Hillyer Grace Clarke, MacLean Sarah A, Beauchemin Melissa, Basch Corey H, Schmitt Karen M, Segall Leslie, Kelsen Moshe, Brogan Frances L, Schwartz Gary K
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States.
Herbert Irving Comprehensive Cancer Center, New York, NY, United States.
JMIR Cancer. 2018 Jun 26;4(1):e10060. doi: 10.2196/10060.
Clinical trials are essential to the advancement of cancer treatment but fewer than 5% of adult cancer patients enroll in a trial. A commonly cited barrier to participation is the lack of understanding about clinical trials.
Since the internet is a popular source of health-related information and YouTube is the second most visited website in the world, we examined the content of the top 115 YouTube videos about clinical trials to evaluate clinical trial information available through this medium.
YouTube videos posted prior to March 2017 were searched using selected keywords. A snowballing technique was used to identify videos wherein sequential screening of the autofill search results for each set of keywords was conducted. Video characteristics (eg, number of views and video length) were recorded. The content was broadly grouped as related to purpose, phases, design, safety and ethics, and participant considerations. Stepwise multivariable logistic regression analysis was conducted to assess associations between video type (cancer vs noncancer) and video characteristics and content.
In total, 115 videos were reviewed. Of these, 46/115 (40.0%) were cancer clinical trials videos and 69/115 (60.0%) were noncancer/general clinical trial videos. Most videos were created by health care organizations/cancer centers (34/115, 29.6%), were oriented toward patients (67/115, 58.3%) and the general public (68/115, 59.1%), and were informational (79/115, 68.7%); altruism was a common theme (31/115, 27.0%). Compared with noncancer videos, cancer clinical trials videos more frequently used an affective communication style and mentioned the benefits of participation. Cancer clinical trial videos were also much more likely to raise the issue of costs associated with participation (odds ratio [OR] 5.93, 95% CI 1.15-29.46) and advise patients to communicate with their physician about cancer clinical trials (OR 4.94, 95% CI 1.39-17.56).
Collectively, YouTube clinical trial videos provided information on many aspects of trials; however, individual videos tended to focus on selected topics with varying levels of detail. Cancer clinical trial videos were more emotional in style and positive in tone and provided information on the important topics of cost and communication. Patients are encouraged to verify and supplement YouTube video information in consultations with their health care professionals to obtain a full and accurate picture of cancer clinical trials to make an adequately informed decision about participation.
临床试验对于癌症治疗的进展至关重要，但成年癌症患者中参与临床试验的比例不到5%。一个普遍提到的参与障碍是对临床试验缺乏了解。
由于互联网是健康相关信息的流行来源，且YouTube是全球访问量第二大的网站，我们研究了YouTube上关于临床试验的115个热门视频的内容，以评估通过该媒介可获得的临床试验信息。
使用选定的关键词搜索2017年3月之前发布的YouTube视频。采用滚雪球技术识别视频，即对每组关键词的自动填充搜索结果进行顺序筛选。记录视频特征（如观看次数和视频长度）。内容大致分为与目的、阶段、设计、安全性和伦理以及参与者考虑因素相关的类别。进行逐步多变量逻辑回归分析，以评估视频类型（癌症与非癌症）与视频特征和内容之间的关联。
共审查了115个视频。其中，46/115（40.0%）是癌症临床试验视频，69/115（60.0%）是非癌症/一般临床试验视频。大多数视频由医疗保健组织/癌症中心制作（34/115，29.6%），面向患者（67/115，58.3%）和普通公众（68/115，59.1%），且具有信息性（79/115，68.7%）；利他主义是一个常见主题（31/115，27.0%）。与非癌症视频相比，癌症临床试验视频更频繁地使用情感沟通方式并提及参与的益处。癌症临床试验视频也更有可能提出与参与相关的费用问题（优势比[OR]5.93，95%置信区间1.15 - 29.46），并建议患者与医生就癌症临床试验进行沟通（OR 4.94，95%置信区间1.39 - 17.56）。
总体而言，YouTube上的临床试验视频提供了关于试验多个方面的信息；然而，单个视频往往侧重于选定的主题，细节程度各不相同。癌症临床试验视频在风格上更具情感性，语气更积极，并提供了关于费用和沟通等重要主题的信息。鼓励患者在与医疗保健专业人员的咨询中核实并补充YouTube视频信息，以全面、准确地了解癌症临床试验，从而就参与做出充分知情的决定。
