Quality, Understandability, And Actionability Of Youtube Videos On Blepharitis: A Cross-Sectional Assessment Using Pemat And Modified Discern Tools

To evaluate the quality, understandability, and actionability of patient education videos on blepharitis available on YouTube, and to compare content quality between healthcare professional and industry/pharmaceutical sources. Blepharitis is a common chronic eyelid condition, and patients increasingly turn to video-based platforms for health information. However, the reliability and comprehensibility of such content remains poorly characterized.

Cross-sectional analysis of YouTube videos retrieved using the search term "blepharitis" conducted in February 2025. Videos were assessed by two independent reviewers using validated quality assessment instruments.

The first 30 English-language patient-directed videos on blepharitis were identified and categorized by uploader type (healthcare professional vs industry/pharmaceutical). Videos were assessed using the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V) for understandability and actionability, modified DISCERN (mDISCERN) for reliability, and a 5-point Global Quality Score. Video characteristics (length, views, likes, Video Power Index) and content features (treatment methods demonstrated, safety warnings, Demodex discussion) were recorded. Inter-rater reliability was calculated and mean scores between reviewers were used for analysis.

Thirty videos (20 long-form, 10 shorts) were analyzed: 20 from healthcare professionals, 8 from industry/pharma sources and 2 from layperson/influencer. Median video length was 164 seconds (IQR 53-327). Mean PEMAT understandability was 68.7±15.1% with only 50% of videos meeting the ≥70% threshold for adequate understandability. Mean PEMAT actionability was lower at 46.7±24.8% with only 26.7% achieving ≥70%. Mean mDISCERN score was 2.57±0.95 (scale 0-5) and Global Quality Score 2.95±1.04 (scale 1-5). Long-form videos demonstrated significantly higher quality (3.35 vs 2.15, p=0.002) and mDISCERN scores (2.95 vs 1.80, p<0.001) compared to shorts. Only 13.3% included safety warnings.

YouTube videos on blepharitis demonstrate moderate quality and understandability, with significant deficiencies in actionability and safety information. Only half of videos meet recommended understandability thresholds, and fewer than one-third provide actionable guidance for patients. Long-form videos are significantly superior to shorts in quality and reliability. The paucity of safety warnings and limited discussion of Demodex in only 30% of videos represents a substantial educational gap. Healthcare professionals should be aware of these limitations when patients use YouTube for blepharitis information and should direct patients toward high-quality, evidence-based video resources from professional sources.