YouTube as a source of patients and specialists' information on hemorrhoids and hemorrhoid surgery

Background: In the past, most people sought medical information by consulting heath care professionals. Nowadays, many people started to use online resources to access medical information. Objective: The study aims to investigate whether YouTube videos on hemorrhoids and hemorrhoid surgery can be a useful e-learning source for the general population, surgical trainees and specialists. Methods: A YouTube search was performed in October 2019 using the keywords "hemorrhoids" and "hemorrhoid surgery", and the videos were divided into 2 groups according to the keywords. Three independent researchers assessed the metadata and classified them according to the level of accuracy (hemorrhoid group) and to the level of usefulness (hemorrhoid surgery group). Cohen's test and Kappa (K) value was used to evaluate the inter-investigators agreement. Results: A total of 200 videos were analyzed, 100 for each keyword. Regarding hemorrhoid group, 43 videos (48.3%) were misleading, 9 were accurate (10.1%), 18 were approximate (20.2%), and 19 were considered a personal experience (21.4%). Regarding hemorrhoid surgery group, around 60% of the videos were lacking clear explanation, while about 16% were inaccurate. Only the remaining 24% were considered useful for teaching. Conclusion: Around half of the YouTube videos regarding hemorrhoids topic are misleading or inaccurate and present a risk of harmful consequences. Credible videos with accurate information need to be uploaded by medical professionals and medical institutions and some sort of filtering using categories by the staff of YouTube appear to be necessary. Care must be taken to produce clear highquality operative clips with generous scientific commentary.