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 <front>
  <journal-meta>
   <journal-id journal-id-type="nlm-ta">Ulutas Med J</journal-id>
   <journal-title-group>
    <journal-title>The Ulutas Medical Journal</journal-title>
    <abbrev-journal-title>Ulutas Med J</abbrev-journal-title>
   </journal-title-group>
   <issn pub-type="ppub">2149-0430</issn>
   <issn pub-type="epub">2149-388X</issn>
   <publisher>
    <publisher-name>Hayriye Zehra Ulutaş</publisher-name>
   </publisher>
  </journal-meta>
  <article-meta>
   <article-id pub-id-type="doi">10.5455/umj.20230905100234</article-id>
   <article-id pub-id-type="publisher-id">168432</article-id>
   <article-categories>
    <subj-group subj-group-type="heading">
     <subject>Original Article</subject>
    </subj-group>
    <subj-group subj-group-type="subject">
     <subject>Orthopedics</subject>
    </subj-group>
   </article-categories>
   <title-group>
    <article-title>Do The Videos About Hallux Rigidus On YouTube Generally Exhibit High Quality?</article-title>
   </title-group>
   <contrib-group>
    <contrib contrib-type="author" corresp="yes">
     <contrib-id contrib-id-type="orcid" authenticated="false">https://orcid.org/0000-0002-1366-9163</contrib-id>
     <name name-style="western">
      <surname>Yilmaz</surname>
      <given-names>Mehmet</given-names>
     </name>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Conceptualization" vocab-term-identifier="https://credit.niso.org/contributor-roles/conceptualization/">Conceptualization</role>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Data curation" vocab-term-identifier="https://credit.niso.org/contributor-roles/data-curation/">Data curation</role>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Formal analysis" vocab-term-identifier="https://credit.niso.org/contributor-roles/formal-analysis/">Formal analysis</role>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Funding acquisition" vocab-term-identifier="https://credit.niso.org/contributor-roles/funding-acquisition/">Funding acquisition</role>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Investigation" vocab-term-identifier="https://credit.niso.org/contributor-roles/investigation/">Investigation</role>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Methodology" vocab-term-identifier="https://credit.niso.org/contributor-roles/methodology/">Methodology</role>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Project administration" vocab-term-identifier="https://credit.niso.org/contributor-roles/project-administration/">Project administration</role>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Resources" vocab-term-identifier="https://credit.niso.org/contributor-roles/resources/">Resources</role>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Software" vocab-term-identifier="https://credit.niso.org/contributor-roles/software/">Software</role>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Supervision" vocab-term-identifier="https://credit.niso.org/contributor-roles/supervision/">Supervision</role>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Validation" vocab-term-identifier="https://credit.niso.org/contributor-roles/validation/">Validation</role>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Visualization" vocab-term-identifier="https://credit.niso.org/contributor-roles/visualization/">Visualization</role>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Writing – original draft" vocab-term-identifier="https://credit.niso.org/contributor-roles/writing-original-draft/">Writing – original draft</role>
     <role vocab="credit" vocab-identifier="https://credit.niso.org/" vocab-term="Writing – review &amp; editing" vocab-term-identifier="https://credit.niso.org/contributor-roles/writing-review-editing/">Writing – review &amp; editing</role>
     <xref ref-type="aff" rid="aff1">1</xref>
    </contrib>
    <aff id="aff1">
     <label>1</label>
     <institution-wrap>
      <institution>Department of Orthopedics and Traumatology, Private Deva Hospital, Gaziantep, Turkey</institution>
     </institution-wrap>
    </aff>
   </contrib-group>
   <pub-date publication-format="electronic" date-type="pub" iso-8601-date="2023-09-13">
    <day>13</day>
    <month>09</month>
    <year>2023</year>
   </pub-date>
   <pub-date publication-format="print" date-type="collection">
    <year>2023</year>
   </pub-date>
   <volume>9</volume>
   <issue>3</issue>
   <fpage>173</fpage>
   <lpage>177</lpage>
   <history>
    <date date-type="received" iso-8601-date="2023-07-12">
     <day>12</day>
     <month>07</month>
     <year>2023</year>
    </date>
    <date date-type="rev-recd" iso-8601-date="2023-08-08">
     <day>08</day>
     <month>08</month>
     <year>2023</year>
    </date>
    <date date-type="accepted" iso-8601-date="2023-08-25">
     <day>25</day>
     <month>08</month>
     <year>2023</year>
    </date>
   </history>
   <permissions>
    <copyright-statement>© 2023 The Author(s)</copyright-statement>
    <copyright-year>2023</copyright-year>
    <license>
     <ali:license_ref>https://creativecommons.org/licenses/by-nc/4.0/</ali:license_ref>
     <license-p>This is an open access article distributed under the CC BY-NC 4.0 licence.</license-p>
    </license>
   </permissions>
   <self-uri xlink:href="https://www.ulutasmedicaljournal.com/?mno=168432"/>
   <self-uri content-type="pdf" xlink:href="https://www.ulutasmedicaljournal.com/pdf/168432.pdf"/>
   <abstract>
    <p>Introduction: Hallux Rigidus is a disease characterized by pain and weakness in the first metatarsophalangeal joint of the foot. Patients with this condition describe severe pain when walking and taking steps. Research on the quality of information available on the Internet is lacking. Our study aimed to analyze the videos about Hallux Rigidus on YouTube, one of the video-sharing applications. Methods: Our research is based on data collected from a video-sharing site (YouTube) on 12 July 2023. The search is done through the configuration process. &quot;Change hallux&quot; was typed into the search engine. The popularity of the video was analyzed using the Video Power Index (VPI) [(Like/(Like+Dislike)) x 100]. Videos were classified into five different groups based on the source they were uploaded to: [1] Community/Nonprofits, [2] Medical Professionals, [3] Medical school patients, [4] Universities / Schools, and [5] Patients / Independent users / Other places. The quality of movies is evaluated with the Global Quality Score (GQS). All videos were evaluated by one surgeon. A modified DISCERN scale was used to assess the reliability and quality of information provided in the videos. Results: Fifty videos were analyzed in this study. The average number of views of the video is 6507, and the average length is 958 seconds. When the video-based scores of the DISCERN variable were compared with the GQS, the scores of the patient/independent user/other group were lower, but it was not significant (p&gt;0.05). Conclusion: We believe the content of this video is good and informative. Do not use channels other than healthcare providers or dubious channels, as videos uploaded by individuals can be misleading.</p>
   </abstract>
   <kwd-group kwd-group-type="author">
    <kwd>Hallux rigidus</kwd>
    <kwd>YouTube</kwd>
    <kwd>Pain</kwd>
    <kwd>Video</kwd>
   </kwd-group>
   <funding-group>
    <funding-statement>Funding information was not reported in the published version of this article.</funding-statement>
   </funding-group>
  </article-meta>
 </front>
 <body>
  <sec id="sec-1">
   <title>Introduction</title>
   <p id="b-1">Social media is a general definition that covers all technological online environments where people share thoughts, knowledge, experiences and comments with other people. Social media platforms can be counted as Wikipedia, online forums, social networks (Facebook, Twitter), video sharing sites (YouTube, VuMedi, Vimeo), blogs (WebMD), audio files called podcasts, and live chat environments. All Hundreds of pages of information, pictures and media elements are added to the Internet network from these media at any time. For example, the total amount of video content uploaded per minute to the popular video site YouTube is more than 100 hours and this is increasing (    <xref ref-type="bibr" rid="ref1">1</xref>
). Social media is a new topic for orthopedics and traumatology. In fact, Orthopedics is one of the leading fields of specialization in the field of medicine, which has always been intertwined with technological innovations. Therefore, in the virtual world, Orthopedics is expected to reach the high level it deserves. You can access many publications with the use of the Internet, as well as numerous professional resources are available (    <xref ref-type="bibr" rid="ref2">2</xref>
).</p>
   <p id="b-2">Hallux rigidus is a problem arising from pain and limitation of movement in the first metatarsophalangeal joint of the foot. Diagnosis of this condition includes physical examination and direct radiography. Patients with this condition describe severe pain when walking and taking steps (    <xref ref-type="bibr" rid="ref3">3</xref>
). These diseases can inflict pain on every step we take for most of the day. Today, the closest source of information for patients who need information about this disease is the internet. 95% of internet users use YouTube (    <xref ref-type="bibr" rid="ref4">4</xref>
). Having rich video content is one of the most important factors that direct patients to where the disease is being investigated. The Internet is an important and accessible source of information. Research on the quality of information available on the Internet is lacking. In current study, we aimed to analyse the videos about hallux rigidus on the YouTube platform, one of the widely used video sharing sites.</p>
  </sec>
  <sec id="sec-2">
   <title>Materials and Methods</title>
  </sec>
  <sec id="sec-3">
   <title>Ethical Statement</title>
   <p id="b-3">Ethics committee approval is not required as humans or animals were not included in this study. Similar studies have been conducted without ethics committee approval (    <xref ref-type="bibr" rid="ref5">5</xref>
).</p>
  </sec>
  <sec id="sec-4">
   <title>Study Design</title>
   <p id="b-4">Our research is based on data collected from a video sharing website (YouTube) on July 12, 2023. Before conducting the research, the Internet browser's search history was removed to support the integrity of the results. The search is done through the configuration process. &quot;Change hallux&quot; was typed into the search engine. Silent, uninterrupted and advertising videos are not included. The first selection includes the first 50 videos of the study by exclusion. Video watch time, upload date, likes and dislikes, daily view index, number of comments, video length, status etc. analysis of animation content and playback settings with information. In addition, Video Power Index (VPI) [(like / (like + dislike)) x 100]] is used to measure the popularity of videos (    <xref ref-type="bibr" rid="ref5">5</xref>
). The videos are divided into 5 categories according to the source of the upload: (    <xref ref-type="bibr" rid="ref1">1</xref>
) Community Organizations/Non-Profit Organizations, (    <xref ref-type="bibr" rid="ref2">2</xref>
) Doctors, (    <xref ref-type="bibr" rid="ref3">3</xref>
) Health-Related Websites, (    <xref ref-type="bibr" rid="ref4">4</xref>
) Universities/Academic Institution and (    <xref ref-type="bibr" rid="ref5">5</xref>
) Patient /Individual User/Other.</p>
   <p id="b-5">The Global Quality Score (GQS) is used to rate the quality of videos uploaded specifically to online platforms such as YouTube. It contains a rating from 1 to 5; 5 is good and 1 is bad quality. To determine its quality, GQS considers aspects such as the originality, authenticity, reliability of the video and the presentation of all content (Table-1) (    <xref ref-type="bibr" rid="ref6">6</xref>
). All videos were evaluated by one surgeon. A modified DISCERN scale was used to assess the reliability and quality of the information presented in the videos (Table 2). The DISCERN scale is measured on a 0-to-5- point scale. A higher score indicates that the information presented in the video is more secure (    <xref ref-type="bibr" rid="ref7">7</xref>
).</p>
   <sec id="sec-5">
    <title>Statistical Analysis</title>
    <p id="b-6">Analysis was performed using the Statistical Analysis for Social Sciences (IBM SPSS v.27, New York, USA). The Kolmogorov-Smirnov/Shapiro- Wilk was used to test the normal distribution. Descriptive data are presented using the mean and standard deviation of normal distribution. Most of the group differences were compared with the Mann-Whitney U and chi-square tests. Parameters were compared with one-way ANOVA. Significance level was accepted as p&lt;0.05.</p>
   </sec>
  </sec>
  <sec id="sec-6">
   <title>Results</title>
   <p id="b-7">A total of 50 video were analysed in this study. The average number of views of the video is 6507, and the average length of the video is 958 seconds. The characteristics of the videos are seen in Table-3. All videos are 3 animations, 29 are real images and 18 are combinations of animation and real images.</p>
   <p id="b-8">Analysis by Video Upload Source 21 videos were uploaded by doctors, 18 videos were uploaded by health sites, 4 videos were uploaded by health institutions, 5 videos were uploaded by schools/educational institutions, 2 were uploaded by health-related websites. There was no significant difference between GQS scores and modified DISCERN scores in the evaluation made according to the presence or absence of the video (p&gt;0.05). Average of DISCERN and GQS scores were calculated separately by the video creator (Table 4). When the video-based scores of the DISCERN variable were compared with the GQS, it was observed that the independent user/patient/other group were lower but not significant (p&gt;0.05)(Table 4).</p>
   <table-wrap id="tbl-1" position="float">
    <label>Table 1</label>
    <caption>
     <title>The parameters of the Global Quality Scale (GQS)</title>
    </caption>
    <graphic xlink:href="tbl-1.png">
     <alt-text>Table 1: The parameters of the Global Quality Scale (GQS)</alt-text>
    </graphic>
   </table-wrap>
   <table-wrap id="tbl-2" position="float">
    <label>Table 2</label>
    <caption>
     <title>Modified DISCERN Scale (Yes:1, No:0, points for each question)</title>
    </caption>
    <graphic xlink:href="tbl-2.png">
     <alt-text>Table 2: Modified DISCERN Scale (Yes:1, No:0, points for each question)</alt-text>
    </graphic>
   </table-wrap>
   <table-wrap id="tbl-3" position="float">
    <label>Table 3</label>
    <caption>
     <title>General characteristics of videos</title>
    </caption>
    <graphic xlink:href="tbl-3.png">
     <alt-text>Table 3: General characteristics of videos</alt-text>
    </graphic>
   </table-wrap>
   <table-wrap id="tbl-4" position="float">
    <label>Table 4</label>
    <caption>
     <title>Average GAS and DISCERN scores by video creator</title>
    </caption>
    <graphic xlink:href="tbl-4.png">
     <alt-text>Table 4: Average GAS and DISCERN scores by video creator</alt-text>
    </graphic>
   </table-wrap>
  </sec>
  <sec id="sec-7">
   <title>Discussion</title>
   <p id="b-9">The purpose of our research is to analyse the content and quality of YouTube videos for hallux rigidus. Our findings show the reliability and quality of these videos vary by location. In particular, videos shared by independent users or not related to the medical industry are seen as poor quality and less reliable.</p>
   <p id="b-10">When patients need to search for information about any disease, they often prefer internet because of its easy accessibility. This is seen in diseases that are common in the community. If we consider videos about lateral epicondylitis (1-3% of people see this disease), there is a lot of content on YouTube (    <xref ref-type="bibr" rid="ref8">8</xref>
–    <xref ref-type="bibr" rid="ref11">11</xref>
). During the evaluation of the video, it was determined that the content of video was different. Differences in online information can confuse patients and damage the doctor-patient relationship. Accurate and reliable information can enable patients to play an important role in decision making and reduce stress (    <xref ref-type="bibr" rid="ref12">12</xref>
,    <xref ref-type="bibr" rid="ref13">13</xref>
).</p>
   <p id="b-11">Studies in the literature have evaluated the mismatch between video quality and user interest (    <xref ref-type="bibr" rid="ref5">5</xref>
,    <xref ref-type="bibr" rid="ref14">14</xref>
–    <xref ref-type="bibr" rid="ref16">16</xref>
). Singh et al. (    <xref ref-type="bibr" rid="ref16">16</xref>
) used DISCERN scoring system to evaluate video content, while Bernard et al. GQS is preferred to measure the quality of videos (    <xref ref-type="bibr" rid="ref17">17</xref>
). In a study of Kilinc et al., (    <xref ref-type="bibr" rid="ref5">5</xref>
,    <xref ref-type="bibr" rid="ref14">14</xref>
–    <xref ref-type="bibr" rid="ref16">16</xref>
) DISCERN was applied to the reliability of the video and GQS was recommended for the overall quality of the video. In our study, we evaluated the quality of the films using the GQS, and the reliability and completeness of the data using the modified DISCERN scale. It should be noted that this model is widely used in many studies in the current literature (    <xref ref-type="bibr" rid="ref5">5</xref>
,    <xref ref-type="bibr" rid="ref14">14</xref>
–    <xref ref-type="bibr" rid="ref16">16</xref>
).</p>
   <p id="b-12">There are mixed results regarding shared page views, content quality, and likes/dislikes in the literature. While some studies have shown that videos with positive content are more popular, some have shown that videos with negative content are more popular (    <xref ref-type="bibr" rid="ref18">18</xref>
,    <xref ref-type="bibr" rid="ref19">19</xref>
). In our study, no significant difference was found between adjusted DISCERN score, GQS and views, views, video duration, like/dislike, comments, and VPI. Many of the ideas that remain in the literature have many causes. Medical content may be less popular, making doctors the primary target audience for such content. Therefore, videos with good content will attract more likes and views, as they will attract the attention of doctors. In addition, non-health professionals may watch more videos about community diseases, which may have consequences that are irrelevant to the quality of video content. While evaluating the research data, it was determined that a large number of patients or doctors did not provide enough health-related videos on the Internet (    <xref ref-type="bibr" rid="ref20">20</xref>
). However, in our study, we found that the participation of non-health professionals in the sharing of these videos is still low. In addition, when we examined the video quality, we found that the DISCERN and GQS scores of the patient/non-patient/independent user/other groups were lower than the other group. Conversely, universities/technical institutions scored the highest. Regarding our specific research topic, since the number of non-health professionals sharing medical videos is small; we can assume that viewers will access to the best content. Our study has some limitations that are not unique to our study but are often encountered in YouTube analysis. The nature of YouTube as a social media is one of its limitations. New videos are added all the time and the view, like/dislike and comment ratings are constantly changing. Also, even if you clear your internet browser's history, past searches will still work. In addition, our work may be affected by geolocation searches, limited to English videos.</p>
  </sec>
  <sec id="sec-8">
   <title>Conclusion</title>
   <p id="b-13">As we know, thumb stiffness videos are mostly uploaded by doctors. We stated that these videos are informative about good content and accurate information. Since videos uploaded by people can be misleading, channels that are suspicious or not medical professionals should not be used.</p>
  </sec>
 </body>
 <back>
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