YouTube as a source of information on ectopic pregnancy: A qualitative and quantitative analysis

PLOS ONE RESEARCH ARTICLE YouTube as a source of information on ectopic pregnancy: A qualitative and quantitative analysis Camille Bulle ID1*, Marine Lallemant1,2, Clara Rigori1, Rajeev Ramanah1,3 a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 1 Department of Obstetrics and Gynecology, University Medical Center of Besancon, University of FrancheComte, Besançon, France, 2 Department of Applied Mechanics, FEMTO-ST Institute, UMR 6174 CNRS, University of Franche-Comte, Besançon, France, 3 Nanomedecine Laboratory, INSERM EA4662, University of Franche-Comte, Besancon, France * Abstract OPEN ACCESS Objective Citation: Bulle C, Lallemant M, Rigori C, Ramanah R (2023) YouTube as a source of information on ectopic pregnancy: A qualitative and quantitative analysis. PLoS ONE 18(7): e0287603. https://doi. org/10.1371/journal.pone.0287603 The aim of this study was to assess the quality and reliability of YouTube videos on ectopic pregnancies for the public. Editor: Angelica Espinosa Miranda, Universidade Federal do Espirito Santo, BRAZIL We searched for the key terms “ectopic pregnancy”, “ectopic birth” and “extra uterine pregnancy” on YouTube. Each video that met the inclusion criteria was analyzed by two independent raters. Quantitative and qualitative metrics were recorded, and the videos were scored using the DISCERN instrument. Received: April 17, 2023 Accepted: June 8, 2023 Method Published: July 12, 2023 Peer Review History: PLOS recognizes the benefits of transparency in the peer review process; therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. The editorial history of this article is available here: https://doi.org/10.1371/journal.pone.0287603 Copyright: © 2023 Bulle et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the paper and its Supporting Information files. Results A total of 37 videos met the inclusion criteria. The mean overall DISCERN score was 44.5 ± 15.6. Videos had significantly a higher DISCERN score if they contained explanations on anatomy (pvalue <0.01), physiopathology (p-value <0.01), diagnosis (p-value = <0.01), treatments (p-value <0.01), symptoms (p-value <0.01), clear information (p-value <0.01), animations (p-value <0.01) and if it was a physician speaking (p-value <0.01). Conclusion YouTube videos on ectopic pregnancy have been assessed to be only fairly reliable. We identified the five best ones using the validated DISCERN instrument. While ectopic pregnancy is not uncommon, YouTube videos should be improved to provide more accurate information for the public. Funding: The author(s) received no specific funding for this work. PLOS ONE | https://doi.org/10.1371/journal.pone.0287603 July 12, 2023 1 / 11 PLOS ONE Competing interests: The authors have declared that no competing interests exist. YouTube as a source of information on ectopic pregnancy Introduction Nowadays, thanks to social networks and scientific popularization, 80% of the population has access to health information on the internet [1]. YouTube is the second most visited website in the world after Google [2] and the most popular video-sharing platform [3]. Besides normal pregnancy, the most common cause of pelvic pain and metrorrhagia with positive HCG hormone is ectopic pregnancy. It accounts for 2% of pregnancies. For the record, an ectopic pregnancy is defined as a pregnancy implanted outside the uterine cavity. It can be located in the fallopian tube (in 94% of cases and mainly in the ampullary part); but also in the cervix, the ovaries, the isthmus and even rarely intra-abdominally [4]. Ectopic pregnancy can be fatal if undetected, especially in developing countries [5]. According to the study by Laura L. Marion et al., the ectopic pregnancy mortality is around 3.9 of 1 000 which is 9% of all maternal deaths in USA [6]. In African developing countries, mortality raises between 1 and 3% of cases, making it one of the most important causes of maternal mortality [7]. Thus, about 75 to 80% of people use the internet for reassurance [8] because it is an infinite source of information. However, the question arises as to whether it can be trusted. For all these reasons, we wondered about the quality of YouTube videos on ectopic pregnancies and what criteria influenced this quality. The aim of this study was to assess the quality and reliability of YouTube videos on ectopic pregnancy for public. We also determined what information about ectopic pregnancies appealed to the audience, so that future educational video creators could better meet the needs of viewers and create more friendly videos. Finally, we tried to determine quality criteria for a public video. Methods Study design and data collection The YouTube evaluation was conducted from 3 February 2022 to 14 April 2022. For this study, it was necessary to abide as closely as possible to the population. Therefore, we used non-technical keywords. We chose the following keywords: “ectopic pregnancy”, “ectopic birth” and “extra uterine pregnancy”. The videos were ordered according to the default “relevance” sorting of YouTube. Only the first 30 videos for each keyword were evaluated, as some studies have shown that 90% of YouTube users looked at the results from the first three pages [9]. Only English-speaking videos were included because this language is considered universal [10]. All duplicate videos, unrelated to ectopic pregnancy, surgical videos or ultrasound videos without explanations were excluded. Variable extraction The number of views, duration, number of comments, number of likes, source of the video were extracted. Other quantitative variables were obtained by vidIQ Vision for YouTube version 3.69.2 (Google Chrome extension) such as upload date, count of word and links in the description, referrers and tags, the number of views per hour, number of followers, number of followers per day and number of views of the channel. With the extension vidIQ Vision, we also extracted the VidIQ SEO score, which estimates the probability of the video appearing at the top of the search. We calculated some information such as the average number of daily views with (total number of views / day since upload) and the likeability with two variables: the like ratio calculated by [like/ (like + dislike)] x100 and the video power index (VPI) calculated by [(like*100/ PLOS ONE | https://doi.org/10.1371/journal.pone.0287603 July 12, 2023 2 / 11 PLOS ONE YouTube as a source of information on ectopic pregnancy (like+dislike)) *(view/day)/100]. Since November 2021, dislikes are hidden to reduce cyberbullying. Thanks to a google extension named Return YouTube Dislike 2.1.0.3, we c (...truncated)