The Quality of Evidence of and Engagement With Video Medical Claims

The unexplored quality of evidence supporting online video claims by medical professionals creates a credibility-evidence gap that threatens the principles of evidence-based medicine.

To systematically evaluate the evidence hierarchy supporting medical claims in health care professional-created online videos using a novel evidence classification framework. Design, Setting, and Participants: In this quality improvement study using a cross-sectional analysis, YouTube was searched using cancer- and diabetes-related terms. A total of 309 videos met the inclusion criteria. The video search, data extraction, and archiving were conducted between June 20 and 21, 2025, to create a static dataset. Videos were assessed using the newly developed Evidence-GRADE (E-GRADE [Grading of Recommendations Assessment, Development and Evaluation]) framework, categorizing evidence into 4 levels: grade A (high certainty from systematic reviews and/or guidelines), grade B (moderate certainty from randomized clinical trials, cohort studies, and high-quality observational studies with clear citations), grade C (low certainty from limited observational studies, physiological mechanisms, or case series without critical appraisal), and grade D (very low or no certainty from anecdotal evidence). Exposure: Videos that had a minimum of 10 000 views, were created by health care professionals, had a minimum duration of 1 minute, and contained specific health claims. Main Outcomes and Measures: Primary outcomes included the distribution of evidence grades (A-D) supporting medical claims. Secondary outcomes included correlations between evidence quality and engagement metrics (views and likes) and traditional quality scores (DISCERN, JAMA benchmark criteria, and Global Quality Scale).