Accuracy, Quality, and Misinformation of YouTube Abortion Procedural Videos: Cross-Sectional Study

The internet is often the first source patients turn to for medical information. YouTube is a commonly used internet-based resource for patients seeking to learn about medical procedures, including their risks, benefits, and safety profile. Abortion is a common yet polarizing medical procedure. People interested in obtaining an abortion are likely to use the internet to learn more about abortion procedures and may encounter misinformed and biased information. This is troubling as information found on the internet can significantly alter perceptions and understanding of these procedures. There is no current research that evaluates the accuracy, quality, and misinformation of instructional abortion videos available to patients.

The purpose of this study was to assess if any given video can deliver accurate and quality information about this topic in an unbiased manner and to assess the level of factually incorrect, distorted, or medically irrelevant information in any given video.

Procedural methods of abortion were queried on YouTube on August 22, 2022. The videos were screened with strict exclusion criteria. Videos were categorized into "video slants" based on the language and attitudes expressed in each video. Video accuracy was calculated using the Surgical Curriculum in Obstetrics and Gynecology (SCOG) checklist for each corresponding procedure. Video quality was calculated using the Laparoscopic Surgery Video Educational Guidelines (LAP-VEGaS) criteria. The level of misinformation was assessed with the evidence-based Anti-Choice Rubric, which scores the amount of factually incorrect, distorted, or medically irrelevant information in each video.

A total of 32 videos were analyzed and categorized into 3 "video slant" groups: neutral (n=23, 72%), antichoice (n=4, 12%), and prochoice (n=5, 16%). Using the SCOG checklist, neutral videos had the highest median accuracy (45.9%), followed by antichoice videos (24.6%) and prochoice videos (18.5%). None of the videos met the LAP-VEGaS quality control criteria, (score>11, indicating adequate quality). Neutral videos had a median score of 8.8 out of 18, with antichoice videos scoring 10.75 and prochoice videos scoring 6.2. Using the Anti-Choice Rubric, neutral videos mentioned only 1 factually incorrect piece of information. Antichoice videos mentioned 12 factually incorrect pieces of information, 8 distortions, and 3 medically irrelevant pieces of information. Prochoice videos did not mention any of the 3 themes.

Using the SCOG checklist, the accuracy of instructional videos were inconsistent across the 3 identified "video slants." Using LAP-VEGaS criteria, the quality of educational videos were also inconsistent across the 3 "video slants." Prochoice videos had the lowest level of misinformation, with no mentions of any of the 3 themes. Antichoice videos had the highest levels of misinformation, with mentions in all 3 themes. Health care professionals should consider this when counseling patients who may watch YouTube videos for information regarding abortion procedures.