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Information completeness, sentiment, and engagement of orthodontic patient experience content on Chinese social
Zehua Jin1, Jin'e Zhang1, Zhijue Zhang1
1Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
Background:
Social media has become an important source of orthodontic information, yet patient experience content varies in completeness and may shape treatment expectations. This study evaluated information completeness, comment sentiment, and engagement patterns in orthodontic experience content on three major Chinese social media platforms.
Methods:
A cross-sectional sample of 180 eligible posts was collected from Bilibili, Douyin, and Xiaohongshu using two search terms, "orthodontic experience" and "braces diary." Information completeness was assessed using a modified 6-point Information Completeness Score (ICS). Comment sentiment and title sentiment were quantified using sentiment analysis scores (SAS). Engagement metrics, including likes, favorites, shares, and comments, were recorded. Platform differences and subgroup differences by appliance type, treatment population, video duration, and video age were analyzed.
Results:
Inter-rater reliability for total ICS was excellent (ICC (3,1) = 0.954). The automated SAS classifications showed strong agreement with the human consensus gold standard, with an overall accuracy of 91.6% (κ = 0.848). ICS differed significantly across platforms (H = 40.70, p < 0.001), with Bilibili showing the highest score (3.53 ± 1.46) and Xiaohongshu the lowest (1.78 ± 1.24). Treatment details and treatment duration were the most frequently mentioned dimensions, whereas clinician or institution credentials and cost were least frequently covered. Title sentiment showed a statistically significant but weak positive correlation with comment sentiment in the full sample (rho = 0.247, p < 0.001), with platform-specific variation. Engagement indicators were strongly intercorrelated (rho = 0.69-0.87), but ICS showed no meaningful correlation with engagement. Longer videos, clear aligner content, adult orthodontic content, and older videos had higher ICS, whereas SAS varied only slightly across groups.
Conclusions:
Orthodontic patient experience content on Chinese social media shows substantial variation in information completeness. High engagement does not necessarily indicate high information quality. Professional orthodontic content should provide balanced information on treatment benefits, risks, costs, duration, and professional sources to support informed patient decision-making.
