Bilibili and TikTok heart failure short video evaluation: a cross-sectional study

The prognosis of heart failure is highly dependent on patient self-management, and short-video platforms have become a key channel for the public to access information about heart failure (HF). This cross-sectional study systematically evaluated HF-related short videos on TikTok and Bilibili platforms. After screening from January 10 to 11, 2026, 190 videos were included (103 from Bilibili and 87 from TikTok). Two cardiologists conducted quality assessments using the Global Quality Score, modified DISCERN scale, and Patient Education Assessment Tool for Audiovisual Materials (PEMAT-A/V). Results showed higher engagement for TikTok videos and longer duration for Bilibili videos (both P < 0.05). Content primarily focused on symptoms (71.1%) and treatment (66.3%), with insufficient coverage of prevention (36.3%). Overall quality was moderately low: median scores were 3 on both the Global Quality Score and modified DISCERN scale; PEMAT understandability score was 69%, and actionability score was 50%. Bilibili videos scored higher on actionability (P = 0.029), and videos uploaded by professional institutions demonstrated the best quality (P = 0.045). Longer video duration and inclusion of symptom-related content were independent predictors of higher GQS scores. Notably, video interactivity showed no positive correlation with content quality, revealing an obvious quality-dissemination decoupling phenomenon. This finding carries important clinical implications, as high-quality professional medical content fails to gain corresponding public dissemination, which hinders standardized popular science and long-term self-management among HF patients. The overall quality of heart failure short videos urgently requires improvement, necessitating enhanced professional content supply and rigorous quality control via multiparty collaborative mechanisms. Additionally, short-video health education should be integrated into routine clinical management and telemedicine systems to optimize patient self-management.