Resident Physician Stony Brook University School of Medicine
Introduction: There has been a marked increase in commercial advertising and prescriptions for testosterone therapy over the last two decades. Patients are increasingly turning to the internet and social media as their initial source for medical information. We sought to investigate the quality of information for testosterone therapy on YouTube.
Methods: A YouTube search was performed using the keyword ‘testosterone therapy’. The top 150 most viewed videos were then assessed for inclusion criteria. Videos were evaluated using the DISCERN consumer health evaluation technique and scored via the Patient Education Materials Assessment Tool (PEMAT) by five reviewers. Videos that exceeded twenty minutes in duration, were non-English, were duplicated, consisted of unrelated content, or were presentations intended for medical professionals only, were excluded.
Results: A total of 88 videos met inclusion criteria with a cumulative total of 14,282,476 views. Median video length was 9 minutes (range 1-20). Sixty-eight percent (n=60) of videos were produced by individual YouTubers with no medical background. Twenty-three percent of videos featured a physician with only 7% featuring a urologist. Median DISCERN quality score was 2 (1-5) with 76% of videos rated as moderate to poor quality (DISCERN =3). Videos featuring a physician had better content quality compared to videos that did not (DISCERN 3.5 vs 2, p<0.01). Median PEMAT understandability and actionability scores were 81 (31-100) and 50 (0-100) respectively. Forty-five percent of videos included the YouTubers’ personal experiences of undergoing testosterone therapy. Eight (9%) videos discussed testosterone therapy in females. Forty-three percent of videos discussed side effects of testosterone therapy; however, only 10 % (n=9) mentioned infertility as a negative effect. Seventeen percent (n=15) of videos contained potentially misleading information with a total of 3,537,609 views.
Conclusions: Less than a quarter of the most popular videos on YouTube discussing testosterone therapy featured a physician. Less than half of them discussed side effects of testosterone therapy with only ten percent mentioning infertility. With the increasing role of the internet and social media in patient medical decision making, a stronger physician presence on YouTube and other platforms can help deliver more accurate and accessible information to the public.