Evaluating the quality of educational TikTok videos on diabetic retinopathy: a cross-sectional study

Diabetic retinopathy (DR) is a leading cause of vision loss among working-age adults, and enhancing public health literacy through effective education is crucial for its prevention and management. With the rise of mobile internet and short video platforms such as TikTok, new opportunities have emerged for disseminating medical knowledge. However, concerns remain regarding the accuracy and quality of this content.

A cross-sectional search was conducted on September 18, 2025. A total of 200 Mandarin-language TikTok videos directly relevant to DR were included after screening. Baseline characteristics, uploader type, and user engagement metrics were extracted. Video quality was assessed independently by two trained reviewers using the DISCERN tool and the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V). Content coverage was evaluated against the American Academy of Ophthalmology (AAO) Preferred Practice Pattern®. Inter-rater reliability was measured by intraclass correlation coefficients (ICCs). Group comparisons and correlation analyses were performed.

Significant differences were observed in quality scores across uploader categories (one-way ANOVA, p < 0.001). Non-profit organizations achieved the highest DISCERN scores (59.4 ± 8.2) and PEMAT-A/V understandability (88.5%), while for-profit accounts had the lowest DISCERN scores (23.0 ± 6.5; understandability 61.5%). Videos from non-profit sources also demonstrated balanced coverage across six core DR themes (14-20% per theme). Inter-rater reliability was excellent for all tools (ICC range 0.825-0.933). Engagement metrics were strongly correlated with DISCERN scores (likes r = 0.76, comments r = 0.64, favorites r = 0.73, shares r = 0.71; all p < 0.05), whereas video duration showed no significant correlation with quality (p > 0.05).

The quality of DR-related educational short videos on TikTok varies widely, with the source of the video emerging as the key determinant. High-quality content from non-profit organizations and medical professional users not only demonstrates greater reliability but also fosters comprehensive health education. Strengthening professional participation, platform regulation, and evidence-informed communication strategies is essential to maximize the potential of short videos in DR health education and ultimately improve patient outcomes.