Bias Toward Surgical Treatment of Acromioclavicular Injuries Exists on YouTube

Abstract

Purpose

To evaluate the quality and comprehensiveness of videos regarding acromioclavicular dislocation posted on the YouTube platform and to evaluate potential reinforcement of misinformation that may hinder proper management of these injuries.

Methods

A YouTube search was performed in November 2024 using key words “acromioclavicular joint dislocation.” Videos were ranked on relevance and the first 50 videos that met inclusion criteria were analyzed by 2 reviewers. Video source, content type, time since upload, video duration, number of views, likes, subscribers and comments were recorded. Video educational quality was measured using the modified DISCERN, Journal of the American Medical Association (JAMA) score, Global Quality Score and Shoulder-Specific Score (SSS). Quality scores from different sources and content categories were compared using the Kruskal-Wallis test. Strength of relationship between variables was assessed using Spearman's rank correlation coefficient.

Results

In total, 209,005 videos were identified of which the first 50 videos were analyzed. Mean mDISCERN, JAMA, GQS and SSS were 2.19, 2.13, 2.48, and 6.26, respectively. The most common uploader source were physicians (28%) and the most common content category was surgical management (32%). Videos uploaded by an academic source had significantly higher mDISCERN, JAMA, and SSS (P < .05). Other uploader sources did not show significant differences among each other. Quantitative video characteristics showed no significant correlation with quality scores, except the video duration. Finally, only 2 of 50 videos mention nonoperative treatment options for high-grade AC joint dislocations and only 3 of 50 videos refer to the lack of scientific evidence for operative treatment in these high-grade injuries.

Conclusions

Current YouTube video content about AC dislocations has low overall quality, despite being mostly uploaded by physicians. It does not provide sufficient information and potentially reinforces misinformation that may downplay potential benefits of nonsurgical interventions.

Clinical Relevance

Given the widespread use of YouTube by patients seeking medical information, evaluating the quality of this content is essential for surgeons to better understand and address the information their patients may encounter.