Évaluation de la qualité des vidéos d'infiltrations échoguidées disponibles sur les plateformes de partage vidéo sur internet

Par : Bourdaïm, Sofian

Document archivé le : 06/07/2017

Introduction : ultrasound (US) guided injections are becoming widespread in the treatment of rheumatic articular disorders. US allows a real time assessment of the needle progression and increase the accuracy of the injection. Video sharing platforms can be sources of information and learning material for healthcare professionals as for patients. We conducted this cross-sectional study to assess the quality of educational resources on US-guided injections published on video sharing platforms. Method : YouTube, Dailymotion and Vimeo were searched using predefined keywords on US-guided shoulder, elbow, wrist, hand, hip, knee, ankle, foot, sacroiliac, pubic symphysis and caudal epidural injections. The videos were classified according to their source. We determined the injection site and the explanations shown for each site. We collected information on patient positioning, equipment, needle, ultrasound settings and teaching material used by the author. When demonstration was performed live in patient, the compliance with the rules of asepsis and the accuracy of the injection were evaluated. Overall, videos were evaluated for quality on a 5-point ordinal global quality scale (GQS) (from 1 = poor quality to 5 = excellent quality). Results are given as median (min-max). Results : we found 69 979 results with the keywords. We screened 2 802 videos by titles and included 153 videos (10.05 hours). Most of videos were published on Youtube (92.2%) and 82.4% included oral explanation. 53.6% videos were published by medical advertisement or profit companies and only 9.2% videos by university, professional organization or physician group. Among the 41.2% videos showing live demonstration of injection on the patient only 25.4% followed the strict rules of asepsis. When the videos included US cineloops of injection, 10.4 % of them were outside the target. Very few videos gave details about information on the pathophysiology of the disease (6.5%), the risk (0.7%), the benefice (11.2%) or the products used for the injection (58.2%). Overall, 3.3% of the videos were classified as “Excellent quality” on the GQS, 24.2% as “Good quality”, 23.5% as “Moderate quality”, 34.6% as “Generally poor quality” and 14,4% “Poor quality”. We compared the characteristics of the good quality videos (GQS score ≥ 4) versus the one rated ≤3. Better quality videos were longer (1.3 min ((0.07-1.05) versus 3.62 (0.32-40.43) min), had oral explanation (95% versus 77%; p=0.008). They more frequently showed the clinical and US site of injection and accurately reached their target (90% versus 68%). They were significantly more viewed (m2719 (13-80195) versus 856 (11-60174); p=0.026) and more liked (1 (0-80) versus 7 (0-58) (p=0.002)). However, some poor quality videos had more than 60 000 views. Quality of the video created by medical advertisement or profit companies were not different from those coming from university but significantly better than those from individual physician or with unknown origin (p=0.011). Conclusion : our study reveals a generally a low quality of US guided learning videos available on the most popular video sharing platforms. We observed a lack of information on the treatment, its risks and benefits. Institutional videos are unfortunately rare on internet although video released by private companies were overall of good quality. Strict aseptic techniques are rarely followed and the injection can be outside the target. Finally, we identified characteristics associated with the quality of the video that can be used to improve their educational impact in the future. 17NANT031M

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