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A Lot of Eczema Quackery from Dr. YouTube

— One-third of the site's videos about atopic dermatitis had misleading information

MedpageToday

YouTube is flooding patients with inaccurate health information, but clinicians can use the service to their own advantage, researchers said.

A cross-sectional study of 128 YouTube videos on atopic dermatitis (AD) showed that almost one-third contained misleading information uploaded by advertisers, for-profit companies, and individuals without any healthcare expertise.

Forty-two (32.8%) of the videos in the analysis were categorized as useful, 22 (17.2%) as misleading, and another 42 (32.8%) as useful personal experiences, and 22 (17.2%) as misleading personal experiences, Andrea Suarez, MD, PhD, of McGovern Medical School at the University of Texas Health Science Center at Houston, and colleagues found.

Action Points

  • YouTube is providing patients with inaccurate health information: a study of 128 YouTube videos on atopic dermatitis (AD) showed that almost one-third contained misleading information uploaded by advertisers, for-profit companies, and individuals without any healthcare expertise.
  • Note that clinicians and professional organizations could and should expand the reach of their own patient-education initiatives using the same tactic, researchers suggested, and posting scientifically accurate videos on YouTube that contain a personal-experience narrative could be one of the most effective ways to do this.

In the study, published as a research letter in the, personal-experience videos featuring an individual telling his or her own story about AD had the highest user engagement and "like" ratios (P<0.0001 and P=0.0377, respectively).

Clinicians and professional organizations should expand the reach of their own patient-education initiatives using the same tactic, the study authors suggested. Posting scientifically accurate videos on YouTube that contain a personal-experience narrative could be one of the most effective ways to do this.

"Online services such as YouTube have the potential to greatly improve patient education on diseases such as AD if used cautiously. With the knowledge of what patients with AD look for in videos, healthcare professionals and professional organizations can better use YouTube to educate patients on AD."

Two-thirds of the YouTube videos on AD featured scientifically accurate information uploaded by universities, other professional organizations, government and news agencies, and healthcare providers, the study showed. However, YouTube's loose content regulations make broadcasting false information just as easy as sharing accurate information, the researchers pointed out, citing previous studies.

For example, one looked at 72 YouTube videos about tanning beds and found that 49 (68%) presented them in a positive light even though ultraviolet light is a known carcinogen. Another analyzing 153 YouTube videos on immunization found that about 50% did not explicitly support immunization.

In the current study, most of the misleading information on AD dealt with treatment, Suarez et al found. Inaccurate content "mainly consisted of the promotion of specific dietary regimens or supplements and demonstrated negative views of topical corticosteroids."

Asked for his perspective, Joseph F. Merola, MD, MMSc, director of the Clinical Unit for Research Innovation and Trials and co-director of the Center for Skin and Related Musculoskeletal Diseases at Brigham and Women's Hospital, Harvard Medical School, in Boston, who was not affiliated with the study, told 鶹ý that the study underscores what many clinicians already know: "Dr. Google is seeing many of our patients before we do."

The findings highlight an opportunity to talk to patients about how they prefer to receive medical information, he added. It's also a chance to share with them what the medical community considers reputable sources of online health information. "This study should be a call to action. We as a community need to embrace that patients will continue to consider the internet a major source of medical information. It is our responsibility to help our patients sort through the deluge of information and misinformation they will invariably encounter."

The American Academy of Dermatology (AAD) is one destination for reliable online information for patients, and societies such as the National Psoriasis Foundation are another, Merola suggested.

It's also important to realize that not all patients have access to the internet or would consider watching a video on YouTube the best way to learn, Merola said. "We need resources that we can quickly refer patients to."

Also asked for his opinion, Marc Glashofer, MD, an AAD expert practicing at The Dermatology Group, with several offices throughout New Jersey, agreed that dermatologists need to be more aware of the online sources that patients are using to get medical information.

"It's not just Google anymore," he told 鶹ý. "I always tell patients to take non-clinician websites with a grain of salt, as there can be a lot of misinformation and unreliable facts out there."

Glashofer, also not affiliated with the study, said that if his patients want to know where to get vetted information about AD, for example, he recommends sites such as or the Mayo Clinic.

He also confirmed that patients often want to hear from other individuals who are facing the same health challenges. Patient-experience videos could be vastly improved, however, if the personal narrative was followed by a clinician reviewing the facts -- "I feel that would be the most beneficial," Glashofer said.

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    Kristin Jenkins has been a regular contributor to 鶹ý and a columnist for Reading Room, since 2015.

Disclosures

Suarez and co-authors reported having no conflicts of interest.

Primary Source

Journal of the American Academy of Dermatology

Suarez, A et al "A cross-sectional study of YouTube videos about atopic dermatitis" J Am Acad Dermatol 2018; 78(3): 612-613.