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Reliability and Quality of YouTube Videos regarding Gender-Affirming Mastectomy
Kelly Spiller, MD
Sydni Meunier, MD
Kiersten Woodyard De Brito, MPH
Justin Puthoff, MD
University of Cincinnati Medical Center
2024-01-15
Presenter: Kelly Spiller, MD
Affidavit:
I certify that the material included in the following abstract has not been previously published in any scientific journal or major meeting. The work of this project is 100% original work of the residents and medical student included.
Director Name: Ann Schwentker, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background: Transgender patients utilize online resources to learn about gender-affirming mastectomies, the most common gender-affirming plastic surgery. This investigation assessed the reliability and quality of YouTube videos about gender-affirming mastectomy.
Methods: YouTube was queried for videos regarding gender-affirming mastectomy. Five search terms were used: 'Top Surgery,' 'Gender-affirming mastectomies,' 'Female to male top surgery,' 'Transmasculine top surgery,' and 'Transgender mastectomy.' Three authors independently reviewed videos. The modified DISCERN score (DS) assessed clinical reliability while the Global Quality Scale (GQS) measured information quality and utility. Number of views, uploader identity, length, and publication year were also noted. Cohen kappa analysis assessed interrater reliability. Welch's t-tests assuming unequal variance compared DS, GQS, views, and length.
Results: 49 eligible videos totaling 28,349,552 views were identified. 28 videos were physician-produced. 21 videos were non-physician produced, the majority being patients (95%). Interrater agreement was substantial (κ=0.88). Physician-produced videos scored an average DS of 3.27±1.16, while non-physician uploaders scored 2.00±0.67. This demonstrated higher clinical reliability of physician-uploaded videos (p<0.001). Physician-uploaded videos scored 3.46±1.22 on the GQS versus 2.86±0.91 for non-physicians, demonstrating no significant difference in patient utility (p=0.0522). Views for physician-uploaded videos were lower than non-physicians (p<0.001).
Conclusions: Although physician-produced videos had higher clinical reliability, there was no significant difference in information quality or utility between physician and non-physician uploaders. This varies from previous investigations demonstrating discordant GQS and DS scores. Moving forward, physicians should consider collaboration with transgender patients to increase community engagement while maintaining clinical reliability of videos.
