TikTok as a Patient Educational Resource for 3rd Line Overactive Bladder Therapies

Objectives: TikTok is a social media outlet with over 1 billion monthly users, but the quality and accuracy of its health-related videos is unknown. In this cross-sectional study, we assessed the quality of TikTok videos on overactive bladder (OAB) 3^rd line therapies.

Methods: We abstracted the top 50 TikTok videos for each of these keywords: "axonics", "sacral neuromodulation","interstim", "PTNS", "posterior tibial nerve stimulation", and "bladder botox". Videos were included if they contained information about the therapy and excluded if they were non-English, did not contain information about the therapy, or were unavailable for viewing at time of scoring. Demographic information was compiled. Videos were scored for quality by 3 independent reviewers using the Medical Quality Video Evaluation Tool (MQ-VET), a validated tool for assessing medical videos. A

composite score, ranging 15-75, was tallied from the mean scores. Two of the authors, both urologists, determined if videos had misinformation (MI).

Results: Of 300 videos screened, 119 videos met inclusion criteria. 25 (21%) were made by medical professionals (MPs) (Table 1). MP videos had significantly more shares (5 vs 1, p< 0.01) but were similar in length (24 vs 16 sec), views (3811 vs 2275), likes (96 vs 94), and comments (7 vs. 8). Although MP videos had significantly higher MQ-VET scores (43 vs 27, p< 0.01), there was no difference in rate of MI between MP and non-MP videos (21 vs 18%). Videos with more shares ( >1) correlated with a higher MQ-VET score (34 vs 26, p< 0.01), but the same pattern was not seen for higher median likes, comments, or views. 22 (18.4%) videos contained MI, which were 3 times longer (50.5 vs 15 sec, p< 0.01) and had higher MQ-VET scores (34.5 vs 27, p=0.03) than those without MI (Table 2). Common themes of MI were related to therapy indication or mechanism of action and patient limitations after undergoing therapy.

Conclusions: Most TikTok videos on OAB 3^rd line therapies are poor quality and made by the public. While more frequently shared videos tend to be of higher quality, that is not true for videos with more views, likes, and comments. About one-fifth of all TikTok videos on OAB 3^rd line therapies contain MI; we found that videos with MI tend to be longer and, paradoxically, of higher quality than those without MI. MPs should be aware of MI permeating TikTok given its large audience. MPs on TikTok have credibility with the public and should ensure they are not posting, and inadvertently promoting, MI.