Background/Purpose: Patients are turning to the Internet for guidance and information at an increasing rate, requiring clinicians to be aware of the constantly changing resources and quality of information that is available. A previous study demonstrated a minority of YouTube videos were useful for teaching methotrexate self injection.

Methods: Using the search term “Methotrexate injection”, two reviewers analyzed the first 75 videos in the YouTube search results. Videos were classified as useful, misleading or a personal patient view. Videos were rated for reliability, comprehensiveness and quality. Discrepancies in ratings were resolved by discussion between the two reviewers.

Results: Out of the 75 videos reviewed, 12 were classified as useful (16%), 47 misleading (63%), and 16 personal patient view (21%). Although this represents a substantial increase from the 2014 study in the proportion of videos that were deemed misleading (63% vs 28%), many of these videos were on methotrexate in general. Mean reliability rating was 4/5 (±0.5) for useful videos, 4/5 (±0.8) for misleading videos, and 3/5 (±0.3) for patient videos (p < 0.0001). Mean comprehensiveness was 4/4 (±0.0) for useful videos, 0/4 (±0.0) for misleading videos, and 2/4 (±2) for patient videos (p < 0.0001). Mean global quality score was 5/5 (±0.3) for useful videos, 4/5 (±0.7) for misleading videos, and 4/5 (±0.8) for patient videos (p=0.0002). Compared to the 2014 study, videos classified as misleading or personal patient view scored significantly higher in the categories of reliability and global quality score (p < 0.0001).

Conclusion: While the majority of the videos from the YouTube search were deemed misleading for teaching subcutaneous methotrexate injection, the useful videos were of good quality and had the highest ratings for comprehensiveness. In general, reliability and global quality scores were increased from the previous study, suggesting improvement in overall videos over time. Logistics of the YouTube algorithm may still impede access to the ‘best’ videos for patient teaching; therefore, clinicians should be prepared to recommend strategies for patients to find high quality videos.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-qualitative-analysis-of-methotrexate-self-injection-education-videos-on-youtube-an-update/