bims-librar 2025-03-16 papers

bims-librar

Biomed News

on Biomedical librarianship

Issue of 2025–03–16
23 papers selected by
Thomas Krichel, Open Library Society

Teen Perspectives on Integrating Digital Mental Health Programs for Teens Into Public Libraries ("I Was Always at the Library"): Qualitative Interview Study.
Improving peer review of systematic reviews and related review types by involving librarians and information specialists as methodological peer reviewers: a randomised controlled trial.
How the National Library of Medicine should evolve in an era of artificial intelligence.
Evaluating search engines and large language models for answering health questions.
The Need to Improve the Medical Subject Headings (MeSH) and the Excerpta Medica Tree (EMTREE) Thesauri to Perform Systematic Review on Oral Potentially Malignant Disorders.
Readability of written information for patients across 30 years: A systematic review of systematic reviews.
Evaluating if ChatGPT Can Answer Common Patient Questions Compared With OrthoInfo Regarding Rotator Cuff Tears.
Sports Medicine Patient-Reported Outcomes Fail to Meet National Institutes of Health (NIH) and American Medical Association (AMA) Recommended Reading Levels.
Eyes on the Text: Assessing Readability of AI & Ophthalmologist Responses to Patient Surgery Queries.
The readability of online laryngectomy patient information: how do Australia and New Zealand compare?
A critical analysis of online patient-directed resources on catheter ablation for ventricular arrhythmias.
A review of Canadian online resources providing information on COVID-19 vaccination for caregivers of children aged 5-11 years.
Evaluating the effectiveness and limitations of online health information tools in assessing the quality of medication-related content.
Readability of Online Patient-Directed Content About Cystoscopy and Urodynamic Testing.
Evaluation of the quality and reliability of YouTube videos on obstetric perineal tears.
Evaluating the Effect of Video Source and Other Video Characteristics on the Quality, Reliability, Actionability, and Understandability of Videos on Acromioclavicular Joint Repair.
Oral Health Misinformation on Youtube - A Content Analysis.
Assessment of the quality and reliability of YouTube videos related to teleradiology in musculoskeletal and rheumatic diseases: a cross-sectional study.
The Reliability and Quality of Videos as Guidance for Gastrointestinal Endoscopy: Cross-Sectional Study.
Investigating TikTok Trends in Transcranial Direct Current Stimulation: A Comprehensive Descriptive Analysis.
Assessing the educational impact and quality of medical microvideos on TikTok: the case of Latin America.
Exploring the impact of discharged patients' characteristics on online health information-seeking behaviors: insights from patients' dilemmas.
Associations Among Online Health Information Seeking Behavior, Online Health Information Perception, and Health Service Utilization: Cross-Sectional Study.

JMIR Form Res. 2025 Mar 13. 9 e67454

Teen Perspectives on Integrating Digital Mental Health Programs for Teens Into Public Libraries ("I Was Always at the Library"): Qualitative Interview Study.

Ashley A Knapp, Katherine Cohen, Kaylee P Kruzan, Rachel Kornfield, Miguel Herrera, Aderonke B Pederson, Sydney Lee, Kathryn Macapagal, Chantelle A Roulston, Kaleigh Clarke, Clarisa Wijaya, Robert Simmons, Latonia Jackson, Simrandeep Kour, Sandra Franco, David C Mohr.

   BACKGROUND: Rising rates of anxiety among teens necessitate innovative approaches for implementing evidence-based mental health support. Public libraries, seen as safe spaces for patrons with marginalized identities, offer free public services such as broadband internet access. Many teens spend significant amounts of time in their local libraries due to the safety of this space as well as the trusted adults working there. The American Library Association has shifted its priorities to focus more on mental health through employing social workers and providing mental health programs. As such, public libraries may be promising sites for the implementation of digital mental health (DMH) programs for teens.
OBJECTIVE: This study aimed to examine how teens who attended their local public library experienced and managed their anxiety, what mental health supports they were interested in receiving, and how DMH programs and public libraries can meet their needs.
METHODS: We interviewed 16 teens aged 12-18 (mean 15.2, SD 2.0) years who used the library frequently at the time of the interviews. Of these teen patrons, 56% (9/16) identified as female, 31% (5/16) identified as male, and 12% (2/16) identified as nonbinary. Most (11/16, 69%) identified as either White or Black or African American individuals, with the remainder (5/16, 31%) identifying as Hispanic or Latino or Chinese American individuals or with ≥2 races. The interviews were individual and semistructured, designed to elicit recommendations for designing and implementing digital tools in libraries to improve teen mental health. Interview transcripts were coded by multiple coders using thematic analysis to synthesize key themes.
RESULTS: Teens reported experiencing uncontrollability, unpredictability, and anger related to their anxiety, which they managed using strategies such as guided breathing, distress tolerance, and social connection. They also talked about other helpful management techniques (eg, progressive muscle relaxation, journaling, and mood tracking). Teens underscored the importance of pairing mood tracking with daily activities to reveal patterns. They also stressed the significance of context and anxiety severity when choosing anxiety management strategies. Teens underscored the centrality of the public library in their lives and their view of it as a safe space where they can easily access resources and connect with friends and trusted adults. When considering the design of a DMH program implemented in libraries, they suggested including personalization for different identities, gamification, and simple navigation. Teens emphasized the importance of protecting their privacy within digital programs and that their end goal was to use the skills learned in the DMH program offline.
CONCLUSIONS: Teens who frequently used their local public library expressed interest in receiving digital tools via libraries to help them manage anxiety. Their recommendations will help inform future research on the adaptation and implementation of DMH programs for teens in public libraries.

Keywords:  adolescents; anxiety; digital mental health; implementation; mental health; mobile phone; public libraries; safe spaces; smartphone; teens; youth

DOI:  https://doi.org/10.2196/67454
BMJ Evid Based Med. 2025 Mar 11. pii: bmjebm-2024-113527. [Epub ahead of print]

Improving peer review of systematic reviews and related review types by involving librarians and information specialists as methodological peer reviewers: a randomised controlled trial.

Melissa L Rethlefsen, Sara Schroter, Lex M Bouter, Jamie J Kirkham, David Moher, Ana Patricia Ayala, David Blanco, Tara J Brigham, Holly K Grossetta Nardini, Shona Kirtley, Kate Nyhan, Whitney Townsend, Maurice Zeegers.

   OBJECTIVE: To evaluate the impact of adding librarians and information specialists (LIS) as methodological peer reviewers to the formal journal peer review process on the quality of search reporting and risk of bias in systematic review searches in the medical literature.
DESIGN: Pragmatic two-group parallel randomised controlled trial.
SETTING: Three biomedical journals.
PARTICIPANTS: Systematic reviews and related evidence synthesis manuscripts submitted to The BMJ, BMJ Open and BMJ Medicine and sent out for peer review from 3 January 2023 to 1 September 2023. Randomisation (allocation ratio, 1:1) was stratified by journal and used permuted blocks (block size=4). Of 2670 manuscripts sent to peer review during study enrollment, 400 met inclusion criteria and were randomised (62 The BMJ, 334 BMJ Open, 4 BMJ Medicine). 76 manuscripts were revised and resubmitted in the intervention group and 90 in the control group by 2 January 2024.
INTERVENTIONS: All manuscripts followed usual journal practice for peer review, but those in the intervention group had an additional (LIS) peer reviewer invited.
MAIN OUTCOME MEASURES: The primary outcomes are the differences in first revision manuscripts between intervention and control groups in the quality of reporting and risk of bias. Quality of reporting was measured using four prespecified PRISMA-S items. Risk of bias was measured using ROBIS Domain 2. Assessments were done in duplicate and assessors were blinded to group allocation. Secondary outcomes included differences between groups for each individual PRISMA-S and ROBIS Domain 2 item. The difference in the proportion of manuscripts rejected as the first decision post-peer review between the intervention and control groups was an additional outcome.
RESULTS: Differences in the proportion of adequately reported searches (4.4% difference, 95% CI: -2.0% to 10.7%) and risk of bias in searches (0.5% difference, 95% CI: -13.7% to 14.6%) showed no statistically significant differences between groups. By 4 months post-study, 98 intervention and 70 control group manuscripts had been rejected after peer review (13.8% difference, 95% CI: 3.9% to 23.8%).
CONCLUSIONS: Inviting LIS peer reviewers did not impact adequate reporting or risk of bias of searches in first revision manuscripts of biomedical systematic reviews and related review types, though LIS peer reviewers may have contributed to a higher rate of rejection after peer review.
TRIAL REGISTRATION NUMBER: Open Science Framework: https://doi.org/10.17605/OSF.IO/W4CK2.

Keywords:  Information management

DOI:  https://doi.org/10.1136/bmjebm-2024-113527
J Am Med Inform Assoc. 2025 Mar 10. pii: ocaf041. [Epub ahead of print]

How the National Library of Medicine should evolve in an era of artificial intelligence.

Leslie Andrew Lenert.

   OBJECTIVES: This article describes the challenges faced by the National Library of Medicine with the rise of artificial intelligence (AI) and access to human knowledge through large language models (LLMs).
BACKGROUND AND SIGNIFICANCE: The rise of AI as a tool for the acceleration and falsification of science is impacting every aspect of the transformation of data to information, knowledge, and wisdom through the scientific processes.
APPROACH: This perspective discusses the philosophical foundations, threats, and opportunities of the AI revolution with a proposal for restructuring the mission of the National Library of Medicine (NLM), part of the National Institutes of Health, with a central role as the guardian of the integrity of scientific knowledge in an era of AI-driven science.
RESULTS: The NLM can rise to new challenges posed by AI by working from its foundations in theories of Information Science and embracing new roles. Three paths for the NLM are proposed: (1) Become an Authentication Authority For Data, Information, and Knowledge through Systems of Scientific Provenance; (2) Become An Observatory of the State of Human Health Science supporting living systematic reviews; and (3) Become A hub for Culturally Appropriate Bespoke Translation, Transformation, and Summarization for different users (patients, the public, as well as scientists and clinicians) using AI technologies.
DISCUSSION: Adapting the NLM to the challenges of the Internet revolution by developing worldwide-web-accessible resources allowed the NLM to rise to new heights. Bold moves are needed to adapt the Library to the AI revolution but offer similar prospects of more significant impacts on the advancement of science and human health.

Keywords:  National Library of Medicine; artificial intelligence; data; information; knowledge

DOI:  https://doi.org/10.1093/jamia/ocaf041
NPJ Digit Med. 2025 Mar 10. 8(1): 153

Evaluating search engines and large language models for answering health questions.

Marcos Fernández-Pichel, Juan C Pichel, David E Losada.

Search engines (SEs) have traditionally been primary tools for information seeking, but the new large language models (LLMs) are emerging as powerful alternatives, particularly for question-answering tasks. This study compares the performance of four popular SEs, seven LLMs, and retrieval-augmented (RAG) variants in answering 150 health-related questions from the TREC Health Misinformation (HM) Track. Results reveal SEs correctly answer 50-70% of questions, often hindered by many retrieval results not responding to the health question. LLMs deliver higher accuracy, correctly answering about 80% of questions, though their performance is sensitive to input prompts. RAG methods significantly enhance smaller LLMs' effectiveness, improving accuracy by up to 30% by integrating retrieval evidence.

DOI: https://doi.org/10.1038/s41746-025-01546-w
J Oral Pathol Med. 2025 Mar 09.

The Need to Improve the Medical Subject Headings (MeSH) and the Excerpta Medica Tree (EMTREE) Thesauri to Perform Systematic Review on Oral Potentially Malignant Disorders.

Vito Carlo Alberto Caponio, Gennaro Musella, Mario Pérez-Sayáns, Lorenzo Lo Muzio, Rui Amaral Mendes, Rosa María López-Pintor.

   BACKGROUND: Despite recent advancements in the understanding and classification of oral potentially malignant disorders (OPMD), their terminology remains inconsistent and heterogeneous throughout the scientific literature, thus affecting evidence-based decision-making relevant for clinical management of these disorders. Updating this classification represents a necessity to improve the indexing and retrieval of OPMD publications, in particular for systematic reviews and meta-analysis.
METHODS: Through a critical appraisal of the Medical Subject Headings (MeSH) and Excerpta Medica Tree (EMTREE) thesauri, we assessed gaps in the indexing for OPMD literature and propose improvements for enhanced categorisation and retrieval.
RESULTS: The present study identifies inconsistencies and limitations in the classification of these disorders across the major medical databases, which may be summarized in the following findings: a) The MeSH database lacks a dedicated subject heading for "oral potentially malignant disorders"; b) EMTREE indexing is incomplete, with only 5 out of 11 recognised OPMD having corresponding terms; c) Incoherent controlled vocabulary mappings hinder systematic literature retrieval.
CONCLUSION: To ensure accurate evidence synthesis, the authors recommend searching both PubMed and Embase for OPMD studies. Moreover, the use of Embase's PubMed query translator and Large Language Models, such as ChatGPT, may lead to retrieval biases due to indexing discrepancies, posing challenges for early-career researchers and students. We recommend introducing "oral potentially malignant disorders" as a standardised subject heading. Evidence-based medicine underpins clinical decision support systems, which rely on standardised clinical coding for reliable health information. Enhanced medical ontologies will facilitate structured clinical coding, ensuring interoperability and improving clinical decision support systems.

Keywords:  medical informatics; meta‐analysis; mouth diseases; oral lichen planus; oral potentially malignant disorder; precancerous conditions

DOI:  https://doi.org/10.1111/jop.13616
Patient Educ Couns. 2025 Jan 31. pii: S0738-3991(25)00023-0. [Epub ahead of print]135 108656

Readability of written information for patients across 30 years: A systematic review of systematic reviews.

Tsuyoshi Okuhara, Emi Furukawa, Hiroko Okada, Rie Yokota, Takahiro Kiuchi.

   OBJECTIVE: This study conducted a systematic review of the systematic reviews of readability assessment studies to contribute to future readability research and practice by providing a comprehensive overview of information readability for patients.
METHODS: We searched multiple databases. We included systematic reviews of studies that quantitatively assessed the readability of health information.
RESULTS: This study included 24 systematic reviews, which assessed the readability of 29,424 materials across 438 studies from 1990 to 2022. All systematic reviews reported that the readability of most materials exceeded the recommended sixth to eight-grade reading level. The readability level did not improve between 2001 and 2022, when the included systematic reviews were published.
CONCLUSIONS: We found that the required reading level of information was too high for patients in all clinical areas included in this systematic review. We also identified gaps in readability assessment research in clinical areas and across media types and languages, which should be addressed by future studies.
PRACTICE IMPLICATIONS: Health professionals should use available guidelines to make existing patient information easy to read and to write easy-to-read patient information, thereby improving readability. Such efforts are needed regardless of the organizations these professionals work at.

Keywords:  Health communication; Health information; Health literacy; Patient education material; Readability

DOI:  https://doi.org/10.1016/j.pec.2025.108656
J Am Acad Orthop Surg Glob Res Rev. 2025 Mar 01. 9(3):

Evaluating if ChatGPT Can Answer Common Patient Questions Compared With OrthoInfo Regarding Rotator Cuff Tears.

Alexander Jurayj, Julio Nerys-Figueroa, Emil Espinal, Michael A Gaudiani, Travis Baes, Jared Mahylis, Stephanie Muh.

PURPOSE: To evaluate ChatGPT's (OpenAI) ability to provide accurate, appropriate, and readable responses to common patient questions about rotator cuff tears.
METHODS: Eight questions from the OrthoInfo rotator cuff tear web page were input into ChatGPT at two levels: standard and at a sixth-grade reading level. Five orthopaedic surgeons assessed the accuracy and appropriateness of responses using a Likert scale, and the Flesch-Kincaid Grade Level measured readability. Results were analyzed with a paired Student t-test.
RESULTS: Standard ChatGPT responses scored higher in accuracy (4.7 ± 0.47 vs. 3.6 ± 0.76; P < 0.001) and appropriateness (4.5 ± 0.57 vs. 3.7 ± 0.98; P < 0.001) compared with sixth-grade responses. However, standard ChatGPT responses were less accurate (4.7 ± 0.47 vs. 5.0 ± 0.0; P = 0.004) and appropriate (4.5 ± 0.57 vs. 5.0 ± 0.0; P = 0.016) when compared with OrthoInfo responses. OrthoInfo responses were also notably better than sixth-grade responses in both accuracy and appropriateness (P < 0.001). Standard responses had a higher Flesch-Kincaid grade level compared with both OrthoInfo and sixth-grade responses (P < 0.001).
CONCLUSION: Standard ChatGPT responses were less accurate and appropriate, with worse readability compared with OrthoInfo responses. Despite being easier to read, sixth-grade level ChatGPT responses compromised on accuracy and appropriateness. At this time, ChatGPT is not recommended as a standalone source for patient information on rotator cuff tears but may supplement information provided by orthopaedic surgeons.

DOI: https://doi.org/e24.00289
Arthroscopy. 2025 Mar 06. pii: S0749-8063(25)00150-1. [Epub ahead of print]

Sports Medicine Patient-Reported Outcomes Fail to Meet National Institutes of Health (NIH) and American Medical Association (AMA) Recommended Reading Levels.

Harjot Uppal, Daniel J Garcia, Matthew Kruchten, Matthew J Kraeutler, Andrew McGinniss, Arash Emami, Anthony J Scillia.

PURPOSE: To evaluate the readability of commonly used patient-reported outcome measures (PROMs) in the sports medicine literature to determine if they meet the recommended reading levels set by the National Institutes of Health (NIH) and the American Medical Association (AMA).
METHODS: A readability analysis was conducted on 26 PROMs commonly used in the sports medicine literature. Primary readability metrics used were the Flesch Reading Ease Score (FRES) and the Simple Measure of Gobbledygook (SMOG) Index. Readability scores were obtained using an online readability calculator and compared against NIH and AMA guidelines. A FRES ≥ 80 or SMOG < 7 was applied as a threshold for a 6th-grade or lower reading level.
RESULTS: The average FRES and SMOG Index for all PROMs were 65 ± 13 and 9 ± 1, respectively, indicating an 8th to 9th-grade reading level. Four PROMs met the FRES and SMOG threshold for readability (12-Item Short Form Survey, Pediatric Quality of Life Inventory, Numeric Pain Rating Scale, and Musculoskeletal Function Assessment). Patient-Specific Functional Scale, Disablement of the Physically Active Scale, Upper Extremity Functional Index, Low Back Outcome Score, and the International Knee Documentation Committee Questionnaire were among the least readable PROMs.
CONCLUSIONS: Most sports medicine PROMs are written above the recommended 6th-grade reading level.
CLINICAL RELEVANCE: Ensuring that sports medicine PROMs meet recommended readability standards may improve data accuracy and patient comprehension. By reducing literacy barriers, clinicians can obtain more reliable responses, better evaluate outcomes, and ultimately enhance patient care.

DOI: https://doi.org/10.1016/j.arthro.2025.02.029
Ophthalmologica. 2025 Mar 10. 1-18

Eyes on the Text: Assessing Readability of AI & Ophthalmologist Responses to Patient Surgery Queries.

Sai S Kurapati, Derek J Barnett, Antonio Yaghy, Cameron J Sabet, David N Younessi, Dang Nguyen, John C Lin, Ingrid U Scott.

INTRODUCTION: Generative artificial intelligence (AI) technologies like GPT-4 can instantaneously provide health information to patients; however, the readability of these outputs compared to ophthalmologist-written responses is unknown. This study aims to evaluate the readability of GPT-4-generated and ophthalmologist-written responses to patient queries about ophthalmic surgery.
METHODS: This retrospective cross-sectional study used 200 randomly selected patient questions about ophthalmic surgery extracted from the American Academy of Ophthalmology's EyeSmart platform. The questions were inputted into GPT-4, and the generated responses were recorded. Ophthalmologist-written replies to the same questions were compiled for comparison. Readability of GPT-4 and ophthalmologist responses was assessed using six validated metrics: Flesch Kincaid Reading Ease (FK-RE), Flesch Kincaid Grade Level (FK-GL), Gunning Fog Score (GFS), SMOG Index (SI), Coleman Liau Index (CLI), and Automated Readability Index (ARI). Descriptive statistics, one-way ANOVA, Shapiro-Wilk, and Levene's tests (α=0.05) were used to compare readability between the two groups.
RESULTS: GPT-4 used a higher percentage of complex words (24.42%) compared to ophthalmologists (17.76%), although mean [SD] word count per sentence was similar (18.43 [2.95] and 18.01 [6.09]). Across all metrics (FK-RE; FK-GL; GFS; SI; CLI; and ARI), GPT-4 responses were at a higher grade level (34.39 [8.51]; 13.19 [2.63]; 16.37 [2.04]; 12.18 [1.43]; 15.72 [1.40]; 12.99 [1.86]) than ophthalmologists' responses (50.61 [15.53]; 10.71 [2.99]; 14.13 [3.55]; 10.07 [2.46]; 12.64 [2.93]; 10.40 [3.61]), with both sources necessitating a 12th-grade education for comprehension. ANOVA tests showed significance (p<0.05) for all comparisons except word count (p=0.438).
CONCLUSIONS: The National Institutes of Health advises health information to be written at a sixth-seventh grade level. Both GPT-4- and ophthalmologist-written answers exceeded this recommendation, with GPT-4 showing a greater gap. Information accessibility is vital when designing patient resources, particularly with the rise of AI as an educational tool.

DOI: https://doi.org/10.1159/000544917
N Z Med J. 2025 Mar 14. 138(1611): 93-101

The readability of online laryngectomy patient information: how do Australia and New Zealand compare?

Howard Webb, Jason Toppi.

AIM: The decision for a patient to undergo a laryngectomy is an extremely important one. The aim of our research was to review the readability of international laryngectomy patient information and compare this with Australian and New Zealand resources.
METHODS: Online searches were undertaken using the terms "laryngectomy", "laryngectomy patient information", "voice box removal" and "voice box removal patient information". Twenty-nine articles were included for review. The primary outcomes measures were the Flesch-Kincaid Grade Level, the Flesch Reading Ease Score, the Gunning Fog Index, the Coleman-Liau Index, the SMOG Index, the Automated Readability Index and the Linsear Write Formula.
RESULTS: Overall, we found that laryngectomy patient information from Australian and New Zealand sources was more difficult for patients to understand compared with international sources. The average Flesch-Kincaid Grade Level (equivalent to the United States grade level of education) for Australian and New Zealand websites was 10.41, compared with 9.09 for international websites. For reference, guidelines suggest that articles aimed at the public should have a grade level of 8. Similarly, the average Flesch Reading Ease Score was 55.8 and 58.23 for Australian/New Zealand and international resources respectively-which correlate to "fairly hard" to read, rather than the "easy" or "very easy" categories that are recommended for the general population.
CONCLUSION: For the resources analysed, Australian and New Zealand laryngectomy patient information was less readable than information distributed by international organisations, and is at a high risk of being too complicated for patients to read and understand. Consideration should be given to distributing patient information accessible to patients with lower literacy levels.

DOI: https://doi.org/10.26635/6965.6853
J Arrhythm. 2025 Apr;41(2): e70026

A critical analysis of online patient-directed resources on catheter ablation for ventricular arrhythmias.

Ashish Sood, Yu J Hui, Samual Turnbull, Kasun De Silva, Ashwin Bhaskaran, Timothy G Campbell, Richard G Bennett, Mary S Wong, Saurabh Kumar.

   Background: Patients search online content to improve their understanding of medical procedures. The quality of online patient education materials (OPEMs) on catheter ablation of ventricular arrhythmias (VAs) requires investigation.
Methods: Six predetermined search terms relating to VA ablation were used to search Google, Bing and Yahoo for written OPEMs, and YouTube for video OPEMs. Written OPEMs were assessed for readability using five readability indices to produce a required reading grade level, and quality using the DISCERN and Journal of the American Medical Association (JAMA) instruments. Video OPEMs were assessed for quality according to compliance with a list of investigator-developed essential discussion points.
Results: 1200 written and 480 videos were identified using the search strategy, of which 60 and 25 respectively were unique OPEMs included in this study. The mean reading grade level for written OPEMs was 11.3 ± 1.9, with no articles being written at the 6th grade level recommended by the American Medical Association. Using quality metrics, only 26.7% of written OPEMs attained a 'high-quality' JAMA rating, and 30% had a DISCERN score of 'good' or better. Video OPEMs similarly had poor quality, only discussing a mean of 3.50 ± 2.57 out of 18 total essential criteria.
Conclusion: There is a paucity of online patient-directed materials on VA catheter ablation. Available OPEMs are of insufficient quality to adequately convey essential information, and written OPEMs are written at a level higher than the recommended reading level.

Keywords:  catheter ablation; patient education; quality; readability; ventricular arrhythmia

DOI:  https://doi.org/10.1002/joa3.70026
Vaccine. 2025 Mar 10. pii: S0264-410X(25)00287-7. [Epub ahead of print]54 126990

A review of Canadian online resources providing information on COVID-19 vaccination for caregivers of children aged 5-11 years.

Costanza Di Chiara, Elahe Karimi-Shahrbabak, Joelle Peresin, Daniel S Farrar, Brooke Low, Sarah Abu Fadaleh, Katie Lee, Lauren Tailor, Nikki Wong, Pierre-Philippe Piché-Renaud, Shaun K Morris.

   BACKGROUND AND OBJECTIVES: Vaccination is one of the most searched health topics online, yet the quality of resources varies considerably. This study evaluated the quality of Canadian COVID-19 vaccines online resources for caregivers of 5-11-year-old children.
METHODS: We reviewed Canadian public-facing websites from academic pediatric hospitals, governments, professional organizations, and public health authorities until April 22, 2022. Inclusion criteria included English/French resources targeting caregivers of 5-11-year-olds, presented as webpages, FAQs, posters/infographics, and/or videos. Reliability, readability, and understandability/actionability were appraised using the JAMA Benchmark, Flesch-Kincaid Grade Level, and Patient Education Material Assessment Tool for Printable/Audiovisual materials, respectively. We used a content checklist to assess key vaccine topics (e.g., effectiveness and safety). Descriptive statistics included Fisher's exact and ANOVA tests.
RESULTS: Of 1046 websites screened, 43 primary webpage clusters and 141 secondary webpages were analyzed. Twenty (46.5 %), 9 (20.9 %), 7 (16.3 %), and 7 (16.3 %) primary webpage clusters belonged to government, academic pediatric hospitals, professional organizations, and public health authorities, respectively. The mean JAMA Benchmark score was 3.47 ± 0.55 (out of 43). Of 43 clusters, only five (11.6 %) scored at or below a US 6th-grade education level. While 42/43 (97.7 %) primary clusters including printable materials were understandable (PEMAT-P > 70 %), only 7/43 (16.3 %) were considered actionable. The mean content score was 12.65 ± 3.60 (out of 20) among the 43 primary clusters. No differences in quality were seen across organization types, except for actionability (p = 0.016).
CONCLUSIONS: Although most Canadian webpages on COVID-19 vaccines received high scores in understandability, areas requiring improvement in actionability, readability, and content were identified.

Keywords:  COVID-19; Children; Quality metrics; Vaccine; Websites; eHealth literacy

DOI:  https://doi.org/10.1016/j.vaccine.2025.126990
Front Public Health. 2025 ;13 1460202

Evaluating the effectiveness and limitations of online health information tools in assessing the quality of medication-related content.

Adel S Alhlayl, Haitham A Alzghaibi.

   Introduction: The internet has become a primary source of information on medicines, yet the quality of this information is inconsistent. Despite the proliferation of web-based resources, limited research has specifically examined the reliability of online information on medicines. The variability in quality can be attributed to the recent shift toward digital information-seeking and the absence of specialized tools designed to assess the quality of medication-related information online.
Aim: To evaluate the quality of information about Amitriptyline available on websites using three well-established, generic evaluation tools-HONcode, DISCERN, and JAMA-compared against the domain-specific Keystone action plan criteria.
Methods: Adopting an evaluative research design, this study utilized the aforementioned four assessment tools to collect and analyze data. Four independent assessors were recruited to evaluate the quality of the information on selected websites.
Results: A Google search using "Amitriptyline" identified 30 websites for the study sample. Reliability analysis using Cronbach's alpha, the Inter-Class Correlation coefficient, and Kendall's rank-order correlation coefficient revealed that the Keystone criteria demonstrated the highest internal consistency and reliability compared to DISCERN, HONcode, and JAMA.
Conclusion: This study indicates that the Keystone action plan criteria may serve as a reliable, domain-specific tool for evaluating medicines information on websites. The results underscore the importance of specialized assessment criteria for online medication information, as they provide more consistent and accurate evaluations compared to generic tools.

Keywords:  amitriptyline; keystone criteria; medication information; online health information; reliability testing; web-based assessment tools

DOI:  https://doi.org/10.3389/fpubh.2025.1460202
Int Urogynecol J. 2025 Mar 11.

Readability of Online Patient-Directed Content About Cystoscopy and Urodynamic Testing.

Mehr Jain, Jocelyn Stairs, Alana Sorgini, Aisling Clancy.

   INTRODUCTION AND HYPOTHESIS: The objective was to assess the readability of commonly accessed patient-focused websites about cystoscopy or urodynamic studies (UDS).
METHODS: Keywords related to cystoscopy and UDS were searched in three commonly accessed search engines in 2024 and compared with a search from 2022. The top 25 search results from each search engine were assessed against the study inclusion/exclusion criteria. Readability scores (Flesch Reading Ease score [FRES], Flesch-Kincaid Grade Level [FKGL], Gunning Frequency of Gobbledygook [FOG], Simple Measure of Gobbledygook [SMOG]) were calculated for the websites included. Mean readability scores of websites were compared by procedure type and publisher using the Mann-Whitney test.
RESULTS: In 2024, a total of 75 patient-oriented websites were identified, 33 (44.0%) of which were about cystoscopy and 42 (56.0%) websites were about UDS. Cystoscopy websites were difficult to read (FRES median 56 [55-69]), requiring grade 8-11 reading level (Gunning FOG median 11.3 [10.3-12.3]; FKGL median 8 [7.11-8.84]) and 8 years of education to read (SMOG median 8.06 [7.41-8.71]). UDS websites were difficult to read (FRES median 56 [41-66]), requiring grade 9-11 reading level (Gunning FOG median 11.45 [9.5-13.7]; FKGL median 8.85 [6.93-10.88]) and 8 years of education to read (SMOG median 8.49 [7.11-9.98]). Websites in 2024 were significantly easier to read than websites in 2022 based on Gunning FOG (p value 0.0079), FKGL (p value 0.0001), and SMOG scores (p value 0.0001), but still did not meet the recommendation of grade 6 reading level.
CONCLUSIONS: Patient-focused online information about cystoscopy and UDS was harder to read than the American Medical Association-recommended grade 6 reading level of patient information. Readability of cystoscopy and UDS online information has improved over 2 years.

Keywords:  Cystoscopy; Patient education; Readability; Urodynamic studies; Urogynecology

DOI:  https://doi.org/10.1007/s00192-025-06100-6
Eur J Obstet Gynecol Reprod Biol. 2025 Mar 07. pii: S0301-2115(25)00145-9. [Epub ahead of print]308 228-233

Evaluation of the quality and reliability of YouTube videos on obstetric perineal tears.

F Tellier, E Vignozzi, R Ramanah, N Mottet, M Lallemant.

   OBJECTIVE: The aim of this study was to assess the quality and reliability of YouTube videos on obstetric perineal tears.
METHOD: We chose six keywords: "tearing birth", "perineal trauma", "perineal laceration", "perineal tear", "obstetrical anal sphincter injuries (OASIS)" and "vaginal tear". Each video that met the inclusion criteria were analyzed by two independent raters. Quantitative and qualitative metrics were recorded and scored using the DISCERN instrument.
RESULTS: A total of 51 videos were included. The mean overall DISCERN score between the two raters was 44.5 ± 13.6. There was no significant difference between the two raters (43.4 vs 45.6; p = 0.4). The DISCERN sore was statistically higher in videos presented by a physician (p < 0.001) and those that included an explanation of symptoms (p < 0.001).
CONCLUSION: YouTube videos on obstetric perineal tears have only been rated as fairly reliable. We identified the top four videos using the validated DISCERN instrument. Our top four best videos were unpopular because they used medical terms, narrated by physician and the duration was long. Thus, they would be more appropriate to a medical cohort. YouTube videos should be improved to better explain obstetric perineal tears to the public.

Keywords:  OASIS; Perineal laceration; Perineal trauma; Public; Tearing birth; Videos analysis

DOI:  https://doi.org/10.1016/j.ejogrb.2025.03.008
Cureus. 2025 Feb;17(2): e78518

Evaluating the Effect of Video Source and Other Video Characteristics on the Quality, Reliability, Actionability, and Understandability of Videos on Acromioclavicular Joint Repair.

Abdullah B Chandasir, Justin T Skariah, Justin D Abes, Akshar Patel, Mitchell J Lomis, Noora S Chandasir, Brett D Owens, Stephen A Parada.

   PURPOSE: This study aims to evaluate video quality, reliability, actionability, and understandability differences based on length, popularity, and source credentials (physician versus non-physician). The hypothesis suggests that current videos are of low quality and limited usefulness to patients, highlighting significant disparities based on the credentials of the video source.
METHODS: The phrase "acromioclavicular joint separation" was searched on YouTube. The first 100 videos that populated were selected. Of those 100, 45 were excluded based on pre-existing criteria. Two reviewers watched and graded the included videos using four established, additive algorithmic grading scales. Grades for all included videos were analyzed using R software version 4.2.3.
RESULTS: The mean Journal of the American Medical Association (JAMA) score was 2.32 (standard deviation (SD) = 0.74), with patient-made videos having a significantly lower reliability score (p = 0.008). The mean Patient Education Materials Assessment Tool (PEMAT) understandability and actionability scores were 59.78% (SD = 15.28%) and 67.55% (SD = 15.28%) respectively. PEMAT actionability scores were positively correlated to views (p = 0.002). The average DISCERN score was 2.51 (SD = 0.70); longer videos were correlated with higher DISCERN scores (p = 0.047).
CONCLUSION: Analysis indicated that there were significant differences in reliability and understandability between video source types. Additionally, there was no correlation between quality and/or reliability and views, indicating that the YouTube algorithm is not an effective indicator of the quality of videos.

Keywords:  acromioclavicular separation; patient education; sprain; student education; youtube™

DOI:  https://doi.org/10.7759/cureus.78518
J Pharm Bioallied Sci. 2024 Dec;16(Suppl 5): S4507-S4510

Oral Health Misinformation on Youtube - A Content Analysis.

Mohammed Meera Riyaz, V Gousalya, V Anu, S Prashanth, S Prabhu Ram, Vj Keerthi Varshini, R Rajsanjay.

   Introduction: With the rise of social media and widespread smartphone use, information is now readily accessible worldwide. However, the credibility of this information often remains unchecked. Few studies have evaluated oral health content on online platforms. However, YouTube, despite its popularity, is frequently overlooked. This study aims to identify and analyze oral health misinformation on YouTube.
Methods: A search was done on YouTube using common keywords related to oral health through Google chrome browser with incognito mode to limit the bias associated with Google accounts. The videos obtained were subjected to analysis using a coding framework and both auditory and visual content were examined together by two coders to ensure a comprehensive coding process. All the videos were classified either as accurate information (useful) or misleading information.
Results: A total of 72 videos were included in the study, of which about 55% of them had misleading content. About 75% of the videos containing misleading information were created by non-professionals and only about 15% of the videos containing misleading information were created by medical professionals. It was surprising to note that the misleading information had more positive engagement metric (137429) than the useful information (71207).
Conclusion: From the content analysis, it was found that there was a large amount of misleading information on oral health in YouTube. Therefore, it's crucial to address the potential risks of misleading content and to increase public awareness about the impact of following such misleading information.

Keywords:  Health literacy; home remedies; information dissemination; internet

DOI:  https://doi.org/10.4103/jpbs.jpbs_1038_24
Rheumatol Int. 2025 Mar 14. 45(4): 74

Assessment of the quality and reliability of YouTube videos related to teleradiology in musculoskeletal and rheumatic diseases: a cross-sectional study.

Yerlan Yemeshev, Dana Bekaryssova, Burhan Fatih Kocyigit.

  Teleradiology, the remote evaluation of medical images using digital communication technologies, has altered healthcare delivery, particularly in musculoskeletal and rheumatic disorders. This article aims to assess YouTube videos regarding teleradiology in these disorders. The video inspection was conducted on January 15, 2025, using the search terms "teleradiology musculoskeletal system," "teleradiology rheumatic diseases," "teleradiology rheumatology," and "teleradiology arthritis".A total of 200 videos were evaluated. Total views, likes and comments, video duration, time since upload, and daily engagement metrics were recorded. The videos were categorized based on their origin. The evaluation tools utilized to analyze each video were the Global Quality Scale (GQS), Modified DISCERN Questionnaire, JAMA Benchmark Criteria, and Patient Education Materials Assessment Tool for Audio/Visual Materials (PEMAT-A/V). Of the 44 videos, 20.4% (n = 9) were of low quality, 27.3% (n = 12) were of intermediate quality, and 52.3% (n = 23) were of high quality. Physicians (81.8%) and nonprofit organizations (66.7%) were the predominant producers of high-quality videos. In contrast, health-related websites (29.4%) and nonacademic healthcare institutions (28.6%) constituted the primary sources of poor content. The quality groups showed significant differences in daily views and likes (p < 0.05), with high-quality videos receiving the highest engagement. Significant correlations were detected between video duration and content assessment tools (p < 0.01). The current results emphasize the need to select high-quality videos from reliable sources such as physicians and nonprofit organizations. Considering YouTube's extensive use as a source of medical information, it is essential to advocate for expert-driven, high-quality content to augment its educational efficacy.

Keywords:  Arthritis; Internet; Musculoskeletal system; Rheumatic diseases; Social media; Teleradiology

DOI:  https://doi.org/10.1007/s00296-025-05831-5
J Med Internet Res. 2025 Mar 11. 27 e58855

The Reliability and Quality of Videos as Guidance for Gastrointestinal Endoscopy: Cross-Sectional Study.

Jinpei Liu, Yifan Qiu, Yilong Liu, Wenping Xu, Weichen Ning, Peimei Shi, Zongli Yuan, Fang Wang, Yihai Shi.

   BACKGROUND: Gastrointestinal endoscopy represents a useful tool for the diagnosis and treatment of gastrointestinal diseases. Video platforms for spreading endoscopy-related knowledge may help patients understand the pros and cons of endoscopy on the premise of ensuring accuracy. However, videos with misinformation may lead to adverse consequences.
OBJECTIVE: This study aims to evaluate the quality of gastrointestinal endoscopy-related videos on YouTube and to assess whether large language models (LLMs) can help patients obtain information from videos more efficiently.
METHODS: We collected information from YouTube videos about 3 commonly used gastrointestinal endoscopes (gastroscopy, colonoscopy, and capsule endoscopy) and assessed their quality (rated by the modified DISCERN Tool, mDISCERN), reliability (rated by the Journal of the American Medical Association), and recommendation (rated by the Global Quality Score). We tasked LLM with summarizing the video content and assessed it from 3 perspectives: accuracy, completeness, and readability.
RESULTS: A total of 167 videos were included. According to the indicated scoring, the quality, reliability, and recommendation of the 3 gastrointestinal endoscopy-related videos on YouTube were overall unsatisfactory, and the quality of the videos released by patients was particularly poor. Capsule endoscopy yielded a significantly lower Global Quality Score than did gastroscopy and colonoscopy. LLM-based summaries yielded accuracy scores of 4 (IQR 4-5), completeness scores of 4 (IQR 4-5), and readability scores of 2 (IQR 1-2).
CONCLUSIONS: The quality of gastrointestinal endoscope-related videos currently on YouTube is poor. Moreover, additional regulatory and improvement strategies are needed in the future. LLM may be helpful in generalizing video-related information, but there is still room for improvement in its ability.

Keywords:  LLM; YouTube; colonoscopy; cross-sectional study; endoscopy; endoscopy-related videos; gastrointestinal endoscopy; gastroscopy; health information; large language model; patient education; quality; reliability; social media gastrointestinal; video

DOI:  https://doi.org/10.2196/58855
Clin Teach. 2025 Apr;22(2): e70067

Investigating TikTok Trends in Transcranial Direct Current Stimulation: A Comprehensive Descriptive Analysis.

Edson Silva-Filho, Tatiana Camila de Lima Alves da Silva, Silvia Di-Bonaventura, Letícia Amaro Vieira, Rodrigo Pegado, Maria Thereza Albuquerque Barbosa Cabral Micussi.

   BACKGROUND: Transcranial direct current stimulation (tDCS) has gained significant attention in both academic and clinical settings due to its potential benefits in treating various neurological conditions. However, the accessibility and accuracy of information on social media platforms, such as TikTok, can greatly influence public perception and understanding of this technology. Therefore, because the information on the platform is not peer-reviewed, the analysis of the TikTok content is essential for the audience.
OBJECTIVE: To assess the reliability, accuracy, quality of consumer health information and overall quality of the videos on TikTok pertaining to tDCS.
METHODS: We conducted a search from 10 to 30 June 2024 using the terms 'transcranial direct current stimulation' and/or 'tDCS' to identify relevant videos on the TikTok platform. The videos were analysed based on the JAMA benchmark criteria, DISCERN, global quality score and the Patient Education Materials Assessment Tool.
RESULTS: A total of 53 videos were included for analysis, with an average of approximately 40.000 views each. Most videos were uploaded by private users detailing their personal experiences. According to the JAMA benchmark, the majority of the videos lacked reliability and accuracy. The DISCERN assessment indicated that most videos were classified as very poor or poor. The global quality assessment revealed that the videos provided minimal useful information to the audience. However, the Patient Education Materials Assessment Tool results showed that most videos had moderate to high understandability but low actionability.
CONCLUSION: Most tDCS-related videos on the TikTok platform exhibited low accuracy, reliability and overall quality. Additionally, the understandability and actionability for viewers were limited.

Keywords:  TikTok; audiovisual aids; transcranial direct current stimulation

DOI:  https://doi.org/10.1111/tct.70067
Med Educ Online. 2025 Dec;30(1): 2474129

Assessing the educational impact and quality of medical microvideos on TikTok: the case of Latin America.

Juan S Izquierdo-Condoy, Marlon Arias-Intriago, Melizza Mosquera-Quiñónez, Fernando P Melgar Muñoz, Mariana Jiménez-Ascanio, Valentina Loaiza-Guevara, Esteban Ortiz-Prado.

   BACKGROUND: Social media use in medical education has surged, with YouTube and Facebook leading before COVID-19. Recently, TikTok has drawn young learners, expanding access but often lacking alignment with formal curricula and quality standards.
OBJECTIVES: This study aims to analyze the quality of academic medical content on TikTok within the Latin American context, focusing on the most-viewed Spanish-language accounts.
MATERIALS AND METHODS: This cross-sectional study analyzed medical education microvideos on TikTok through a systematic search conducted on 1 March 2024, using the keywords 'medical education' and 'medical review.' The search yielded 300 microvideos, from which the 100 most-viewed were selected. The 13 most popular accounts were identified, and their top three most-viewed microvideos were analyzed, resulting in a final sample of 39 microvideos. Popularity was measured through views, likes, and the Viewability Index (VPI), while educational quality was assessed using the JAMA Benchmark Criteria, which evaluates authorship, attribution, disclosure, and validity.
RESULTS: The majority of accounts (69.2%) were male-created, with 30.8% based in Mexico and Peru. Physicians comprised 53.8% of content creators, followed by medical students (23.1%). General medical education was the main focus (69.2%), with general medicine as the most common topic (76.9%). The dataset included 39 microvideos, averaging 1,653,677 views, and #medicina was the most frequently used hashtag. Popularity metrics strongly correlated with engagement metrics (comments, shares) but weakly with favorites. Educational quality scores were low, with only two accounts scoring 1 out of 4 points on the JAMA Benchmark.
CONCLUSION: TikTok's engagement metrics amplify popular medical microvideos among Spanish-speaking users but do not reliably reflect educational quality, raising concerns about misinformation. 'Favorites' may serve as a more accurate indicator of perceived informational value. Standardized assessment tools should incorporate both engagement and quality metrics to improve content reliability and accessibility to evidence-based medical information.

Keywords:  Latin America; Medical education; Microlearning; TikTok; health profession

DOI:  https://doi.org/10.1080/10872981.2025.2474129
Front Psychol. 2025 ;16 1500627

Exploring the impact of discharged patients' characteristics on online health information-seeking behaviors: insights from patients' dilemmas.

Fei Liu, Xiangyin Kong, Tian Xia, Huijing Guo.

   Introduction: Aligned with the dual-factor model, this study aims to investigate why discharged patients seek online health information, considering the complexity of patients' dilemmas. Additionally, we account for specific cultural context factor in China and seek to examine the role of living with children in mitigating the dilemmas faced by discharged patients in their pursuit of additional online information.
Methods: We empirically tested the research model using data collected from 292 discharged patients. The data was examined through structural equation modeling, employing Smart PLS.
Results: The findings suggest that perceived stress facilitates discharged patients' engagement in seeking online health information, whereas resistance to change and learned helplessness impede such behaviors. Furthermore, our analysis reveals that cohabiting with children moderates the effects of resistance to change on online health information-seeking behavior.
Discussion: In conclusion, this paper extends the literature by examining the role of discharged patients' characteristics on online health information-seeking behaviors. Following the practices in China, this study involves living arrangements (with children) as an essential factor in the research model. This paper offer suggestions to online providers to make health-related information more suitable for discharged patients.

Keywords:  dilemmas; discharged patients; dual-factor model; living with children; online health information-seeking behaviors

DOI:  https://doi.org/10.3389/fpsyg.2025.1500627
J Med Internet Res. 2025 Mar 14. 27 e66683

Associations Among Online Health Information Seeking Behavior, Online Health Information Perception, and Health Service Utilization: Cross-Sectional Study.

Hongmin Li, Dongxu Li, Min Zhai, Li Lin, ZhiHeng Cao.

   BACKGROUND: Seeking online health information can empower individuals to better understand their health concerns, facilitating their ability to manage their health conditions more effectively. It has the potential to change the likelihood and frequency of health service usage. Although existing literature has demonstrated the prevalence of seeking online health information among different populations, the factors affecting online health information perception and discussions on the associations between seeking online health information and health service utilization are limited.
OBJECTIVE: We analyzed the associations between online health information seeking behavior and health service utilization, as well as the online health information perception delivery mechanism.
METHODS: We analyzed data from the Chinese General Social Survey, the first national representative survey conducted in mainland China. The independent variable was the online health information seeking behavior. The outcome variable was health service utilization by the respondents, and online health information perception was selected as the mediating variable in this analysis. Factor analysis was conducted to obtain online health information perception. Multiple regressions were performed to investigate the effect of online health information seeking behavior on physician visits. Bootstrap methods were conducted to test the mediation effects of online health information perception.
RESULTS: This analysis included 1475 cases. Among the participants, 939 (63.66%) sought online health information in the last 12 months. The mean age of the respondents was 46.72 (SD 15.86) years, and 794 (53.83%) were females. After controlling for other variables, individuals with online health information seeking behaviors showed 0.289 times more outpatient visits (P=.003), 0.131 times more traditional Chinese medicine outpatient visits (P=.01), and 0.158 times more Western medicine outpatient visits (P=.007) over the past year compared to those who did not seek health information online. Additionally, multiple regression analyses revealed statistically significant effects of gender, age, and health status on physician visits. The total effect revealed that seeking online health information significantly influenced the total physician visits (β=0.290; P=.003), indicating a certain correlation between online health information seeking behavior and physician visits. Seeking online health information had a significant positive impact on the perception (β=0.265; P<.001). The mediation effects analysis identified that online health information perception led to a significant increase in physician visits with the increase in the online health information seeking behaviors (β=0.232; P=.02).
CONCLUSIONS: The online health information perception of an individual influences the effect online health information seeking has on the frequency of physician visits. The online health information seeking behavior impacts outpatient service utilization both directly and indirectly through online health information perception and significantly increases the frequency of clinic visits after controlling for other variables. Interventions can be explored to improve the health utilization of residents by increasing their online health information perception.

Keywords:  China; Chinese General Social Survey (CGSS); data; database; health information; health perception; health service utilization; mediating effect; medical information; online health information perception (OHIP); online health information seeking (OHIS); survey

DOI:  https://doi.org/10.2196/66683