YouTube videos contain poor and biased thoracic surgery educational content

Although YouTube is used by patients and providers for self-education, the quality of content is variable. We hypothesized that thoracic surgery videos on YouTube would be poor quality and vary by procedure type.

Four thoracic procedures were assessed for educational quality on YouTube: "Esophagectomy", "Thymectomy", "Lobectomy", and "Hiatal Hernia Repair". The top 20 videos for each procedure were scored using the DISCERN criteria for education content. 15 criteria were scored to generate a total DISCERN score (DS), which was further categorized as very poor(15-26), poor(27-38), fair(39-50), very good(51-62), or excellent(63-75). We also performed a multivariable analysis of DISCERN score, which adjusted for video length, number of views, likes, and procedure type.

Among the videos reviewed, hiatal hernia repair had the most views (1,456,473) and thymectomy had the fewest views (78,210). All procedure types were associated with "poor" DS scores: Hiatal hernia repair 34.6, Esophagectomy 36.3, Lobectomy 30.2, and Thymectomy 33.80. The DS varied between the groups (p = 0.05). Bias score also varied between groups (p = 0.05). In a multivariate model of DS, longer video length was associated with higher DISCERN score, but lobectomy procedure type was associated with worse DS.

Although widely available, YouTube content pertaining to thoracic surgery deliver poor educational information to patients and are frequently biased. Despite these findings, the top videos for common thoracic procedures have been streamed over 284,320 h. There is an opportunity to improve educational value of YouTube content, which could enhance thoracic surgery education.