Quality of rib fracture-related video information on TikTok and Bilibili: a cross-sectional study

Rib fracture is one of the most common thoracic injuries and is associated with impaired respiratory function, severe pain, and adverse clinical outcomes. With the increasing demand for accessible health information, short-video platforms such as TikTok and Bilibili have emerged as major channels for public medical knowledge dissemination. However, due to the lack of standardized content regulation, the quality, accuracy, and reliability of health-related videos remain highly variable. In this context, a systematic evaluation of such content is needed. Therefore, this study aims to comprehensively assess the quality, reliability, and dissemination characteristics of rib fracture-related videos on TikTok and Bilibili, and to further examine the impact of uploader background on content quality.

A cross-sectional study was conducted on 136 videos (TikTok=85; Bilibili=51). Video characteristics, uploader information, and engagement metrics were systematically collected. Content quality and reliability were evaluated using four validated instruments: the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V), Video Information and Quality Index (VIQI), Global Quality Score (GQS), and modified DISCERN (mDISCERN). Non-parametric statistical tests were applied for group comparisons, and Spearman correlation analysis was used to explore associations between video quality and engagement indicators.

TikTok videos were significantly shorter and demonstrated higher engagement metrics compared with Bilibili videos (all P<0.001). In contrast, Bilibili videos showed superior educational quality. The GQS score was significantly higher on Bilibili (3 vs. 2, P=0.019), while PEMAT-A/V and VIQI scores were also higher, although without statistical significance. Videos uploaded by medical professionals or institutional accounts achieved significantly higher scores across all quality assessment tools (P<0.01). Correlation analysis indicated that video quality was weakly to moderately negatively associated with engagement metrics, particularly comment counts (e.g., TikTok mDISCERN: r=-0.270, P<0.05).

The overall quality and reliability of rib fracture-related short videos on TikTok and Bilibili remain suboptimal. While Bilibili provides relatively higher-quality and more educational content, TikTok demonstrates stronger dissemination capacity. Uploader background plays a critical role in determining content quality. Enhancing professional participation and establishing standardized content review and certification mechanisms are essential to improve the accuracy, reliability, and public health value of medical information on short-video platforms.