Quality assessment of spinal cord injury-related health information on short-form video platforms: Cross-sectional content analysis of TikTok, Kwai, and BiliBili.

BACKGROUND

Spinal cord injury (SCI) severely affects patients' quality of life. With the rise of short video platforms, they have become important sources of health information, yet few studies have assessed the quality of SCI-related content on these platforms.

OBJECTIVE

This study aimed to analyze the content and quality of SCI-related videos on three major short video platforms.

MATERIAL AND METHODS

This study collected SCI-related short videos published between 28 March and 10 April 2025 on three platforms: BiliBili, Kwai, and TikTok. After strict screening (removing advertisements, duplicates, and irrelevant content), 251 valid samples were finally included. To minimize the influence of platform recommendation algorithms, the study used newly registered accounts to conduct standardized searches with "spinal cord injury" as the uniform search term. Video quality was assessed using four methods: Journal of the American Medical Association (JAMA), global quality scale (GQS), modified DISCERN, and patient education materials assessment tool. Two staff members (Z-SH and Z-GF) independently scored all videos. When their ratings differed by more than 15%, an expert (TY) made the final decision.

RESULTS

A total of 251 SCI-related videos were analyzed across BiliBili ( = 68), Kwai ( = 91), and TikTok ( = 92), revealing marked differences in content characteristics and quality. BiliBili featured the longest videos (median: 300 s) and the highest collection rate. It also achieved the highest JAMA (2.10 ± 0.85) and GQS (3.18 ± 0.91) scores. Kwai videos were the shortest (median: 15 s) but generated the most user interaction (likes, comments, and shares). However, it consistently scored lowest across all quality metrics (e.g. JAMA = 1.28 ± 0.42; GQS = 2.00 ± 0.83), with limited understandability (38 ± 24) and actionability (22 ± 24). TikTok content, primarily created by professionals, showed the highest modified DISCERN score (2.80 ± 0.78) and moderate practical value (understandability: 71 ± 21; actionability: 41 ± 29), though user engagement was relatively low. Quality indicators (JAMA, GQS, and DISCERN) were moderately correlated with follower count but weakly or negatively correlated with user engagement. Finally, understandability and actionability showed a moderate correlation ( = 0.49).

CONCLUSION

This cross-platform comparative study reveals significant disparities in content quality among SCI-related videos on three leading short video platforms. Despite diverse video formats, the overall quality and reliability remain suboptimal.