YouTube spreads low-quality medical information on recurrent UTIs, study finds

In today’s world, it is easy to find information on the internet, whether it be through search engines or social media. Much of that information, however, is not reliable.

A recent study¹ confirms this idea by investigating the quality of information regarding recurrent urinary tract infections (UTIs) that is posted on YouTube. In this interview, coauthors Connie Huang, MD, and Jason M. Kim, MD, discuss the findings of this study and why it is important for urologists to understand where the sources of misinformation are coming from. This study was presented at the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction 2022 Winter Meeting. Huang is a urology resident and Kim is a clinical assistant professor of urology at Stony Brook Medicine in New York.

Please discuss the background for this study.

Huang: As we all know, social media is becoming more and more important in everyone's life. There's TikTok, YouTube, Instagram, [and] really a wide array of medical information available out there on the social media. In the urology literature, we actually have quite a few studies looking at some of the urologic topics, such as prostate cancer, overactive bladder, [and] erectile dysfunction, to [investigate] the quality of those medical information on social media and found that some sources could present as a major source of misinformation for a lot of our patients. So, we turned our attention to urinary tract infections. It's fairly common in my patients, especially female patients. About 50% to 80% of female patients had a history of UTI, and up to 40% of them had recurrent UTIs. So, we were curious to look at the quality of the medical information on UTIs on YouTube. Hopefully, we can have a better understanding of what patients are learning from online materials before they come to the doctor's office. That's where the idea of this study was coming from.

What were the notable findings of this study? Were any of them surprising to you or your coauthors?

Huang: We looked at the top 200 most-viewed videos on YouTube. I think it was interesting that a lot of the videos had relatively poor quality, based on the standardized instruments that we used to evaluate the quality of the material. Only 11% of the videos featured a urologist, which is a very small portion. Less than half of the videos actually featured a medical provider, so a majority of videos are being produced by non-medical providers, commercial media, or individual YouTubers with no medical experience. Then, we found that, very importantly, videos produced by medical providers have better content quality compared to those that did not feature any medical professionals. I thought those were interesting findings. This is consistent with other similar studies looking at online materials on medical information. We found that those that come from a medical institution or medical source or [were] produced by a physicianhad a better quality, with more accurate information.

Kim: And didn't our results also show that most of the videos were actually about home remedies for UTIs and not necessarily other medical advice?

Huang: Absolutely. Another very interesting finding was that a majority of the videos were featuring some kind of homeopathic supplements, such as herbal supplements or certain dietary remedies, to prevent and treat urinary infection. Some of the regimens, such as vitamin C, probiotics, or cranberries, do have scientific evidence—especially cranberries—featured in the [American Urological Association (AUA)] guidelines, but a lot of the other supplements, such as the herbal supplements or certain random dietary remedies, did not really have much of the scientific evidence n the literature. Those can pose as potential misinformation for a lot of our patients who are seeking for treatments for UTIs.

With an increase in digital media use around the world, how can physicians combat misinformation?

Huang: Ideally, if we can increase the presence of physicians on social media platforms, I think that can help deliver more accurate and more accessible information for the general public. I know that some physicians, some urologists in our field are making an effort to contribute to higher quality of online patient education material, but for those of us who are really busy with clinics, with the work in the hospital, I think another way to combat misinformation is to have a better idea of what is available on the internet so that we can provide better patient counseling when we see them in office.

Kim: I'll add [that] every day when patients come to the office, everyone has done their "research" on urinary tract infections or other things, and we really need to understand where this information is coming from. I think this study shows us that a lot of the information out there isn't necessarily sound medical advice or given by non-medical professionals. So, I think it's essential to understand where information is coming from so that we can counsel the patients appropriately.

What is the take-home message for the practicing urologist?

Huang: From my perspective, the main take-home message would be [that] social media is obviously very important, and it plays a very big role in impacting [the] patient’s decision to seek proper care and make their medical decision. So, as a urologist, as a practicing physician, we should be aware of the online content so we can properly guide our patients and provide proper care and counseling.

Kim: I'll also add that I know all physicians are extremely busy, but I think it's very important to have a bigger social media presence with sound medical advice. I think it's tremendously helpful for patients, and also for counseling. So, I think in the future, physicians should try to take the time to invest some more energy in this realm. I think it's an area that we've done poorly in, and hopefully, if we increase our presence on social media, it'll help the patients and it'll help the physicians.

Is there anything else you feel our audience should know about this topic?

Kim: I think some of these videos may actually lead to patient frustration, because they're giving some of these home remedies for UTIs. In some cases, they may work, but in a lot of cases they don't. Patients come in extremely frustrated, saying things like, "I don't know what's wrong with me. I've done my research on the internet, I've watched YouTube, and I've done everything they said, and nothing's working. What's wrong with me?" So, I think patients need to understand [that] they don't always work.

Reference

1. Huang Z, Jeong R, Lee E, et al. Urinary Tract Infection on Social media: Examining YouTube content as a source of patient educational information. Paper presented at: Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction 2022 Winter Meeting; San Diego, California. February 22-26, 2022. Poster #OM8