YouTube as a source of information for arteriovenous malformations: A content-quality and optimization analysis

Aim: YouTube (YT) is not only a source of entertainment but also, a popular source of medical knowledge. Our goal was to evaluate the quality of videos concerning arteriovenous malformations (AVM) available on YT. Materials and methods: A YT search was conducted for the terms "Arteriovenous malformation", "AV malformations", "Intracranial AVM", "Cerebral AVM"," Brain AVM" and "Pial AVM." The first 70 videos for each search were evaluated and yielded 122 unique videos after the exclusion was applied. The videos were examined by two independent Raters using a validated quality criteria such as the Quality Criteria for Consumer Health Information (DISCERN), the Journal of the American Medical Association instrument (JAMA), and the Global Quality Score (GQS). Results: The mean DISCERN score was 30 out of 75 possible points, with an intraclass correlation coefficient for the absolute agreement of 0.98, indicating an excellent interrater reliability. Most videos were produced in the United States (51.6%) and were uploaded by educational channels. Videos had statistically higher DISCERN, JAMA, and GQS scores when they presented clear information, AVM symptoms, angioarchitecture, AVMs with concomitant aneurysms, risks of bleeding, Spetzler-Martin Grading, treatment information, treatment risks, treatment results, follow-up, diagrams, and a doctor as a speaker. Videos that featured animations observed higher popularity as indicated by the Video Power Index (VPI) and observed a higher DISCERN and GQS score. Videos with the overall highest VPI generated poor DISCERN scores. Conclusions: YT does not provide high content quality medical information regarding AVMs and, in some cases, offer misleading information.