Quality and Reliability of Diabetic Retinopathy-Related Chinese Videos on Bilibili and TikTok: Cross-Sectional Study in China (Preprint)

<sec> <title>BACKGROUND</title> The increasing prevalence of diabetes in China has led to a growing burden of diabetic retinopathy (DR), a major complication, posing significant challenges to public health systems and socioeconomic development. There is a notable trend where patients increasingly access health education content through diabetic retinopathy-related videos on Chinese social media platforms like Bilibili and TikTok (Chinese version). However, the quality and reliability of health education videos about diabetic retinopathy on Chinese social media platforms have not yet been evaluated. </sec> <sec> <title>OBJECTIVE</title> This study conducted a comprehensive analysis of the quality and reliability of such health education videos on these platforms, aiming to provide insights for patients seeking medical information and offer improvement suggestions for content creators and platform operators. </sec> <sec> <title>METHODS</title> On March 5, 2025, this study retrieved the top 100 videos under comprehensive ranking (totaling 200 videos) from Bilibili and TikTok platforms using the search term "糖尿病性视网膜病变". The videos were categorized by video source, recording the video characteristics, including the video content. A dual-assessment framework was implemented using the Global Quality Scores (GQS) for content quality and the modified DISCERN (mDISCERN) instrument for reliability evaluation. </sec> <sec> <title>RESULTS</title> Bilibili demonstrated marginally higher Global Quality Scores (GQS) for DR-related videos compared to TikTok, though this difference lacked statistical significance (P = 0.597). However, Bilibili videos showed significantly greater reliability than their TikTok counterparts (P = 0.04). Video duration on Bilibili substantially exceeded TikTok's (P &lt; 0.001), whereas TikTok videos garnered significantly higher social engagement metrics, including likes, bookmarks, shares, and comments (P &lt; 0.001 for all). While ophthalmologists constituted the primary video source on both platforms, preventive and screening content remained underrepresented. Notably, videos from ophthalmologists did not demonstrate higher reliability than other video sources. Video quality (GQS) and reliability (mDISCERN) showed no correlation with social engagement metrics, while positive correlations with video duration (r = 0.494, p &lt; 0.01 and r = 0.489, p &lt; 0.01, respectively). </sec> <sec> <title>CONCLUSIONS</title> This study reveals suboptimal quality and reliability of diabetic retinopathy health education videos on both Bilibili and TikTok platforms. Given viewers' limited discernment capacity, we recommend video uploaders optimize the popular science content and video presentation formats. Additionally, platforms are advised to implement necessary regulatory measures and enhance the exposure rate of high-quality health education content. </sec>