Evidence-based quality and accuracy of YouTube videos about nephrolithiasis

Objective To assess the quality and accuracy of online videos about the medical management of nephrolithiasis. Materials and Methods To evaluate trends in online interest, we first examined the frequency of worldwide YouTube searches for 'kidney stones' from 2015 to 2020. We then queried YouTube with terms related to symptoms and treatment of kidney stones and analysed English-language videos with >5000 views. Quality was assessed using the validated DISCERN instrument. Evidence-based content analysis of video content and viewer comments was performed. Results Online searches for videos about kidney stones doubled between 2015 and 2019 (P < 0.001). We analysed 102 videos with a median (range) number of views of 46 539 (5024-3 631 322). The mean (sd)DISCERN score was 3.0 (1.4) out of 5, indicating 'moderate' quality; scores were significantly higher for the 21 videos (21%) authored by academic hospitals (mean 3.7 vs 2.8,P = 0.02). Inaccurate or non-evidence-based claims were identified in 23 videos (23%); none of the videos authored by academic institutions contained inaccurate claims. Videos with inaccurate statements had more than double the viewer engagement (viewer-generated comments, 'thumbs up' and 'thumbs down' ratings) compared to videos without inaccuracies (P < 0.001). Among viewer comments, 43 videos (43%) included comments with inaccurate or non-evidence-based claims, and a large majority (82 videos, 80%) had 'chatbot' recommendations. Conclusions Interest in YouTube videos about nephrolithiasis has doubled since 2015. While highly viewed videos vary widely in quality and accuracy, videos produced by academic hospitals have significantly fewer inaccurate claims. Given the high prevalence of stone disease and poor-quality videos, patients should be directed to evidence-based content online.