Evaluating the reliability and quality of knee osteoarthritis educational content on TikTok and Bilibili: A cross-sectional content analysis
Open accessAbstract
Background: Knee osteoarthritis (KOA), a prevalent degenerative joint disease, burdens global health. Amid the digital era, patients increasingly seek KOA-related information on TikTok and Bilibili, but its quality is scarcely studied, raising accuracy, and reliability concerns. Aim: To systematically evaluate the reliability and quality of KOA educational videos on TikTok and Bilibili using validated tools (modified DISCERN and Global Quality Score, GQS), and to analyze associations between content quality, uploader types, and user engagement metrics. Methods: Using “Knee Osteoarthritis” as the keyword, the top 100 videos from each platform were retrieved. After excluding duplicates and irrelevant videos, 164 were analyzed. Videos were classified by uploader type and content. Two senior orthopedic physicians evaluated their reliability and quality via a modified DISCERN tool and GQS. Nonparametric statistical methods were applied for data analysis. Results: Bilibili had a significantly higher proportion of high-quality videos (GQS ≥4: 38.0% vs. 11.8%; DISCERN ≥4: 49.3% vs. 24.7%, P < 0.05). Professional institutions’ videos ranked highest, while TikTok was mostly run by professional uploaders (with medical or healthcare-related qualifications) (98%). Disease knowledge and treatment were the main content types. Engagement metrics were intercorrelated but not with quality scores. Conclusion: Bilibili hosted more high-quality KOA videos than TikTok (GQS ≥4: 38.0% vs. 11.8%, DISCERN ≥4: 49.3% vs. 24.7%, P < 0.05), with professional institutions showing the highest reliability. Engagement metrics did not correlate with quality. To mitigate misinformation, targeted strategies—such as platform-specific guidelines for health content and integration of video quality discussions into clinical consultations—are needed.
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Videos with fewer than 100 cumulative views were excluded as long-tail content with negligible reach and no meaningful public health exposure, consistent with over 80% of published social media health content analyses prioritizing high-visibility content.
“videos with fewer than 100 cumulative views at the time of data extraction, a pre-specified threshold to exclude long-tail content with negligible reach and no meaningful public health exposure”
From Quality, reliability, and treatment misinformation risk of epilepsy content on Chinese short-video platforms TikTok (Douyin) and Bilibili: a cross-sectional analysis (2026) · cites this paper as [16]
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Experimental — accuracy not yet measuredStudies of health-related videos on social media for kidney stones, esophageal cancer, knee osteoarthritis, and myopia prevention have consistently found overall information quality suboptimal.
“Studies examining content related to kidney stones14, esophageal cancer15, knee osteoarthritis16, and myopia prevention17 have consistently found that the overall information quality is suboptimal”
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- Authors
- Tu, J., Zhang, C., Zhang, H., Liang, L., & He, J.
- Affiliations
- Jiangxi University of Traditional Chinese Medicine (CN)
- Department of Orthopedic Trauma I, Jiangxi Province Hospital of Integrated Chinese and Western Medicine, Nanchang 330003, China.
- Corresponding author
- He, Jianhua
- Venue
- DIGITAL HEALTH
- Publisher
- SAGE Publications
- Published
- 2025-05
- Volume
- 11
- Pages
- 20552076251366390-20552076251366390
- ISSN
- 2055-2076 (ISSN-L)
- PMC
- PMC12344336
- OpenAlex
- W4413115683
- Cited by
- 44
- References
- 57
- Citations by year
- 2026: 40 · 2025: 4
- FWCI
- 49.43
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Digital Health (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Social Sciences › Health › Social Media in Health Education
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Social Sciences › Education › Health Education and Validation
- Keywords
- knee osteoarthritis, health misinformation, educational videos, TikTok, Bilibili, content quality, reliability, mDISCERN, Global Quality Score, user engagement, social media health information
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