Quality and reliability of femoral neck fracture educational short videos: a cross-sectional study

Abstract

Background: Femoral neck fracture (FNF) patients increasingly use short-video platforms (TikTok, Bilibili) for education, but content quality and reliability are underexplored. Objective: To systematically evaluate FNF-related educational short videos on TikTok and Bilibili, and explore associations between video characteristics, user engagement, and quality scores. Methods: This cross-sectional study analyzed 166 top-ranked videos (accessed in May 2025 as guest users) using modified DISCERN, Global Quality Score (GQS), the newly developed Femoral Neck Fracture-Specific Clinical Comprehensiveness Score (FNF-SCCS), and Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V). Videos were categorized by uploader type and content theme; non-parametric statistics, Cohen’s kappa, and Intraclass Correlation Coefficient (ICC) assessed associations and inter-rater reliability. Results: Professionals created 59.04% of content, non-professionals 25.9%. Bilibili videos were longer (162s vs. 59s, P  < 0.05) and higher-quality (GQS ≥ 4: 43.7% vs. 12.6%; DISCERN ≥ 4: 40.9% vs. 23.2%, P  < 0.05). Disease knowledge and rehabilitation training videos scored highest (DISCERN = 4, GQS = 4), personal experiences lowest (DISCERN = 2, GQS = 2). FNF-SCCS (ICC = 0.91) and PEMAT-A/V (ICC = 0.89) showed excellent inter-rater reliability; professional institutions/individuals outperformed non-professionals in FNF-SCCS and PEMAT understandability (Median = 75.0% vs. 58.3%, P  < 0.001), while overall actionability was low except for rehabilitation training videos (Median = 100.0%). Engagement weakly correlated with quality ( r =-0.21–0.08); Cohen’s kappa = 0.806–0.839. Conclusions: FNF-related content on TikTok and Bilibili exhibits suboptimal quality, with professional sources outperforming non-professional ones. Critical gaps exist in guideline adherence and actionable instructions. Platforms and healthcare professionals should optimize medical content dissemination.