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December 3, 2019

Doctors are turning to YouTube for medical training. Is that safe?

Daily Briefing

    More doctors are turning to YouTube to "fill gaps" in their training before certain medical procedures, but research has found that some of the videos are not medically sound, Christina Farr reports for CNBC.

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    Why YouTube is popular for medical training

    According to Farr, there are tens of thousands of videos on YouTube that talk through a variety of medical procedures—and the number of such videos is growing. In January, researchers identified more than 20,000 videos on prostate surgery alone, compared with 500 videos in 2009.

    Moreover, some of the medical procedure videos on the site have more than one million views, Farr reports—one video of a cataract removal, for example, has garnered 1.7 million.

    In most cases, clinicians are uploading these videos to market their services or to help guide other doctors through procedures, including births and face-lifts, Farr reports. The videos are particularly helpful for doctors-in-training who are learning to perform new procedures, Farr writes.

    The University of Iowa, for instance, found that YouTube was the most popular video source for surgical preparation among its fourth-year medical students and residents.

    But Farr reports that even some experienced doctors look at the videos. Oliver Aalami, a vascular surgeon at Stanford Hospital, said he recently turned to YouTube for surgery preparation before a complicated procedure.

    Quality concerns

    However, Aalami said while the videos were "helpful," he "kept thinking that some of these videos should be verified" for quality. Currently, doctors have no way of knowing which YouTube videos contain high-quality instructions and which contain incorrect and potentially harmful information.

    And in at least one study, researchers found that only 16 of the more than 68,000 videos on distal radius fracture immobilization they evaluated actually met basic criteria for technical and educational skill, including whether the procedure was performed by a health care professional. In some videos, it was impossible to identify who was performing the procedure at all.

    Other studies have found that YouTube algorithms give high rankings to videos with suboptimal technique, according to Farr. For instance, one group of researchers found that about 50% of videos for the surgical technique laparoscopic cholecystectomy showed unsafe practices.

    The lack of curation is a particularly pressing issue for less experienced physicians who rely on the videos to fill gaps in their medical training, sometimes right before they perform a procedure, Farr reports.

    Joshua Landy, a Canadian physician who developed an Instagram-like service for doctors called Figure 1, said, "Seeing cases is what makes you better at medicine." He explained, "So many doctors will watch these videos over and over again for thousands of hours."

    Is change on the horizon?

    According to medical experts, YouTube content isn't vetted for quality likely because examining all of the medical videos would be costly.

    Farr writes, "Massive-scale internet platforms like YouTube limit expenses by stressing that they are a platform with some basic rules, and they don't vet or add editorial notes to content." She continues, "YouTube doesn't claim to be accredited for medical education, and therefore can surface content based on popularity and not on quality."

    Even if Google, which owns YouTube, decided to invest in vetting the videos, the company would need experienced clinicians to recognize which videos are high quality, Landy explained. He added, "You'd need to be experienced to distinguish between the surgeries done properly and the technique is the most up-to-date and safe."

    Google Health declined to comment on the matter, Farr reports. However, David Feinberg, a physician and Google's VP of health, at a conference this year implied the team is looking into managing the content as part of its focus on combating health misinformation across Google.

    YouTube did not return CNBC's request for comment, according to Farr (Farr, CNBC, 11/24).

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