Do YouTube videos facilitate informed decisions about knee osteoarthritis treatment? A cross-sectional analysis of German-language videos.

BACKGROUND: YouTube is an important source of health information. The YouTube Health initiative aims to improve access to high-quality information and support informed decision-making. Informed decisions require objective, transparent, and comprehensive information about the benefits and risks of medical interventions. This study systematically evaluated whether German-language YouTube videos on knee osteoarthritis (OA) treatment facilitate informed decision-making. METHODS: We conducted a systematic search on YouTube. Eligible health information materials (HIMs) were evaluated using the validated MAPPinfo checklist, which operationalises the guideline Evidence-Based Health Information across four quality dimensions: definition, transparency, content, and presentation. Two raters assessed all HIMs independently. Additional structured content mapping identified the range and balance of treatment options and assessed the reporting of benefits, complications, and anaesthesia for total knee arthroplasty (TKA). Information quality was scored from 0% to 100%, and descriptive analyses examined mean scores by provider type, country, and YouTube Health certification. RESULTS: Seventy-nine videos representing 50 HIMs met the inclusion criteria. Most HIMs (n = 23) were provided by hospitals; 28 were certified by YouTube Health. The mean information quality was 15.4% (range 5-25, SD 4.5), with no HIM meeting all criteria. The information quality was similar for certified and non-certified HIMs (15.4% [SD 4.5] and 15.3% [SD 4.4], respectively). Among HIMs mentioning TKA (n = 37), 20 omitted complications and 16 omitted benefits. CONCLUSIONS: The quality of German-language YouTube videos on knee OA treatment was insufficient for facilitating informed decisions. The quality criteria for YouTube Health certification did not align with the stated aims.