Assessing the Quality and Credibility of Publicly Available Videos on Cervical Fusion: Is YouTube a Reliable Educational Tool?

• Published in: International journal of spine surgery 2021-08, Vol.15 (4), p.669-675
• Main Authors: Baker, James D., Baig, Younus, Siyaji, Zakariah K., Hornung, Alexander L., Zavras, Athan G., Mallow, G. Michael, Zbeidi, Shadi, Shepard, Nicholas A., Sayari, Arash J.
• Format: Article
• Language: English
• Subjects: Cervical Spine
• ISSN: 2211-4599; 2211-4599
• DOI: 10.14444/8088

BACKGROUNDYouTube has become a popular source for patient education, though there are concerns regarding the quality and reliability of videos related to orthopaedic and neurosurgical procedures. This study aims to evaluate the credibility and educational content of videos on YouTube related to cervical fusion. Secondarily, the study aims to identify factors predictive of higher or lower quality videos. METHODSA YouTube query using the search terms "cervical fusion" was performed, and the first 50 videos were included for analysis. Reliability was assessed using the Journal of the American Medical Association (JAMA) criteria. Educational quality was assessed using the Global Quality Score (GQS) and the Cervical Fusion Content Score (CFCS). Videos were stratified by content and source, and differences in JAMA, GQS, and CFCS scores were assessed. Multivariable linear regression was used to identify predictors of higher or lower JAMA, GQS, and CFCS scores. Statistical significance was established at P < 0.05. RESULTSTotal number of views was 6 221 816 with a mean of 124 436.32 ± 412 883.32 views per video. Physicians, academic, and medical sources had significantly higher mean JAMA scores (P = 0.042). Exercise training and nonsurgical management videos had significantly higher mean CFCS scores (P = 0.018). Videos by physicians (β = 0.616; P = 0.025) were independently associated with higher JAMA scores. Advertisements were significant predictors of worse CFCS (β = -3.978; P = 0.030), and videos by commercial sources predicted significantly lower JAMA scores (β = -1.326; P = 0.006). CONCLUSIONSWhile videos related to cervical fusion amassed a large viewership, they were poor in both quality and reliability. Videos by physicians were associated with higher reliability scores relative to other sources, whereas commercial sources and advertisements had significantly lower reliability and educational content scores. Currently, YouTube seems to be an unreliable source of information on cervical fusion for patients. LEVEL OF EVIDENCE4. CLINICAL RELEVANCEThe results of this study aid surgeons in counseling patients interested in cervical fusion, and suggest that publicly available videos regarding cervical fusion may not be an adequate tool for patient education at this time.