Abstract
OBJECTIVE: To evaluate the quality, reliability, and user engagement of endometriosis-related videos on TikTok and Bilibili, identifying variations by platform, uploader type, and content category to inform digital health strategies. METHODS: The top 100 videos per platform were retrieved using the Chinese keyword for "endometriosis." After excluding irrelevant or promotional content, 195 videos (99 TikTok, 96 Bilibili) were analyzed. Categorization included uploader type (professional individuals, nonprofessionals, institutions) and content (disease knowledge, treatment, Traditional Chinese Medicine, other). Quality was assessed via Global Quality Score (GQS), modified DISCERN (mDISCERN), JAMA benchmarks, and Video Information and Quality Index (VIQI). Engagement (likes, collections, comments, shares) and duration were recorded. Analyses used the Wilcoxon rank-sum, Kruskal-Wallis, Fisher's exact, and Spearman correlations. RESULTS: Professionals uploaded 83.6% of videos; disease knowledge dominated (64.1%). Bilibili videos were longer (median 281.5 vs. 64.67 s; P < .0001) with higher GQS (3.29 vs. 3.04; P = .0123), mDISCERN (3 vs. 2; P < .0001), and JAMA (1 vs. 0; P < .0001). TikTok excelled in engagement (e.g., likes 355 vs. 18.5; P < .0001). Professional sources scored higher (P < .001-.003). Treatment content was most engaging but shorter (P < .001). Engagement correlated internally (P > .7) but weakly with quality (P < .3). CONCLUSIONS: Videos show moderate quality, with Bilibili emphasizing reliability and TikTok virality. Professional content is superior, but the popularity-quality disconnect highlights needs for verification and education to reduce misinformation.