More and more patients are turning to social media outlets like YouTube to find health information, especially about topics such as the radiation dose risk from CT. But this information may not be accurate, according to a presentation given at the American Roentgen Ray Society meeting (ARRS 2016) in Los Angeles.
That's why radiologists and radiology professional organizations need to step up their efforts to use social media options such as YouTube proactively, presenter Dr. Ajit Goenka from the Mayo Clinic in Rochester, MN, told session attendees.
"Radiation risks from CT continue to attract intense interest from the general public," he said. "And social media has the potential to influence patients' perspectives. In fact, one study found that 92% of cancer patients believe that information found on the internet empowers them to make good health decisions and to talk to their physicians."
Can 1 billion users be wrong?
Why examine YouTube's influence in particular? Because of the platform's accessibility, Goenka said.
"YouTube has more than 1 billion users," he said. "It's an archetypical social media source that allows any individual to generate and share content -- on any topic," he said.
Goenka and colleagues sought to investigate the quality of information about CT radiation risk on YouTube in a study supported by a dose reduction research grant from Siemens Healthcare. To do so, they created a new YouTube user account that would be free of prior internet activity, and they cleared the cache and search history on the computer used for the study.
With this new account, Goenka's group searched the site using the phrase "CT radiation" for three consecutive weeks. Each time, the team screened the first 200 videos on the topic of CT radiation as ranked by YouTube's own relevance algorithm. At the end of the three weeks, Goenka and colleagues had identified 63 relevant videos that appeared consistently.
"We acted like a patient might, going to YouTube and entering in keywords," Goenka told AuntMinnie.com.
The team recorded various attributes of the videos, including length, total views, upload date, views per month, and the uploading source, which ranged from independent users and advertisers to government organizations, health information websites, and radiologists/radiology professional groups.
Goenka's team chose a set of 10 videos and created an assessment checklist. They used these 10 videos to train two medical physicists to assess criteria such as production quality, content accuracy, position toward CT radiation risk and dose (unfavorable, favorable, or neutral), and intended audience. The two reviewers then evaluated the remaining 53 videos.
What were some of the key characteristics of these 53 videos? More than half (57%) were uploaded by nonradiologists, Goenka said. In addition:
- 70% were short, less than four minutes
- 87% were more than 2 years old
- 70% were rated by the reviewers as "amateur" in their production quality
- 53% were judged by the reviewers as intended for a lay audience
Not surprisingly, the study reviewers found that videos uploaded by radiology sources were more likely to be accurate and to take a favorable or neutral position toward CT radiation, while the majority of videos uploaded by nonradiologists focused on radiation overexposure, according to Goenka.
But here's the rub: Goenka and colleagues didn't find significant differences in the number of views the videos got based on whether they were categorized as radiologist-generated or layperson-generated -- which suggests that accurate information isn't reaching its target.
"Videos by nonradiologists tended to focus on the risks of CT radiation and tended to be misleading," he said. "Yet these were viewed just as often as those uploaded by radiology sources."
Take it to the street
The influence of social media on patients suggests there's a need for radiologists and professional organizations to actively engage, Goenka said. Proactively circulating balanced information about CT radiation risks could mitigate the public's overreaction to such risks, and empower patients to be better informed about medical imaging studies.
This active engagement needs to go beyond uploading resources on the websites of radiology professional organizations -- or even radiology practices or hospital departments, Goenka said. For example, the American College of Radiology could create its own YouTube channel.
"We really need to take information about CT and radiation risk to patients' proverbial doorstep, by uploading videos to social media platforms rather than assuming people will come to a hospital's or practice's website," he said.
