Since many individuals seek information online about their healthcare—including those with diagnosed conditions— new research published in Eye & Contact Lens cautions YouTube videos that provide the best sources of information on keratoconus are often the least popular amongst viewers.

“Although disease-related YouTube videos seem to be popular among patients with keratoconus, their educational value and reliability are of concern,” the authors wrote in their paper.

The research team, based in Turkey, conducted a YouTube search with the words, “keratoconus,” “contact lenses for keratoconus,” “corneal crosslinking” and “corneal transplant surgery for keratoconus.”  Based on the findings, two ophthalmologists independently classified videos as useful, misleading or patient testimonials, and then rated them using four different measures of educational value and accuracy. The videos were deemed poor overall.

Of the 300 videos screened, 201 were included in the study. The investigators classified slightly over half (58%) of the videos as useful, 13% as misleading and 29% as patient viewpoints.

Of note: misleading videos scored significantly lower than average but had higher popularity compared with useful videos. Medical advertisements or for-profit companies and TV shows were the leading sources of misleading videos, which mostly presented a certain surgical technique or a piece of special equipment (generally about corneal crosslinking), which claimed to cure the disease and vision in seconds, and very few of them, if any, addressed indications, side effects or prognosis, the investigators said.

On the other hand, videos uploaded by university channels provided useful information but constituted only 12% of all videos.

The contrast between the poor quality of content and high audio and video quality (75% were rated as professionally made videos of good quality) highlights the underlying profit-oriented intent of most videos and indicates that misinformation doesn’t emerge from a lack of resources or missing expertise but could rather be deliberate, the researchers suggested.  

Another point: nearly half (48%) of the misleading videos were uploaded by ophthalmologists, which meant that one-out-of-four videos uploaded by MDs with the intention of providing information was misleading, they added.

Additionally, video length inversely correlated with the popularity index. Clinicians need to be aware that misleading content may often be filtered to patients by popularity, which can have negative impacts both on patients’ perception of the disease and the patient-physician relationship, the investigators noted. Still, they also found that, despite its disadvantages, the potential use of online platforms such as YouTube for effective health communication cannot be ignored.

“In an increasingly digital world, universities and medical communities should be more actively involved in the development of e-resources and seek to develop strategies to improve the quality and quantity of online educational materials and increase patient engagement in higher quality health sources,” the authors wrote.

Zeydanli EO, Alkan AA. Era of “Dr. YouTube”: evaluation of YouTube videos as a valid source for patient education on keratoconus. Eye Contact Lens. July 08, 2021. [Epub ahead of print].