Systematic YouTube Review - Trigger Finger Release

Background: With lack of regulation and incentivisation on YouTube for high-quality healthcare information, it is important to objectively evaluate the quality of information on trigger finger - a common condition for hand surgeon referral. Methods: YouTube was queried (11/21/2021) for videos on trigger finger release surgery. Videos were excluded if they were about unrelated topics or not in English. The most viewed 59 videos were categorised by source as physician or non-physician. Two independent reviewers quantified the reliability, quality and content of each video, with inter-rater reliability assessed using Kohen's Kappa test. Reliability was assessed using the Journal of the American Medical Association (JAMA) score. Quality was assessed using the DISCERN score with high-quality videos defined as those with scores in the sample upper 25th percentile. Content was assessed using the informational content score (ICS) with scores in the sample upper 25th percentile indicating more complete information. Two-sample t-tests and logistic regression were used to assess variations between sources. Results: Videos by physicians had higher DISCERN quality (42.6 +/- 7.9, 36.4 +/- 10.3; p = 0.02) and informational content (5.8 +/- 2.6, 4.0 +/- 1.7; p = 0.01) scores compared to those by non-physician sources. Videos by physicians were associated with increased odds of high-quality (Odds Ratio [OR] 5.7, 95% Confidence Interval [95% CI] 1.3-41.3) and provided more complete patient information (OR 6.3, 95% CI 1.4-48.9). The lowest DISCERN sub-scores for all videos were discussion of the uncertainties and risks associated with surgery. The lowest ICS for all videos were in the diagnosis of trigger finger (11.9%) and non-surgical prognosis (15.3%). Conclusions: Physician videos have more complete and higher quality information on trigger finger release. Additionally, discussion of treatment risks, areas of uncertainty, the diagnostic process, non-surgical prognosis and transparency on references used were identified as lacking content. Level of Evidence: Level III (Therapeutic)