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Effectiveness of YouTubeTM as a source of patient information for ureteroscopy

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Effectiveness of YouTubeTMas a source of patient information for ureteroscopy



The internet has become an importance source of health information with approximately 80% of patients admitting to using the internet for medical information purposes [1].

YouTubeTM (http://www.youtube.com/) is a free video-sharing site with over 100 million videos, that allows people to find, view and share their own videos. Considering its popularity and ease of access, YouTubeTM should be regarded as an important platform for sharing health care information [2].


The overall prevalence of kidney stones in the United States is estimated at approximately 9%, with the peak incidence of stones occurring between the ages of 20 – 50 years [3]. Retrograde intrarenal surgery in the form of ureteroscopy (URS) is currently recommended as a first line strategy for renal calculi less than and equal to 10-20 mm in size. Furthermore URS is also an accepted first line therapy for patients with ureteral calculi.


The aim of this study was to assess the quality of YouTubeTM videos as a source of patient information for URS.





YouTubeTM was searched using the term ‘ureteroscopy’. The search was limited to the English language and to videos of less than 10 minutes duration. The exclusion criteria were: videos longer than ten minutes, individual patient accounts, non-surgical management, videos relating to animals, and videos not in the English language. Only the first five pages were reviewed.


Content was assessed by two urology trainees using criteria based on recommendations from the British Association of Urological Surgeons website [4]. Points were awarded for each of the criteria shown in Table 1. An overall rating of ‘poor’, ‘average’, ‘good’ or ‘excellent’ was given. Videos were also analysed in terms of country of origin, view count, likes, dislikes, source and technical quality. The kappa statistic was used to measure interobserver variability. 



Fifty-nine videos met the inclusion criteria and of these, the total number of viewings was 557,896 (range: 42 – 121,943), with an average number of 9,456 viewings per video. The majority of videos were uploaded from either the United States (n-20) or India (n-18).


The majority of videos provided only basic information and focussed on recordings of the endoscopic view with limited or no description of the procedure itself. The one video which was rated by both reviewers as good included the following information: treatment options, procedure, need for anaesthetic, length of recovery, likely stay in hospital, complications, and received 5.2% of the viewership. Fifty-eight videos were rated ‘poor’ or ‘average’ and only 1 as ‘good’ (Table 2).


The most common information that was missing in the videos was complications and alternative management options. In terms of technical quality namely; picture quality, lighting, sound; 28 were rated as ‘poor’, 22 as ‘average’ and 9 as ‘good’. All 59 videos were posted by individual surgeons or healthcare providers. The kappa coefficient for the two reviewers was 0.62 and the interclass correlation was 0.89. Absolute agreement with ratings of the two reviewers was seen in 56 out of the 59 videos. 



•The quality of YouTubeTM videos is variable
•Patients should not be encouraged to use YouTubeTM as a platform for education
•Opportunity has arisen for the endourology community to produce high quality video broadcasts to optimise patient understanding`

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