Introduction: Cholesteatoma is common chronic ear condition that usually requires surgical treatment and long-term follow-up. The In- ternet helps patients find information about their medical conditions and assists in shared clinical decision making. This work aims to as- sess the quality of information on YouTube for cholesteatoma. We aim to assess the quality of the most popular cholesteatoma videos on YouTube using recognized scoring systems and determine if quality correlated with video likes and views.
Methods: The YouTube website was systematically searched on separate days with a formal search strategy to identify videos relevant to cholesteatoma. Each video was viewed and scored by three inde- pendent assessors using a novel Essential and Ideal Video Complete- ness criteria for cholesteatoma and the validated DISCERN tool. Pop- ularity metrics were analyzed and compared with video popularity.
Results: A total of 90 YouTube videos were analyzed with an aver- age 55,292 views per video with an average of 271 likes and 22 dislikes. The interrater correlation was moderate with Fleiss kappa score 0.42 (p < 0.01) using the Essential and Ideal Video Com- pleteness criteria for cholesteatoma and interrater correlation coef- ficient was 0.78 (95% confidence interval, 0.58–0.90), indicating good reliability for DISCERN scores. The overall video quality was poor with higher DISCERN scores found from academic institutions.
Conclusion: YouTube content with regard to cholesteatoma is of poor quality. Videos with unclassified sources or more dislikes correlated with poor quality. Otology societies should be encour- aged to publish high-quality YouTube videos on cholesteatoma and other ear conditions.
Key Words: Cholesteatoma—Consent—Health information— Otology—Patient education—YouTube.