Quality and reliability of Hyperbaric Oxygen Therapy-related videos on TikTok and Bilibili: a cross-sectional study

Quality and reliability of Hyperbaric Oxygen Therapy-related videos 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 Quality and reliability of Hyperbaric Oxygen Therapy-related videos on TikTok and Bilibili: a cross-sectional study Bingtao He, Keweng Wang, Yuchang Gui, Xue Diao, JianWen Xu This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9409606/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 Background With the rapid development of digital media, short-video platforms have become primary channels for the public to access health information. Despite the proliferation of videos regarding hyperbaric oxygen therapy (HBOT), their quality and reliability remain unassessed. Methods A cross-sectional search was conducted on TikTok and Bilibili using the keyword "高压氧治疗" on February 25, 2026. The top 100 videos from each platform were selected. Video characteristics, uploader identities, and content themes were extracted. Two independent reviewers assessed video quality and reliability using the Global Quality Scale (GQS) and the modified DISCERN (mDISCERN) tools. Non-parametric tests (Mann-Whitney U test, Kruskal-Wallis H test) and Spearman's rank correlation were used for statistical analysis. Results A total of 172 videos were included (98 from TikTok, 74 from Bilibili). The overall quality was moderate, yielding a median GQS of 3.00 and mDISCERN of 2.00. TikTok videos showed significantly higher user engagement metrics and GQS scores compared to Bilibili ( p = 0.019). Videos uploaded by healthcare professionals demonstrated significantly superior quality and reliability scores ( p < 0.001). However, adverse effects and potential complications were rarely mentioned (2.91%). A subgroup analysis revealed that videos promoting off-label anti-aging benefits (11.04%) were predominantly uploaded by non-professionals (73.68%) and generated exceptionally high collections despite lacking scientific rigor. Furthermore, user engagement indicators (likes, collections, comments, and shares) showed no significant correlation with video quality scores ( p > 0.05). Conclusions HBOT-related videos on TikTok and Bilibili exhibit moderate quality and reliability, accompanied by a concerning omission of safety information. While healthcare professionals produce more accurate content, high user engagement does not equate to scientific validity. Improved digital communication strategies and strict platform regulations are urgently needed to disseminate high-quality, evidence-based HBOT information to the public. Trial registration Not applicable. Health sciences/Health care Health sciences/Medical research hyperbaric oxygen therapy short-video platforms health information quality TikTok Bilibili Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 6 Introduction Hyperbaric oxygen therapy (HBOT) is a medical treatment that involves exposing patients to pure oxygen under increased atmospheric pressure (typically 2 to 3 atmospheres). This process enhances tissue oxygen bioavailability, particularly in hypoxic regions, thereby elevating the oxygen content in both blood and tissues [ 1 ] . Additionally, HBOT exhibits various clinical benefits, including antibacterial [ 2 , 3 ] , immunomodulatory [ 4 , 5 ] , angiogenic [ 6 , 7 ] , and antioxidant effects [ 7 , 8 ] . Due to its high safety profile, non-invasive nature, and relative cost-effectiveness, HBOT has been approved for 14 clinical indications, such as carbon monoxide poisoning, decompression sickness, and sudden sensorineural hearing loss [ 1 , 9 , 10 ] . Moreover, its applications are continuously expanding as an adjunctive treatment for conditions like COVID-19 [ 11 ] , traumatic brain injury [ 12 ] , and cancer [ 13 , 14 ] , highlighting its broadening role in modern clinical practice. With the rapid development of digital media, social platforms have become integral to the healthcare sector, serving as crucial channels for disseminating medical knowledge, raising health awareness, and promoting behavioral changes [ 15 , 16 ] . Among these, short-video platforms have emerged as a primary medium for the public to access health information, supported by a massive user base [ 17 ] . However, these platforms often host unverified, inaccurate, or entirely false information. Such misinformation can mislead the public, potentially leading to delayed treatments or adverse health outcomes [ 18 – 20 ] . Such misinformation can mislead the public, potentially leading to delayed treatments or adverse health outcomes. Previous infodemiology studies have consistently demonstrated that videos related to medical treatments, such as orthognathic surgery [ 21 ] , bariatric surgery [ 22 ] , and radiotherapy [ 23 ] , on these platforms frequently suffer from low quality, with significant variations in content reliability. Despite the proliferation of HBOT-related videos on TikTok and Bilibili, their quality and accuracy remain unassessed. While emerging literature explores the therapy's potential anti-aging benefits [ 24 – 27 ] , influencers frequently oversimplify these preliminary findings, exaggerating HBOT as a proven panacea. This lack of quality control misleads the public, encourages dangerous off-label use, and threatens patient safety. Therefore, this cross-sectional study evaluates the content, quality, and reliability of HBOT videos on these platforms, aiming to provide evidence-based insights for improving digital health communication. Methods Ethical considerations This study did not involve human participants, clinical data, laboratory animals, or histological procedures. All data were obtained from publicly accessible TikTok and Bilibili videos, and collection complied with both platforms' Terms of Service. No private or personally identifiable information was collected or processed, and no user interaction occurred; therefore, individual consent was not required. We confirm that this exemption complies with national guidelines, and formal ethics approval is not required for this type of publicly available social media content analysis [ 28 – 31 ] . Furthermore, the study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. Search strategy and data collection Data collection was strictly limited to a single day, February 25, 2026. Given the highly dynamic nature of the TikTok and Bilibili ecosystems, where videos are constantly uploaded, updated, or deleted, and search algorithms fluctuate daily, we adopted a cross-sectional snapshot design to ensure methodological consistency and data reliability. All searches were completed within a 24-hour window to maintain sample consistency. This strategy ensured that all videos were retrieved under identical algorithmic conditions, avoiding systematic bias caused by daily content updates and minimizing temporal bias. Furthermore, to mitigate the influence of personalized recommendation algorithms, investigators cleared all cookies, browsing history, and temporary internet files prior to each search. All platform accounts were logged out, and searches were conducted exclusively in incognito mode. The keyword "高压氧治疗" (the Chinese term for hyperbaric oxygen therapy) was searched on TikTok (specifically the Chinese version, Douyin; https://www.douyin.com/ ) and Bilibili ( https://www.bilibili.com/ ). Videos were sorted using the platforms' default comprehensive algorithms without restricting the publication date, reflecting typical user search behavior. The top 100 videos from each platform were selected for analysis, as previous studies have demonstrated that reviewing videos beyond this threshold yields diminishing returns for data validity [ 30 , 31 ] . For each included video, we extracted metadata and user engagement metrics (i.e., video duration, likes, collections, comments, and shares). Uploaders were classified into five categories: hospitals, neurosurgeons, hyperbaric medicine and rehabilitation physicians, other specialists (e.g., neurology, orthopedics), and individual users. With the exception of individual users, all other categories were grouped under the umbrella term "professionals." We conducted a key theme analysis of the video content, categorizing it into the following domains: mechanisms of action and therapeutic effects; clinical indications and contraindications; descriptions of the treatment environment and equipment; treatment procedures and patient experiences; adverse effects and potential complications; ear equalization techniques; and claims regarding anti-aging benefits. All extracted data were recorded in Microsoft Excel. Inclusion and Exclusion Criteria To be included in the study, videos had to be primarily focused on hyperbaric oxygen therapy (HBOT) and presented in Mandarin Chinese. Videos were excluded if they met any of the following criteria: (1) they were duplicate uploads on the same platform; or (2) they lacked clear human audio narration (e.g., silent videos or those containing only background music), which precluded accurate quality assessment. The study flowchart is presented in Fig. 1 . Video quality and reliability assessment In this study, we utilized the Global Quality Scale (GQS) and the modified DISCERN (mDISCERN) tools to evaluate the quality and reliability of the video content. The GQS is a widely used instrument for assessing the quality of health information in videos [ 32 ] . It employs a 5-point scale ranging from 1 (poor quality) to 5 (high quality). Specifically, scores of 1 to 2 indicate poor quality, a score of 3 indicates moderate quality, and scores of 4 to 5 denote high quality (detailed in Table 1 ). Table 1 The Global Quality Score (GQS) quality criteria. Item features Points Poor quality; poor flow of the videos; most information missing; not at all useful for patients 1 Generally poor quality; some information listed, but many important topics missing; of very limited use to patients 2 Moderate quality; suboptimal flow; some important adequately discussed, but other information poorly discussed; somewhat useful for patients 3 Good quality and generally good flow; most of the relevant information listed, but some topics not covered; useful for patients 4 Excellent quality and flow; very useful for patients 5 The mDISCERN tool is a broadly validated and applied instrument designed to assist consumers and healthcare professionals in evaluating the reliability of health-related video content [ 33 ] . This tool assesses videos based on five key questions (detailed in Table 2 ). For each question, a score of 1 is assigned for a "yes" response and 0 for a "no" response, resulting in a total score ranging from 0 to 5. For both scales, higher scores indicate superior video quality and reliability. Table 2 The Modified DISCERN (mDISCERN) quality criteria. Reliability Score 1. Is the video clear, concise, and understandable? 2. Are valid sources cited? 3. Is the content presented balanced and unbiased? 4. Are additional sources of content listed for patient reference? 5. Are areas of uncertainty mentioned? To ensure rigorous evaluation, each video was independently scored by two reviewers with expertise in hyperbaric medicine. Any discrepancies between the two primary reviewers were resolved through adjudication by a third independent reviewer with certified qualifications in hyperbaric oxygen therapy, who determined the final consensus score. Statistical analysis Statistical analyses and data visualizations were performed using R software (version 4.3.2). The normality of continuous variables was evaluated using the Shapiro-Wilk test. Given the non-normal distribution of the data, continuous variables were expressed as medians with interquartile ranges (IQRs), while categorical variables were presented as frequencies and percentages. The Mann-Whitney U test was employed for comparisons between two independent groups (e.g., platforms or professionals vs. non-professionals). For comparisons involving three or more independent groups (e.g., specific uploader categories), the Kruskal-Wallis H test was utilized. Spearman's rank correlation coefficient (ρ) was calculated to evaluate the associations between video quality scores (GQS and mDISCERN) and user engagement indicators (likes, comments, shares, and collections). All statistical tests were two-sided, and statistical significance was set at p < 0.05. Results Overview of the video features A total of 172 HBOT-related videos were included in this study, comprising 98 from TikTok and 74 from Bilibili. Video characteristics were analyzed based on duration, number of likes, collections, comments, and shares. Compared to Bilibili, TikTok videos were significantly shorter in length (median: 70.00 seconds, IQR: 46.50–144.50) but demonstrated superior performance in user engagement metrics, including likes (median: 168.00, IQR: 59.75–752.50), collections (median: 68.00, IQR: 16.50–244.25), comments (median: 17.00, IQR: 5.00–60.00), and shares (median: 83.50, IQR: 16.50–308.00), as shown in Table 3 . When categorized by uploader identity, there were no significant differences in video duration, likes, collections, or comments between professionals and non-professionals. However, videos uploaded by professionals had a significantly higher number of shares ( p = 0.038). Table 3 General Information, Quality, and Reliability Scores of Hyperbaric Oxygen Therapy-related Videos on TikTok and Bilibili Variables Total (n = 172) TikTok (n = 98) Bilibili (n = 74) P General information Video length(s),M (Q1,Q3) 79.50 (52.75, 189.25) 70.00 (46.50, 144.50) 103.50 (57.00, 376.25) 0.001 Likes,M (Q1,Q3) 58.00 (8.75, 310.50) 168.00 (59.75, 752.50) 7.00 (2.25, 28.00) < .001 Collections,M (Q1,Q3) 25.50 (6.00, 116.00) 68.00 (16.50, 244.25) 7.50 (2.00, 29.75) < .001 Comments,M (Q1,Q3) 6.00 (0.00, 33.25) 17.00 (5.00, 60.00) 0.50 (0.00, 6.00) < .001 Shares,M (Q1,Q3) 25.50 (6.75, 166.50) 83.50 (16.50, 308.00) 7.00 (1.00, 24.00) < .001 Video content Mechanisms of action and therapeutic effects 85(49.42%) 42(42.86%) 43(58.11%) Clinical indications and contraindications 111(64.53%) 68(69.39%) 43(58.11%) Description of the treatment environment and equipment 38(22.09%) 18(18.36%) 20(27.03%) Treatment procedures and patient experiences 48(27.90%) 29(29.59%) 19(25.68%) Adverse effects and potential complications 5(2.91%) 3(3.06%) 2(2.70%) Ear equalization techniques 25(14.53%) 18(18.36%) 7(9.46%) Claims regarding anti-aging benefits 19(11.04%) 6(6.12%) 13(17.56%) Video quality GQS score,M (Q1,Q3) 3.00 (3.00, 3.00) 3.00 (3.00, 3.00) 3.00 (2.00, 3.00) 0.019 mDISCERN score,M (Q1,Q3) 2.00 (2.00, 2.00) 2.00 (2.00, 2.00) 2.00 (2.00, 2.00) 0.219 GQS: Global Quality Scale; mDISCERN: modified DISCERN; IQR: interquartile range. Uploader characteristics and video content By uploader classification, hospitals accounted for the largest share of videos (28.49%), closely followed by individual users (27.91%), neurosurgeons (16.28%), hyperbaric medicine and rehabilitation physicians (14.53%), and other healthcare professionals (12.79%; Fig. 2 (a)). Platform distribution varied significantly: hospitals and neurosurgeons each contributed 26% on TikTok, whereas individual users dominated Bilibili at 43%, leaving neurosurgeons at only 4% (Fig. 2 (b)). Regarding content, clinical indications and contraindications were the most prevalent across the 172 videos (64.53%), followed by mechanisms of action (49.42%). Notably, clinical indications dominated TikTok, while Bilibili addressed both topics equally. Across both platforms, adverse effects and potential complications were consistently the least mentioned content (2.91%) (Fig. 3 ). Characteristics of videos claiming anti-aging benefits A subgroup analysis was conducted on the 19 videos addressing anti-aging benefits (Table 5 ). Notably, the majority of these videos were disseminated on Bilibili (13/19, 68.42%) rather than TikTok (6/19, 31.58%). Regarding the uploaders, non-professionals heavily dominated this content, with individual users accounting for 73.68% (14/19) of the videos. Conversely, professional entities such as hospitals (1/19, 5.26%) and hyperbaric medicine physicians (2/19, 10.53%) rarely published content promoting anti-aging effects. Although these videos generated substantial user engagement (e.g., a median of 83.00 likes and 55.00 collections), their overall quality and reliability remained moderate to low, with a median GQS score of 3.00 and an mDISCERN score of 2.00. Table 5 General Characteristics, Quality, and Reliability of Hyperbaric Oxygen Therapy-related Videos Regarding Anti-aging Benefits Variables Total (n = 19) Short-video sharing platforms [n(%)] TikTok 6(31.58%) Bilibili 13(68.42%) Uploaders [n(%)] Individual users 14(73.68%) Hyperbaric medicine and rehabilitation physicians 2(10.53%) Neurosurgeons 1(5.26%) Other healthcare professionals 1(5.26%) Hospitals 1(5.26%) General information Video length(s),M (Q1,Q3) 187.00 (64.50, 374.00) Likes,M (Q1,Q3) 83.00 (4.50, 1798.00) Collections,M (Q1,Q3) 55.00 (5.00, 285.00) Comments,M (Q1,Q3) 18.00 (0.00, 150.50) Shares,M (Q1,Q3) 35.00 (7.50, 193.00) Video quality GQS score,M (Q1,Q3) 3.00 (2.00, 3.00) mDISCERN score,M (Q1,Q3) 2.00 (2.00, 2.00) GQS: Global Quality Scale; mDISCERN: modified DISCERN; IQR: interquartile range. Video quality and reliability The overall quality of the HBOT-related videos was moderate, yielding a median GQS score of 3.00 (IQR: 3.00–3.00) and a median mDISCERN score of 2.00 (IQR: 2.00–2.00). Between the platforms, TikTok videos scored significantly higher in GQS than those on Bilibili ( p = 0.019), whereas mDISCERN scores showed no significant difference ( p = 0.219) (Table 3 ). Regarding uploader identity, professional content exhibited significantly superior quality and reliability. Professionals outperformed non-professionals on both the GQS (median: 3.00 vs. 2.00) and mDISCERN tools (median: 2.00 vs. 1.00) (both p < 0.001; Table 4 ). These distinct score distributions and significant quality disparities between the two uploader types are visually detailed in Figs. 4 and 5 . Table 4 Characteristics, Quality, and Reliability of Hyperbaric Oxygen Therapy-related Videos by Different Uploaders on TikTok and Bilibili Variables Professionals (n = 124) Non-professionals(n = 48) P Video length(s),M (Q1,Q3) 77.00 (49.50, 176.00) 97.50 (54.75, 209.00) 0.316 Likes,M (Q1,Q3) 61.50 (12.00, 235.50) 47.00 (4.00, 629.50) 0.624 Collections,M (Q1,Q3) 29.00 (8.75, 104.75) 23.00 (2.00, 196.75) 0.306 Comments,M (Q1,Q3) 5.50 (0.75, 26.25) 11.00 (0.00, 126.25) 0.254 Shares,M (Q1,Q3) 28.50 (10.00, 169.00) 15.50 (1.00, 114.75) 0.038 GQS score,M (Q1,Q3) 3.00 (3.00, 3.00) 2.00 (2.00, 3.00) < .001 mDISCERN score,M (Q1,Q3) 2.00 (2.00, 2.00) 1.00 (1.00, 2.00) < .001 Correlation of Video General Information With Quality and Reliability Analysis showed that video length was not significantly correlated with any user engagement metrics, including likes ( r = -0.09, p > 0.05), collections ( r = 0.03, p > 0.05), comments ( r = 0.02, p > 0.05), and shares ( r = -0.03, p > 0.05). However, video length was significantly and positively correlated with video quality, showing a weak positive correlation with both the GQS score ( r = 0.26, p < 0.05) and the mDISCERN score ( r = 0.18, p < 0.05). A strong and significant positive correlation was observed among all user engagement indicators ( p < 0.05). Specifically, the number of likes was highly correlated with collections ( r = 0.89), comments ( r = 0.89), and shares ( r = 0.88). The number of collections was strongly correlated with comments ( r = 0.80) and shares ( r = 0.92), while comments were also positively correlated with shares ( r = 0.81). Importantly, none of the user engagement indicators (likes, collections, comments, and shares) showed any significant correlation with the video quality scores (GQS or mDISCERN) (all p > 0.05). Finally, a strong positive correlation was observed between the two quality evaluation tools, the GQS and mDISCERN scores ( r = 0.68, p < 0.05) (Fig. 6 ). Discussion Principal findings This cross-sectional study systematically evaluated the content, quality, and reliability of HBOT videos on two major short-video platforms, TikTok and Bilibili. Our findings indicate that HBOT-related video content primarily focuses on clinical indications and contraindications, as well as mechanisms of action, whereas information regarding adverse effects and potential complications is notably scarce. Although TikTok videos were significantly shorter in duration than those on Bilibili, they demonstrated significantly higher user engagement metrics. Overall, the general quality of the analyzed videos was moderate, with a median GQS score of 3.00 and an mDISCERN score of 2.00. Videos uploaded by professionals were significantly superior in both quality and reliability compared to those from non-professionals. Importantly, user engagement metrics (such as likes, collections, comments, and shares) showed no significant correlation with video quality. These findings offer valuable evidence for optimizing digital communication strategies and enhancing public health education regarding HBOT. Video content Regarding the video content, clinical indications and contraindications (64.53%) and mechanisms of action (49.42%) were the most frequently discussed topics, whereas adverse effects and potential complications were consistently the least mentioned, appearing in only 2.91% of the videos. This imbalance in information coverage may restrict the public's comprehensive understanding of HBOT. Particularly, in light of recent literature reporting the potential anti-aging benefits of HBOT [ 24 – 27 ] , 11.04% of the evaluated videos promoted such claims without adequately addressing the associated risks. Notably, our subgroup analysis revealed that non-professionals heavily dominated this specific narrative, with individual users accounting for 73.68% of the anti-aging content. Although some literature provides a foundation for the anti-aging effects of HBOT, there is currently no direct evidence demonstrating that short-term hyperoxic therapy can genuinely extend human lifespan [ 24 ] . Furthermore, while HBOT is generally safe, it is not without risks; potential adverse events include middle ear barotrauma, sinus squeeze, and rare central nervous system oxygen toxicity [ 1 , 24 , 34 ] . The disproportionate emphasis on therapeutic benefits and off-label uses can mislead the public and threaten patient safety, underscoring an urgent need for platform-level interventions, such as mandatory verification labels for medical content or requiring professional review prior to publication. Differences across platforms and uploaders Significant differences in video duration and user engagement were observed between the two platforms. Although TikTok videos were shorter, they demonstrated superior performance across interactive metrics, including likes, shares, comments, and collections. In contrast, Bilibili hosted longer videos but exhibited lower overall engagement. This finding aligns with previous studies evaluating short-video content [29, 33]. These variations reflect the distinct content delivery and user interaction paradigms of each platform. TikTok, renowned for its short-form nature, facilitates rapid dissemination, attracts a massive user base, and drives high interaction volumes. Conversely, Bilibili predominantly targets a younger demographic and fosters a strong cultural community, which translates to relatively longer video formats and the unique utilization of "bullet comments" for user interaction [ 30 , 35 ] . Our study found that TikTok videos scored significantly higher in GQS than those on Bilibili, although mDISCERN scores were comparable. This specific quality distribution pattern aligns closely with recent infodemiology studies evaluating videos related to diabetic kidney disease and osteoarthritis across the same platforms [ 36 , 37 ] . This quality disparity is likely closely tied to the distinct uploader ecosystems of the two platforms. Specifically, healthcare professionals, such as hospitals and neurosurgeons, contributed a substantial proportion of the content on TikTok (26% each). In contrast, Bilibili was predominantly driven by individual users (43%), with specialist content being relatively scarce. Consequently, the higher concentration of authoritative medical accounts on TikTok likely elevated its overall content quality. The lack of a significant difference in mDISCERN scores, however, can be primarily attributed to a widespread shortcoming across both platforms: even healthcare professionals rarely cite verifiable references or provide additional information sources in their short videos. Therefore, we strongly recommend that all uploaders explicitly include reliable references and data sources when producing video content to ensure the scientific credibility and reliability of the health information disseminated. Similar to other short-video studies, videos uploaded by healthcare professionals yielded significantly higher GQS and mDISCERN scores compared to those from non-professionals [ 38 , 39 ] . This advantage is largely attributable to their strong medical backgrounds and clinical expertise. However, despite their superior content quality, professional videos did not garner significantly more likes, collections, or comments than those from non-professionals; they only achieved a significantly higher number of shares. This indicates that while viewers may recognize the authoritative value of professional content enough to distribute it, healthcare professionals still have room for improvement in the production of HBOT-related short videos. Specifically, professionals should strive to enhance the visual appeal and narrative engagement of their videos while strictly maintaining scientific rigor and medical authority. Association between video quality and user engagement Our correlation analysis revealed a phenomenon consistent with previous short-video investigations: while a strong and significant positive correlation was observed among all user engagement indicators, none of these metrics (likes, collections, comments, and shares) showed any significant correlation with the video quality scores (GQS or mDISCERN). This finding aligns with similar infodemiology studies on short-video platforms, which consistently report that popularity does not equate to credibility [ 29 , 40 , 41 ] . Social media algorithms may preferentially recommend high-traffic videos, which often favor emotionally resonant, sensationalized, or visually appealing content over scientifically rigorous explanations. Since highly interactive videos naturally generate greater traffic, they are further amplified by these recommendation systems. Consequently, users may erroneously associate high visibility with medical trustworthiness. Furthermore, we found that video length was weakly, yet positively, correlated with video quality. This finding is consistent with a recent short-video study on pancreatic cancer [ 35 ] . This correlation likely indicates that longer videos allow for a more comprehensive narrative structure and thorough content delivery, thereby yielding better overall educational quality and medical reliability. Limitations This study has several limitations. First, data collection was strictly limited to a single day (February 25, 2026) to mitigate temporal bias. However, this cross-sectional snapshot may not capture long-term trends and inherently exposes the sample to algorithmic popularity bias, potentially omitting high-quality but less visible content in the "long tail". Second, the searches were restricted to the Chinese language and two specific platforms (TikTok and Bilibili), which limits the cross-cultural generalizability of our findings to other global digital health ecosystems like YouTube. Finally, the application of the GQS and mDISCERN tools inherently involves subjective judgment. Furthermore, as these tools were originally developed to evaluate text-based health information, they may not fully capture the complex audiovisual attributes and narrative structures unique to short videos. Future longitudinal studies across diverse international platforms, ideally incorporating video-specific evaluation metrics, are warranted to further track the evolution of digital health information regarding HBOT. Conclusions In conclusion, HBOT-related short videos on TikTok and Bilibili exhibit moderate overall quality and reliability. Although healthcare professionals produce significantly superior content compared to non-professionals, a concerning lack of safety information and a disproportionate emphasis on off-label uses, particularly regarding anti-aging benefits, persist across both platforms. Importantly, high user engagement metrics (including likes, collections, comments, and shares) do not reflect scientific credibility, exposing a critical vulnerability in digital health communication. To safeguard public health, platform administrators should implement mandatory verification labels for medical content and optimize recommendation algorithms to prioritize evidence-based information. Simultaneously, healthcare providers must actively bridge the gap between scientific rigor and visual engagement, ensuring that fully referenced and comprehensive health information effectively reaches the public. Abbreviations HBOT Hyperbaric oxygen therapy GQS Global Quality Scale mDISCERN modified DISCERN IQR interquartile range Declarations Ethics approval and consent to participate This study did not involve human participants, clinical data, laboratory animals, or histological procedures. All data were obtained from publicly accessible TikTok and Bilibili videos, and collection complied with both platforms' Terms of Service. No private or personally identifiable information was collected or processed, and no user interaction occurred; therefore, individual consent was not required. We confirm that this exemption complies with national guidelines, and formal ethics approval is not required for this type of publicly available social media content analysis [28-31] . Furthermore, the study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. Consent for publication Not applicable. Availability of data and materials The data supporting the findings of this study are available from the corresponding author upon reasonable request. Competing interests The authors declare no competing interests. Funding None. Authors' contributions BH carried out the conceptualization, study design, formal analysis, investigation, and drafted the manuscript. BH and KW participated in the methodology. BH, KW, YG, and XD carried out the data curation. JX participated in the writing (review and editing), supervision, and project administration. All authors read and approved the final manuscript. Acknowledgements The authors express their gratitude to The First Affiliated Hospital of Guangxi Medical University. Authors' information Bingtao He and Keweng Wang share co-first authorship. References ORTEGA M et al. A General Overview on the Hyperbaric Oxygen Therapy: Applications, Mechanisms and Translational Opportunities. LID – 10.3390/medicina57090864 [doi] LID – 864 [J]. 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Hyperbaric oxygenation for tumour sensitisation to radiotherapy [J]. (1469-493X (Electronic)). MENG, Y. et al. Breaking the hypoxia barrier: Advances and challenges of hyperbaric oxygen therapy in cancer treatment [J]. –6007 (Electronic)). (1950). GHAHRAMANI, A. & DE COURTEN M, P. R. O. K. O. F. I. E. V. A. M. The potential of social media in health promotion beyond creating awareness: an integrative review [J]. (1471–2458 (Electronic)). CHEN J A-O & WANG Y A-O Social Media Use Health Purposes: Syst. Rev. [J] (1438–8871 (Electronic)). LIU, J. et al. How do health content creators perform well? An integration research of short video and livestream behaviors [J]. (2296–2565 (Electronic)). OSMAN, W. et al. Is YouTube a reliable source of health-related information? A systematic review [J]. (1472–6920 (Electronic)). SUAREZ-LLEDO V A-O & ALVAREZ-GALVEZ J A-O Preval. Health Misinformation Social Media: Syst. Rev. [J] (1438–8871 (Electronic)). JEYARAMAN, M. et al. 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Hyperbaric oxygen therapy increases telomere length and decreases immunosenescence in isolated blood cells: a prospective trial [J]. Aging (Albany NY) . 12 (22), 22445–22456 (2020). FU, Q. et al. Hyperbaric oxygen therapy for healthy aging: From mechanisms to therapeutics [J]. Redox Biol. 53 , 102352 (2022). ZHAO, K. & LIU, J. The quality and reliability of herpes zoster information on TikTok and Bilibili: A cross-sectional study [J]. Digit. Health . 12 , 20552076251412693 (2026). WANG, H. et al. Quality and content evaluation of thyroid eye disease treatment information on TikTok and Bilibili [J]. –2322 (Electronic)). (2045). GE R A-O et al. The Quality and Reliability of Online Videos as an Information Source of Public Health Education for Stroke Prevention in Mainland China: Electronic Media-Based Cross-Sectional Study [J]. (2564 – 1891 (Electronic)). LIANG M A-O, YANG, F. et al. Quality and reliability of prostate cancer-Videos on TikTok and Bilibili: Cross-sectional content analysis study [J]. (2055–2076 (Print)). TU J A-O, ZHANG, C. et al. Evaluating the reliability and quality of knee osteoarthritis educational content on TikTok and Bilibili: A cross-sectional content analysis [J]. (2055–2076 (Print)). LI, X. et al. Quality assessment of Chinese robot-assisted rehabilitation shorts [J]. Digit. Health . 11 , 20552076251391841 (2025). CANNELLOTTO, M., YASELLS GARCíA A, LANDA, M. S. & Hyperoxia Effective Mechanism of Hyperbaric Treatment at Mild-Pressure [J]. Int. J. Mol. Sci. , 25 (2). (2024). LEI, Y. et al. Quality and reliability evaluation of pancreatic cancer-related video content on social short video platforms: a cross-sectional study [J]. (1471–2458 (Electronic)). LIN, S., JU, J. & WANG, Z. Information quality assessment and user engagement prediction of short videos about diabetic kidney disease on TikTok and bilibili [J]. Sci. Rep. 15 (1), 43572 (2025). ZUO Q, H. et al. Quality and reliability of osteoarthritis-related health information on short video platforms: a cross-sectional comparative study of TikTok and Bilibili [J]. Front. Digit. Health . 7 , 1623247 (2025). LIU, H. et al. Assessment of the reliability and quality of breast cancer related videos on TikTok and Bilibili: cross-sectional study in China [J]. (2296–2565 (Electronic)). LIU, Z. et al. YouTube/ Bilibili/ TikTok videos as sources of medical information on laryngeal carcinoma: cross-sectional content analysis study [J]. (1471–2458 (Electronic)). ZHAO K A-O, Y. A. N. G. J. & LIU J A-O The quality and content of gonorrhea-related short videos on TikTok: A cross-sectional study [J]. (2055–2076 (Print)). CHEN, Y. et al. The quality and reliability of short videos about thyroid nodules on BiliBili and TikTok: Cross-sectional study [J]. Digit. Health . 10 , 20552076241288831 (2024). Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9409606","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":638881410,"identity":"b64fd8eb-47d6-41bb-a2dd-34a4120c2dbe","order_by":0,"name":"Bingtao He","email":"","orcid":"","institution":"The First Affiliated Hospital of Guangxi Medical University","correspondingAuthor":false,"prefix":"","firstName":"Bingtao","middleName":"","lastName":"He","suffix":""},{"id":638881411,"identity":"b2a4c819-1f9c-4d1a-a684-7465bb76e06f","order_by":1,"name":"Keweng Wang","email":"","orcid":"","institution":"The First Affiliated Hospital of Guangxi Medical University","correspondingAuthor":false,"prefix":"","firstName":"Keweng","middleName":"","lastName":"Wang","suffix":""},{"id":638881412,"identity":"eae46b30-8069-4594-ad63-af1af5d3ed88","order_by":2,"name":"Yuchang Gui","email":"","orcid":"","institution":"The First Affiliated Hospital of Guangxi Medical University","correspondingAuthor":false,"prefix":"","firstName":"Yuchang","middleName":"","lastName":"Gui","suffix":""},{"id":638881413,"identity":"df8c8e80-ff8d-4677-b95e-3cee58b41bea","order_by":3,"name":"Xue Diao","email":"","orcid":"","institution":"The First Affiliated Hospital of Guangxi Medical University","correspondingAuthor":false,"prefix":"","firstName":"Xue","middleName":"","lastName":"Diao","suffix":""},{"id":638881414,"identity":"84455e61-ccdb-44d2-9ade-b5e7f9d50c4c","order_by":4,"name":"JianWen Xu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA70lEQVRIiWNgGAWjYHCChANgir0Byj9AtBYemFIitECBRAKRWgxuJDw88HPHYTlzyefXpG62Mcjx3Uhg/FyAR4vkjISEg71nDhtbzs4pNs5tYzCWvJHALD0DjxZ+iYSEA7xttxM33M5JfAzUkrjhRgIbMw8eLWxALQf/tt2u33DzTMJhoJZ6glpAthwG2pJgcIP9IMgWIIOAFsmeBwmHZdv+G244k8NsnHNOwnDmmYfN0vi0GBzPSf74ti1N3uD48WfSOWU28nzHkw9+xqcFGIUJMIYBkJAAYsYGvBqACeUAjPGAgMpRMApGwSgYqQAA9vVTx64jdpcAAAAASUVORK5CYII=","orcid":"","institution":"The First Affiliated Hospital of Guangxi Medical University","correspondingAuthor":true,"prefix":"","firstName":"JianWen","middleName":"","lastName":"Xu","suffix":""}],"badges":[],"createdAt":"2026-04-14 02:38:42","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9409606/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9409606/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":109222296,"identity":"0564cefb-a928-41cd-befb-c3454cffa033","added_by":"auto","created_at":"2026-05-13 21:07:02","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":6063449,"visible":true,"origin":"","legend":"\u003cp\u003eFlowchart of the selection process for Hyperbaric Oxygen Therapy-related videos on TikTok and Bilibili.\u003c/p\u003e","description":"","filename":"figure1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9409606/v1/43f17122877fdeec6622ef1b.jpg"},{"id":109213793,"identity":"3f41fa40-e428-4669-a82a-579c2dad4eab","added_by":"auto","created_at":"2026-05-13 17:18:10","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":1215791,"visible":true,"origin":"","legend":"\u003cp\u003eDistribution of video uploaders. (A) Overall proportion of different uploader categories across all included videos; (B) Comparison of uploader distribution between TikTok and Bilibili.\u003c/p\u003e","description":"","filename":"figure2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9409606/v1/1bd198f23e7826ee0e339ad7.jpg"},{"id":109252429,"identity":"14fc6fa0-15cc-4603-9a25-dcbff87c08c6","added_by":"auto","created_at":"2026-05-14 09:26:17","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":2297142,"visible":true,"origin":"","legend":"\u003cp\u003eDistribution of video content across TikTok and Bilibili.\u003c/p\u003e","description":"","filename":"figure3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9409606/v1/5a9eb0e9303f4bf73b6a5d85.jpg"},{"id":109213797,"identity":"d5ad561a-2157-4205-a7d2-73d152efaf60","added_by":"auto","created_at":"2026-05-13 17:18:10","extension":"jpg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":1271202,"visible":true,"origin":"","legend":"\u003cp\u003eComparison of quality and reliability scores between professionals and non-professionals. (A) GQS score; (B) mDISCERN score. \u003cstrong\u003eNote: p\u0026lt;0.001 (****).\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"figure4.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9409606/v1/61c7ebbaf67bde9f7d686c99.jpg"},{"id":109213796,"identity":"732db135-f951-4db2-8578-2e94fb9ab686","added_by":"auto","created_at":"2026-05-13 17:18:10","extension":"jpg","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":2378240,"visible":true,"origin":"","legend":"\u003cp\u003eCorrelation heatmap of video quality and user engagement metrics. \u003cstrong\u003eNote: Crossed-out values indicate non-significant correlations (\u003c/strong\u003e\u003cem\u003e\u003cstrong\u003ep \u003c/strong\u003e\u003c/em\u003e\u003cstrong\u003e\u0026gt; 0.05).\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"figure6.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9409606/v1/8bc669e95ff8c675d1a0ecc9.jpg"},{"id":109295983,"identity":"cdb5557d-a1b7-44cf-a6a3-6b2b7efbe11f","added_by":"auto","created_at":"2026-05-15 08:42:49","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":11586919,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9409606/v1/ccb6d2e9-0876-4a98-8cab-d020d13369a3.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Quality and reliability of Hyperbaric Oxygen Therapy-related videos on TikTok and Bilibili: a cross-sectional study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eHyperbaric oxygen therapy (HBOT) is a medical treatment that involves exposing patients to pure oxygen under increased atmospheric pressure (typically 2 to 3 atmospheres). This process enhances tissue oxygen bioavailability, particularly in hypoxic regions, thereby elevating the oxygen content in both blood and tissues\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e. Additionally, HBOT exhibits various clinical benefits, including antibacterial\u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e, immunomodulatory\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e, angiogenic\u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e, and antioxidant effects\u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e. Due to its high safety profile, non-invasive nature, and relative cost-effectiveness, HBOT has been approved for 14 clinical indications, such as carbon monoxide poisoning, decompression sickness, and sudden sensorineural hearing loss\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e. Moreover, its applications are continuously expanding as an adjunctive treatment for conditions like COVID-19\u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/sup\u003e, traumatic brain injury\u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e, and cancer\u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e, highlighting its broadening role in modern clinical practice.\u003c/p\u003e \u003cp\u003eWith the rapid development of digital media, social platforms have become integral to the healthcare sector, serving as crucial channels for disseminating medical knowledge, raising health awareness, and promoting behavioral changes\u003csup\u003e[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e. Among these, short-video platforms have emerged as a primary medium for the public to access health information, supported by a massive user base\u003csup\u003e[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e. However, these platforms often host unverified, inaccurate, or entirely false information. Such misinformation can mislead the public, potentially leading to delayed treatments or adverse health outcomes\u003csup\u003e[\u003cspan additionalcitationids=\"CR19\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/sup\u003e. Such misinformation can mislead the public, potentially leading to delayed treatments or adverse health outcomes. Previous infodemiology studies have consistently demonstrated that videos related to medical treatments, such as orthognathic surgery\u003csup\u003e[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/sup\u003e, bariatric surgery\u003csup\u003e[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]\u003c/sup\u003e, and radiotherapy\u003csup\u003e[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/sup\u003e, on these platforms frequently suffer from low quality, with significant variations in content reliability.\u003c/p\u003e \u003cp\u003eDespite the proliferation of HBOT-related videos on TikTok and Bilibili, their quality and accuracy remain unassessed. While emerging literature explores the therapy's potential anti-aging benefits\u003csup\u003e[\u003cspan additionalcitationids=\"CR25 CR26\" citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]\u003c/sup\u003e, influencers frequently oversimplify these preliminary findings, exaggerating HBOT as a proven panacea. This lack of quality control misleads the public, encourages dangerous off-label use, and threatens patient safety. Therefore, this cross-sectional study evaluates the content, quality, and reliability of HBOT videos on these platforms, aiming to provide evidence-based insights for improving digital health communication.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eEthical considerations\u003c/h2\u003e \u003cp\u003eThis study did not involve human participants, clinical data, laboratory animals, or histological procedures. All data were obtained from publicly accessible TikTok and Bilibili videos, and collection complied with both platforms' Terms of Service. No private or personally identifiable information was collected or processed, and no user interaction occurred; therefore, individual consent was not required. We confirm that this exemption complies with national guidelines, and formal ethics approval is not required for this type of publicly available social media content analysis\u003csup\u003e[\u003cspan additionalcitationids=\"CR29 CR30\" citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]\u003c/sup\u003e. Furthermore, the study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSearch strategy and data collection\u003c/h3\u003e\n\u003cp\u003eData collection was strictly limited to a single day, February 25, 2026. Given the highly dynamic nature of the TikTok and Bilibili ecosystems, where videos are constantly uploaded, updated, or deleted, and search algorithms fluctuate daily, we adopted a cross-sectional snapshot design to ensure methodological consistency and data reliability. All searches were completed within a 24-hour window to maintain sample consistency. This strategy ensured that all videos were retrieved under identical algorithmic conditions, avoiding systematic bias caused by daily content updates and minimizing temporal bias. Furthermore, to mitigate the influence of personalized recommendation algorithms, investigators cleared all cookies, browsing history, and temporary internet files prior to each search. All platform accounts were logged out, and searches were conducted exclusively in incognito mode.\u003c/p\u003e \u003cp\u003eThe keyword \"高压氧治疗\" (the Chinese term for hyperbaric oxygen therapy) was searched on TikTok (specifically the Chinese version, Douyin; \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.douyin.com/\u003c/span\u003e\u003cspan address=\"https://www.douyin.com/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e) and Bilibili (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.bilibili.com/\u003c/span\u003e\u003cspan address=\"https://www.bilibili.com/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e). Videos were sorted using the platforms' default comprehensive algorithms without restricting the publication date, reflecting typical user search behavior. The top 100 videos from each platform were selected for analysis, as previous studies have demonstrated that reviewing videos beyond this threshold yields diminishing returns for data validity\u003csup\u003e[\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eFor each included video, we extracted metadata and user engagement metrics (i.e., video duration, likes, collections, comments, and shares). Uploaders were classified into five categories: hospitals, neurosurgeons, hyperbaric medicine and rehabilitation physicians, other specialists (e.g., neurology, orthopedics), and individual users. With the exception of individual users, all other categories were grouped under the umbrella term \"professionals.\" We conducted a key theme analysis of the video content, categorizing it into the following domains: mechanisms of action and therapeutic effects; clinical indications and contraindications; descriptions of the treatment environment and equipment; treatment procedures and patient experiences; adverse effects and potential complications; ear equalization techniques; and claims regarding anti-aging benefits. All extracted data were recorded in Microsoft Excel.\u003c/p\u003e\n\u003ch3\u003eInclusion and Exclusion Criteria\u003c/h3\u003e\n\u003cp\u003eTo be included in the study, videos had to be primarily focused on hyperbaric oxygen therapy (HBOT) and presented in Mandarin Chinese. Videos were excluded if they met any of the following criteria: (1) they were duplicate uploads on the same platform; or (2) they lacked clear human audio narration (e.g., silent videos or those containing only background music), which precluded accurate quality assessment. The study flowchart is presented in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e\n\u003ch3\u003eVideo quality and reliability assessment\u003c/h3\u003e\n\u003cp\u003eIn this study, we utilized the Global Quality Scale (GQS) and the modified DISCERN (mDISCERN) tools to evaluate the quality and reliability of the video content. The GQS is a widely used instrument for assessing the quality of health information in videos\u003csup\u003e[\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]\u003c/sup\u003e. It employs a 5-point scale ranging from 1 (poor quality) to 5 (high quality). Specifically, scores of 1 to 2 indicate poor quality, a score of 3 indicates moderate quality, and scores of 4 to 5 denote high quality (detailed in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe Global Quality Score (GQS) quality criteria.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eItem features\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePoints\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoor quality; poor flow of the videos; most information missing; not at all useful for patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGenerally poor quality; some information listed, but many important topics missing; of very limited use to patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModerate quality; suboptimal flow; some important adequately discussed, but other information poorly discussed; somewhat useful for patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGood quality and generally good flow; most of the relevant information listed, but some topics not covered; useful for patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExcellent quality and flow; very useful for patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe mDISCERN tool is a broadly validated and applied instrument designed to assist consumers and healthcare professionals in evaluating the reliability of health-related video content\u003csup\u003e[\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]\u003c/sup\u003e. This tool assesses videos based on five key questions (detailed in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). For each question, a score of 1 is assigned for a \"yes\" response and 0 for a \"no\" response, resulting in a total score ranging from 0 to 5. For both scales, higher scores indicate superior video quality and reliability.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe Modified DISCERN (mDISCERN) quality criteria.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"1\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReliability Score\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1. Is the video clear, concise, and understandable?\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2. Are valid sources cited?\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3. Is the content presented balanced and unbiased?\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4. Are additional sources of content listed for patient reference?\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5. Are areas of uncertainty mentioned?\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTo ensure rigorous evaluation, each video was independently scored by two reviewers with expertise in hyperbaric medicine. Any discrepancies between the two primary reviewers were resolved through adjudication by a third independent reviewer with certified qualifications in hyperbaric oxygen therapy, who determined the final consensus score.\u003c/p\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eStatistical analyses and data visualizations were performed using R software (version 4.3.2). The normality of continuous variables was evaluated using the Shapiro-Wilk test. Given the non-normal distribution of the data, continuous variables were expressed as medians with interquartile ranges (IQRs), while categorical variables were presented as frequencies and percentages. The Mann-Whitney U test was employed for comparisons between two independent groups (e.g., platforms or professionals vs. non-professionals). For comparisons involving three or more independent groups (e.g., specific uploader categories), the Kruskal-Wallis H test was utilized. Spearman's rank correlation coefficient (ρ) was calculated to evaluate the associations between video quality scores (GQS and mDISCERN) and user engagement indicators (likes, comments, shares, and collections). All statistical tests were two-sided, and statistical significance was set at \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eOverview of the video features\u003c/h2\u003e \u003cp\u003eA total of 172 HBOT-related videos were included in this study, comprising 98 from TikTok and 74 from Bilibili. Video characteristics were analyzed based on duration, number of likes, collections, comments, and shares. Compared to Bilibili, TikTok videos were significantly shorter in length (median: 70.00 seconds, IQR: 46.50\u0026ndash;144.50) but demonstrated superior performance in user engagement metrics, including likes (median: 168.00, IQR: 59.75\u0026ndash;752.50), collections (median: 68.00, IQR: 16.50\u0026ndash;244.25), comments (median: 17.00, IQR: 5.00\u0026ndash;60.00), and shares (median: 83.50, IQR: 16.50\u0026ndash;308.00), as shown in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e. When categorized by uploader identity, there were no significant differences in video duration, likes, collections, or comments between professionals and non-professionals. However, videos uploaded by professionals had a significantly higher number of shares (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.038).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eGeneral Information, Quality, and Reliability Scores of Hyperbaric Oxygen Therapy-related Videos on TikTok and Bilibili\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal (n\u0026thinsp;=\u0026thinsp;172)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eTikTok (n\u0026thinsp;=\u0026thinsp;98)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBilibili (n\u0026thinsp;=\u0026thinsp;74)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGeneral information\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVideo length(s),M (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e79.50 (52.75, 189.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e70.00 (46.50, 144.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e103.50 (57.00, 376.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLikes,M (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e58.00 (8.75, 310.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e168.00 (59.75, 752.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.00 (2.25, 28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCollections,M (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e25.50 (6.00, 116.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e68.00 (16.50, 244.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.50 (2.00, 29.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eComments,M (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6.00 (0.00, 33.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17.00 (5.00, 60.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.50 (0.00, 6.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eShares,M (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e25.50 (6.75, 166.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83.50 (16.50, 308.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.00 (1.00, 24.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eVideo content\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMechanisms of action and therapeutic effects\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e85(49.42%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e42(42.86%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e43(58.11%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClinical indications and contraindications\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e111(64.53%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e68(69.39%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e43(58.11%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDescription of the treatment environment and equipment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38(22.09%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18(18.36%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20(27.03%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTreatment procedures and patient experiences\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e48(27.90%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e29(29.59%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19(25.68%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdverse effects and potential complications\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5(2.91%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3(3.06%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2(2.70%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEar equalization techniques\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e25(14.53%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18(18.36%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7(9.46%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClaims regarding anti-aging benefits\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19(11.04%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6(6.12%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13(17.56%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eVideo quality\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGQS score,M (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.00 (3.00, 3.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.00 (3.00, 3.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.00 (2.00, 3.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.019\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003emDISCERN score,M (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.00 (2.00, 2.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.00 (2.00, 2.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.00 (2.00, 2.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.219\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eGQS: Global Quality Scale; mDISCERN: modified DISCERN; IQR: interquartile range.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eUploader characteristics and video content\u003c/h3\u003e\n\u003cp\u003eBy uploader classification, hospitals accounted for the largest share of videos (28.49%), closely followed by individual users (27.91%), neurosurgeons (16.28%), hyperbaric medicine and rehabilitation physicians (14.53%), and other healthcare professionals (12.79%; Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e(a)). Platform distribution varied significantly: hospitals and neurosurgeons each contributed 26% on TikTok, whereas individual users dominated Bilibili at 43%, leaving neurosurgeons at only 4% (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e(b)). Regarding content, clinical indications and contraindications were the most prevalent across the 172 videos (64.53%), followed by mechanisms of action (49.42%). Notably, clinical indications dominated TikTok, while Bilibili addressed both topics equally. Across both platforms, adverse effects and potential complications were consistently the least mentioned content (2.91%) (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eCharacteristics of videos claiming anti-aging benefits\u003c/h2\u003e \u003cp\u003eA subgroup analysis was conducted on the 19 videos addressing anti-aging benefits (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e5\u003c/span\u003e). Notably, the majority of these videos were disseminated on Bilibili (13/19, 68.42%) rather than TikTok (6/19, 31.58%). Regarding the uploaders, non-professionals heavily dominated this content, with individual users accounting for 73.68% (14/19) of the videos. Conversely, professional entities such as hospitals (1/19, 5.26%) and hyperbaric medicine physicians (2/19, 10.53%) rarely published content promoting anti-aging effects. Although these videos generated substantial user engagement (e.g., a median of 83.00 likes and 55.00 collections), their overall quality and reliability remained moderate to low, with a median GQS score of 3.00 and an mDISCERN score of 2.00.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eGeneral Characteristics, Quality, and Reliability of Hyperbaric Oxygen Therapy-related Videos Regarding Anti-aging Benefits\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal (n\u0026thinsp;=\u0026thinsp;19)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eShort-video sharing platforms [n(%)]\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTikTok\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6(31.58%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBilibili\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13(68.42%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eUploaders [n(%)]\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIndividual users\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14(73.68%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHyperbaric medicine and rehabilitation physicians\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2(10.53%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeurosurgeons\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1(5.26%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther healthcare professionals\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1(5.26%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHospitals\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1(5.26%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGeneral information\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVideo length(s),M (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e187.00 (64.50, 374.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLikes,M (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e83.00 (4.50, 1798.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCollections,M (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e55.00 (5.00, 285.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eComments,M (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18.00 (0.00, 150.50)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eShares,M (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35.00 (7.50, 193.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eVideo quality\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGQS score,M (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.00 (2.00, 3.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003emDISCERN score,M (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.00 (2.00, 2.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"2\"\u003eGQS: Global Quality Scale; mDISCERN: modified DISCERN; IQR: interquartile range.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eVideo quality and reliability\u003c/h2\u003e \u003cp\u003eThe overall quality of the HBOT-related videos was moderate, yielding a median GQS score of 3.00 (IQR: 3.00\u0026ndash;3.00) and a median mDISCERN score of 2.00 (IQR: 2.00\u0026ndash;2.00). Between the platforms, TikTok videos scored significantly higher in GQS than those on Bilibili (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.019), whereas mDISCERN scores showed no significant difference (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.219) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). Regarding uploader identity, professional content exhibited significantly superior quality and reliability. Professionals outperformed non-professionals on both the GQS (median: 3.00 vs. 2.00) and mDISCERN tools (median: 2.00 vs. 1.00) (both \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001; Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e4\u003c/span\u003e). These distinct score distributions and significant quality disparities between the two uploader types are visually detailed in Figs.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e and \u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCharacteristics, Quality, and Reliability of Hyperbaric Oxygen Therapy-related Videos by Different Uploaders on TikTok and Bilibili\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eProfessionals (n\u0026thinsp;=\u0026thinsp;124)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNon-professionals(n\u0026thinsp;=\u0026thinsp;48)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVideo length(s),M (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e77.00 (49.50, 176.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e97.50 (54.75, 209.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.316\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLikes,M (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e61.50 (12.00, 235.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e47.00 (4.00, 629.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.624\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCollections,M (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e29.00 (8.75, 104.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23.00 (2.00, 196.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.306\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eComments,M (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5.50 (0.75, 26.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11.00 (0.00, 126.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.254\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eShares,M (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e28.50 (10.00, 169.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15.50 (1.00, 114.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.038\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGQS score,M (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.00 (3.00, 3.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.00 (2.00, 3.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003emDISCERN score,M (Q1,Q3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.00 (2.00, 2.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.00 (1.00, 2.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eCorrelation of Video General Information With Quality and Reliability\u003c/h2\u003e \u003cp\u003eAnalysis showed that video length was not significantly correlated with any user engagement metrics, including likes (\u003cem\u003er\u003c/em\u003e = -0.09, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05), collections (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.03, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05), comments (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.02, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05), and shares (\u003cem\u003er\u003c/em\u003e = -0.03, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05). However, video length was significantly and positively correlated with video quality, showing a weak positive correlation with both the GQS score (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.26, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05) and the mDISCERN score (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.18, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). A strong and significant positive correlation was observed among all user engagement indicators (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Specifically, the number of likes was highly correlated with collections (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.89), comments (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.89), and shares (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.88). The number of collections was strongly correlated with comments (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.80) and shares (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.92), while comments were also positively correlated with shares (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.81). Importantly, none of the user engagement indicators (likes, collections, comments, and shares) showed any significant correlation with the video quality scores (GQS or mDISCERN) (all \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Finally, a strong positive correlation was observed between the two quality evaluation tools, the GQS and mDISCERN scores (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.68, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05) (Fig.\u0026nbsp;\u003cspan refid=\"Fig6\" class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003ePrincipal findings\u003c/h2\u003e \u003cp\u003eThis cross-sectional study systematically evaluated the content, quality, and reliability of HBOT videos on two major short-video platforms, TikTok and Bilibili. Our findings indicate that HBOT-related video content primarily focuses on clinical indications and contraindications, as well as mechanisms of action, whereas information regarding adverse effects and potential complications is notably scarce. Although TikTok videos were significantly shorter in duration than those on Bilibili, they demonstrated significantly higher user engagement metrics. Overall, the general quality of the analyzed videos was moderate, with a median GQS score of 3.00 and an mDISCERN score of 2.00. Videos uploaded by professionals were significantly superior in both quality and reliability compared to those from non-professionals. Importantly, user engagement metrics (such as likes, collections, comments, and shares) showed no significant correlation with video quality. These findings offer valuable evidence for optimizing digital communication strategies and enhancing public health education regarding HBOT.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eVideo content\u003c/h2\u003e \u003cp\u003eRegarding the video content, clinical indications and contraindications (64.53%) and mechanisms of action (49.42%) were the most frequently discussed topics, whereas adverse effects and potential complications were consistently the least mentioned, appearing in only 2.91% of the videos. This imbalance in information coverage may restrict the public's comprehensive understanding of HBOT. Particularly, in light of recent literature reporting the potential anti-aging benefits of HBOT\u003csup\u003e[\u003cspan additionalcitationids=\"CR25 CR26\" citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]\u003c/sup\u003e, 11.04% of the evaluated videos promoted such claims without adequately addressing the associated risks. Notably, our subgroup analysis revealed that non-professionals heavily dominated this specific narrative, with individual users accounting for 73.68% of the anti-aging content. Although some literature provides a foundation for the anti-aging effects of HBOT, there is currently no direct evidence demonstrating that short-term hyperoxic therapy can genuinely extend human lifespan \u003csup\u003e[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003c/sup\u003e. Furthermore, while HBOT is generally safe, it is not without risks; potential adverse events include middle ear barotrauma, sinus squeeze, and rare central nervous system oxygen toxicity\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]\u003c/sup\u003e. The disproportionate emphasis on therapeutic benefits and off-label uses can mislead the public and threaten patient safety, underscoring an urgent need for platform-level interventions, such as mandatory verification labels for medical content or requiring professional review prior to publication.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eDifferences across platforms and uploaders\u003c/h2\u003e \u003cp\u003eSignificant differences in video duration and user engagement were observed between the two platforms. Although TikTok videos were shorter, they demonstrated superior performance across interactive metrics, including likes, shares, comments, and collections. In contrast, Bilibili hosted longer videos but exhibited lower overall engagement. This finding aligns with previous studies evaluating short-video content [29, 33]. These variations reflect the distinct content delivery and user interaction paradigms of each platform. TikTok, renowned for its short-form nature, facilitates rapid dissemination, attracts a massive user base, and drives high interaction volumes. Conversely, Bilibili predominantly targets a younger demographic and fosters a strong cultural community, which translates to relatively longer video formats and the unique utilization of \"bullet comments\" for user interaction\u003csup\u003e[\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eOur study found that TikTok videos scored significantly higher in GQS than those on Bilibili, although mDISCERN scores were comparable. This specific quality distribution pattern aligns closely with recent infodemiology studies evaluating videos related to diabetic kidney disease and osteoarthritis across the same platforms\u003csup\u003e[\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]\u003c/sup\u003e. This quality disparity is likely closely tied to the distinct uploader ecosystems of the two platforms. Specifically, healthcare professionals, such as hospitals and neurosurgeons, contributed a substantial proportion of the content on TikTok (26% each). In contrast, Bilibili was predominantly driven by individual users (43%), with specialist content being relatively scarce. Consequently, the higher concentration of authoritative medical accounts on TikTok likely elevated its overall content quality. The lack of a significant difference in mDISCERN scores, however, can be primarily attributed to a widespread shortcoming across both platforms: even healthcare professionals rarely cite verifiable references or provide additional information sources in their short videos. Therefore, we strongly recommend that all uploaders explicitly include reliable references and data sources when producing video content to ensure the scientific credibility and reliability of the health information disseminated.\u003c/p\u003e \u003cp\u003eSimilar to other short-video studies, videos uploaded by healthcare professionals yielded significantly higher GQS and mDISCERN scores compared to those from non-professionals\u003csup\u003e[\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]\u003c/sup\u003e. This advantage is largely attributable to their strong medical backgrounds and clinical expertise. However, despite their superior content quality, professional videos did not garner significantly more likes, collections, or comments than those from non-professionals; they only achieved a significantly higher number of shares. This indicates that while viewers may recognize the authoritative value of professional content enough to distribute it, healthcare professionals still have room for improvement in the production of HBOT-related short videos. Specifically, professionals should strive to enhance the visual appeal and narrative engagement of their videos while strictly maintaining scientific rigor and medical authority.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eAssociation between video quality and user engagement\u003c/h2\u003e \u003cp\u003eOur correlation analysis revealed a phenomenon consistent with previous short-video investigations: while a strong and significant positive correlation was observed among all user engagement indicators, none of these metrics (likes, collections, comments, and shares) showed any significant correlation with the video quality scores (GQS or mDISCERN). This finding aligns with similar infodemiology studies on short-video platforms, which consistently report that popularity does not equate to credibility\u003csup\u003e[\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]\u003c/sup\u003e. Social media algorithms may preferentially recommend high-traffic videos, which often favor emotionally resonant, sensationalized, or visually appealing content over scientifically rigorous explanations. Since highly interactive videos naturally generate greater traffic, they are further amplified by these recommendation systems. Consequently, users may erroneously associate high visibility with medical trustworthiness. Furthermore, we found that video length was weakly, yet positively, correlated with video quality. This finding is consistent with a recent short-video study on pancreatic cancer\u003csup\u003e[\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]\u003c/sup\u003e. This correlation likely indicates that longer videos allow for a more comprehensive narrative structure and thorough content delivery, thereby yielding better overall educational quality and medical reliability.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eThis study has several limitations. First, data collection was strictly limited to a single day (February 25, 2026) to mitigate temporal bias. However, this cross-sectional snapshot may not capture long-term trends and inherently exposes the sample to algorithmic popularity bias, potentially omitting high-quality but less visible content in the \"long tail\". Second, the searches were restricted to the Chinese language and two specific platforms (TikTok and Bilibili), which limits the cross-cultural generalizability of our findings to other global digital health ecosystems like YouTube. Finally, the application of the GQS and mDISCERN tools inherently involves subjective judgment. Furthermore, as these tools were originally developed to evaluate text-based health information, they may not fully capture the complex audiovisual attributes and narrative structures unique to short videos. Future longitudinal studies across diverse international platforms, ideally incorporating video-specific evaluation metrics, are warranted to further track the evolution of digital health information regarding HBOT.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eIn conclusion, HBOT-related short videos on TikTok and Bilibili exhibit moderate overall quality and reliability. Although healthcare professionals produce significantly superior content compared to non-professionals, a concerning lack of safety information and a disproportionate emphasis on off-label uses, particularly regarding anti-aging benefits, persist across both platforms. Importantly, high user engagement metrics (including likes, collections, comments, and shares) do not reflect scientific credibility, exposing a critical vulnerability in digital health communication. To safeguard public health, platform administrators should implement mandatory verification labels for medical content and optimize recommendation algorithms to prioritize evidence-based information. Simultaneously, healthcare providers must actively bridge the gap between scientific rigor and visual engagement, ensuring that fully referenced and comprehensive health information effectively reaches the public.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eHBOT\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHyperbaric oxygen therapy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eGQS\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eGlobal Quality Scale\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003emDISCERN\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003emodified DISCERN\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eIQR\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003einterquartile range\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study did not involve human participants, clinical data, laboratory animals, or histological procedures. All data were obtained from publicly accessible TikTok and Bilibili videos, and collection complied with both platforms\u0026apos; Terms of Service. No private or personally identifiable information was collected or processed, and no user interaction occurred; therefore, individual consent was not required. We confirm that this exemption complies with national guidelines, and formal ethics approval is not required for this type of publicly available social media content analysis\u003csup\u003e[28-31]\u003c/sup\u003e. Furthermore, the study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data supporting the findings of this study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBH carried out the conceptualization, study design, formal analysis, investigation, and drafted the manuscript. BH and KW participated in the methodology. BH, KW, YG, and XD carried out the data curation. JX participated in the writing (review and editing), supervision, and project administration. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors express their gratitude to The First Affiliated Hospital of Guangxi Medical University.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBingtao He and Keweng Wang share co-first authorship.\u003cstrong\u003e\u003cbr clear=\"all\"\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eORTEGA M et al. A General Overview on the Hyperbaric Oxygen Therapy: Applications, Mechanisms and Translational Opportunities. LID\u0026thinsp;\u0026ndash;\u0026thinsp;10.3390/medicina57090864 [doi] LID\u0026thinsp;\u0026ndash;\u0026thinsp;864 [J]. (1648\u0026ndash;9144 (Electronic)).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMEMAR M Y, YEKANI, M. et al. Hyperbaric oxygen therapy: Antimicrobial mechanisms and clinical application for infections [J]. \u0026ndash;6007 (Electronic)). (1950).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCIMŞIT, M. \u0026amp; UZUN G FAU - YILDIZ, S. YILDIZ S. Hyperbaric oxygen therapy as an anti-infective agent [J]. (1744\u0026ndash;8336 (Electronic)).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZHOU D A-O, F. U. D. YAN L, et al. The Role of Hyperbaric Oxygen Therapy in the Treatment of Surgical Site Infections: A Narrative Review. LID\u0026thinsp;\u0026ndash;\u0026thinsp;10.3390/medicina59040762 [doi] LID\u0026thinsp;\u0026ndash;\u0026thinsp;762 [J]. 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YouTube/ Bilibili/ TikTok videos as sources of medical information on laryngeal carcinoma: cross-sectional content analysis study [J]. (1471\u0026ndash;2458 (Electronic)).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZHAO K A-O, Y. A. N. G. J. \u0026amp; LIU J A-O The quality and content of gonorrhea-related short videos on TikTok: A cross-sectional study [J]. (2055\u0026ndash;2076 (Print)).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCHEN, Y. et al. The quality and reliability of short videos about thyroid nodules on BiliBili and TikTok: Cross-sectional study [J]. \u003cem\u003eDigit. Health\u003c/em\u003e. \u003cb\u003e10\u003c/b\u003e, 20552076241288831 (2024).\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":"hyperbaric oxygen therapy, short-video platforms, health information quality, TikTok, Bilibili","lastPublishedDoi":"10.21203/rs.3.rs-9409606/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9409606/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eWith the rapid development of digital media, short-video platforms have become primary channels for the public to access health information. Despite the proliferation of videos regarding hyperbaric oxygen therapy (HBOT), their quality and reliability remain unassessed.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA cross-sectional search was conducted on TikTok and Bilibili using the keyword \"高压氧治疗\" on February 25, 2026. The top 100 videos from each platform were selected. Video characteristics, uploader identities, and content themes were extracted. Two independent reviewers assessed video quality and reliability using the Global Quality Scale (GQS) and the modified DISCERN (mDISCERN) tools. Non-parametric tests (Mann-Whitney U test, Kruskal-Wallis H test) and Spearman's rank correlation were used for statistical analysis.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eA total of 172 videos were included (98 from TikTok, 74 from Bilibili). The overall quality was moderate, yielding a median GQS of 3.00 and mDISCERN of 2.00. TikTok videos showed significantly higher user engagement metrics and GQS scores compared to Bilibili (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.019). Videos uploaded by healthcare professionals demonstrated significantly superior quality and reliability scores (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). However, adverse effects and potential complications were rarely mentioned (2.91%). A subgroup analysis revealed that videos promoting off-label anti-aging benefits (11.04%) were predominantly uploaded by non-professionals (73.68%) and generated exceptionally high collections despite lacking scientific rigor. Furthermore, user engagement indicators (likes, collections, comments, and shares) showed no significant correlation with video quality scores (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eHBOT-related videos on TikTok and Bilibili exhibit moderate quality and reliability, accompanied by a concerning omission of safety information. While healthcare professionals produce more accurate content, high user engagement does not equate to scientific validity. Improved digital communication strategies and strict platform regulations are urgently needed to disseminate high-quality, evidence-based HBOT information to the public.\u003c/p\u003e\u003ch2\u003eTrial registration\u003c/h2\u003e \u003cp\u003eNot applicable.\u003c/p\u003e","manuscriptTitle":"Quality and reliability of Hyperbaric Oxygen Therapy-related videos on TikTok and Bilibili: a cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-13 17:18:05","doi":"10.21203/rs.3.rs-9409606/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":"b520aa47-a426-439b-8c9a-2e028826c72f","owner":[],"postedDate":"May 13th, 2026","published":true,"recentEditorialEvents":[{"type":"decision","content":"Rejected","date":"2026-05-14T05:28:00+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-12T09:23:33+00:00","index":57,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-10T08:53:34+00:00","index":56,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-07T16:08:44+00:00","index":55,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-07T11:19:39+00:00","index":54,"fulltext":""},{"type":"reviewerAgreed","content":"306477281403308399346945570161427828869","date":"2026-05-06T07:36:03+00:00","index":53,"fulltext":""},{"type":"reviewerAgreed","content":"12507579839601773614028544337235013999","date":"2026-05-05T13:44:13+00:00","index":52,"fulltext":""},{"type":"reviewerAgreed","content":"106249807104638331032059458078459240861","date":"2026-05-05T13:33:42+00:00","index":51,"fulltext":""},{"type":"reviewerAgreed","content":"174823687200883854939392726821362917339","date":"2026-05-05T13:23:06+00:00","index":49,"fulltext":""},{"type":"reviewersInvited","content":"8","date":"2026-05-05T13:09:52+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-05-05T12:58:43+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":67997660,"name":"Health sciences/Health care"},{"id":67997661,"name":"Health sciences/Medical research"}],"tags":[],"updatedAt":"2026-05-14T05:40:52+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-13 17:18:05","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9409606","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9409606","identity":"rs-9409606","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}