115 How useful are youtube videos of pacemaker implantation for patients? A qualitative assessment of video and information quality

Background Permanent pacemaker (PPM) implantation is a commonly performed life-saving cardiac procedure. Patients often seek further information on medical interventions beyond traditional consultation spaces via the Internet, but such resources can be of variable quality. This has not been assessed for PPM implantation previously. Furthermore, similar assessments of other healthcare-related multimedia have used criteria that do not provide adequate granularity of assessment. Ideally, such an appraisal should include assessment of the design of a resource, its organisation, audio-visual quality, balance, and acknowledgement of authorship, bias, and conflicts of interest. Purpose To qualitatively assess the video and information quality of YouTube videos discussing PPM implantation for patients. Methods We performed searches on YouTube using the search terms "Pacemaker" and "PPM implantation". Both searches were performed twice for reproducibility. The first 100 results from each search were screened for inclusion. All English language videos covering transvenous pacemaker implantation were included. We assessed videos on the quality of the audio-visual material and the quality of the information across 13 domains, described in table 1. Two authors (SR, RDS) independently assessed the videos for the quality metrics as described. Results Of 196 unique results, 33 videos uploaded by 32 users met inclusion criteria (figure 1). None of the videos fulfilled all the quality criteria as specified (table 1). Videos mostly scored highly on authorship, organisation, relevancy of content, and audio quality. However, there were numerous areas, particularly concerning the quality of information contained in the videos, where videos universally scored poorly. Most videos (82%) did not provide a balanced overview of the risks and benefits of PPM implantation (balance/bias), and, following on from this, conflicts of interests or disclosures of content creators were not provided in most cases (94%). Most videos did not provide information on the date the content was created (currency, 85%), and therefore how up to date content was, or where the information used to create the video came from (attribution, 97%). Finally, few videos (15%) directed patients to further resources to gain further information on PPM implantation. Conclusion YouTube videos of PPM implantation are of mediocre quality. Patients who come across these videos may be unduly influenced by poorly constructed material that does not allow them to independently assess the quality of the information being presented to them, hindering their ability to gain an adequately informed overview of the procedure. There is a need for a professionally regulated, high-quality, exhaustive audio-visual resource on PPM implantation for patients. There is also need for increased oversight on the quality of healthcare intervention-associated videos on the Internet. Conflict of Interest N/A