Health information on M(onkey)pox, posted on the social media platform TikTok, is often inaccurate, incomplete, and of poor quality, finds a recent analysis of relevant videos, published in the open access journal BMJ Global Health.
The findings highlight the potential risks of using social media for health information, particularly during public health emergencies, warn the researchers.
Mpox, formerly called monkeypox, usually describes fever, swollen lymph glands (lymphadenopathy), and painful skin pustules all over the body that last from 2 to 4 weeks.
With more than 1 billion users in 2022, TikTok is one of the most active social media platforms used today to access and share information on timely public health issues, note the researchers. Its users can easily create videos lasting between 15 seconds and 5 minutes.
The researchers wanted to assess the content, quality, and level of engagement of video content on the Mpox outbreak on the platform.
They carried out an online search of relevant video content uploaded between 1 January and 11 August 2022, using 12 hashtags. The initial search returned 2462 videos, but only those that were original, in English, and contained educational content were included in the analysis. After manually checking each video, 85 were left.
The videos were evaluated for content on features and treatment of Mpox. Video and information quality was assessed using three validated tools for evaluating health information, which included DISCERN and the Journal of the American Medical Association (JAMA) criteria.
The video authors were categorised as doctors and science communicators; institutions; nurses and other healthcare workers; and the general public. And information on the number of followers they had, who they were following, and the total number of posted videos and likes was collected.
The average length of the videos was 78 seconds. The average value of received likes, comments, and shares for each video was 11,015, 211, and 693, respectively.
The most common video authors were doctors and science communicators (43.5%; 37), followed by the general public (35%; 30), nurses and other healthcare workers (13%; 11), and institutional users (8%;7).
Video content was assessed, using six content categories related to Mpox in clinical practice. Most (85%) addressed Mpox risk factors, but, on average, the videos addressed only a third of the content items highlighted in clinical practice guidelines.
The overall average score for the videos was 39.56 out of 80 on the DISCERN instrument and 1.93 out of 4 on the JAMA criteria, indicating that the overall quality of information in the videos was poor. No video met all the JAMA criteria.
Overall scores for quality were higher for videos produced by doctors and science communicators than for those made by institutional users or nurses, with those produced by the general public achieving the lowest scores.
The inclusion of people in the video and information on the quality of treatment choices were significant independent determinants of audience engagement.
The researchers acknowledge various limitations to their findings, including the relatively short time period covered by the study, the fact that the DISCERN and JAMA instruments were originally designed to evaluate website information, and the absence of information on the behavioural and psychological impacts of the videos.
But they nevertheless, point out: "Overall, the material on the recent Mpox outbreak shared through TikTok videos was frequently unreliable and incomplete, hindering public health efforts to share accurate information on Mpox."
While the poor quality content of most videos may relate to the limited information available on Mpox and its novelty, guidance is needed for health information content, given the crucial role this has, they insist.
"Our quality-of-information results emphasise the need for developing instructions on health information videos on social media and for encouraging more content from health professionals," they write.
And they conclude: "Our study highlights the risks of referring to TikTok or social media as a health information source….Poor quality videos with biased content may lead to confusion and impair successful informed decision making. This exacerbates the 'infodemic' on social media, deterring efforts to prevent and manage disease outbreaks, notably the Mpox outbreak."
Shi, A., et al. (2023). Mpox (monkeypox) information on TikTok: analysis of quality and audience engagement. BMJ Global Health. doi.org/10.1136/bmjgh-2022-011138.