Hysteroscopic metroplasty and its reproductive impact among the social networks: A cross-sectional analysis on video quality, reliability and creators' opinions on YouTube, TikTok and Instagram

Background: Usefulness of hysteroscopic metroplasty to improve reproductive outcomes is controversial and debated among reproductive specialists and, consequently, patients. Methods: We performed a cross-sectional analysis to assess the quality, reliability, and level of misinformation in YouTube, Instagram, and TikTok videos about hysteroscopic metroplasty. Videos on each social network retrieved using "hysteroscopy" and "septate uterus" or "uterine septum" as keywords were assessed using Patient Education Materials Assessment Tool for audio-visual (PEMAT A/V) content, the modified DISCERN (mDISCERN), Global Quality Scale (GQS), Video Information and Quality Index (VIQI) and Misinformation assessment. Results: One hundred fifteen videos (47 from YouTube, 35 from TikTok, and 33 from Instagram) were included. Median PEMAT A/V Understandability and Actionability scores were 50.0 % (IQR: 0-63.3) and 20 % (IQR: 0.0-50.0). Actionability was higher YouTube relative to TikTok and Instagram (50.0 % [IQR: 0-75.0] vs. 0 % [IQR: 0-66.0]; p < 0.001 and 0 % [IQR: 0-33.0], p < 0.001), with no significant differences for Understandability. Median mDISCERN was 3 (IQR: 0-3), with higher score for YouTube compared to TikTok and Instagram (3 [IQR: 0-3] vs. 0 [IQR: 0-23], p <0.001 and 1 [IQR 0-3.0], p < 0.001 respectively). VIQI showed low-level content (median 9; IQR: 4-19) and no differences among social media platforms. GQS was low (median 2 [IQR 1-4.5]), with no differences in subgroup analysis. Videos on YouTube (97.9 %) and TikTok (62.9 %) favored hysteroscopic metroplasty, while Instagram content was against in 63.6 % of cases (p < 0.001). While most videos were found to be either completely or partially accurate, significant differences in misinformation levels were observed across platforms, with YouTube exhibiting the lowest rate of inaccuracies compared to TikTok and Instagram. (8.5% vs. 42.9% and 36.4%; p < 0.001, respectively). Conclusion: Quality of social networks' videos on hysteroscopic metroplasty seems unsatisfactory, but with low levels of misinformation. YouTube and TikTok were more favorable than Instagram regarding the usefulness of metroplasty. In contrast, a favorable opinion regarding its efficacy in fertility improvement was retrieved in each social.