Online Videos Regarding Relevant Postoperative Patient Information and Postoperative Rehabilitation After Arthroscopic Rotator Cuff Repair Provide Poor Information Quality, Accuracy, and Reliability.

PURPOSE: To evaluate the information quality, accuracy, and reliability of YouTube videos regarding relevant postoperative patient information and postoperative rehabilitation after arthroscopic rotator cuff repair. METHODS: By use of The Onion Router (TOR) software and predefined search terms, 102 videos were assessed. Four scoring systems were used to evaluate included videos: (1) Journal of the American Medical Association (JAMA) benchmark criteria score; (2) Global Quality Score (GQS); (3) DISCERN score; and (4) a newly developed score, the Rotator Cuff Score (RCS). The RCS (0-30 points) was built based on the latest published evidence and guidelines from the American Academy of Orthopaedic Surgeons. Videos that scored up to 9 points were regarded as poor-quality videos. RESULTS: Most of the included videos provided poor information quality, accuracy, and reliability. Videos that were uploaded by medically trained professionals showed significantly better results for all scores compared with commercial or personal-testimony videos (JAMA benchmark criteria score, P < .001; GQS, P < .001; DISCERN score, P = .001; and RCS, P = .001). Multivariate linear regression showed that the involvement of medically trained professionals was a significant predictor of better results for all scores (JAMA benchmark criteria score, ß = 1.496 [P < .001]; GQS, ß = 1.105 [P < .001]; DISCERN score, ß = 11.234 [P < .001]; and RCS, ß = 5.017 [P < .001]). Surprisingly, the like ratio was significantly higher for videos that were uploaded by non-medically trained individuals (P = .041). CONCLUSIONS: The average information quality, accuracy, and reliability of YouTube videos regarding relevant postoperative patient information and postoperative rehabilitation after arthroscopic rotator cuff repair are poor. Videos from medically trained professionals provide significantly higher information quality; however, even these videos lack important information for a better understanding of arthroscopic rotator cuff repair. CLINICAL RELEVANCE: Because of the lack of a peer-review process, available videos on YouTube regarding relevant postoperative patient information and postoperative rehabilitation after arthroscopic rotator cuff repair are of low quality, accuracy, and reliability. However, patients increasingly visit YouTube to gather medical knowledge. Physicians should enlighten patients about these findings and should be able to provide alternative sources of high-quality information.

YouTube provides irrelevant information for the diagnosis and treatment of hip arthritis.

PURPOSE: YouTube is increasingly becoming a key source for people to satisfy the need for additional information concerning their medical condition. This study analyses the completeness of accurate information found on YouTube pertaining to hip arthritis. METHODS: The present study analyzed 133 YouTube videos using the search terms: hip arthritis, hip arthritis symptoms, hip arthritis diagnosis, hip arthritis treatment and hip replacement. Two quality assessment checklists with a scale of 0 to 12 points were developed to evaluate available video content for the diagnosis and the treatment of hip arthritis. Videos were grouped into poor quality (grade 0-3), moderate quality (grade 4-7) and excellent quality (grade 8-12), respectively. Three independent observers assessed all videos using the new grading system and independently scored all videos. Discrepancies regarding the categories were clarified by consensus discussion. For intra-observer reliabilities, grading was performed at two occasions separated by four weeks. RESULTS: Eighty-four percent (n = 112) had a poor diagnostic information quality, 14% (n = 19) a moderate quality and only 2% (n = 2) an excellent quality, respectively. In 86% (n = 114), videos provided poor treatment information quality. Eleven percent (n = 15) of videos had a moderate quality and only 3% (n = 4) an excellent quality, respectively. CONCLUSIONS: The present study demonstrates that YouTube is a poor source for accurate information pertaining to the diagnosis and treatment of hip arthritis. These finding are of high relevance for clinicians as videos are going to become the primary source of information for patients. Therefore, high quality educational videos are needed to further guide patients on the way from the diagnosis of hip arthritis to its proper treatment.

A comparison of two different treatments with navigated extracorporeal shock-wave therapy for calcifying tendinitis - a randomized controlled trial.

BACKGROUND: Extracorporeal shock-wave therapy is recommended for calcifying tendinitis, and navigated low-energy therapy has given better results than biofeedback localization. This investigation was planned to analyze whether the outcome of navigated low-energy shock-wave therapy can be improved by raising energy flux density to middle-energy levels. The clinical and radiological differences in outcome between three sessions of low-energy navigated shock-wave therapy and two sessions of middle-energy therapy were therefore compared. PATIENTS, MATERIALS AND METHODS: A prospective, randomized, observer-blind study was carried out in 50 patients whose mean age was 51 years. The population was randomized into two groups. Pain refractory to therapy was evident for more than six months in all patients. Radiographs and clinical examinations, including the Constant and Murley score, and the visual analog scale for pain assessment were performed before therapy and then after 12 weeks. Both groups of patients received navigated and X-ray-assisted, focused shock-wave treatment at weekly intervals. Group I underwent three sessions of constant low-energy treatment (0.08 mJ/mm(2); 1000 impulses) without local anesthesia; Group II received two middle-energy treatments (0.2 mJ/mm(2); 2000 impulses) with subacromial anesthesia. RESULTS: Forty-four patients (21 in Group I, 23 in Group II) completed the study protocol. Clinically, both groups improved significantly (P<0.0001) in the Constant and Murley score and the visual analog scale. The statistics within the groups were not significantly different. Overall, nine calcium deposits disappeared and 12 changed massively in shape and radiological density. CONCLUSIONS: Navigated shock-wave therapy significantly improves pain and shoulder function. Patients obtained nearly equal results after three low-energy or two middle-energy sessions of shock-wave treatment. We therefore recommend two sessions of middle-energy shock-wave therapy, as performed in Group II, because of the time-saving factor.