Sporotrichosis: Quality of YouTube Contents on a Fungal Neglected Tropical Disease

1. Introduction

Sporotrichosis is a chronic fungal infection caused by the dimorphic fungus Sporothrix schenckii and its related species. Often referred to as “rose gardener’s disease,” it is commonly associated with handling plants and organic material, which serve as primary sources of infection [1, 2]. Sporotrichosis is traditionally associated with the traumatic implantation of Sporothrix species from environmental sources such as soil or vegetation. However, in recent years, its zoonotic transmission, particularly through domestic cats, has emerged as a significant public health concern. In South America, zoonotic outbreaks caused by Sporothrix brasiliensis have resulted in severe and widespread human infections linked to direct contact with infected felines. It is thus important to recognize sporotrichosis not only as an environmental disease but also as a zoonotic threat, with implications for both human and veterinary health education [1, 3, 4, 5, 6]. The disease primarily affects the skin, subcutaneous tissues, and lymphatic system; however, in severe cases, it can disseminate to other parts of the body, including bones, joints, and the central nervous system [6, 7]. Although sporotrichosis has a global distribution, it is particularly prevalent in tropical and subtropical regions where environmental conditions favor the growth and transmission of Sporothrix species [8, 9].

The expansive range of topics and widespread accessibility of YouTube make it a valuable resource for patients seeking information about specific ailments and medical conditions, including sporotrichosis. However, the accuracy and reliability of the information presented in these videos can be a significant concern. Unlike peer-reviewed scientific literature, YouTube videos are not subjected to rigorous editorial processes, and the information presented may be influenced by the creator’s expertise, biases, or commercial interests [10, 11]. This variability raises concerns about the potential for misinformation and its impact on public health.

Assessing the quality and reliability of YouTube content is crucial, particularly for medical conditions like Sporotrichosis, where timely and accurate information is vital for disease management and prevention. Our study aims to address this need by analyzing the popularity, quality, and reliability of YouTube videos related to Sporotrichosis. Through this analysis, the study seeks to provide insights into the current state of online health information on the disease and to identify areas for improvement in the dissemination of accurate and reliable content on digital platforms such as YouTube.

2. Materials and methods

2.1 Search strategy

We retrieved YouTube videos using Sporotrichosis as a search term on August 20, 2024, using a YouTube Data API and an R script, which obtained 200 video URLs. The search results were automatically ranked by YouTube’s default “relevance” setting and also included data on view count, like count, comment count, upload date, and video duration. Figure 1 shows the screening criteria.

3. Statistical analysis

Normal distribution was tested using the Shapiro-Wilk test, which indicated there was no normal distribution, as all p < 0.05. Variables were summarized as sums, medians, and interquartile ranges. The inter-rater agreement among the four reviewers for the GQS and mDISCERN scores was assessed using the Interclass Correlation Coefficient (ICC). ICC values <0.5 were categorized as indicating poor reliability; values between 0.5 and 0.75 as moderate reliability; values between 0.75 and 0.9 as good reliability; and values >0.90 as excellent reliability. Spearman’s rho was also used to evaluate the association between video scores and video metrics. The Mann-Whitney U test was conducted to compare continuous variables between the “Low to Medium Quality” and “High Quality” groups. Statistical significance was set at P ≤ 0.05. All statistical analyses were conducted using R version 4.3.2 [14].

4. Results

Figure 1 shows the data screening of selected videos.

5. Discussion

This study aims to evaluate the quality and reliability of YouTube videos related to sporotrichosis, a subcutaneous fungal neglected tropical disease of global public health significance [15]. YouTube is one of the most visited websites worldwide and has become a popular platform for individuals seeking health-related information [16]. The accessibility of YouTube allows users to easily find videos on a wide range of medical topics [17], including rare conditions such as sporotrichosis. However, the open nature of YouTube, where anyone can upload content, leads to a mix of reliable information and potential misinformation. This lack of content regulation raises concerns, as YouTube does not require health-related videos to undergo expert review [11]. Consequently, the quality and accuracy of information can vary widely, which is particularly problematic given that about 85 million internet users take online health advice without assessing the quality of the content found on the internet [18]. The consequences of relying on such unvetted information can be severe, especially in cases where treatment decisions are influenced by misleading or incorrect content.

Our findings indicate that the majority of videos on sporotrichosis were not only of high quality, with a median GQS of 4.0, but also less reliable, with a modified DISCERN score of 2.825, suggesting that there is a considerable amount of quality information available on YouTube regarding sporotrichosis, though most of it is most likely less reliable. Despite these encouraging results, the study also revealed that video popularity, as measured by the VPI, was strongly correlated with the number of views, likes, and comments but not with GQS or mDISCERN scores. Popular videos are thus not necessarily those with the most accurate or reliable content. In fact, the pursuit of virality can lead to content that prioritizes engagement over accuracy. This disconnection between popularity and quality has been documented in other studies, where videos with sensationalist, compelling headings or oversimplified content attract more viewers than those that are more thorough or scientifically accurate [19]. The implication is that viewers may be misled by the popularity of a video, assuming it to be more trustworthy or informative than it actually is. There were no significant differences in GQS, mDISCERN, and video duration between high-quality and lower-quality videos. Specifically, higher-quality videos tended to be longer, with a median duration of 10 minutes compared to 3 minutes for lower-quality videos, suggesting that more detailed and comprehensive videos—which naturally take longer to produce and watch—are more likely to provide accurate and reliable information, a pattern consistent with the idea that quality health information requires time to present and explain thoroughly. However, the challenge is that longer videos may not attract as many viewers, especially in an era where attention spans are often limited [20, 21]. Of late, shorter videos on YouTube, popularly known as “Shorts,” have garnered more engagement than regular videos [22], though the amount of content released in Shorts is quite limited and may not sufficiently convey all health-related information as a regular full-length video would, creating a tension between the need for thoroughness and the demand for brevity, which content creators must navigate carefully. The implications of our findings are significant for both content creators and viewers. For content creators, there is a clear need to balance accuracy with engagement to ensure that reliable information reaches a broad audience. For viewers, the study emphasizes the importance of critically evaluating the source and content of the information they consume, especially when it concerns health-related topics.

This study had some limitations. While GQS and mDISCERN are validated tools for assessing video quality, they are subjective measures and may not capture all aspects of what constitutes high-quality content. The study did not account for other factors that may influence video quality and reliability, such as visual and audio production quality or the qualifications of the presenter. Another key limitation of this study is the inability to conduct a regional analysis due to the absence of geolocation data. As a result, potential variations in public perceptions or discourse across different geographic areas could not be explored, which limits the generalizability of the findings to specific regional contexts. Future research may address these limitations by incorporating additional metrics and considering other factors that contribute to content quality.

6. Conclusions

There is a disconnection between video popularity and reliability despite the relatively high quality of videos on sporotrichosis. Viewers have to critically evaluate health information on YouTube, and content creators need to prioritize accuracy alongside engagement.

Conflict of interest

None declared.

Funding

None.

Data availability

The data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author upon reasonable request. Data on screening is available in Appendix A.

Appendix

See Table A1.