Abstract
BACKGROUND: YouTube has become a major source of health information, with 2.5 billion monthly users. Despite efforts taken to promote reliable sources, misinformation remains prevalent, particularly regarding medical cannabis. OBJECTIVE: This study aims to evaluate the quality and reliability of medical cannabis information on YouTube and to examine the relationship between video popularity and content quality. METHODS: A systematic review of YouTube videos on medical cannabis was conducted. Search terms were selected based on Google Trends, and 800 videos were retrieved on July 8, 2024. After applying exclusion criteria, 516 videos were analyzed. Videos were categorized by content creators: (1) nonmedical educational channels, (2) medical education channels, and (3) independent users. Two independent reviewers (SK and SE) assessed content quality using the DISCERN grade and the Health on the Net (HON) code. Statistical analysis included one-way ANOVA and Pearson correlation coefficient. RESULTS: Of the 516 videos analyzed, 48.5% (n=251) were from the United States, and 17.2% (n=89) from the United Kingdom. Only 12.2% (n=63) were produced by medical education channels, while 84.3% (n=435) were by independent users. The total views reached 119 million, with nonmedical educational channels having the highest median views with 274,957 (IQR 2161-546,887) and medical education channels having the lowest median views at 5721 (IQR 2263-20,792.50). The mean DISCERN and HON code scores for all videos were 34.63 (SD 9.49) and 3.93 (SD 1.20), respectively. Nonmedical educational creators had the highest DISCERN score (mean 47.78, SD 10.40) and independent users had the lowest score (mean 33.5, SD 8.50; P<.001). Similarly, nonmedical educational creators had the highest HON code score (mean 5.33, SD 1.22), while independent users had the lowest (mean 3.78, SD 1.10; P=.007). Weak positive correlations were found between video views and DISCERN scores (r=0.34, P<.001) and likes and DISCERN scores (r=0.30, P<.001). CONCLUSIONS: YouTube is a key source of information on medical cannabis, but the credibility of videos varies widely. Independent users attract the highest viewers but have reduced reliability according to the DISCERN and HON scores. Educational channels, despite increased reliability received the least engagement. The weak correlation between views and content quality emphasizes the need for content moderation to ensure that the most reliable and accurate information on health issues is widely disseminated. Future research should identify strategies to promote verified sources of information and limit misinformation.