Evaluating Youtube as A Source of Patient Information on Dupuytren’s Disease

Dupuytren’s disease (DD) is a benign, fibroproliferative disorder of the hand resulting in contracture of the digits. Traditionally, surgical treatment (fasciectomy or dermofasciectomy) has been the gold standard. Needle aponeurotomy and collagenase injections are newer alternatives with potentially higher recurrence rates and lower efficacy in severe cases.1,2 There is no consensus on a single superior treatment for DD. Youtube is a free, publically accessible website where users upload and view videos on various topics including healthcare. It is an unregulated information source, making it difficult to verify the credibility of its content.3 With potentially unreliable information being accessed by patients, it is important to assess what is being viewed. We aimed to analyse the content of videos on Youtube concerning DD. YouTube was searched using the terms: “Dupuytren’s contracture”, “Dupuytren’s disease” and “Dupuytren’s treatment”. Results were sorted by relevance, the first 40 videos from each search were included and duplicate videos or videos without dialogue were excluded (n=55). Two medical professionals independently assessed the source, content and educational quality of 55 videos. The source of a video was determined by identifying those who featured in the video or those who had uploaded the content, through the information available to the viewer. The source of each video was divided into medical professional, news/TV, patient/public and non-profit organisation. Content was assessed for the mention of general background information on DD, surgical treatment options, needle aponeurotomy, collagenase injections and other treatment alternatives. It was noted if a video only had a single focus or was an advertisement. Educational quality was assessed and divided into the following categories; useful to patients, useful only to medical professionals, not useful or misleading. For a video to be deemed “useful to patients” it had to be scientifically accurate and in keeping with what is widely accepted in literature about DD. Additionally, it had to avoid the use of medical jargon and assume no prior medical knowledge; otherwise, it would be considered “useful only to medical professionals”. Videos were “not useful” if the information was solely anecdotal, with no emphasis on education about the disease or treatment options. “Misleading” videos either failed deliver accurate disease information or promoted treatment with no evidence base. The majority of videos were uploaded by medical professionals (34), with the remainder by News/TV (10), patient/public (9) or 1. Orthopaedic Department, Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter Hospital, Exeter, UK; 2. Botnar Research Centre, NDORMS, University of Oxford, Nuffield Orthopaedic Centre, Oxford, UK