heatmaps generated using R. Spearman’s rank correlation coefficient (r) was interpreted as: |r| ≤ 0.2 = negligible; 0.2 < |r| ≤ 0.4 = weak; 0.4 < |r| ≤ 0.6 = moderate; 0.6 0.8 = very strong. P < 0.05 was considered statistically significant. Ethical Considerations This study analyzes public content on TikTok and Bilibili platforms, strictly adhering to each platform's service agreements and data usage regulations. The research only collects and analyzes voluntarily published public content and does not involve direct recruitment of participants. This study has received an ethics review exemption from the Ethics Committee of Maternal and Child Health Hospital of Hubei Province, confirming that the analysis of public social media data does not require a comprehensive ethical review (Approval Code: 2025-270-01). We follow ethical guidelines for social media research by removing all personally identifiable information and presenting the results in aggregated and anonymized form to protect user privacy. Results Basic Video Characteristics A total of 200 short videos were included, 100 each from TikTok and Bilibili. Basic characteristics are shown in Table 1 . TikTok videos had significantly higher median engagement metrics (Likes, Favorites, Shares, Comments) than Bilibili videos (P < 0.001). However, Bilibili videos were significantly longer in Duration [201.50 (124.75, 438.00) seconds vs. 50.50 (35.00, 108.25) seconds, P < 0.001] and had been online longer [616.00 (253.25, 1193.00) days vs. 121.50 (57.00, 306.50) days, P < 0.001]. Table 1 Baseline characteristics of videos on TikTok and Bilibili. Variables Total (n = 200) TikTok (n = 100) Bilibili (n = 100) p value Likes, M (Q₁, Q₃) 1442.00 (214.75, 9040.50) 3654.00 (659.00, 17815.25) 717.50 (109.75, 3109.50) < 0.001 Comments, M (Q₁, Q₃) 126.50 (22.00, 770.00) 269.00 (43.00, 1245.50) 75.00 (8.75, 417.00) < 0.001 Favorites, M (Q₁, Q₃) 1000.00 (132.25, 4675.75) 2076.00 (277.50, 9232.00) 464.00 (107.75, 1962.00) < 0.001 Shares, M (Q₁, Q₃) 583.00 (101.50, 5041.00) 1955.50 (289.50, 16430.75) 293.50 (55.50, 1291.50) < 0.001 Duration, M (Q₁, Q₃) 113.50 (48.75, 224.75) 50.50 (35.00, 108.25) 201.50 (124.75, 438.00) < 0.001 Days Since Upload, M (Q₁, Q₃) 289.00 (80.75, 815.75) 121.50 (57.00, 306.50) 616.00 (253.25, 1193.00) < 0.001 GQS score, M (Q₁, Q₃) 3.00 (2.00, 4.00) 2.00 (2.00, 3.00) 3.00 (2.00, 5.00) < 0.001 mDISCERN Score, M (Q₁, Q₃) 2.00 (2.00, 4.00) 2.00 (2.00, 3.00) 3.00 (2.00, 5.00) < 0.001 Video Source and Content Distribution The distribution of video sources and content types is shown in Fig. 2 and in Tables 2 and 3 . Overall, science communicators were the largest source group (46.0%), followed by medical professionals (39.5%) and general users (14.5%). On TikTok, science communicators accounted for the highest proportion (52.0%), followed by medical professionals (28.0%) and general users (20.0%); on Bilibili, medical professionals were the largest group (51.0%), followed by science communicators (40.0%) and general users (9.0%). Table 2 Characteristics of constipation videos by source and content on TikTok. Variables Likes Comments Collects Shares Duration Days Since Upload Video source Medical Professionals (n = 28) 4910.00 (2600.00,26285.50) 297.50 (106.75,2553.75) 3298.50 (1023.25,15311.25) 2169.00 (487.00,38062.25) 55.00 (39.75,86.00) 125.00 (39.50,331.75) Science Communicators (n = 52) 4564.00 (861.50,31453.50) 203.50 (40.25,1305.25) 3235.00 (579.50,9232.00) 2120.00 (402.50,19998.50) 52.50 (34.75,116.25) 139.50 (70.00,287.00) General Users (n = 20) 661.50 (94.25,2783.50) 276.00 (38.00,647.25) 142.00 (14.75,1675.50) 524.00 (42.50,4431.25) 41.50 (33.00,57.75) 98.00 (61.75,208.25) Video content Disease Knowledge (n = 17) 3358.00 (1498.00,23834.00) 302.00 (109.00,994.00) 1694.00 (1050.00,6372.00) 1363.00 (515.00,27137.00) 90.00 (49.00,129.00) 166.00 (40.00,663.00) Drug Therapy (n = 14) 6145.50 (681.50,15190.25) 148.50 (44.00,305.00) 2801.00 (398.75,18507.00) 699.00 (64.75,8358.00) 56.50 (41.75,85.25) 52.00 (37.25,80.75) Non-drug Therapy (n = 9) 3151.00 (488.00,5412.00) 134.00 (17.00,321.00) 2487.00 (270.00,6231.00) 661.00 (143.00,5351.00) 51.00 (33.00,162.00) 82.00 (40.00,142.00) Self-management Skills (n = 41) 4760.00 (1095.00,29453.00) 421.00 (95.00,1318.00) 3873.00 (788.00,22046.00) 6153.00 (859.00,23504.00) 41.00 (30.00,59.00) 184.00 (82.00,306.00) Personal Experiences (n = 19) 753.00 (233.50,8490.50) 336.00 (42.00,957.00) 527.00 (31.00,3018.50) 737.00 (71.00,2835.00) 63.00 (45.00,112.00) 84.00 (67.50,241.50) Table 3 Characteristics of videos by source and content on Bilibili. Variables Likes Comments Collects Shares Duration Days Since Upload Video source Medical Professionals (n = 51) 352.00 (63.00,2465.50) 50.00 (3.00,240.50) 211.00 (58.50,1047.50) 147.00 (43.00,791.50) 175.00 (98.50,335.50) 789.00 (229.50,1274.50) Science Communicators (n = 40) 1116.50 (334.50,7394.00) 119.50 (45.00,626.75) 1123.00 (409.50,5803.75) 601.50 (186.75,3837.50) 241.00 (141.75,483.25) 676.50 (327.25,1194.25) General Users (n = 9) 122.00 (47.00,1012.00) 24.00 (8.00,62.00) 196.00 (67.00,1303.00) 15.00 (9.00,374.00) 436.00 (137.00,681.00) 395.00 (76.00,565.00) Video content Disease Knowledge (n = 29) 747.00 (215.00,3111.00) 91.00 (19.00,429.00) 393.00 (134.00,2845.00) 285.00 (104.00,1356.00) 335.00 (157.00,505.00) 835.00 (420.00,1332.00) Drug Therapy (n = 15) 245.00 (57.00,1109.00) 58.00 (18.00,271.00) 267.00 (78.50,641.00) 148.00 (41.50,507.50) 137.00 (112.00,206.00) 911.00 (310.00,1494.00) Non-drug Therapy (n = 22) 242.50 (55.50,1345.75) 13.00 (2.50,91.50) 710.50 (107.50,2529.25) 338.00 (69.00,1140.25) 241.00 (138.50,906.00) 835.50 (157.50,1166.50) Self-management Skills (n = 21) 1251.00 (215.00,8579.00) 128.00 (24.00,782.00) 1277.00 (164.00,6640.00) 557.00 (81.00,2990.00) 128.00 (91.00,334.00) 521.00 (272.00,789.00) Personal Experiences (n = 13) 1427.00 (122.00,3609.00) 87.00 (25.00,289.00) 254.00 (98.00,1303.00) 139.00 (20.00,603.00) 233.00 (134.00,278.00) 565.00 (131.00,854.00) Regarding content, the two most common categories overall were self-management skills (31.0%) and disease knowledge (23.0%). On TikTok, self-management skills videos were most frequent (41.0%), followed by personal experiences (19.0%), disease knowledge (17.0%), drug therapy (14%), and non-drug therapy (9%). On Bilibili, disease knowledge videos were most frequent (29.0%), followed by non-drug therapy (22.0%), self-management skills (21.0%), drug therapy (15%), and personal experiences (13%). Video Quality and Reliability Assessment Inter-rater agreement was good for both the GQS (κ = 0.701) and the mDISCERN (κ = 0.642). Bilibili videos scored significantly higher [GQS: 3.00 (2.00, 5.00); mDISCERN: 3.00 (2.00, 5.00)] than TikTok videos [GQS: 2.00 (2.00, 3.00); mDISCERN: 2.00 (2.00, 3.00)] (P < 0.001). However, overall video quality and reliability on both platforms were low, with scores mainly distributed between 2 and 3 (Table 1 ; Fig. 3 ). Further analysis (Fig. 4 ) showed that videos from medical professionals had the highest GQS and mDISCERN scores, followed by science communicators, with general users scoring the lowest; differences among the three were statistically significant (P < 0.001). Disease knowledge videos scored significantly higher in quality and reliability than the other four categories (P < 0.001), while self-management skills and personal experiences scored the lowest. Correlation Analysis Spearman correlation analysis results are shown in Fig. 5 . Video quality showed a very strong positive correlation with reliability (r = 0.84, P < 0.05) and a weak positive correlation with Days Since Upload (r = 0.20, P < 0.05). Video reliability showed a very strong positive correlation with quality (r = 0.84, P < 0.05), and weak positive correlations with Duration (r = 0.38, P < 0.05) and Days Since Upload (r = 0.22, P 0.8, P < 0.05) but showed no correlation with quality or reliability (|r| ≤ 0.2). Discussion Study Background and Significance Constipation is a highly prevalent bowel disorder closely related to daily life, with relatively low barriers to understanding basic diagnosis and management knowledge, making it easy to learn, master, and practice 3 . High quality science communication videos can generally improve patients' health awareness and self-management abilities, thereby reducing health risks and healthcare burdens 16 . This study is the first to systematically evaluate the quality and reliability of health information aboutconstipation on the mainstream Chinese short video platforms TikTok and Bilibili. Main Findings The main findings can be summarized as follows: First, the overall quality and reliability of constipation short videos on both platforms are suboptimal. Second, Bilibili videos, those produced by medical professionals, and those focusing on disease knowledge scored significantly higher in quality and reliability. Third, video popularity (measured by engagement) was not associated with information quality and reliability. Cross-Platform Health Video Information Quality and Reliability This study found (Fig. 3 ) that Bilibili videos outperformed TikTok videos in both quality and reliability, partially consistent with recent studies on other health topics (e.g., liver cancer, breast cancer, laryngeal cancer) 17 – 19 . This divergence may be attributable to distinct platform attributes and user habits 20 , 21 . Bilibili is known for mid-to-long-form and in-depth content, with a community culture leaning toward learning and knowledge sharing, attracting more professionals to produce systematic science content (Fig. 2 C). Longer video duration allows for a more comprehensive and in-depth explanation of medical concepts, which could be the reason for the higher quality observed in Bilibili videos 18 , 20 . Our finding of a positive correlation between video reliability and duration is consistent with this explanation (Fig. 5 ). In contrast, TikTok favors short, fast-paced content consumption, and its algorithm may prioritize entertaining, easily shareable yet less in-depth content in the form of "tips". This pattern is evidenced by TikTok's significantly higher scores on all interaction metrics (Table 1 ) and its greater proportion of videos categorized as "self-management skills" and "personal experiences" (Fig. 2 E). Additionally, it is noteworthy that video quality and reliability on both platforms were suboptimal, with scores concentrated in the lower range (Figs. 3 B, D). This highlights the need for platforms to improve their content review and quality evaluation mechanisms. Such improvements are crucial to ensure that high quality videos receive greater visibility and sustained dissemination. Video Source Analysis Our study clearly demonstrates that medical professionals are the most important source of high-quality, reliable health information (Fig. 4 ). Their videos performed better in scientific accuracy, balance, and evidence citation. In contrast, although science communicators produced more content, their average quality was significantly lower than that of medical professionals. Personal experiences shared by general users (primarily patients) can offer emotional support, yet they often consist of subjective feelings and individualized narratives that may include misconceptions. Lacking generalizability and scientific rigor, such content consequently received the lowest scores in both quality and reliability. This finding aligns with other domestic and international studies, emphasizing the importance of professional credentials in health communication 22 , 23 . Encouragingly, the Chinese government has introduced regulations to improve online health content quality, which include encouraging medical professionals to create accurate, engaging videos for better public awareness of common disease 17 . Video Content Analysis Regarding content, "disease knowledge" videos scored the highest, as they are typically based on medical facts and systematic explanations, often citing references or sources. "Self-management skills" videos, while highly prevalent, practical, and easy to imitate, often lack scientific explanation and may spread unverified "folk remedies" or even pose safety risks, resulting in lower scores. This reflects viewers' preference for practical advice and willingness for self-management 24 , 25 . Given this situation, both viewers and platforms should exercise caution with such “tip” videos, seek professional verification when necessary, and improve content filtering mechanisms 9 . Correlation Between Video Quality, Reliability, and Engagement Metrics A noteworthy finding is that video quality and reliability showed no correlation with engagement metrics such as Likes, Comments, Favorites, and Shares (Fig. 5 ). This indicates that the most popular and widely shared videos are not necessarily the most accurate or valuable. This observation aligns with studies by Zheng and Sun et al., suggesting that viewers often cannot discern the quality of health-related videos, highlighting the need for strengthened public health education 17 , 26 . As noted in Mueller et al.'s study on YouTube, if platform algorithms rely solely on engagement and completion rates for recommendations, they may amplify the spread of low-quality or misleading content, creating a "bad money drives out good" effect 27 . Therefore, optimizing recommendation algorithms to incorporate information quality as a weighting factor is crucial for improving the online health information ecosystem. Limitations and Future Directions This study has several limitations. First, as a cross-sectional study, it reflects content status at a specific time point and analyzed only the top 100 eligible videos per platform, potentially not covering all relevant content. Second, the assessment tools (GQS and mDISCERN) primarily evaluate content itself, with limited assessment of production professionalism and visual presentation. Third, the study was confined to Chinese content, which necessitates caution in extrapolating the results to other languages. Future research could be improved by adopting multilingual, large sample designs and by incorporating scales such as PEMAT, VIQI, or JAMA benchmarks. Conclusion In summary, the quality and reliability of constipation short videos on TikTok and Bilibili need overall improvement. Bilibili, videos by medical professionals, and disease knowledge content demonstrated higher information quality. However, current platform popularity mechanisms are not aligned with information quality. Therefore, we recommend: First, platforms should establish more robust content review and quality evaluation systems, optimizing algorithms to prioritize high-quality, reliable medical science content. Second, more medical professionals should be encouraged to use short video platforms to produce scientifically accurate, engaging, and understandable constipation content. Third, public education should be enhanced to improve health information literacy and critical thinking skills, enabling individuals to identify and select high-quality information sources. Multi-party collaboration is essential to build a clearer and more reliable online health information environment. Declarations Competing interests The authors declare that they have no competing interests. Funding No funding was received for this study. Author Contribution Qiu Li and Chengcheng Pei conceived and designed the study. Bitao Wang and Hui Luo performed video searches, data collection, and cross-verification. Qiu Li, Yuchen Wang, and Junhua Zhu conducted data categorization and scoring. Qiu Li analyzed the data and drafted the manuscript. Chengcheng Pei and Junhua Zhu reviewed and revised the manuscript. All authors contributed to the article and approved the submitted version. Acknowledgement The authors thank video creators for their contributions to public health. Data Availability The datasets for the current study are available from the corresponding author upon reasonable request. References Sperber, A. D. et al. Worldwide Prevalence and Burden of Functional Gastrointestinal Disorders, Results of Rome Foundation Global Study. Gastroenterology 160 , 99–114e113. 10.1053/j.gastro.2020.04.014 (2021). Barberio, B., Judge, C., Savarino, E. V. & Ford, A. C. Global prevalence of functional constipation according to the Rome criteria: a systematic review and meta-analysis. lancet Gastroenterol. 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Med. Internet. Res. 25 , e39162. 10.2196/39162 (2023). Mueller, S. M. et al. Fiction, Falsehoods, and Few Facts: Cross-Sectional Study on the Content-Related Quality of Atopic Eczema-Related Videos on YouTube. J. Med. Internet. Res. 22 , e15599. 10.2196/15599 (2020). Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. 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1","display":"","copyAsset":false,"role":"figure","size":276173,"visible":true,"origin":"","legend":"\u003cp\u003eVideo search strategy for constipation.\u003c/p\u003e","description":"","filename":"image1.png","url":"https://assets-eu.researchsquare.com/files/rs-8556425/v1/6e7b7a92df581163627e343b.png"},{"id":100370896,"identity":"ac80c609-3093-4875-ac74-405435ecee69","added_by":"auto","created_at":"2026-01-16 08:08:56","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":285640,"visible":true,"origin":"","legend":"\u003cp\u003ePercentage of constipation videos by source and content on TikTok and Bilibili. (A) Distribution of video sources on both TikTok and Bilibili. (B) Distribution of video sources on TikTok. (C) Distribution of video sources on Bilibili. (D) Distribution of content types on both TikTok and Bilibili. (E) Distribution of content types on TikTok. (F) Distribution of content types on Bilibili.\u003c/p\u003e","description":"","filename":"image2.png","url":"https://assets-eu.researchsquare.com/files/rs-8556425/v1/85bfd5516fa6771793edd340.png"},{"id":100245807,"identity":"0cd422fb-bd51-4eb9-b318-8fc0cecffa01","added_by":"auto","created_at":"2026-01-14 14:12:26","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":147382,"visible":true,"origin":"","legend":"\u003cp\u003eComparative violin plots and ridge plots of GQS and mDISCERN scores for constipation videos on TikTok and Bilibili. (A) Comparison of GQS for videos between TikTok and Bilibili. (B) Distribution of GQS scores on TikTok and Bilibili. (C) Comparison of mDISCERN scores for videos between TikTok and Bilibili. (D) Distribution of mDISCERN scores on TikTok and Bilibili. ****P \u0026lt; 0.0001.\u003c/p\u003e","description":"","filename":"image3.png","url":"https://assets-eu.researchsquare.com/files/rs-8556425/v1/9b78c39167b2d3ce26b8e5eb.png"},{"id":100245809,"identity":"a8aee8aa-e98f-4104-a282-f30879bfcb0f","added_by":"auto","created_at":"2026-01-14 14:12:26","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":317251,"visible":true,"origin":"","legend":"\u003cp\u003eComparative violin plots of quality and reliability grouped by constipation videos source and content type. (A) GQS comparison of videos among different sources. (B) mDISCERN comparison of videos among different sources. (C) GQS comparison of videos among different content types. (D) mDISCERN comparison of videos among different content types. *P \u0026lt; 0.05, **P \u0026lt; 0.01, ***P \u0026lt; 0.001, ****P \u0026lt; 0.0001.\u003c/p\u003e","description":"","filename":"image4.png","url":"https://assets-eu.researchsquare.com/files/rs-8556425/v1/51cc962884c6b0c51de7eded.png"},{"id":100371311,"identity":"4284cf46-4cd5-4030-bd29-fec55da13d16","added_by":"auto","created_at":"2026-01-16 08:09:48","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":413025,"visible":true,"origin":"","legend":"\u003cp\u003eHeatmap of Spearman correlations between the viewer engagement index and videos quality/reliability.\u003c/p\u003e","description":"","filename":"image5.png","url":"https://assets-eu.researchsquare.com/files/rs-8556425/v1/dafb8a96a5496a84c8893872.png"},{"id":105979591,"identity":"1fd9ba45-3c30-47bd-bea9-cbd561aafda9","added_by":"auto","created_at":"2026-04-02 06:27:39","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2085623,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8556425/v1/61f2a1c7-7f42-4ee1-99cf-36aafbcbf4f9.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Assessment of Content Quality and Reliability of Chinese Short Videos about Constipation on TikTok and Bilibili: A Cross-Sectional Study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eConstipation is a highly prevalent functional bowel disorder, affecting approximately 14% of the global population chronically, significantly burdening patients\u0026rsquo; quality of life and healthcare systems \u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e,\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e. Its chronic and recurrent nature makes reliance solely on medical interventions insufficient. Science popularization and education can improve public understanding of constipation, promote self-management, facilitate tiered diagnosis and treatment, reduce misconceptions, and decrease healthcare burdens, holding important clinical and public health significance \u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIn recent years, short video platforms have become a major source of health information for the general public due to their rapid dissemination, broad reach, and engaging format \u003csup\u003e\u003cspan additionalcitationids=\"CR5\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e. Patients and the public have a continuous need for information on constipation etiology, management strategies, and treatment options. However, the open and low-threshold nature of social media content also poses significant challenges regarding uneven information quality \u003csup\u003e\u003cspan additionalcitationids=\"CR8\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e. Previous studies have shown that health information on platforms such as YouTube, TikTok, and Bilibili regarding various diseases (e.g., COPD, diabetes, COVID-19) may be inaccurate, one-sided, or even misleading \u003csup\u003e\u003cspan additionalcitationids=\"CR11\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e. Poor or inaccurate information compromises public perception and self-management practices, as well as hinders standardized diagnosis and treatment \u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eCurrently, there is a lack of systematic evaluation of information quality about constipation content on mainstream Chinese short video platforms. Therefore, this cross-sectional study aims to assess the content quality and reliability of constipation short videos on TikTok and Bilibili, with in-depth comparisons across platforms, video sources, and content categories. The findings aim to reveal the current status and issues in online health science communication, providing evidence for platform governance, professional content creation, and public health education.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eSearch Strategy and Data Collection\u003c/h2\u003e \u003cp\u003eThis cross-sectional study used newly registered accounts without browsing history to minimize bias from personalized recommendations. On November 1, 2025, the Chinese keyword \u0026ldquo;便秘\u0026rdquo; (constipation) was searched on TikTok and Bilibili, sorted by default comprehensive ranking. The top 100 short videos from each platform that satisfied the exclusion criteria were collected as the initial sample (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Exclusion criteria were: (1) upload within one week; (2) duration less than 10 seconds; (3) irrelevant language; (4) duplicate videos; (5) unrelated content; (6) advertisement videos.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eData Extraction and Variable Definitions\u003c/h3\u003e\n\u003cp\u003eBasic video data were extracted from each included video, including platform, source, content, duration, days dince upload, and engagement data (likes, favorites, comments, shares). Professional credentials were verified through platform details and hospital websites. All data were recorded in Excel (Microsoft Corporation, Redmond, USA). Two researchers (Bitao Wang and Hui Luo) independently extracted and cross-checked the data. All data were recorded on the day of collection to minimize bias due to video removal or data changes.\u003c/p\u003e \u003cp\u003eVideo sources were categorized into: medical professionals (doctors, nurses, pharmacists, dietitians, etc.), science communicators (health communication or knowledge sharing bloggers without explicit medical certification), and general users (patients or individuals without professional health backgrounds).\u003c/p\u003e \u003cp\u003eVideo content was classified into: disease knowledge (etiology, classification, symptoms, harms, diagnosis, etc.), drug therapy (mechanism of action, usage, pros/cons, precautions of constipation medications), Non-drug therapy (acupuncture, acupressure, colonic hydrotherapy, pelvic floor biofeedback, magnetic therapy, etc.), self-management skills (dietary adjustments, regular exercise, bowel movement techniques, abdominal massage, simple exercises, etc.), and personal experiences (constipation experiences, feelings, healthcare visits, etc.).\u003c/p\u003e\n\u003ch3\u003eQuality and Reliability Assessment Tools\u003c/h3\u003e\n\u003cp\u003eTwo validated tools were used for independent assessment:\u003c/p\u003e \u003cp\u003eGlobal Quality Scale (GQS) \u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e: Used to evaluate the overall educational quality and structure of videos. This 5-point scale (1\u0026thinsp;=\u0026thinsp;very poor, 5\u0026thinsp;=\u0026thinsp;excellent) rates content based on logical flow, completeness, and usefulness to viewers.\u003c/p\u003e \u003cp\u003eModified DISCERN tool (mDISCERN) \u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e: Used to assess the reliability of video information. This tool contains 5 yes/no questions covering clarity, balance, source citation, mention of additional sources, and explanation of uncertainties. Each \u0026ldquo;yes\u0026rdquo; scores 1 point, with total scores ranging 0\u0026ndash;5. Higher scores indicate greater reliability.\u003c/p\u003e \u003cp\u003eTwo researchers (Qiu Li and Yuchen Wang) independently watched and scored all videos using GQS and mDISCERN. They received consistency training beforehand. Videos with scoring discrepancies were reviewed and finalized by a senior researcher (Junhua Zhu). Cohen\u0026rsquo;s Kappa coefficient was used to assess inter-rater reliability: \u0026gt;0.8 indicated excellent agreement, 0.6\u0026ndash;0.8 high agreement, 0.4\u0026ndash;0.6 moderate agreement, and \u0026lt;\u0026thinsp;0.4 poor agreement.\u003c/p\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eIBM SPSS 24.0 was used for statistical analysis. The Shapiro\u0026ndash;Wilk test was used to assess normality of continuous variables. Normally distributed variables were expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (SD); non-normally distributed variables as median and 25th\u0026ndash;75th percentiles (M[P25, P75]). Group comparisons (platform, source, content) used Mann\u0026ndash;Whitney U or Kruskal\u0026ndash;Wallis H tests, with Bonferroni correction for post-hoc pairwise comparisons. Spearman correlation analysis assessed relationships between audience engagement and video quality, with correlation heatmaps generated using R. Spearman\u0026rsquo;s rank correlation coefficient (r) was interpreted as: |r| \u0026le; 0.2\u0026thinsp;=\u0026thinsp;negligible; 0.2 \u0026lt; |r| \u0026le; 0.4\u0026thinsp;=\u0026thinsp;weak; 0.4 \u0026lt; |r| \u0026le; 0.6\u0026thinsp;=\u0026thinsp;moderate; 0.6 \u0026lt; |r| \u0026le; 0.8\u0026thinsp;=\u0026thinsp;strong; |r| \u0026gt; 0.8\u0026thinsp;=\u0026thinsp;very strong. P\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eEthical Considerations\u003c/h3\u003e\n\u003cp\u003eThis study analyzes public content on TikTok and Bilibili platforms, strictly adhering to each platform's service agreements and data usage regulations. The research only collects and analyzes voluntarily published public content and does not involve direct recruitment of participants. This study has received an ethics review exemption from the Ethics Committee of Maternal and Child Health Hospital of Hubei Province, confirming that the analysis of public social media data does not require a comprehensive ethical review (Approval Code: 2025-270-01). We follow ethical guidelines for social media research by removing all personally identifiable information and presenting the results in aggregated and anonymized form to protect user privacy.\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\n \u003ch2\u003eBasic Video Characteristics\u003c/h2\u003e\n \u003cp\u003eA total of 200 short videos were included, 100 each from TikTok and Bilibili. Basic characteristics are shown in Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e. TikTok videos had significantly higher median engagement metrics (Likes, Favorites, Shares, Comments) than Bilibili videos (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). However, Bilibili videos were significantly longer in Duration [201.50 (124.75, 438.00) seconds vs. 50.50 (35.00, 108.25) seconds, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001] and had been online longer [616.00 (253.25, 1193.00) days vs. 121.50 (57.00, 306.50) days, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001].\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eBaseline characteristics of videos on TikTok and Bilibili.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eTotal (n\u0026thinsp;=\u0026thinsp;200)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eTikTok (n\u0026thinsp;=\u0026thinsp;100)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eBilibili (n\u0026thinsp;=\u0026thinsp;100)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cem\u003ep\u003c/em\u003e value\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLikes,\u003c/p\u003e\n \u003cp\u003eM (Q₁, Q₃)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1442.00 (214.75, 9040.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3654.00 (659.00, 17815.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e717.50 (109.75, 3109.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eComments,\u003c/p\u003e\n \u003cp\u003eM (Q₁, Q₃)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e126.50 (22.00, 770.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e269.00 (43.00, 1245.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e75.00 (8.75, 417.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFavorites,\u003c/p\u003e\n \u003cp\u003eM (Q₁, Q₃)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1000.00 (132.25, 4675.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2076.00 (277.50, 9232.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e464.00 (107.75, 1962.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eShares,\u003c/p\u003e\n \u003cp\u003eM (Q₁, Q₃)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e583.00 (101.50, 5041.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1955.50 (289.50, 16430.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e293.50 (55.50, 1291.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDuration,\u003c/p\u003e\n \u003cp\u003eM (Q₁, Q₃)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e113.50 (48.75, 224.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e50.50 (35.00, 108.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e201.50 (124.75, 438.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDays Since Upload,\u003c/p\u003e\n \u003cp\u003eM (Q₁, Q₃)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e289.00 (80.75, 815.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e121.50 (57.00, 306.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e616.00 (253.25, 1193.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGQS score,\u003c/p\u003e\n \u003cp\u003eM (Q₁, Q₃)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3.00 (2.00, 4.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.00 (2.00, 3.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3.00 (2.00, 5.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003emDISCERN Score,\u003c/p\u003e\n \u003cp\u003eM (Q₁, Q₃)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.00 (2.00, 4.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2.00 (2.00, 3.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e3.00 (2.00, 5.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003ch3\u003eVideo Source and Content Distribution\u003c/h3\u003e\n\u003cp\u003eThe distribution of video sources and content types is shown in Fig. \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e and in Tables \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e and \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e. Overall, science communicators were the largest source group (46.0%), followed by medical professionals (39.5%) and general users (14.5%). On TikTok, science communicators accounted for the highest proportion (52.0%), followed by medical professionals (28.0%) and general users (20.0%); on Bilibili, medical professionals were the largest group (51.0%), followed by science communicators (40.0%) and general users (9.0%).\u0026nbsp;\u003c/p\u003e\n\u003ctable id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eCharacteristics of constipation videos by source and content on TikTok.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eLikes\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eComments\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCollects\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eShares\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eDuration\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eDays Since Upload\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003eVideo source\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMedical Professionals\u003c/p\u003e\n \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4910.00 (2600.00,26285.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e297.50 (106.75,2553.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3298.50 (1023.25,15311.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2169.00 (487.00,38062.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55.00 (39.75,86.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e125.00 (39.50,331.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eScience Communicators\u003c/p\u003e\n \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4564.00 (861.50,31453.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e203.50 (40.25,1305.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3235.00 (579.50,9232.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2120.00 (402.50,19998.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e52.50 (34.75,116.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e139.50 (70.00,287.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGeneral Users\u003c/p\u003e\n \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e661.50 (94.25,2783.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e276.00 (38.00,647.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e142.00 (14.75,1675.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e524.00 (42.50,4431.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41.50 (33.00,57.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e98.00 (61.75,208.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003eVideo content\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDisease Knowledge\u003c/p\u003e\n \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3358.00 (1498.00,23834.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e302.00 (109.00,994.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1694.00 (1050.00,6372.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1363.00 (515.00,27137.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e90.00 (49.00,129.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e166.00 (40.00,663.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDrug Therapy\u003c/p\u003e\n \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6145.50 (681.50,15190.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e148.50 (44.00,305.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2801.00 (398.75,18507.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e699.00 (64.75,8358.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e56.50 (41.75,85.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e52.00 (37.25,80.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNon-drug Therapy\u003c/p\u003e\n \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3151.00 (488.00,5412.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e134.00 (17.00,321.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2487.00 (270.00,6231.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e661.00 (143.00,5351.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51.00 (33.00,162.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e82.00 (40.00,142.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSelf-management Skills\u003c/p\u003e\n \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4760.00 (1095.00,29453.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e421.00 (95.00,1318.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3873.00 (788.00,22046.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6153.00 (859.00,23504.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41.00 (30.00,59.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e184.00 (82.00,306.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePersonal Experiences\u003c/p\u003e\n \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e753.00 (233.50,8490.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e336.00 (42.00,957.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e527.00 (31.00,3018.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e737.00 (71.00,2835.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e63.00 (45.00,112.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e84.00 (67.50,241.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab5\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eCharacteristics of videos by source and content on Bilibili.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eLikes\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eComments\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCollects\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eShares\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eDuration\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eDays Since Upload\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003eVideo source\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMedical Professionals\u003c/p\u003e\n \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e352.00 (63.00,2465.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e50.00 (3.00,240.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e211.00 (58.50,1047.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e147.00 (43.00,791.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e175.00 (98.50,335.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e789.00 (229.50,1274.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eScience Communicators\u003c/p\u003e\n \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1116.50 (334.50,7394.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e119.50 (45.00,626.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1123.00 (409.50,5803.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e601.50 (186.75,3837.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e241.00 (141.75,483.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e676.50 (327.25,1194.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGeneral Users\u003c/p\u003e\n \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e122.00 (47.00,1012.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e24.00 (8.00,62.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e196.00 (67.00,1303.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15.00 (9.00,374.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e436.00 (137.00,681.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e395.00 (76.00,565.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"7\"\u003e\n \u003cp\u003eVideo content\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDisease Knowledge\u003c/p\u003e\n \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e747.00 (215.00,3111.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e91.00 (19.00,429.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e393.00 (134.00,2845.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e285.00 (104.00,1356.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e335.00 (157.00,505.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e835.00 (420.00,1332.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDrug Therapy\u003c/p\u003e\n \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e245.00 (57.00,1109.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e58.00 (18.00,271.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e267.00 (78.50,641.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e148.00 (41.50,507.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e137.00 (112.00,206.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e911.00 (310.00,1494.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNon-drug Therapy\u003c/p\u003e\n \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e242.50 (55.50,1345.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13.00 (2.50,91.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e710.50 (107.50,2529.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e338.00 (69.00,1140.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e241.00 (138.50,906.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e835.50 (157.50,1166.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSelf-management Skills\u003c/p\u003e\n \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1251.00 (215.00,8579.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e128.00 (24.00,782.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1277.00 (164.00,6640.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e557.00 (81.00,2990.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e128.00 (91.00,334.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e521.00 (272.00,789.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePersonal Experiences\u003c/p\u003e\n \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1427.00 (122.00,3609.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e87.00 (25.00,289.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e254.00 (98.00,1303.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e139.00 (20.00,603.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e233.00 (134.00,278.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e565.00 (131.00,854.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eRegarding content, the two most common categories overall were self-management skills (31.0%) and disease knowledge (23.0%). On TikTok, self-management skills videos were most frequent (41.0%), followed by personal experiences (19.0%), disease knowledge (17.0%), drug therapy (14%), and non-drug therapy (9%). On Bilibili, disease knowledge videos were most frequent (29.0%), followed by non-drug therapy (22.0%), self-management skills (21.0%), drug therapy (15%), and personal experiences (13%).\u003c/p\u003e\n\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\n \u003ch2\u003eVideo Quality and Reliability Assessment\u003c/h2\u003e\n \u003cp\u003eInter-rater agreement was good for both the GQS (\u0026kappa;\u0026thinsp;=\u0026thinsp;0.701) and the mDISCERN (\u0026kappa;\u0026thinsp;=\u0026thinsp;0.642). Bilibili videos scored significantly higher [GQS: 3.00 (2.00, 5.00); mDISCERN: 3.00 (2.00, 5.00)] than TikTok videos [GQS: 2.00 (2.00, 3.00); mDISCERN: 2.00 (2.00, 3.00)] (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). However, overall video quality and reliability on both platforms were low, with scores mainly distributed between 2 and 3 (Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e; Fig. \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\n \u003cp\u003eFurther analysis (Fig. \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e) showed that videos from medical professionals had the highest GQS and mDISCERN scores, followed by science communicators, with general users scoring the lowest; differences among the three were statistically significant (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Disease knowledge videos scored significantly higher in quality and reliability than the other four categories (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), while self-management skills and personal experiences scored the lowest.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\n \u003ch2\u003eCorrelation Analysis\u003c/h2\u003e\n \u003cp\u003eSpearman correlation analysis results are shown in Fig. \u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e. Video quality showed a very strong positive correlation with reliability (r\u0026thinsp;=\u0026thinsp;0.84, P\u0026thinsp;\u0026lt;\u0026thinsp;0.05) and a weak positive correlation with Days Since Upload (r\u0026thinsp;=\u0026thinsp;0.20, P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Video reliability showed a very strong positive correlation with quality (r\u0026thinsp;=\u0026thinsp;0.84, P\u0026thinsp;\u0026lt;\u0026thinsp;0.05), and weak positive correlations with Duration (r\u0026thinsp;=\u0026thinsp;0.38, P\u0026thinsp;\u0026lt;\u0026thinsp;0.05) and Days Since Upload (r\u0026thinsp;=\u0026thinsp;0.22, P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Engagement metrics (Likes, Comments, Shares, Favorites) were strongly positively correlated with each other (r\u0026thinsp;\u0026gt;\u0026thinsp;0.8, P\u0026thinsp;\u0026lt;\u0026thinsp;0.05) but showed no correlation with quality or reliability (|r| \u0026le; 0.2).\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eStudy Background and Significance\u003c/h2\u003e \u003cp\u003eConstipation is a highly prevalent bowel disorder closely related to daily life, with relatively low barriers to understanding basic diagnosis and management knowledge, making it easy to learn, master, and practice \u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e. High quality science communication videos can generally improve patients' health awareness and self-management abilities, thereby reducing health risks and healthcare burdens \u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e. This study is the first to systematically evaluate the quality and reliability of health information aboutconstipation on the mainstream Chinese short video platforms TikTok and Bilibili.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eMain Findings\u003c/h2\u003e \u003cp\u003eThe main findings can be summarized as follows: First, the overall quality and reliability of constipation short videos on both platforms are suboptimal. Second, Bilibili videos, those produced by medical professionals, and those focusing on disease knowledge scored significantly higher in quality and reliability. Third, video popularity (measured by engagement) was not associated with information quality and reliability.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eCross-Platform Health Video Information Quality and Reliability\u003c/h2\u003e \u003cp\u003eThis study found (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e) that Bilibili videos outperformed TikTok videos in both quality and reliability, partially consistent with recent studies on other health topics (e.g., liver cancer, breast cancer, laryngeal cancer) \u003csup\u003e\u003cspan additionalcitationids=\"CR18\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e. This divergence may be attributable to distinct platform attributes and user habits \u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e,\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e. Bilibili is known for mid-to-long-form and in-depth content, with a community culture leaning toward learning and knowledge sharing, attracting more professionals to produce systematic science content (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eC). Longer video duration allows for a more comprehensive and in-depth explanation of medical concepts, which could be the reason for the higher quality observed in Bilibili videos \u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e,\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e. Our finding of a positive correlation between video reliability and duration is consistent with this explanation (Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). In contrast, TikTok favors short, fast-paced content consumption, and its algorithm may prioritize entertaining, easily shareable yet less in-depth content in the form of \"tips\". This pattern is evidenced by TikTok's significantly higher scores on all interaction metrics (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003e) and its greater proportion of videos categorized as \"self-management skills\" and \"personal experiences\" (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eE).\u003c/p\u003e \u003cp\u003eAdditionally, it is noteworthy that video quality and reliability on both platforms were suboptimal, with scores concentrated in the lower range (Figs.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003eB, D). This highlights the need for platforms to improve their content review and quality evaluation mechanisms. Such improvements are crucial to ensure that high quality videos receive greater visibility and sustained dissemination.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eVideo Source Analysis\u003c/h2\u003e \u003cp\u003eOur study clearly demonstrates that medical professionals are the most important source of high-quality, reliable health information (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). Their videos performed better in scientific accuracy, balance, and evidence citation. In contrast, although science communicators produced more content, their average quality was significantly lower than that of medical professionals. Personal experiences shared by general users (primarily patients) can offer emotional support, yet they often consist of subjective feelings and individualized narratives that may include misconceptions. Lacking generalizability and scientific rigor, such content consequently received the lowest scores in both quality and reliability. This finding aligns with other domestic and international studies, emphasizing the importance of professional credentials in health communication \u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e,\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e. Encouragingly, the Chinese government has introduced regulations to improve online health content quality, which include encouraging medical professionals to create accurate, engaging videos for better public awareness of common disease \u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eVideo Content Analysis\u003c/h2\u003e \u003cp\u003eRegarding content, \"disease knowledge\" videos scored the highest, as they are typically based on medical facts and systematic explanations, often citing references or sources. \"Self-management skills\" videos, while highly prevalent, practical, and easy to imitate, often lack scientific explanation and may spread unverified \"folk remedies\" or even pose safety risks, resulting in lower scores. This reflects viewers' preference for practical advice and willingness for self-management \u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e,\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e. Given this situation, both viewers and platforms should exercise caution with such \u0026ldquo;tip\u0026rdquo; videos, seek professional verification when necessary, and improve content filtering mechanisms \u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eCorrelation Between Video Quality, Reliability, and Engagement Metrics\u003c/h2\u003e \u003cp\u003eA noteworthy finding is that video quality and reliability showed no correlation with engagement metrics such as Likes, Comments, Favorites, and Shares (Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). This indicates that the most popular and widely shared videos are not necessarily the most accurate or valuable. This observation aligns with studies by Zheng and Sun et al., suggesting that viewers often cannot discern the quality of health-related videos, highlighting the need for strengthened public health education \u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e,\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e. As noted in Mueller et al.'s study on YouTube, if platform algorithms rely solely on engagement and completion rates for recommendations, they may amplify the spread of low-quality or misleading content, creating a \"bad money drives out good\" effect \u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e. Therefore, optimizing recommendation algorithms to incorporate information quality as a weighting factor is crucial for improving the online health information ecosystem.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003eLimitations and Future Directions\u003c/h2\u003e \u003cp\u003eThis study has several limitations. First, as a cross-sectional study, it reflects content status at a specific time point and analyzed only the top 100 eligible videos per platform, potentially not covering all relevant content. Second, the assessment tools (GQS and mDISCERN) primarily evaluate content itself, with limited assessment of production professionalism and visual presentation. Third, the study was confined to Chinese content, which necessitates caution in extrapolating the results to other languages. Future research could be improved by adopting multilingual, large sample designs and by incorporating scales such as PEMAT, VIQI, or JAMA benchmarks.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn summary, the quality and reliability of constipation short videos on TikTok and Bilibili need overall improvement. Bilibili, videos by medical professionals, and disease knowledge content demonstrated higher information quality. However, current platform popularity mechanisms are not aligned with information quality. Therefore, we recommend: First, platforms should establish more robust content review and quality evaluation systems, optimizing algorithms to prioritize high-quality, reliable medical science content. Second, more medical professionals should be encouraged to use short video platforms to produce scientifically accurate, engaging, and understandable constipation content. Third, public education should be enhanced to improve health information literacy and critical thinking skills, enabling individuals to identify and select high-quality information sources. Multi-party collaboration is essential to build a clearer and more reliable online health information environment.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eCompeting interests\u003c/h2\u003e \u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eNo funding was received for this study.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eQiu Li and Chengcheng Pei conceived and designed the study. Bitao Wang and Hui Luo performed video searches, data collection, and cross-verification. Qiu Li, Yuchen Wang, and Junhua Zhu conducted data categorization and scoring. Qiu Li analyzed the data and drafted the manuscript. Chengcheng Pei and Junhua Zhu reviewed and revised the manuscript. All authors contributed to the article and approved the submitted version.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eThe authors thank video creators for their contributions to public health.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe datasets for the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eSperber, A. D. et al. 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Res.\u003c/em\u003e \u003cb\u003e22\u003c/b\u003e, e15599. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2196/15599\u003c/span\u003e\u003cspan address=\"10.2196/15599\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e (2020).\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Constipation, short videos, information quality, reliability, TikTok, Bilibili","lastPublishedDoi":"10.21203/rs.3.rs-8556425/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8556425/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eConstipation is a common functional bowel disorder where self-management and reliable health information are important. Short video platforms are a key health information source, but their content quality varies. This study evaluated the quality and reliability of constipation Chinese short videos on TikTok and Bilibili, comparing platform, source, and content type. The top 100 eligible videos from each platform were retrieved on November 1, 2025, using the keyword \u0026ldquo;constipation\u0026rdquo; and assessed with GQS and mDISCERN tools. Among 200 videos, Bilibili content scored significantly higher in quality (median GQS 3.00 vs. 2.00) and reliability (median mDISCERN 3.00 vs. 2.00) than TikTok (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Videos produced by medical professionals received the highest scores, whereas those from general users received the lowest (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Furthermore, disease knowledge videos significantly outperformed videos in other content categories (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Engagement metrics showed no correlation with information quality. Overall, video quality requires improvement. Content on Bilibili, from professionals, and focusing on disease knowledge performed better, but popularity did not indicate quality. Platforms should optimize review and recommendation systems, encourage professional contributions, and improve public health literacy to support accurate information dissemination.\u003c/p\u003e","manuscriptTitle":"Assessment of Content Quality and Reliability of Chinese Short Videos about Constipation on TikTok and Bilibili: A Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-14 14:12:22","doi":"10.21203/rs.3.rs-8556425/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d8218522-e287-4447-914f-314274c9c69d","owner":[],"postedDate":"January 14th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":61036810,"name":"Health sciences/Gastroenterology"},{"id":61036811,"name":"Health sciences/Health care"},{"id":61036812,"name":"Health sciences/Medical research"}],"tags":[],"updatedAt":"2026-04-02T06:26:44+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-14 14:12:22","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8556425","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8556425","identity":"rs-8556425","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}