Dissemination of misleading and biased information about benign prostate hyperplasia on YouTube in the Republic of Korea

YouTube, a social media platform with over one billion users worldwide, has become a prominent source for health information among the public. Many individuals now turn to YouTube when seeking medical knowledge. This study aimed to evaluate the quality of health information presented in videos concerning benign prostatic hyperplasia (BPH) on YouTube. We conducted a quality assessment of BPH-related content on YouTube in the Republic of Korea, analyzing the 100 most-viewed videos. The validated DISCERN instrument, a standardized tool for evaluating consumer health information, was used. DISCERN consists of 16 questions, each scored on a five-point scale (1 = poor, 2 = generally poor, 3 = moderate, 4 = good, 5 = excellent). The top 100 videos collectively accumulated 24.7 million views, with a median of 89,764 views per video and median of 1,100 thumbs up per video. The mean DISCERN score for overall quality was 2.8, indicating a moderate level of information quality. Videos uploaded by urologists working in university hospitals and those posted by laypersons had a comparable number of views per video, while the latter receiving more thumbs up per video (2,752 vs 4,012). Fifty-two videos (52%) contained potentially misleading or commercially biased content, accumulating a total of 16.4 million views (315,456 views per video) and 5,182 thumbs up per video. A significant negative correlation was found between overall quality and views per month (r = −0.38, p < 0.01), whereas no significant correlation was observed between scientific quality and the thumbs-up/views ratio (r = 0.06, p = 0.58). Low quality and layperson-generated YouTube videos on BPH gained more engagement than high-quality content. This highlights the paradoxical appeal of misleading and biased information and the need for stronger involvement of healthcare professionals to promote accurate and unbiased resources online.