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Related Article Comment on: https://www.jmir.org/2020/10/e22161/ J Med Internet Res 2021;23(5):e26034 doi:10.2196/26034 [ABSTRACT FROM AUTHOR]

Background: Stroke is the second leading cause of death worldwide following ischemic heart disease, and the fifth in the United States. The video-sharing database, YouTube, is the second most popular visited website with more than 2 billion users, thus it's increasingly being used as a medium for delivering health information.Aim: We aimed to evaluate the quality, reliability and audience engagement of stroke-related YouTube videos.Methods: In October 2019 we conducted a search on YouTube using 5 keywords: stroke, brain attack, hemorrhagic stroke, ischemic stroke and transient ischemic attack. We selected the first 30 videos from each search query for further analysis. The validated DISCERN instrument was used (a score of 0-5 per question) to assess the videos by four independent raters. We then recorded qualitative data and quantitative data for each video.Results: After sorting through 150 stroke videos, a total of 101 unique YouTube videos met our inclusion criteria. We found that the mean overall quality of YouTube videos according to DISCERN is of fair quality. Most videos (65.3%) were uploaded by hospitals, mentioned the symptoms of stroke (66.3%), had a doctor speaking (60.4%) and contained diagrams (20.8%).Conclusion: YouTube is a useful source of gathering information about treatment choices for patients and their families as the quality of YouTube videos is fair. The audience engagement suggestions in our paper may help content creators improve the appeal of YouTube videos. [ABSTRACT FROM AUTHOR]

Aim: Postoperative head computed tomography (POCT) is routinely performed in numerous medical institutions, mainly to identify possible postsurgical complications. This study sought to assess the clinical appropriateness of POCT in asymptomatic and symptomatic patients after ruptured or unruptured aneurysm clipping., Methods: This is a retrospective multicenter study involving microsurgical procedures of ruptured (RA) and unruptured intracranial aneurysm (UA) surgeries performed in the Centers associated with the Pomeranian Department of the Polish Society of Neurosurgeons. A database of surgical procedures of intracranial aneurysms from 2017 to 2020 was created. Only patients after a CT scan within 24 h were included., Results: A total of 423 cases met the inclusion criteria for the analysis. Age was the only significant factor associated with postoperative blood occurrence on POCT. A total of 37 (8.75%) cases of deterioration within 24 h with urgent POCT were noted, 3 (8.1%) required recraniotomy. The highest number necessary to predict (NNP) one recraniotomy based on patient deterioration was 50 in the RA group., Conclusion: We do not recommend POCTs in asymptomatic patients after planned clipping. New symptom onset requires radiological evaluation. Simultaneous practice of POCT after ruptured aneurysm treatment within 24 h is recommended.

Objectives: The variety of clinical presentation on the topic of carbon monoxide (CO) intoxication ranges from slight headache to coma or death. YouTube allows patients to search not only for entertainment but also medical advice. Therefore, the aim of this study was to evaluate the content and quality of YouTube videos concerning CO poisoning as a source of knowledge for non-medical audience., Material and Methods: On the December 8, 2020 a YouTube search was conducted for the following phrases: "carbon monoxide poisoning," "carbon monoxide symptoms," "CO poisoning," "carbon monoxide asphyxiation," "carbon monoxide intoxication" using the "incognito mode" and without attachment to Google Account. The search results were set as: "default" in the YouTube browser. The first 50 results were taken into consideration. Two raters, a specialist in emergency medicine and a specialist in clinical toxicology rated videos with Quality Criteria for Consumer Health Information (DISCERN), Global Quality Score (GQS) and Journal of the American Medical Association (JAMA). "VidIQ Vision for YouTube" plug-in was used., Results: Ninety-five videos were included. The interclass coefficient for DISCERN, GQS and JAMA scores were: 0.8, 0.74 and 0.62 reaching good and moderate reliability. The mean DISCERN/GQS/JAMA was 28.1 (SD 7.9), 2.5 (SD 0.8) and 1.1 (SD 0.7) respectively. Higher DISCERN/GQS/JAMA had videos providing information on: exposure time, treatment options, hyperbaric chamber indications as well as physician speaker (p < 0.05). Video Power Index was higher when the video contained animations and presented patients own history of CO exposure but not influenced the DISCERN/ GQS/JAMA scores. Videos providing misleading information had a higher like ratio., Conclusions: The overall video quality was poor indicating inappropriate educational and informative value for patients who search information about carbon monoxide poisoning. Int J Occup Med Environ Health. 2022;35(3):285-95., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

YouTube (YT) has become a popular health information reservoir. In this study, we aimed to evaluate the content and quality of YT videos as a source of patient information for meningiomas. A YT search was conducted for the following terms: "meningioma", "meningiomas", "meningeal tumor", and "psammoma". A total of 119 videos were examined by five independent raters, using validated quality criteria, including the Quality Criteria for Consumer Health Information (DISCERN), the Journal of the American Medical Association instrument (JAMA), and the Global Quality Score (GQS). The mean DISCERN score was 35.6 points, while the mean GQS and JAMA scores were 2.4 and 1.8, respectively. The majority of the videos were produced in the United States (37.82%). Moreover, 47.9% of the evaluated videos were graded as "poor" and only 9.24% were "good". Statistically higher scores in all three scoring systems were associated with the following information: tumor localization, clinical manifestations, indications for surgery, treatment options, risks, adjuvant therapies, results, follow up, diagrams, and those that featured a doctor as the speaker. Misleading information was presented in 35 productions. Our findings show that the overall quality of YT on the topic of meningiomas is defective, and requires further improvement and evaluation.

Introduction: The COVID-19 pandemic greatly disrupted the national healthcare system in Poland, resulting in the implementation of new protocols allowing only patients with severe diagnoses to receive immediate treatment. Given that an intracranial aneurysm (IA) is regarded as one of the most severe diagnoses, we planned to assess whether the current protocol has successfully provided the standard treatment for IAs., Material and Methods: Data on all IA cases treated from 2015 to 2020 was extracted from the JGP (a homogeneous group of patients) catalogue provided by the National Health Index of Poland (NFZ, Narodowy Fundusz Zdrowia). Poisson regression was used to determine the significance of the change in hospital admissions, and differences between proportions were analysed using the "N-1" Chi-squared test., Results: A total of 21,801 IA patients treated during 2015-2020 were included in this study. The overall number of hospitalisations due to IAs fell in the open surgery group, but not in the endovascular cohort. Mortality rates following IA treatment increased significantly by 21% in 2020 compared to preceding years. The demographics changed as well; the patients were significantly younger during the pandemic., Conclusions: Our findings show that the current strategy for optimal care for patients diagnosed with IAs in Poland during the pandemic is failing to maintain high quality treatment. New methods to improve the current plan should be implemented to address future crises.

Background: Incomplete resection of neurenteric cysts (NCs) has been associated with increased recurrence rates in patients compared to complete resection (CR) and information on intracranial NCs appearance on diagnostic imaging is scarce. We sought to identify factors associated with CR and provide the largest up-to-date review of NCs appearances on various diagnostic images., Methods: Data from Medline, EMBASE, and Web of Science were extracted. Univariate and multivariate logistic regression models were used to analyze factors associated with CR., Results: A total of 120 publications reporting 162 original cases on posterior fossa NCs met the inclusion criteria for analysis. Eighty-nine (55.6%) of the patients were female, the mean (SD) age of the patients' during operation was 34.3 (16.9) years, and CR was achieved in 98 (60%) of patients. Univariate analysis identified male sex as a statistically significant predictor for complete reaction (OR 2.13, 95% Cl 1.10-4.11, P = 0.02). The retrosigmoid approach (OR 1.89, 95% Cl 0.98-3.63, P = 0.06), far lateral approach (OR 0.46, 95% Cl 0.21-1.02, P = 0.06), and pediatric patient (OR 2.45, 95% Cl 0.94-6.56, P = 0.07) may be possible predictors for CR, however, they were not statistically significant. NCs are mainly hypodense on CT (32 [61.5%]), varied greatly in intensity on T1WI, hyperintense on T2WI magnetic resonance imaging (98 [67.1%]), and hyperintense on fluid-attenuated inversion recovery (17 [63.0%])., Conclusion: We recommend utilizing various diagnostic imaging tests to help reduce misdiagnoses when identifying intracranial NCs. For patient safety, CR should be achieved when possible, to reduce risk of additional operations due to recurrence., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Surgical Neurology International.)

Aim: YouTube (YT) is not only a source of entertainment but also, a popular source of medical knowledge. Our goal was to evaluate the quality of videos concerning arteriovenous malformations (AVM) available on YT., Materials and Methods: A YT search was conducted for the terms "Arteriovenous malformation", "AV malformations", "Intracranial AVM", "Cerebral AVM"," Brain AVM" and "Pial AVM." The first 70 videos for each search were evaluated and yielded 122 unique videos after the exclusion was applied. The videos were examined by two independent Raters using a validated quality criteria such as the Quality Criteria for Consumer Health Information (DISCERN), the Journal of the American Medical Association instrument (JAMA), and the Global Quality Score (GQS)., Results: The mean DISCERN score was 30 out of 75 possible points, with an intraclass correlation coefficient for the absolute agreement of 0.98, indicating an excellent interrater reliability. Most videos were produced in the United States (51.6%) and were uploaded by educational channels. Videos had statistically higher DISCERN, JAMA, and GQS scores when they presented clear information, AVM symptoms, angioarchitecture, AVMs with concomitant aneurysms, risks of bleeding, Spetzler-Martin Grading, treatment information, treatment risks, treatment results, follow-up, diagrams, and a doctor as a speaker. Videos that featured animations observed higher popularity as indicated by the Video Power Index (VPI) and observed a higher DISCERN and GQS score. Videos with the overall highest VPI generated poor DISCERN scores., Conclusions: YT does not provide high content quality medical information regarding AVMs and, in some cases, offer misleading information., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

YouTube is the world's most popular video-sharing site that in recent years has become an important platform for patients in finding educational information about their disease. The purpose of this study was to assess the quality and reliability of narcolepsy-related YouTube videos. We searched the key terms "Narcolepsy", "Narcolepsy-cataplexy," "Narcolepsy excessive daytime sleepiness" and "Narcolepsy excessive drowsiness" on YouTube. 80 videos were analyzed as they meet the inclusion criteria. Quantitative and qualitative metrics were recorded and the videos were scored using the DISCERN instrument by two independent raters. Our findings show that the majority of videos contained clear information (84%), symptoms (78%) and patient experience (69%). Most videos were published by an educational channel not representing a hospital or clinic (41%) or by a patient suffering from the disease (25%). Videos containing animations had a statistically significant correlation between average daily views (p = .0004) and the video power index (p = .0048), suggesting that this feature increased the popularity among viewers. The mean DISCERN score was 27 ± 8, indicating that the quality of narcolepsy related-videos is poor. Therefore, patients that use YouTube as an educational tool are currently not attaining a comprehensive understanding of the disease. For this reason, we have indicated the top 5 videos that physicians can recommend to their patients. Our paper highlights the gaps of knowledge concerning narcolepsy information on YouTube. Therefore, this information can be used to create better educational content in the future., (© 2020 European Sleep Research Society.)

Objectives: Now that the internet is more accessible to an increasing number of populations worldwide, many rely on the internet for their information about their daily lives. This includes people concerned about their health to students to sometimes also doctors. Since YouTube is the second most visited website, our aim was to evaluate the content-quality of YouTube videos relating to meningitis., Methods: We chose the first 30 videos for four different search phrases: meningitis, bacterial meningitis, viral meningitis, fungal meningitis and meningitis signs. The validated DISCERN scoring criteria was used to assess the videos by two raters independently. Qualitative data, quantitative data and the source of upload of each video were analyzed for video quality and audience engagement., Results: Out of 150 videos, 84 videos met the inclusion criteria. The mean DISCERN score was 34.6 ± 9.76 (out of a total 75), which indicates that the quality of YouTube videos on meningitis is poor. There is an excellent reliability between the two raters. Videos had a higher audience engagement via a greater number of daily views and comments when they included the definition, symptoms, prognosis, animation, diagrams, and an anatomical explanation of the meninges (P < 0.0001 for all)., Conclusion: The quality of YouTube videos on meningitis is poor, however, we have listed the videos which may be most effective for patient education for reference. Our quality and engagement analysis may help content creators make better health content on meningitis., (Copyright © 2021 Elsevier B.V. All rights reserved.)