Is content really king? An objective analysis of the public's response to medical videos on YouTube.

Medical educators and patients are turning to YouTube to teach and learn about medical conditions. These videos are from authors whose credibility cannot be verified & are not peer reviewed. As a result, studies that have analyzed the educational content of YouTube have reported dismal results. These studies have been unable to exclude videos created by questionable sources and for non-educational purposes. We hypothesize that medical education YouTube videos, authored by credible sources, are of high educational value and appropriately suited to educate the public. Credible videos about cardiovascular diseases were identified using the Mayo Clinic's Center for Social Media Health network. Content in each video was assessed by the presence/absence of 7 factors. Each video was also evaluated for understandability using the Suitability Assessment of Materials (SAM). User engagement measurements were obtained for each video. A total of 607 videos (35 hours) were analyzed. Half of all videos contained 3 educational factors: treatment, screening, or prevention. There was no difference between the number of educational factors present & any user engagement measurement (p NS). SAM scores were higher in videos whose content discussed more educational factors (p<0.0001). However, none of the user engagement measurements correlated with higher SAM scores. Videos with greater educational content are more suitable for patient education but unable to engage users more than lower quality videos. It is unclear if the notion "content is king" applies to medical videos authored by credible organizations for the purposes of patient education on YouTube.

Tweeting the meeting: an in-depth analysis of Twitter activity at Kidney Week 2011.

In recent years, the American Society of Nephrology (ASN) has increased its efforts to use its annual conference to inform and educate the public about kidney disease. Social media, including Twitter, has been one method used by the Society to accomplish this goal. Twitter is a popular microblogging service that serves as a potent tool for disseminating information. It allows for short messages (140 characters) to be composed by any author and distributes those messages globally and quickly. The dissemination of information is necessary if Twitter is to be considered a tool that can increase public awareness of kidney disease. We hypothesized that content, citation, and sentiment analyses of tweets generated from Kidney Week 2011 would reveal a large number of educational tweets that were disseminated to the public. An ideal tweet for accomplishing this goal would include three key features: 1) informative content, 2) internal citations, and 3) positive sentiment score. Informative content was found in 29% of messages, greater than that found in a similarly sized medical conference (2011 ADA Conference, 16%). Informative tweets were more likely to be internally, rather than externally, cited (38% versus 22%, p<0.0001), thereby amplifying the original information to an even larger audience. Informative tweets had more negative sentiment scores than uninformative tweets (means -0.162 versus 0.199 respectively, p<0.0001), therefore amplifying a tweet whose content had a negative tone. Our investigation highlights significant areas of promise and improvement in using Twitter to disseminate medical information in nephrology from a scientific conference. This goal is pertinent to many nephrology-focused conferences that wish to increase public awareness of kidney disease.

Time to symptomatic vascular stenosis at different locations in patients with arteriovenous grafts.

Most arteriovenous grafts fail due to irreversible thrombosis, superimposed on hemodynamically significant vascular stenosis. Previous studies observed the highest frequency of stenosis at the venous anastomosis, without addressing the timing of stenosis. The present study quantified time to symptomatic stenosis at different vascular locations, and related it to permanent graft failure. A prospective computerized vascular access database was queried retrospectively to identify 309 hemodialysis patients receiving new upper extremity grafts during a 4-year period at a large dialysis center. For each vascular site we calculated the time to symptomatic stenosis using survival techniques. The cumulative likelihood of symptomatic stenosis at 2 years was 67% for venous anastomotic stenosis, 19% for intra-graft stenosis, 16% for venous outlet stenosis, 13% for central vein stenosis, and 5% for arterial anastomotic stenosis. The cumulative risk of graft failure at 2 years was 40%. Stenosis at the venous anastomosis was twice as likely as cumulative graft failure (hazard ratio [HR] 1.95; 95% confidence interval [CI], 1.65-2.52, p < 0.001). In contrast, intra-graft stenosis was half as likely as cumulative graft failure (HR 0.45; 95% CI, 0.36-0.61, p < 0.001). Central vein stenosis was more likely in patients with a previous ipsilateral catheter compared with those without one (HR 2.40; 95% CI, 1.39-5.58, p = 0.004). Symptomatic stenosis occurs much earlier at the venous anastomosis compared with other vascular sites. Moreover, preexisting ipsilateral internal jugular dialysis catheters more than double the risk of central vein stenosis.