YouTube as a source for information on newborn male circumcision: Is YouTube a reliable patient resource?

Introduction YouTube is the most popular open access media -sharing platform and is the second most visited websites worldwide. However, due to a lack of peer -review, YouTube is largely unregulated and can be susceptible to the spread of biased or misleading information. Objective To evaluate the quality and potential bias of videos pertaining to newborn male circumcision (NMC) on YouTube. Materials & methods A YouTube search was performed on August 27, 2021 using the search term 'circumcision', and the top 100 videos were analyzed by two independent reviewers. Videos were categorized into groupings based on their source, and each video was evalu-ated for bias and was determined to be either pro -circumcision, anti-circumcision or neutral. Video quality was assessed using the DISCERN instrument (1-5 scale) and the Global Quality Scale (GQS)(1-5 scale). Video popularity was measured using the video power index (VPI). Results We found that the overall quality of videos on YouTube pertaining to NMC is generally low (DISCERN: 2.9 +/- 0.7, GQS: 2.9 +/- 1.1). When describing potential bias, 56% of videos were neutral and 44% were biased, of which 30% being anti-circumcision and 14% being pro -circumcision. Videos which were neutral, produced by health channels, or which featured physicians were associated with the highest quality ratings. However, when correlating total video views and likes with our quality assessments, we observed a significant nega-tive correlation between the overall popularity of a video and its DISCERN (r =-0.297, p = 0.031) and GQS quality ratings (r =-0.274, p = 0.048). Conclusion Information pertaining to NMC on YouTube is generally of low quality and has a high potential for bias. Lower quality content is overrepresented on YouTube and tended to be more popular than higher quality content. Patients and their families should be cautious when accessing YouTube for health in-formation pertaining to NMC.