Nearly 90 million Americans have health literacy skills that are basic or below basic. The Centers for Disease Control define health literacy as the capacity of an individual to obtain, process, communicate, and understand health information to make appropriate medical decisions [1]. Increasingly, individuals are using YouTube, the largest video-sharing site, to acquire medical knowledge. The aim of this study was to review the readability and quality of pelvic organ prolapse (POP) YouTube videos.

The search term, “Pelvic Organ Prolapse” was used to analyze the readability of the first 50 written transcripts of YouTube videos. Transcripts were excluded if they lacked narration in English or contained both no text and no audio. The readability of written transcripts was evaluated using an online software (www.readabilityformulas.com) to determine reading grade levels. The quality of videos was scored using the DISCERN quality criteria and the Patient Education Materials Assessment Tool (PEMAT). Accuracy was assessed by comparing content to accepted POP treatment guidelines.

The mean readability scores of all 50 videos was 13.0 (Table 1). Over 80% of the videos contained poor quality information with mean Gunning Fog, Flesch-Kincaid, and SMOG scores of 15.8, 12.6, and 10.6 respectively. The mean readability index for videos with a low PEMAT score (score < 70%) for understandability and actionability was 12.5 and 12.9 respectively (Table 1). The PEMAT understandability and actionability scores for videos with low readability (score > 9) was 73% and 61% respectively. Videos with low readability scores had an average DISCERN score of 3. The average Gunning Fog, Flesch-Kincaid, and SMOG readability scores for videos with high misinformation was 15.3, 11.9, and 10.4 respectively (Table 1).

Transcripts of POP YouTube videos are written at difficult levels with many transcripts exceeding the reading capabilities of the American population. The typical American adult reads at a seventh-grade level, yet the overall readability index of POP transcripts on YouTube requires an education grade level greater than twelve [2]. The majority of videos are low quality, with many omitting other treatment options, risks of treatment, and/or shared decision making with medical professionals.

Appropriate patient understanding is essential when dispersing patient driven resources. Difficult-to-comprehend transcripts can impede upon the intended message. These findings suggest that there is an immense need for improvement in patient education materials. Efforts should be made to avoid complex terms when creating patient focused content and helping patients navigate to content of appropriate literacy online.

Rudd R. Health Literacy. Centers for Disease Control and Prevention. https://www.cdc.gov/healthliteracy/learn/index.html. Updated December 13, 2016.
Gaines T, Malik RD. Readability of pelvic floor dysfunction questionnaires. Neurourology & Urodynamics. 2020;39(2):813. http://search.ebscohost.com.proxy-hs.researchport.umd.edu/login.aspx?direct=true&db=edb&AN=141660718&site=eds-live.