Assessing the Quality of Patient Information for Cholesteatoma on the Video Sharing Platform YouTube

Objectives: The objective of this study is to assess quality of the most popular cholesteatoma videos on YouTube using recognized scoring systems and to determine if video quality metrics correlated with video popularity based on likes and views Design: Cross sectional survey of available data Setting: Metadata acquisition using YouTube searches using Australian IP addresses Participants: Three independent neuro-otologists partaking in scoring videos Main outcome measures: Each video was viewed and scored by three independent assessors using both a novel tool to score the usefulness of the video as well as the validated DISCERN scoring tool. Popularity metrics were analyzed and compared to video popularity. Results: A total of 90 YouTube videos were analyzed with an average 55,292 views per video with an average of 271 likes and 22 dislikes. The inter-rater correlation was moderate with Fleiss-kappa score 0.42 [P < 0.01] using a novel scoring tool for cholesteatoma and inter-rater correlation coefficient was 0.78 [95% CI = 0.58 - 0.90] indicating good reliability for DISCERN scores. The overall video quality was poor with higher DISCERN scores found in videos uploaded from Academic Institutions. Conclusions: Informative video quality on YouTube on cholesteatoma is overall of poor quality. Videos with unclassified sources or more dislikes correlated poorly with video quality. Given the increase in patients turning to the internet for information regarding their health conditions, otology and otolaryngology societies should be encouraged to publish high quality YouTube videos on cholesteatoma and other ear conditions.