Quality and reliability of osteoporosis-related health information on short-video platforms: a multi-source...

Osteoporosis (OP) affects approximately 145.86 million people in China, imposing a substantial disease burden and broader societal costs. Effective management requires evidence-based patient education. Short-video platforms have become increasingly important channels for health communication, yet few studies have provided systematic comparisons of OP content across Chinese platforms using concurrent measures of overall quality, reliability, and transparency.

This cross-sectional study analyzed 300 OP-related short videos (100 each from TikTok, RedNote, and Bilibili). Two trained raters independently assessed all videos using the Global Quality Scale (GQS), modified DISCERN (mDISCERN), and Journal of the American Medical Association (JAMA) benchmarks; a third reviewer adjudicated disagreements. The primary outcomes evaluated in this study were GQS, mDISCERN, and JAMA scores. Scores were summarized primarily as median (interquartile range [IQR]) and compared using Kruskal-Wallis test, Dunn-Bonferroni pairwise comparisons, and Holm adjustment across the three omnibus tests. Spearman correlations were used to explore associations between quality scores and engagement metrics.

TikTok videos had the highest descriptive engagement metrics, whereas Bilibili videos had the longest duration. Platform differences were observed for GQS, H(2) = 39.878, P = 2.19 × 10⁻⁹, Holm-adjusted P = 6.57 × 10⁻⁹, η²H = 0.128; mDISCERN, H(2) = 20.453, P = 3.62 × 10⁻⁵, Holm-adjusted P = 7.24× 10⁻⁵, η ²H = 0.062; and JAMA, H(2) = 9.651, P = 0.008, Holm-adjusted P = 0.008, η²H = 0.026. Bilibili had the highest mDISCERN and JAMA distributions, whereas RedNote had the lowest GQS distribution. Institutions had higher JAMA scores than all other uploader groups; their GQS advantage was limited to comparison with ordinary users, and mDISCERN did not differ significantly by uploader identity. In the pooled analysis, no statistically significant association was detected between engagement indicators and any quality score (all |ρ|< 0.10).

Overall, the quality, reliability, and transparency of OP information on major short-video platforms were suboptimal, varied markedly across platforms, and showed a striking disconnect between popularity and credibility.