Sader Nicholas, Kulkarni Abhaya V, Eagles Matthew E, Ahmed Salim, Koschnitzky Jenna E, Riva-Cambrin Jay
1Department of Clinical Neurosciences, Division of Neurosurgery, Alberta Children's Hospital, University of Calgary, Alberta, Canada.
2Division of Neurosurgery, Hospital for Sick Children, University of Toronto, Ontario, Canada; and.
J Neurosurg Pediatr. 2020 Mar 6;25(6):607-614. doi: 10.3171/2019.12.PEDS19523. Print 2020 Jun 1.
YouTube has become an important information source for pediatric neurosurgical patients and their families. The goal of this study was to determine whether the informative quality of videos of endoscopic third ventriculostomy (ETV) and endoscopic third ventriculostomy with choroid plexus cauterization (ETV + CPC) is associated with metrics of popularity.
This cross-sectional study used comprehensive search terms to identify videos pertaining to ETV and ETV + CPC presented on the first 3 pages of search results on YouTube. Two pediatric neurosurgeons, 1 neurosurgery resident, and 2 patient families independently reviewed the selected videos. Videos were assessed for overall informational quality by using a validated 5-point Global Quality Score (GQS) and compared to online metrics of popularity and engagement such as views, likes, likes/views ratio, comments/views ratio, and likes/dislikes ratio. Weighted kappa scores were used to measure agreement between video reviewers.
A total of 58 videos (47 on ETV, 7 on ETV + CPC, 4 on both) of 120 videos assessed met the inclusion criteria. Video styles included "technical" (62%), "lecture" (24%), "patient testimonial" (4%), and "other" (10%). In terms of GQS, substantial agreement was seen between surgeons (kappa 0.67 [95% CI 0.55, 0.80]) and excellent agreement was found between each surgeon and the neurosurgical resident (0.77 [95% CI 0.66, 0.88] and 0.89 [95% CI 0.82, 0.97]). Only fair to moderate agreement was seen between professionals and patient families, with weighted kappa scores ranging from 0.07 to 0.56. Academic lectures were more likely to be rated good or excellent (64% vs 0%, p < 0.001) versus surgical procedure and testimonial video types. There were significant associations between a better GQS and more likes (p = 0.01), views (p = 0.02), and the likes/dislikes ratio (p = 0.016). The likes/views ratio (p = 0.31) and comments/views ratio (p = 0.35) were not associated with GQS. The number of likes (p = 0.02), views (p = 0.03), and the likes/dislikes ratio (p = 0.015) were significantly associated with video style (highest for lecture-style videos).
Medical professionals tended to agree when assessing the overall quality of YouTube videos, but this agreement was not as strongly seen when compared to parental ratings. The online metrics of likes, views, and likes/dislikes ratio appear to predict quality. Neurosurgeons seeking to increase their online footprint via YouTube would be well advised to focus more on the academic lecture style because these were universally better rated.
YouTube已成为小儿神经外科患者及其家属的重要信息来源。本研究的目的是确定内镜下第三脑室造瘘术（ETV）和内镜下第三脑室造瘘术联合脉络丛烧灼术（ETV + CPC）视频的信息质量是否与受欢迎程度指标相关。
这项横断面研究使用综合搜索词，以识别在YouTube搜索结果首页上展示的与ETV和ETV + CPC相关的视频。两名小儿神经外科医生、一名神经外科住院医师和两名患者家属独立审查选定的视频。通过使用经过验证的5分全球质量评分（GQS）评估视频的整体信息质量，并将其与观看次数、点赞数、点赞/观看次数比、评论/观看次数比和点赞/不喜欢次数比等在线受欢迎程度和参与度指标进行比较。加权kappa评分用于衡量视频审查者之间的一致性。
在评估的120个视频中，共有58个视频（47个关于ETV，7个关于ETV + CPC，4个两者都有）符合纳入标准。视频风格包括“技术类”（62%）、“讲座类”（24%）、“患者推荐类”（4%）和“其他类”（10%）。在GQS方面，外科医生之间有高度一致性（kappa 0.67 [95% CI 0.55, 0.80]），并且每位外科医生与神经外科住院医师之间有极好的一致性（0.77 [95% CI 0.66, 0.88]和0.89 [95% CI 0.82, 0.97]）。专业人员与患者家属之间只有一般到中等程度的一致性，加权kappa评分范围为0.07至0.56。学术讲座比手术过程和推荐视频类型更有可能被评为良好或优秀（64%对0%，p < 0.001）。更好的GQS与更多的点赞数（p = 0.01）、观看次数（p = 0.02）和点赞/不喜欢次数比（p = 0.016）之间存在显著关联。点赞/观看次数比（p = 0.31）和评论/观看次数比（p = 0.35）与GQS无关。点赞数（p = 0.02）、观看次数（p = 0.03）和点赞/不喜欢次数比（p = 0.015）与视频风格显著相关（讲座式视频最高）。
医学专业人员在评估YouTube视频的整体质量时倾向于达成一致，但与家长评分相比，这种一致性没有那么明显。点赞数、观看次数和点赞/不喜欢次数比等在线指标似乎可以预测质量。寻求通过YouTube增加其在线影响力的神经外科医生最好更多地关注学术讲座风格，因为这些视频的评分普遍更高。
